Something off my list

I spent Monday and Tuesday in Washington on company business. I found a little time for business of my own.

On Tuesday morning I got up at 6:15, did the usual, and took the Metro to the Federal Triangle stop. It was a longer walk down the Mall to my destination than I expected, so I got my daily exercise too.

I have not been downtown in Washington since the statues were added to the Wall. I know they were erected chiefly to satisfy those whose sense of the monumental demands figures in bronze, and I also know they have been derided as artistically hokey. The male tryptych is: it has no fair chance, because the Wall overwhelms it totally. I did not go to see that group of statuary. I did not even go to see the Wall again: too many ghosts there.

I went to see the womens' memorial. For anyone who saw the nurses of that war doing their job, the memorial has a power that transcends the admitted limits of its artistic merit.

I went to thank one of those nurses.

It's just as well that it was early morning, foggy in Foggy Bottom, with no one around to watch another old guy crying his eyes out....For all the time I've spent living with those memories, this time the emotion and tears still came as a surprise. I had any number of pretty speeches in my head: couldn't do them. I just managed a "thank you," then went away when I got back under control.

Here's some of the pretty speech.

Thank you, Miss W. All of you should have more thanks than I can give, but it's you I remember best. You came on watch gleaming in the whites that the other nurses weren't wearing. You never lost it. You laughed and smiled and made a ward full of hurt, young, self-absorbed men feel like they had a reason for recovery. Some did not recover, and you handled that too. I suspect that you were playing a part, the angel of mercy, perhaps to control your own emotions. As you played it, you became it.

I always hope the price was not too high for you, that you found a way to step back from those hurt people, and so many awful wounds, and let the pain out without it destroying you. I know that pain has destroyed others.

We are all getting old now, those who survive. I hope life has given you all that you wanted of it, joy and smiles, happiness, prosperity. Life could not possibly give you all that you deserve.

In behalf of the 4th floor medical-surgical ward, Philadelphia Naval Hospital, 1970

Reflex vs. Reason

These periods of healing suck, partly because it takes so long, and partly because your body has a highly developed system of reflexes that a) works faster than your forebrain, b) thinks your forebrain is full of shit at least half the time.

My daughter, the real doctor in the house and a shoulder surgery veteran, said, " no matter what else you do, don't fall."

Talk about the power of subconscious suggestion. Since she said that, I've fallen--twice. Trifling little accidents that one would not even notice when well. As you're on the way down (or over), the reflexes elbow the forebrain out of the way and take charge. Both arms go out to fend off the fall. They do their job. However, the nervous system of the surgically invaded limb sends a message to the brain which, roughly translated, says "ohhhhhhhh, SHIT!!"

During the moment when you're taking inventory and making sure that everything is still attached and more or less works, it doesn't help to play host to the "told ya so" response of the forebrain and the chastened sulk of the reflexes. Can't we all get along?

After nearly two weeks, I'm left with one pain point (the AC joint, for those keeping score) that elicited a "hmm" during my exam yesterday. I have always felt that "aha...aha" was acceptably non-committal from a clinician. "Hmm" makes me want to grab the white lapels and shout, "just what the fuck do you mean by 'hmm'?" I refrained, thinking it would do no good and spoil my member-of-the-club creds. One more exam awaits in a month. If this is still happening then, there'll be a lot more than "hmm" out of me.

Brief comment

Here I am. I'm sparing my keyboarding for work, mostly. My treatment, at least, was first rate. Nevertheless there was a minor detour in the recovery...all resolved...and it looks like this is going to be bloody uncomfortable for some time to come. So far, I've avoided whining and I hope to keep that up.

Take care of your shoulders, chilluns. These days, you can get them fixed or replaced, but the process is far from amusing.

The pre-surg assessment

So, the worst part of this turned out to be getting through Salem while they indulge another fit of completely pointless highway construction.

I had another one of those guilty twinges that come when, by your words, you announce yourself as a member of the health care club. You are often treated better and more promptly than the ordinary mortals: I sure was. There's a short-term selfish benefit, but wouldn't it be nice if all the patients got treated that way? I know: silly damfool idealist.

The major piece of business was something I'd begun with the physician's asst (PA) at the surgical practice. I take half a pharmacy's inventory. Two of them are medications which I must take, religiously, every day. Even the slightest interruption in either makes sudden and unpleasant death a real possibility. I have no objections to sudden. It's the unpleasant part I'd rather avoid.

This bit of clinical reality conflicts with the standing instruction for outpatient surgery: don't eat or drink anything after midnight before the procedure. Being what is called "an informed patient," I pointed this conflict out to the PA, who wrote it onto the chart, and I discussed it again with the assessment nurse. We have all agreed that I will take the two crucial meds with a little water, as far ahead of surgery as possible.

What happens, precious, when the patient is not informed? We wonders, yes, we wonders.