Category: Life

I’m just the plumber

It was like a scene from a movie. My husband on top of his bed, in blue pyjamas, his skin pale against the contrast of royal blue and white sheets.

After a brief exchange, I took off down stairs in search of a cup of coffee leaving my husband and daughter mid conversation. I needed sustenance but had the presence of mind to take my mobile with me in case the doctor arrived before my return.

We weren’t expecting this doctor till after seven but as with most things in this hospital – in any hospital, I imagine – very little goes to plan.

Just as earlier that day when I’d rung to hear from my husband the results of the TOE test he’d undergone that morning to determine the fate of his infection, I couldn’t raise him.

I tried his mobile, his hospital room phone and then I tried the nurses’ station.

‘Your husbands with they eye doctor,’ the nurse reported when I asked his whereabouts.

This was news. An eye doctor now. I knew he’d had a bout of what my husband thought was conjunctivitis but since when do people need to visit a specialist over gritty eyes?

My husband rang back soon after to say that the doctors had become alarmed at something he’d mentioned to them, though not to me. Three days earlier he’d noticed some blurring of his vision in the lower quadrant of his right eye.

At first the caravan of doctors seemed little concerned but that morning when my husband mentioned it again they decided to act. After all today was the day he was due to go home, all being well with the results of the TOE test.

And so we found ourselves several hours later on Friday night waiting for a visit from the surgeon who was to take a biopsy of my husband’s temporal arteries to establish whether a new development had arisen, whether as a consequence yet again of the antibiotics – iatrogenesis gone wild – or the result of something else, some sort of autoimmune thing that might signify a disease, Temporal Arteritis, which the eye doctor had told my husband might have ‘catastrophic’ consequences for him, including stroke or blindness.

With warnings like this, you tend to go along with whatever course of action the doctors recommend. In any case, there I was on a Friday night – these things seem to happen on Fridays, I’d just reached the counter at the café ready to order my coffee when my phone rang.

‘The doctors here,’ my daughter said and I bolted back upstairs to behold a tall man in a dark suit leaning over my husband and pointing to the sides of my husband’s head where this surgeon planned to use his knife.

‘Here on both sides, a neat cut beyond the hairline.’ He had explained all to my husband in the three minutes it took me to run back to the ward.

‘What will you do?’ I asked and the surgeon sighed as he explained once more that he would cut out a tiny piece of artery on either side to send off to the pathology lab for testing.

‘If this is merely a consequence of the antibiotics and it will rectify itself once he’s off the antibiotics (which was the case now given the doctors had finally after 42 days stopped all antibiotic infusions) is this test really necessary?’ I asked.

The surgeon stood to his full height and waved his arms around as he backed off towards the door.

‘I’m just the plumber here, I don’t make the decisions. I just do my job. If you want to know the whys and whens, and whatever for, you have to talk to them. They’re the brains. I’m just the plumber.’

He pushed the curtains aside to leave. ‘If you don’t want to go ahead with it tomorrow or you’d rather talk about it first it can wait till next week.’

‘No,’ my husband said. ‘Go ahead with it.’

And so it was that my husband, a day later sported two red lines of stitched blood down his temples, neat wounds I might add, and not too painful.

We wait now for the results of this test before he can go home.

The endless waiting in this tedious drama.

A drama to us perhaps, but just another day in the life of a busy hospital surgeon.

My daughter quoted a friend who works in the health industry who reports that some seventy five per cent of complaints in hospitals are about doctors and their poor communication skills.

And one of the reasons people take themselves off to alternative therapists, quite apart from the treatment modalities, is the fact that the so-called ‘quacks’ have better bedside manners.

You can go a long way on good manners.

Smile. You’re on Candid Camera

There’s a mirror on the back wall of the lift that takes you up to the third floor of the south wing of Cabrini hospital. I sometimes look into it when I’m alone in the lift.

I make faces to check the state of my face or of my teeth, and then check myself all over.

Still here, still the same old me but ever so weary.

Even though I know it’s impossible, it’s not the first time I’ve wondered whether the far wall of the lift in the south wing includes one of those strange two way mirrors they have in police stations through which a group of unseen detectives watch their colleagues interrogate someone and thereby establish the state of mind of the person interrogated.

They have these mirrors in certain therapeutic establishments as well, where a therapist in training or even a more experienced therapist interviews a person, or more likely, an entire family, while the rest of the therapeutic team look on through the two way screen, unseen by the people interviewed, to pass judgement on what is going on.

It gives me the creeps.

The idea of being watched by persons unseen.

This is the feeling I have in the hospital, too, only the medical staff make themselves visible. Still I have a sense they’re not as curious about my husband, the person, though they’re deeply curious about his physical condition, which had been going well until Thursday night when he copped a nose bleed that refused to stop.

For three days earlier, he’d managed to come home for the best part of the day. I brought him back to the hospital at night around 9 pm so that he’d be there first thing in the morning for further tests and infusions of antibiotic.

Thursday night after dinner was no exception.

But then his nose started to bleed after he’d brushed his teeth post dinner and it continued on the drive back to the hospital and for the next half hour. The nurse applied an ice pack to the back of his neck and he tilted forward in is chair.

He nurse told us this was the new way of stopping a nosebleed. But even as I later helped my husband to bed and he lay back on his pillow exhausted and the bleeding appeared to have stopped, I worried that it signified something more serious.

My husband gets nosebleeds from time to time but they stop in no time. This one did not. It bled all night.

The next morning my daughter who visited first thing told me that the caravan had been in to check my husband and they were still happy with his progress as far as the infection goes, but behind closed doors they changed their mind about that morning’s infusion of the third antibiotic, the Vacomycin, because the latest blood tests revealed my husband’s platelets had dropped from 155 ten days earlier – when they first started him on Vancomycin – to 22.

Alarmed, they had thoughts of giving him a transfusion of blood, but by mid afternoon they had changed their minds again.

After they had gathered in a huddle, as my husband described it, they decided if it was true that the Vancomycin had been ‘eating’ his platelets there was no point giving him a transfusion till they could be sure it was out of his system.

Maybe after forty-eight hours, but in the meantime, the platelets might rise of their own accord with a new antibiotic.

So they started my husband on a fourth antibiotic – fifth, if you include the Cephalex they prescribed in the early days before they had established the nature of the infection.

The new antibiotic is called Daptomycin and one of the nurses told me it’s a third generation antibiotic, state of the art, but very expensive.

‘Eight hundred a pop,’ she said – eight hundred dollars a small sachet and so my husband’s getting Rolls Royce treatment.

There are now only seven more days of these antibiotic infusions to go.

So we hope this one will hold till the end of the week. This  coming Friday, 23 March, is day 42 of the targeted treatment, the day they make a decision on whether or not the treatment has worked and what to do next.

In the mirror of the lift on the way down stairs to the café to fetch another latte loaded with sugar, despite the fact everyone treats sugar like it’s a poison these days, I sip off the frothy top and consider my forlorn state.

How many more trips up and down this lift, the lift behind which I imagine stand a group of camera men, perhaps people from the old Candid Camera, a show I used to watch as a child.

A show in which people are introduced to a problem, say in the street, a problem that is really a trick and when they try to solve the problem, say shift a log off a road or some other such difficulty, they can’t because it’s concreted in and we, the audience, laugh at them as they try this way and that to get it free, until eventually something dreadful happens and they topple over flat, face in the mud and the camera reveals itself.

They realise then, this poor soul, her muddy face aghast and the camera team call:

‘Smile, you’re on Candid camera’.

And the muddied person laughs and shakes the cameraman’ s hand and welcome the experience, made famous through their efforts to improve a situation that was contrived to trip them up.

It’s not unlike the way I feel in the hospital and my husband more so.

He talks of the ‘tricks’ the doctors have up their sleeves.

Whenever we think we have a pattern established, a routine. Whenever we think things are going smoothly enough and there is some hopeful conclusion ahead, the doctors drag out a fresh series of hoops through which he and his body must jump before deliverance is possible.

It’s a paranoid position I know, induced through too much helplessness when you’re on the receiving end of the trial and error process that is modern medicine.

We’ll throw this one at him and good if it works but when it stops working and something untoward happens we’ll try to rectify that with something else and they try something new and see how that goes.

It’s a function of iatrogenesis, the negative side effect of treatment, the unwanted, unexpected things that can go wrong on the way either to recovery or death.