Wounded animals crawl away to find a comfortable place to die. When confronted with a deteriorating hip-joint (a condition that would have no doubt meant a slow and painful death in hunter-gatherer days, and a fractious and drunken premature senescence in the days of unscientific medicine), I too crawled into something of a protective shell.
Chores that I used to approach with something approaching joy, or at least enthusiasm -- walking to the mailbox, fetching the morning paper, mowing the lawn, walking the dogs -- became something to be avoided, or, worse, left undone completely. This avoidance-of-enjoyable-things has a terrible psychological effect; one can easily see other, even more vital tasks, like bathing or eating, dropping off the list. The inevitable outcome of this process is death. I'm terribly grateful that I live when I do, where I do, under the economic circumstances I enjoy, and with the people who love me and help me and protect me. In another time and another place, this bad hip could easily have killed me, slowly and painfully.
Monday I entered the hospital in a state of terrible emotional turmoil. I was terrified, frankly, by the thought of what was going to be done to my body. (It was a grave mistake, of course, visiting that Edheads site and watching the process of the surgery. I should, in retrospect, have never looked it up at all; it only added to my terror -- those stupid Flash cartoons haunted my dreams, they did -- without giving me any useful information.)
The operation was, as many of you who've experienced it assured me, quite unremarkable. I was completely unaware of anything being done to me -- all my Jacob's Ladder nightmares had been unnecessary. They put you out, zip, zam, zowie, you're awake again. Only now you're in quite a lot of pain.
I never want to go through those first 24 hours again. The hospital pre-op support staff make a great buzz over a device they give you to "control your pain": Essentially, you are given a handheld device that allows you to administer yourself a minuscule dose of morphine every six minutes. I can understand how the idea of this device gives comfort to someone about to undergo major surgery, but now with the experience on the rearview mirror, I call it a fraud. The device gives you no immediate feedback whether the dose was administered or not; you click the button, and something goes buzz. Nothing else happens. It gives you no timer, no visual confirmation that you've waited the proper six minutes. In a state of narcotic alteration, time is extremely subjective, and unless one watches a clock for six minutes -- a ridiculous task to ask of a narcotized person -- one has no idea when a dose has actually been successfully given. If you fall asleep and can't push the button (family members are prohibited from pushing it for you), you're SOL. When you wake up again, predictably in agony, as the morphine has worn off, you have to accurately self-administer three times -- over 18 minutes, during which you can't fall asleep again or pay the same penalty -- to get yourself back to painlessness. I lay for hours, drifting in and out of sleep, grinding my teeth at the knowledge that I was caught in a trap of user-hostile design. (Designers of medical devices, call me. You'll find my consultancy fees amazingly low for your industry.)
During this time, I came to heartily detest another device, this one attached to my feet. It is supposed to massage your feet to prevent blood-clots -- an entirely laudable task, I suppose, but in practice an inflating bladder squeezes one foot and then the other, each time emitting a thunderous popping noise. After a few hours, this became profoundly irritating; it's like being poked at with a stick every time you begin to find health-restoring sleep.
Narcotics being what they are, another problem went quickly from mild irritation to deep agony: I lost the ability to control my urinating muscles. I didn't become incontinent; quite the opposite. I lost the ability to pull the trigger, if you follow. I strained and strained, concentrating as hard as I could, bathroom taps going full autosuggestive blast, and produced -- nothing. I first pointed this out to the nurse on duty at about 4PM on the day of surgery; by midnight I was in exquisite agony. I had the temerity to ask this officious nurse -- a person I will not remember in my will -- for a urinary catheter; you'd have thought I'd asked for a tracheotomy kit to play with. I was informed that a catheter was quite out of the question -- imagine that! A patient trying to direct his own medical care! Who does he think he is, Ben Casey? When finally the dam broke somewhere deep in the lobster shift, I filled one and a half 1000-cc. urinal bottles. The relief was indescribably delicious. Sexual doesn't even come close.
About 24 hours into the stay, my physical capabilities began to improve drastically. During the morning physical-therapy session, if the PT nurse asked for 10 reps of thigh-lifts, I gave her 20. Asked to walk 150 feet, I did 300.
You see, two bits of information had made themselves known to me. First, I'd cottoned on to the hospital's criteria for the release of patients from the Total Joint Center: Once you can do so many reps of the exercises and have walked so many feet (and you aren't running a death-fever from some flesh-eating streptococcal infection and haven't ripped your own sutures out), you are free to go.
The second piece of intelligence became abundantly clear when the first tray of food was set in front of me. It consisted of a dreadfully watery "soup" with some disintegrating gray vegetable matter sloshing about in it; some deeply nauseating tuna-and-diet-mayo lolling about on a bed of wilted lettuce, and a chunk of bread with the consistency of a well chewed piece of Juicy Fruit but with none of the flavorful appeal, accompanied with approximately three molecules of generic margarine. No salt. One package of three-year-old ground pepper. I'll freely grant that my appetite was pretty well shot by the dope, but even if I'd just come in out of the snow after chopping a cord of wood and raising a new barn for the Clodfelters, this grub would have had me throwing my plastic spork across the room and looking up the Suicide Hotline.
Clearly, they were trying to starve me out. So with each painful leg-lift, each abduction/adduction stretch, each heel-slide, I whispered to myself, Chicken Korma. T-bone steak. Sierra Nevada Pale Ale. And with each ten yards I managed to hobble on the walker (Jesus Christ, was there ever a more humiliating device?) I essayed images of Afghan flat-bread straight from the Tandoori oven, of basil-rich lasagna with a rough Chianti, a loaf of San Francisco sourdough bread... So crusty.... Soooo crusty....
My stratagem seems to have worked. I got out 24 hours early.
I'm back at home, "resting comfortably," as the kids say nowadays. I spent all day today luxuriating on my bed, desultorily answering emails, catching up on the blogs, deliriously lifting my leg and letting it fall again. I have a home-care nurse who comes in and checks for those death-fevers and unripped sutures, and another who gently leads me through PT exercises meant for someone twenty-five years my senior. I am, in short, a pig in shit.
I've weathered it, baby! Officious nurses, burst bladders, being poked at with a stick when I try to sleep, and food that would have been scorned on an eighteenth-century whaler two years from port.
And most gloriously of all, I have a future. I can contemplate anything again. I'm planning this summer's garden. I'm talking up a ski vacation next spring, a walking tour of Europe, a bicycle trip across the Andes, kite-surfing from Jedda to Calcutta and back again. No, most of these won't happen, here's the important part: I can pretend that they will!