Wednesday, December 08, 2004

 

C.B.'s Big Adventure

Many of his devoted fans have wondered why the Clockwork Bluejay has been strangely silent for the last week.

First, his mother-in-law visited. Her presence in the Man-Cave (the site of the Blogger machine) had a bizarrely chilling effect on blogging, since she seems to have lost any and all power of personal body heat generation. She turned the heat up to approximately--broil. Frau Bluejay considered using the Man-Cave as an auxiliary oven for the preparation of the Thanksgiving feast.

Second, and more importantly the Bluejay had an involuntary tour of America's healthcare industry.

It began innocently enough with a simple belly ache on the Wednesday after Thanksgiving. The Bluejay chalked this up to misdemeanor gluttony and the temporary holiday abandonment of the Atkins Diet. On Thursday morning, the belly ache increased in intensity. Again, there seemed to be a perfectly logical explanation. Frau Bluejay had decreed that where the Nest had nylon wall-to-wall carpeting there would now be exotic Brazilian cherry hardwood floors (Rainforest be damned!). The dutiful husband had single-handedly moved the dining room furniture, a secretary, and a sideboard from the fancy-eating room/parlor and a mammoth computer credenza and two bookshelves from Frau Bluejay's home office (the "She-Den"). Obviously, a simple case of muscle strain...

By Thursday night the pain had become acute. The Bluejay made his way back to New Market from the People's Republic of Takoma Park and asked the Frau to drive him to the local urgent care facility. For those of you who don't know, an urgent care facility seems to be a place designed to keep the merely sick and pretty sick out of emergency rooms (where the really dying or smarter pretty sick people get attention). The urgent care facility seems to function as a dispenser of prescriptions for antibiotics or Tylenol 3 and the advice "You are not dying. Please consult your primary care physician in the morning." It's like being put on hold with really good classic rock playing as hold music. After a short wait, the doctor said that the Bluejay had either a kidney infection or a kidney stone. She prescribed an antibiotic, oxycontin (Rush's drug of choice!), and the ritual straining of the urine. The Doctor also advised a trip to the urologist.
On Friday, Mrs. Bluejay contacted the primary care physician who wrote a referral to a urolgist. She picked up this vital document, only to learn that the urologst wanted x-rays to be done by the primary care physician prior to his seeing the wounded Bluejay. Nothing was accomplished.
On Saturday, all players rested. The hardwood floor guys arrived to find that they could not lay the flooring in the fancy eating room/parlor due to a suspicious water leak under a window. They suggested finding a "handyman" to re-caulk the window and replace any rotten wood. The Bluejays now learned it is far easier to find a urologist than a "handyman".

On Sunday, the oxycontin (hillbilly heroin!) was no longer working. The Clockwork family migrated to the "real" emergency room at Frederick Memorial Hospital at around 2:00 p.m. After a fairly short wait, the Bluejay entered the portals of healing. After describing the situation, the kidney stone-infection theory was quickly discarded. (unlike on FoxTV's House, M.D., no babies or other patients had to die in order to rule out this diagnosis). The smart money was now being placed on the gall bladder. The Bluejay was assured that the gall bladder was a basically purposeless organ which exists to store bile and aid in the digestion of fat.http://www.uphs.upenn.edu/surgery/clin/gi/gallblad.html

Ultrasound pictures were needed to check out the state of the gall bladder.
The ultrasound pictures showed a gall bladder full of evil stones with a thickened wall. The pictures also showed a kidney stone 8 mm in size (for those of you who are metrically challenged 25.4 mm equals an inch, so we're talking approximately 1/3 of an inch). The kidney stone was, like the Washington Redskins, not "in passing formation" (A good thing, too! It is easier for a rich Republican to enter the kingdom of heaven than an 8 mm stone to...). The plan was to admit the Bluejay to the hospital and remove the evil gallist insurgents the next day.

Hours and hours of delay ensued. In keeping with the holiday season there was no room at the inn. Finally, at about 10:00 p.m. , the Bluejay was in his room. Alone...

Well, not really. There seemed to be either a not very well preserved Second Dynasty Egyptian mummy or a semi-alive comatose male senior citizen in the next bed. (It was later determined that the second option was true. He was a 90 year old, very hard of hearing, retired accountant.)
By way of background, the Bluejay had not been admitted to a hospital as a patient since he had his tonsils removed at the age of 3. This was a very, very long time ago. The only memory that the Bluejay had retained of his previous hospitalization was an aversion to scrambled eggs with cheddar cheese. His only knowledge of how to be a patient had been gleaned from Hollywood/TV and his observations as a visitor of friends and relatives. There was no instruction manual or orientation session. After about an hour a strapping, balding guy in a sport shirt entered the room. He strongly resembled Tony Soprano. He spoke in a South Jersey/Philly accent. "Hi, I'm Dr. G, if you want me to, I'm going to cut out your gall bladder tomorrow." This was the surgeon. He explained that he was going to put a hole in the Bluejay's belly button in order to insert a camera (laparascope). Then he was going to cut 3 more small holes in the belly and suck the gall bladder and stones out. Ba-da-bing! No more belly pain (unless there was another problem). He diagrammed this on a napkin, and explained that the only problems were that he could accidentally cut the bile duct in which case they would fly the Bluejay to Johns Hopkins, where "they got a guy who knows how to fix that" or he could cut some nerves that would require more repair work. The thought occurred to the Bluejay that the guy at Hopkins might be the "guy to see"(maybe there was an alumni discount), but he was in Frederick not Baltimore, and Dr. G seemed like he really knew what he was talking about. Only on sober reflection, did the Bluejay realize that he and the Frau had spent more time picking out hardwood floors...

An aside about Nurses. Nurses and nurses' aides are the people who really run the patient's life. The first thing that seems to happen to a patient is that he/she is plugged into something--a drip bag, a heart rate monitor, or some other Tom Swiftian gizmo, the patient is then rendered basically immobile, helpless, and utterly dependent on someone else for anything that requires movement beyond arm's reach. The medical industry seems to like this. Immobile patients are orderly patients. Orderly patients know their place--in bed--and don't interfere with important nursing conversations which seem to involve incessant bitching. Nurses bitch about their patients, the doctors, and how busy they are. For the most part nurses and aides are female. Nurses don't like being mistaken for nurse's aides. They do dress alike. They each wear a badge which one assumes states their name and rank. The type on these badges is so small that in dim light or without one's glasses it is impossible to differentiate one from the other. Nurses don't like to do menial tasks (unless they feel like it). The Bluejay decided that it was better to err in elevating the aide rather than demoting the nurse. He told everyone that she was a "great nurse". (Luckily, he didn't run into any female doctors on his trip.) He did run into some truly great nurses...or were they aides?

Late Monday morning, the Bluejay was presented with his "informed consent" and anesthetic information sheet. He appreciated the exquisite irony of these documents. Lawyers had spent a lot of time wording these documents in order to show in some potential litigation that the patient had been fully warned about all of the potential dangers of surgery, but like a thrill seeking, adrenaline junkie, the patient had persisted in foolishly going forward in risking possible mutilation, paralysis, or death. The hospital bureaucrat seemed somewhat surprised that the Bluejay actually read most (some) of these documents. It was like a meaningless scene in some forgotten ritual.

The Frau arrived and accompanied the Bluejay to pre-op. There they met the anesthesiologist. He was Russian, and resembled Viktor Putin. He looked at the Bluejay and announced in a menacing accent: "You are a smoker. Because of this I must insert a tube down your throat. It will scratch your throat and after the surgery, it will hurt. It makes my job much more difficult". The Bluejay thought about replying, "Hey guy, lighten up. That's why you get the big bucks and get to drive your Porsche to your golf dates on Wednesdays". Insulting a guy, who will take you to the very brink of death and then bring you back, didn't seem to be a good idea to the Bluejay. The Bluejay also thought about a new Surgeon General's warning: "WARNING: Cigarette smoking may make your anesthesiologist cranky and have a slightly tougher day". After he left, the Frau and the Bluejay agreed that Viktor was such a warm "people person" with such a great bedside manner that his life was being wasted as an anesthesiologist, he would have made a great pathologist.

Soon, the Bluejay was wheeled into the operating room. Peter Gabriel's "Solsbury Hill" was blasting on the sound system. The Bluejay liked that. Dr. G was hip, but not too hip. Then the Bluejay remembered the lyrics: "Grab your things, I've come to take you home", but at least it was an upbeat death song. "Don't Fear the Reaper" would have been a real downer. "Tell Laura I love her", "Deadman's Curve". " A Day in the Life", or "The End" would have been much, much worse. Top 10 Rock Death Songs should not flit through one's mind just before succumbing to anesthesia.

Dr. G asked the Bluejay his name. He told him. Then Dr. G said "We're going to take out your spleen, right?". The Bluejay objected. Dr. G said there was "more money in spleens". The Last thing the Bluejay remembered was offering Dr. G a twenty dollar tip if he would cut out 20 lbs. of excess belly fat.

The recovery room was and is a detailless blur. Nurses kept coming and going, the Bluejay was in that strange drowsy, but dreamless, sleep but not sleep.

Later, with his worried, faithful Frau at his side, the Bluejay awakened in his very own little hospital room, just like Dorothy back from Oz. The Frau told him that his son, the crown prince, had slept with his father's shirt the night before because he liked "Daddy's smell". After she left, a virtual banquet was set before him: chicken broth, orange Italian ice, jello, and cranberry juice. Since the Bluejay had not eaten since the previous Wednesday, he devoured this feast like a ravenous animal.

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