The diagnosis was gallstones and the suggested response was laparoscopic cholecystectomy, a commonly-performed minimally invasive method in which 4 small incisions are made in the abdomen, through which small tubes are inserted. One of them contains a tiny camera and the others carry surgical instruments. The gall bladder is cut and then removed, along with the pesky stones, through the belly button.
I had been waiting my turn for well over a year and in that time had learned the habits that resulted in the painful attacks and thus avoided them; no fatty foods; no eating after 8 pm. By no means a hard regimen to follow, but with the realization that whatever process had created the stones in the first place was one that would continue, and thus worsen the condition, there was no doubt. I was going t get the procedure done as soon as the opportunity presented itself.
It had—a call out of the blue at work indicating that a cancellation had presented itself and that I could come the following week— and here I was, standing in line, waiting my turn to check in at Day Surgery.
“Jake? Sandy?” two of my students (and one another’s boyfriend/girlfriend) took their place in the lineup behind me. “What are you two doing here?”
“I’m finally getting it fixed for good,” said Jake, holding out his hand, the injury he’d received years earlier while still in school still clearly visible. Josephine, just back from parking the car, joined us. We all chatted until our turns came to be checked in. After that Jake, along with Sandy went to orthopedics and Josephine and I made our way to where we were sent.
It was, by all appearances, a typical hospital ward. Eight (or so) hospital beds were set out along the wall and sliding curtains afforded the degree of privacy that was necessary. Nurse A greeted us and led us to one of the beds. She indicated the two “Johnny Coats” laid out on the bed. I was to put one on the standard way and would don the second back-to-front as an improvised dressing gown. She spoke in a gentle voice, telling me to remove everything but in a way that could not be misunderstood, then left me to change.
After a few minutes she returned. From outside the curtain she inquired, “Are you ready?” and then came inside when I answered. She asked me the questions that had already been posed at check-in: name, address, type of procedure, and so on. She took my vitals and gave me an injection of something that would prevent clotting. “This will sting for a bit, but that will go away after a few minutes.” She was correct. When finished she smiled, got up, and then returned with a warm blanked which she placed over me. “You can recline that chair and get more comfortable while you wait. Would you like me to do that?”
“No, it’s OK,” I replied and she left after assuring me I would not have long to wait.
Dr. Smith, the lead on the procedure, dropped by soon after. His eyes showed that he recognized me from the consult, even though that had been eight months prior. No mistake—he recalled what we’d been talking about at the time; remarkable. He asked if I had any questions. I did. When could I expect to be active again after the surgery? He gave me a detailed answer. “It’s been a while since you signed the consent,” he chuckled, handing me another one which I signed. “See you inside. It won’t be long.”
He was right and after a few minutes, pretty much 10am on the dot, just like I’d been told, I was led to the operating waiting area, but only after Josephine insisted on a parting kiss. “See you in a few hours.”
Nurse B led me to the waiting area, showed me to a comfy chair and brought me another warm blanket. In the minute or so it took to get there we discovered that in all likelihood the Volleyball team I coached almost 25 years ago had played hers on several occasions. I laughed and admitted that I hadn’t recalled winning any games against her team since Dave had been such a good coach. Dave. She stopped, turned to me and started saying, “Dave, you know what happened—“ I interrupted, “Yes, Dave and I remained friends long after we’d left the schools we were teaching in at the time. I know. It’s been three years now. So sad.” We shared a few more memories of our old friend and chatted some more until another person arrived. Nurse B went on her way.
It was one of the surgical residents. He introduced himself and verified my name and the procedure I was to have. He asked if I had any questions. I didn’t. He smiled and left, saying “See you in a few minutes.”
Another visitor arrived; the anesthesiologist resident, late twenties, bright eyed and smiling but with a gentle friendliness more suggestive of someone older. Once again she asked me all the usual questions. I answered them all again matter-of-factly, but thinking of how some patients must react from time to time. “What—again?” some must say, “I’ve already answered these a million times!”
But, of course, that’s the way it has to be. Each day, each medical professional here sees many, many souls, each with their own history, and each with their particular circumstances. Safeguards have to be in place to ensure that the correct things happen and if a few questions have to be repeated, so be it.
She went more in depth: allergies, previous medical history and so on. Of course she was only verifying what was already before her. Dr. B had already asked those same questions during the pre-op a few days previous. The anesthesiologist arrived—a huge man (or so it seemed from my vantage point in the comfy chair) but with the same gentle manner. “Any questions?” I shook my head, “No. I’m good. Let’s do this.”
“Then let’s go.”
I followed them to the OR. It was more or less what I expected. Clean, brightly lit and furnished with the things you’d expect. I walked to the table. “Give me a sec while I adjust it,” I heard and I stood awkwardly by the table as it was lowered. In that time the other people in the room introduced themselves. I tried hard to repeat the names but know that they wouldn’t stick. The gentle tones of voice they used both with me and amongst themselves and they went about their duties would, though.
I laid down and felt a little pinch as my hand was deadened, then (sort of) felt the tube being inserted at that site. “This is for the anesthesia.” I heard. A mask was placed over my nose and mouth. “This is oxygen, just breathe normally.” I did. “We are going to give you something to relax first. A pause, and I felt myself get strangely light headed.
“Can you feel it?”
I blinked, signifying “Yes.”
“We are starting the anesthetic now—“
I opened my eyes and quickly found the clock on the wall. It was just after two in the afternoon.
My eyes scanned the room, clearly the recovery area. Six or seven beds lined the walls, some of which were occupied. Two nurses were quietly going from patient to patient. I moved a bit to see how I was doing and my hands easily found the bandages that covered the four incisions. Strange—there was no great amount of pain even though all of my senses were back in order.
Nurse C soon noticed I was awake and came by me. “How are you doing?”
She checked the machines by the bedside then turned to me saying gently, “Good. You need to rest some more now.”
I obliged, drifting in and out, comfortably occupying that space just between sleep and wakefulness. Time passed slowly, measured in ten-minute increments, as the big hand went all the way around, once. Nurse C made frequent visits, checking the machines by my bedside each time.
“Nope. On a scale of one to ten I’d give it a two or a three; nothing much really.”
“Do you need anything for it?”
“No, I’m ok as-is.”
“Good. Funny the two of you who just came out both feel that way. It’s not always like that.”
“I guess Dr. Smith and the team are good.”
At three she stopped and spoke. “Let’s work on waking you up now.” I tried, but you know how it is—sometimes you just want to rest. You try and wake up but keep dozing back off again. I saw Nurse C pick up the phone and heard her say, “no, he’s just chillin’ there in the bed now. I’m a bit concerned about his blood oxygen level.” She conversed with the voice at the other end for a bit then hung up and came over, repeating the concern I’d already heard.
“That was the anesthesiologist and he said to give you something to open your airways a bit more to address the issue. I don’t want to release you just yet, ‘cause you might just stop breathing and we don’t want that!”
I nodded, fully understanding and thinking, “It’s not everyone who can say that quite so well and not scare the pants off you.”
She smiled, gave me the stuff, and came back a while later. “It seems to be working. Try this.” She handed me a spirometer and I breathed as instructed.
“Excellent.” Keep it up.
After a while she said, “You’re fine now. Let’s bring you back.”
She wheeled me—bed and all—back to exactly where I started out earlier that morning. We chatted a while before she left, returning to the recovery unit.
A group of nurses were nearby at a desk. It was shift-change time and they were doing the briefing. It ended with some light casual talk. One of the nurses, let’s call her Nurse D, said something which made the others laugh. It made me smile too. She caught my eye, “You heard that.” She grinned widely and walked over to my bed. “Looks like you’re about ready to go home. Are you able to get dressed?”
“I’ll call—,” she checked the chart she was holding, “Josephine?”
“Yes. You have the number?”
She said it back to me and I nodded. “Take your time getting dressed.” She left, closing the curtain.
I slowly got out of the bed and got dressed, then sat in the chair. A wave of giddiness swept over me and I know it would soon turn to nausea. I got back on the bed and laid back down.
Nurse D must have sensed it as she came right back to the curtain, “are you okay?”
“Feeling a bit light headed,” I replied.
“That’s normal for this. They put a lot of air in your belly when doing that procedure and almost every recovering patient feels some nausea.” She laid a cold cloth on my forehead. “Better?”
It was…so much better. I closed my eyes and the giddiness soon passed. Everything is relative I suppose but as the nausea went away it was replaced with a huge feeling of relief. I felt just fine. Josephine came in. She looked concerned. “You’re white as a ghost!”
“Nah, I’m good.”
An attendant came by with a wheelchair and brought me to the entrance where Josephine was waiting with the car. We drove home.
That was Thursday. Today is Saturday and I’m sitting at the dining room table typing away on the laptop. Aside from a little tightness in the belly and some light soreness around the incision sites I am experiencing no undue discomfort. A little time for rest and everything will be as before, no, better than before.
Thursday, the day of the procedure, was budget day in the province of Newfoundland Labrador. It could not be a good news budget since NL has allowed itself to become far too dependent on oil revenues. The falling price of oil therefore means lean times ahead. The governing party had a difficult task, specifically to bring down a lean budget in an election year. Simply put, the knives are out. The parties not in power, as well as individuals who enjoy a good bloody match of politics are all having a fine time criticizing it. The lead-up happened before my procedure and after I returned home I took the time to read the document and create the previous blog post, one that reflected my general feeling of guarded optimism, asking the political types, “instead of criticizing, can you please state what you’d do if you had the chance?”
I still haven’t heard any sensible replies to that question and, as expected, nobody had paid much attention to my opinion anyway. After all, why should they? I’m just one tiny private voice of reason (or so I hope) among half a million others, some reasonable, some not. The cacophony of ego-fueled anger, resentment and outrage has effectively drowned my voice out, that’s for sure. Besides, here, as everywhere else the phrase, “if it bleeds it leads” is the watch word. Who wants to hear, “what would you do instead,” when it’s so much more satisfying to just vent.
So what has that got to do with the rest of this? Just this: the overwhelming roars of derision that have been let loose against the budget remind me of the many negative stories reported regarding bad experiences patients relate regarding our health care system. Week after week we are treated to yet another story of an experience that leads the listener to conclude that “the health care system is failing us.”
Week after week, anecdote after anecdote. What else can you conclude?
But then there’s the personal experience, outside that one hears reported. Stories of the many that come and go, day after day, get treated and then return home, getting on with life. You don’t hear those. After all, those are just more, tiny, private voices of reason; small and quiet, never reported.
That exactly is the point here. We only hear when things go wrong. “Everyone I met was super—professional and caring—and everything went according to plan,” doesn’t make much of a story, does it? No grief, no conflict, no big emotional resolution means, effectively, no story.
Well, that’s it, then. I have no story for you. Only gratitude to the skilled, hard-working, selfless, caring professionals I encountered last Thursday.