12:15 PM . DEPARTING HOPKINS WITHIN MINUTES
At 10:00 AM there was a heart glitch that might have meant a problem, a problem that might have kept us here. After an hour and a half of uncertainty, Col was given the green light to go. All IVs have now been removed. All extraneous cords, except for Colleen's oxygen cannula, have also been removed! At this very moment, Colleen has on street clothes. We're only waiting for hospital "transport" now to wheel Colleen down to the Main Entrance of the hospital.
Saturday, May 18, 2013
PART IV: COLLEEN'S ICU INTERLUDE
After sending off the email to Mathai, Dr. Tottenham and I sat in a windowless break room or conference room just yards away from Colleen's room. She took me back through all the risks again of the two lines she felt were likely to be needed. I signed off. Her demeanor remained detached and clinical, with an I'm-just-doing-my-job-ma'am manner. Before finally initialing the documents, I asked her if she was going to be able to remove the breathing tube. "Your sister is very, very sick. I can't give you any guarantee," she said.
"Have you removed breathing tubes before?" I asked her point-blank.
"Yes."
"Are the nurses and techs in Colleen's room experienced in removing breathing tubes?"
"Yes."
"Put in the other lines if you believe they are necessary. I ask only one thing. Do not add one iota of physical or mental suffering to my sister. She's suffered enough," I said through sobs. The doctor's eyes teared up, which surprised me.
She continued, "I will make sure to inform your sister of the risks before doing anything."
"No," I said. "I've just taken on the responsibility of the risks. I don't want her to hear them. If the new lines need to be inserted, I also don't want her to see them. I don't want her frightened any more than she already is. If she looks inquiring, please tell her you're merely putting in another IV."
The doctor agreed to that.
After sending off the email to Mathai, Dr. Tottenham and I sat in a windowless break room or conference room just yards away from Colleen's room. She took me back through all the risks again of the two lines she felt were likely to be needed. I signed off. Her demeanor remained detached and clinical, with an I'm-just-doing-my-job-ma'am manner. Before finally initialing the documents, I asked her if she was going to be able to remove the breathing tube. "Your sister is very, very sick. I can't give you any guarantee," she said.
"Have you removed breathing tubes before?" I asked her point-blank.
"Yes."
"Are the nurses and techs in Colleen's room experienced in removing breathing tubes?"
"Yes."
"Put in the other lines if you believe they are necessary. I ask only one thing. Do not add one iota of physical or mental suffering to my sister. She's suffered enough," I said through sobs. The doctor's eyes teared up, which surprised me.
She continued, "I will make sure to inform your sister of the risks before doing anything."
"No," I said. "I've just taken on the responsibility of the risks. I don't want her to hear them. If the new lines need to be inserted, I also don't want her to see them. I don't want her frightened any more than she already is. If she looks inquiring, please tell her you're merely putting in another IV."
The doctor agreed to that.
SATURDAY 8:30 AM . HOPKINS REFLECTIONS
For the past ten days, every day, I've walked the long hospital halls here when arriving in the morning, leaving at day's end, heading to the cafeteria or Balducci's Market or Salad Sensations. As the days wore on, fragments of this long forgotten phrase kept coming to mind: "There are eight million stories in the naked city," a line that ended every weekly episode of a major New York City cop drama from fifty years ago, a line that has run through my head like a refrain since I've been here. Because you can't help but feel the thousands upon thousands of human stories recorded in the venerable halls and walls of Hopkins. You can almost hear them being told.
For the past ten days, every day, I've walked the long hospital halls here when arriving in the morning, leaving at day's end, heading to the cafeteria or Balducci's Market or Salad Sensations. As the days wore on, fragments of this long forgotten phrase kept coming to mind: "There are eight million stories in the naked city," a line that ended every weekly episode of a major New York City cop drama from fifty years ago, a line that has run through my head like a refrain since I've been here. Because you can't help but feel the thousands upon thousands of human stories recorded in the venerable halls and walls of Hopkins. You can almost hear them being told.
....
Sampling of names of those who've been taking care of Colleen here: Cynquetta, Towanda, Cornelius Red Deer, Mohammed, Quetta, and nurse Cara from time to time took to calling Colleen "Lovington."
....
PART III: COLLEEN'S ICU INTERLUDE
Before leaving Col's ICU bedside, I spoke again to the nurse standing opposite me. "Is my sister sufficiently sedated to protect her from feeling extreme distress when she becomes fully conscious of the breathing tube?"
"Oh, yeah, you mean if she gets crazy?" she said with a jokey tone.
I heard myself forcefully saying back to her, "Do not use the word 'crazy' about or around my sister. Do not. And this is not funny."
I left to speak to Colleen's ICU doctor, the same Dr. Tottenham, who had called me to ask about Colleen's DNR wishes. She had found out for me that the pacemaker procedure had gone well. I registered the good news dispassionately. The doctor proceeded directly to asking for my approvals on treatments that might be necessary to perform on Colleen within the next twenty minutes. Her blood pressure had plummeted to dangerously low levels. Dopamine had been administered immediately to bring them back up but, the doctor explained, dopamine is dangerous in itself at higher or prolonged dosages. If Colleen's blood pressure fails to return to normal in the next twenty minutes, drugs other than dopamine would need to be given. And administering these alternative drugs would require putting in a "central line," probably on the right side of Colleen's neck.
At this point, I'm reeling. Nineteen minutes to go? Eighteen?
"I don't know what a central line is," I tell her. "It sounds big."
She used her hands to illustrate eight inches. "It will allow us to administer multiple medications," she said. "And we most likely will also have to put in an arterial line, but that can be inserted into the groin area."
"I need to contact Colleen's doctor before I sign anything," I said. "By the way, I am not comfortable with one of the nurses taking care of my sister. Her choice of words within earshot of my sister was highly insensitive. I do not want her in the same room with my sister. I do not want anyone near her who could hurt her in any way." (The nurse was removed.)
I dashed off the following email to Dr. Mathai, whom I knew must have gone home from the hospital by now:
8:53 PM, Monday, May 13, 2013
SUBJECT: Need You
Please call me. Colleen is in ICU, as
you probably know. On a ventilator.
The ICU MD wants to do all kinds of
things with all kinds of risks.
Mignon 310-889-8583
Before leaving Col's ICU bedside, I spoke again to the nurse standing opposite me. "Is my sister sufficiently sedated to protect her from feeling extreme distress when she becomes fully conscious of the breathing tube?"
"Oh, yeah, you mean if she gets crazy?" she said with a jokey tone.
I heard myself forcefully saying back to her, "Do not use the word 'crazy' about or around my sister. Do not. And this is not funny."
I left to speak to Colleen's ICU doctor, the same Dr. Tottenham, who had called me to ask about Colleen's DNR wishes. She had found out for me that the pacemaker procedure had gone well. I registered the good news dispassionately. The doctor proceeded directly to asking for my approvals on treatments that might be necessary to perform on Colleen within the next twenty minutes. Her blood pressure had plummeted to dangerously low levels. Dopamine had been administered immediately to bring them back up but, the doctor explained, dopamine is dangerous in itself at higher or prolonged dosages. If Colleen's blood pressure fails to return to normal in the next twenty minutes, drugs other than dopamine would need to be given. And administering these alternative drugs would require putting in a "central line," probably on the right side of Colleen's neck.
At this point, I'm reeling. Nineteen minutes to go? Eighteen?
"I don't know what a central line is," I tell her. "It sounds big."
She used her hands to illustrate eight inches. "It will allow us to administer multiple medications," she said. "And we most likely will also have to put in an arterial line, but that can be inserted into the groin area."
"I need to contact Colleen's doctor before I sign anything," I said. "By the way, I am not comfortable with one of the nurses taking care of my sister. Her choice of words within earshot of my sister was highly insensitive. I do not want her in the same room with my sister. I do not want anyone near her who could hurt her in any way." (The nurse was removed.)
I dashed off the following email to Dr. Mathai, whom I knew must have gone home from the hospital by now:
8:53 PM, Monday, May 13, 2013
SUBJECT: Need You
Please call me. Colleen is in ICU, as
you probably know. On a ventilator.
The ICU MD wants to do all kinds of
things with all kinds of risks.
Mignon 310-889-8583
SATURDAY . DAY 11 . COL'S ROOM
I just survived a night in the hospital quasi-sleeping in a chair. Colleen has just survived 10 hospital nights quasi-sleeping in a series of 3 different beds during this particular Johns Hopkins admission.
It's now 7:30 AM. I estimate we both awoke from our respective quasi-sleeps at 6:00 AM. I can't be sure what exactly we've been doing for the past hour and a half but it did include early morning groans and such.
A doctor just came in to confirm Colleen's 11:00 AM discharge. We're too punchy from yesterday to be excited. I imagine, though, that we're both going to be feeling quite good once we're actually in the car with the wheels rolling.
I just survived a night in the hospital quasi-sleeping in a chair. Colleen has just survived 10 hospital nights quasi-sleeping in a series of 3 different beds during this particular Johns Hopkins admission.
It's now 7:30 AM. I estimate we both awoke from our respective quasi-sleeps at 6:00 AM. I can't be sure what exactly we've been doing for the past hour and a half but it did include early morning groans and such.
A doctor just came in to confirm Colleen's 11:00 AM discharge. We're too punchy from yesterday to be excited. I imagine, though, that we're both going to be feeling quite good once we're actually in the car with the wheels rolling.
Friday, May 17, 2013
MIDDLE-NIGHT . COL'S ROOM
2 AM. Nurse Liz just came in to start a one-hour magnesium IV drip for Col. Intravenous magnesium burns at the IV port site as well as the length of the arm, just like intravenous potassium which Colleen has gotten multiple times since being here. Her hands, wrists, and inner elbows are thoroughly black and blue from all the IVs and blood sticks. I hope she can fall back to sleep. It's been surprisingly quiet, only two intercom blasts so far.
2 AM. Nurse Liz just came in to start a one-hour magnesium IV drip for Col. Intravenous magnesium burns at the IV port site as well as the length of the arm, just like intravenous potassium which Colleen has gotten multiple times since being here. Her hands, wrists, and inner elbows are thoroughly black and blue from all the IVs and blood sticks. I hope she can fall back to sleep. It's been surprisingly quiet, only two intercom blasts so far.
....
A word on Colleen's pulmonologist, Dr. Stephen Mathai, whose name you've encountered many times here. Months back I posted his official Hopkins photograph in which he looks like a 15-year-old boy, smallish, and wearing an outdated bulky tie and outdated hairstyle. Having met him on this trip, I can tell you that his old photograph hardly resembles the mature man he is now. I scoured the internet for a more recent photo and found only the one below, which is better but still fails to reflect the tall, vibrant, handsome, au courant man that he is.
Old Photo Later
I met his assistant Traci, an RN, today who told Colleen and I that he is the "fashion plate of the department," that no one other than Mathai could pull off wearing bright green or even bright orange pants. His socks, when he's wearing socks, are also far from ordinary, anything but dull brown or black. Traci confirmed that Mathai (pronounced Ma-tai') is an Indian surname. Dr. Mathai's father is Indian, his mother American. She told us, when I couldn't help asking, that his wife, who also works at Hopkins, is quite beautiful, "a catch" is how she put it. And his three sons are also gorgeous.
....
And now to try to fall back to sleep. My bed is a very good reclining chair, yes, but a chair nonetheless. It doesn't allow sleeping comfortably on your side, and certainly no turning over onto your stomach.
FRIDAY 10 PM . OVERNIGHT IN ROOM 956
Okay, so it turned out not to be our last day here. As a matter of fact, it's not only not our last day here, but guess where I'm sleeping tonight. St Johns Hopkins Hotel, Room 956, in the reclining chair positioned right next to Colleen reclining bed. In fact, we are wearing matching mint-green cotton gowns, except I'm tying mine in the front and Colleen ties hers in the back. I've elected to don hospital bottoms as well; Colleen prefers not.
As noon struck today without any sign that Colleen was being discharged, we both fell into a funk. The social worker who arranges transfers to physical therapy rehabs finally came by and admitted that she had only begun today seeking a facility for Colleen. We'd thought yesterday. She came back a while later to report that Colleen's first choice near Somers Point didn't feel medically confident enough to manage Colleen because of her oxygen needs. By this time, it's closing in on two o'clock. She proferred two others, another one not too distant from Somers Point and the other Hopkins own acute PT center on an adjoining campus. No matter what, it looked likely we'd be spending another weekend in Baltimore. These transfers involve paperwork and take time.
How could we survive another lost weekend here? Plus, I'd checked out of my hotel this morning and, because of the Preakness Stakes running at Pimlico here tomorrow, there are no rooms available anywhere in Baltimore tonight and through the weekend. My only option was to sleep in the hospital for the next three nights, which felt like the dimmest of prospects.
At 3:45, the second New Jersey prospect called Colleen. She calmly answered the rehab liaison's many questions and ultimately was given the green light to check in tomorrow. Colleen's face lit up at the news. We were leaving after all. And she'd been admitted to rehab. Suddenly, sleeping overnight in the hospital seemed not so bad. In fact, it's turned out to be rather fun. Colleen's a few yards away reading a novel she just started called "The Magician's Assistant" by Ann Patchett. I'm propped up in this comfortable but temperamental recliner writing. So far no blaring intercom.
The plan: Colleen is supposed to be discharged at 11 o'clock tomorrow morning. I will pick up our car that's been gathering dust for the past ten days in the Hopkins parking garage, drive back to my hotel to pick up the bags I left behind with the valet, and then swing back to the main hospital to pick up Colleen. Up I-95 we will go, go, go.
Our eyes are at half-mast. Petite Nurse Liz of the long blond hair, our favorite, will soon bring in Col's last meds of the day. Voices from the hall are audible but blessedly muted. The plastic water tank attached to Colleen's oxygen sounds like a babbling brook, truly. I like this.
Okay, so it turned out not to be our last day here. As a matter of fact, it's not only not our last day here, but guess where I'm sleeping tonight. St Johns Hopkins Hotel, Room 956, in the reclining chair positioned right next to Colleen reclining bed. In fact, we are wearing matching mint-green cotton gowns, except I'm tying mine in the front and Colleen ties hers in the back. I've elected to don hospital bottoms as well; Colleen prefers not.
As noon struck today without any sign that Colleen was being discharged, we both fell into a funk. The social worker who arranges transfers to physical therapy rehabs finally came by and admitted that she had only begun today seeking a facility for Colleen. We'd thought yesterday. She came back a while later to report that Colleen's first choice near Somers Point didn't feel medically confident enough to manage Colleen because of her oxygen needs. By this time, it's closing in on two o'clock. She proferred two others, another one not too distant from Somers Point and the other Hopkins own acute PT center on an adjoining campus. No matter what, it looked likely we'd be spending another weekend in Baltimore. These transfers involve paperwork and take time.
How could we survive another lost weekend here? Plus, I'd checked out of my hotel this morning and, because of the Preakness Stakes running at Pimlico here tomorrow, there are no rooms available anywhere in Baltimore tonight and through the weekend. My only option was to sleep in the hospital for the next three nights, which felt like the dimmest of prospects.
At 3:45, the second New Jersey prospect called Colleen. She calmly answered the rehab liaison's many questions and ultimately was given the green light to check in tomorrow. Colleen's face lit up at the news. We were leaving after all. And she'd been admitted to rehab. Suddenly, sleeping overnight in the hospital seemed not so bad. In fact, it's turned out to be rather fun. Colleen's a few yards away reading a novel she just started called "The Magician's Assistant" by Ann Patchett. I'm propped up in this comfortable but temperamental recliner writing. So far no blaring intercom.
The plan: Colleen is supposed to be discharged at 11 o'clock tomorrow morning. I will pick up our car that's been gathering dust for the past ten days in the Hopkins parking garage, drive back to my hotel to pick up the bags I left behind with the valet, and then swing back to the main hospital to pick up Colleen. Up I-95 we will go, go, go.
Our eyes are at half-mast. Petite Nurse Liz of the long blond hair, our favorite, will soon bring in Col's last meds of the day. Voices from the hall are audible but blessedly muted. The plastic water tank attached to Colleen's oxygen sounds like a babbling brook, truly. I like this.
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