Paul Jason
Chapter 14: “Get Out and Stay Out”
By the fourth day after the surgery, Saturday, April 8, 2000, I could get on and off the hospital bed myself, but with great difficulty and pain. My left leg was swollen to a girth one and a half times the size of my right leg, from the inner mid-thigh down to the ankle. My breathing was shallow, and my wired chest was very unstable.
You may remember that I said in an earlier chapter that the thoracic surgeon told me that, barring unforeseen complications, I would be discharged from the hospital four and one-half days after the surgery. Well, on that fourth day one of my physical therapists came to visit me. She said that her mission was to be sure that I could walk, and that I knew how to negotiate steps. She explained that since my left leg was temporarily incapacitated, I would have to go up and down steps one at a time, leading always with my stronger right leg. So, for example, if I were to go down a flight of stairs, I was to descend from step to step by lowering my right foot to the step first, and then bringing my left foot down. Conversely, to mount a flight of stairs I was to ascend to each level by stepping first with my right foot, and then bringing my left foot to that level. Sounds easy enough (a child can do it), until you take into consideration the feeble breathing, general weakness and aching chest factors.
I believe that it was sometime during that fourth day that a PA (Physician’s Assistant) appeared in my room and announced that he was there to remove the tubes that were still protruding from my body. I had tried to ignore them during the past couple of days, while the inevitability of their removal buried itself within the recesses of my mind. Moreover, they were camouflaged amongst the millions of little surgical strips that covered my wounds.
To the best of my recollection, I still had two tubes right below my breastbone which had served to drain the fluid that collects around the heart after this surgery, and a third tube located just below and to the left of my breastbone, in the rib cage area, to drain any fluid which collects in the chest cavity. What these tubes drained into I cannot tell you. In fact, that’s the very point: there are so many things hanging from your body during those first days; so many debilitating things going on with your body and mind; so many thoughts and pains darting back and forth, that simple, probing questions that curious minds usually entertain, such as where those drains empty, are blotted out from conscious thought.
Up to that moment it never occurred to me that anyone other than my surgeon would be removing from my body anything that had been inserted during surgery. But that PA was on a mission and anything I had to say on the matter was of no concern to him. Not knowing whether I should brace myself, I asked him if this was going to hurt; “Not much” he replied. Easy for him to say. I was laying on my bed. With aplomb, he grabbed hold of one of those tubes and started to pull. I couldn’t look. From the sensation it felt like he withdrew two feet of tubing, although I’m sure it was much, much shorter. Then he went on to the second tube, and then the third. I couldn’t believe what was coming out of me. He dressed the wounds and left. The whole procedure probably lasted five minutes.
Well, it was becoming apparent that they really were determined to discharge me on the next day. I couldn’t believe it. Could I really function outside the confines of this hospital so soon? Given the state of my mobility, I questioned how I would be able to get home and into the house. My “significant other” was making arrangements to come to the hospital with a friend and to drive me home. How would I get to the car? How would I get into it? How would I get out of it?
Sunday morning, April 9, 2002, it started to snow. That’s right, snow. A little late in the year for snow in New York City, but you can look it up. I limped out to the hallway window (remember, the dividing curtain in the center of the hospital room was never drawn back, so I could never see the room window) and watched the flakes coming down… slowly at first, and then more frequently. By 11:00 a.m., snow was beginning to accumulate on the ground.
“They’ll never release me on a day like today,” I thought to myself. “How can they expect me to go outside, as unsteady and unstable as I am, and travel home? What happens if the car gets stuck in the snow? I’m not physically capable of maneuvering myself out of any situation.” These thoughts raced through my mind.
My significant other had the same thoughts, and she called me to express them. Should she drive the long distance to the hospital in this weather? Should I be exposed to such harsh weather so soon after such critical surgery?
I hobbled to the Nurse’s Station and made inquiry regarding my impending discharge. “Oh, yes” I was advised, “you are scheduled to leave the hospital as soon as your cardiologist arrives to examine you.” My cardiologist? Well, thank God . . . I can’t imagine that he’ll let me out in this weather.
How wrong I was. In fact, it was not my cardiologist, but one of his partners, who appeared that day. I expressed my concern as he was examining me. He declared me fit for discharge, downplayed my fears, and told me to go home. He wrote prescriptions to be filled at an outside pharmacy that day, wished me well, and left. Boy, I wished I was as optimistic as he was.
I guess the moral to the story, if there is any, is that modern American medicine is controlled by the insurance companies, HMOs, managed care services, etc., and that, short of a catastrophe, my post-operative days in the hospital were pre-ordained and carved in stone.
The “Discharge Plan/Instructions” sheet that was delivered to me by an RN indicated that my blood pressure was currently 102/60, my body temperature was 99.4 degrees F. and my pulse was 84. All of my medications, their dosages and frequency of ingestion were listed there. It also advised me to call for medical assistance if I experienced chest pain, palpitations, dizziness, redness or discharge on my incision sites, fever, “etc.” In case of an emergency, call 911. An emergency? How the hell would I know what an emergency is. To me, this is an emergency!!!
Tired, weak and faced with the inevitable conclusion that the insurance company bean counters would dictate my exit from this medical facility, I phoned my significant other, told her what had happened, and asked her to please come and get me.
To be continued…
