Decrepit Old Fool

While I’m recovering from surgery, a kindly neighbor loaned me a DVD set of the first season of WKRP In Cincinnati, the 1970’s era MTM sitcom about a little AM rock radio station.  I remember loving the show when it was broadcast, and it’s a real pleasure to revisit.

One episode makes for 25 minutes on the treadmill, which is just about right because I wear out very easily.  A session now is 25 minutes at 1.4 mph, instead of 50 minutes at 3.6 mph.  I’m also doing 5-minute sessions every hour, so it still adds up to about an hour per day, only slower.  Much, much slower.

Anyway, my neighbor described the episodes as “dated” but on watching them again I can see why that show won so many awards.  It doesn’t try to dazzle the viewer with cleverness – they’re just small human stories, often very touching.  Each episode is like a little stage play, in fact.  A few end with hilarious zingers (“As God is my witness, I thought turkeys could fly!”) but many episodes end with a moment of wry introspection and no dialog.

I’m also realizing how much I enjoyed listening to the radio back in the ‘70’s.  For those who don’t remember, it wasn’t dominated by syndicated conservative blowhards or self-help phonies. There were actual disk jockeys, who played records, cracked jokes, and took requests. That’s an actual human person who kept a microphone live whenever there wasn’t an ad running or a record playing.  They’d even bring in local musicians to talk and jam. The news was often local and immediate, too.  I guess those days are gone forever.

Mister History walked into the battered classroom in his suburban school and stopped.  Everything looked… different somehow.  All the same students were there, but they were dressed a little better.  They were carrying little shoulder bags with electronic readers in them, instead of piles of the approved textbooks that History hated so much. The readers were tough plastic panels about the size of a glossy magazine and almost as flexible. Three walls of the room were covered with visual aids; a layered historical time-line, major inventions, printouts of newspages.  A strange-looking projection device hung from the ceiling center.

The room was just as cluttered as usual but the atmosphere was different.  A few students were chewing gum, with no apparent concern that they might be caught.  One was sipping on a coffee! Small groups were clustered around the room.  Some were idly watching videos on their readers; one was taking notes on the tiny keyboard at the bottom of the screen.

History himself was an imposing figure – six feet tall, handsome with black glasses and thick dark hair.  He raised his rich, slightly accented voice and said;  “Good morning class!  I trust you’ve all watched the assigned video on HippoCampus this morning?”

A few hands drifted up in the air; some students repositioned themselves.  A few seemed to ignore him altogether.

“Well OK then; if you didn’t, you missed out.  It was actually pretty funny right at the end there.  Today is Friday, so you know what that means?”

A few voices clamored: “A history spiderweb!”

“That’s right, but first let’s check the roll.”  He glanced at his desktop, and two names were highlighted.  “Jimmy and LeSuan?”  One hand went up. “Oh, hello LeSuan.  Where’s your reader?”

“I think it’s broken.”

He handed the teen a pass slip.  “All right, take it by the office for a replacement after class.  Grab one of the spares and sign in, OK?”

One name went off-highlight.  From a range of options he clicked to send an “explanation-please” form requiring input from Jimmy’s parents.  In extreme cases (such as a missing student and no one could be raised), and with sign-in from the principal and a law officer, it could even give a location for the student’s reader.

“OK, first the weird story.  Every History Spiderweb begins with a weird story.”  There was a small clamor from the students, and a couple flat ‘oh, goodies”. He touched an option on his teacher’s reader; the projector highlighted a spot on the time-line.  He tossed a ball of brightly colored yarn to a student, who got up and pinned the yarn to the highlighted spot and waited.

“On 30 December, 1912, the spoiled granddaughter of a rich Illinois politician was having a party at their home in Bloomington.  Many of the children of the rich and well-connected were there.  On the big estate there were games and groups and a good time was being had by all her friends.  And her even more spoiled brother was at the party, hanging out with his buddies.”

“The young man’s name was Adlai Stevenson.  Has anyone heard that name?”

“There’s Stevenson hall at ISU,” said one girl.  “My dad works there.”

“That’s right; same guy,” said Mister History.  Well on this morning young Adlai was 12 years old – three years younger than you are now.  And he was clowning around with some of his friends and in those days, you could legally keep unlocked guns in a house with children.”

The class grew quieter at the mention of guns.  Almost all of Mister History’s weird stories ended with somebody dying, sometimes a lot of sombodies.  But still – 12 year olds at a party!

“There was a .22 rifle around, and it was rusty and nobody thought it even worked.  Adlai’s dad was a funny guy – he always thought somebody was out to get him.  But even with guns all over the house, he never taught his kids a lick of gun safety.  And Adlai and his friends were clowning around with this .22, showing off rifle “drill and presentation” techniques, and taking aim at rabbits and other kids, like it was a video game or something.”

“And when it was Adlai’s turn – nobody knows why – he aimed the rifle at his cousin Buffie Merwin, and pulled the trigger.  He shot her in the face.  He killed her with one shot.  She fell to the ground right in front of her friends.”

A boy asked; “What happened to him?”

“Well what does everyone think happened to him?  Anyone?”

The ceiling projector could throw hundreds of laser-projected images and videos around the room at once. It hummed as its rotating mirror spun inside the glass dome.  As they typed, students’ guesses appeared on the white board at the front of the room.

“The girl’s brother came back and shot him”
“He went to juvie?”
“His sister hated him.”
“Nothing. Rich kid.”
“The whole thing was covered up”
“The girls’ parents sued?”
“He was sent away to private school”

“OK, here’s what did happen.  The girl’s brother didn’t come back and shoot him.  He really didn’t get into any trouble at all.  His dad was really angry but he got over it.  The girl’s parents understood that it was an accident and were determined not to ruin any more lives over it.  The newspaper – which the family owned by the way – covered the shooting in the back pages in the most delicate possible way.”

“Young Adlai was not permitted to testify at the inquest, which found it was an accidental shooting. His sister always adored him – maybe not that year, but every other year.  He was sent away to live with relatives in Chicago and then in South Carolina for a year, and never permitted to speak of the accident again.  His parents almost succeeded in erasing it from his memory, but not from his personality.  He felt forever unworthy after that.”

“What do you think should have happened?”

No guesses appeared on the board.

“OK, now let’s light up some more history.”  He touched more items on his reader, projecting images on the time-line of young Einstein publishing his theory of relativity, Pearl Harbor, The Manhattan Project, Hiroshima, Nagasaki, Bravo Test, the arms’ race, and finally the Cuban Missile Crisis.  The room was glowing with moving videos and still pictures, suspended on their parts of the 20th century layer of the time-line.  Mister History tossed out balls of yarn and directed students to connect the images – including the 1912 Pantagraph clipping about the shooting – to the Missile Crisis. The room began to look like a color-obsessed mad spider had spun its web from wall to wall.

History played the video on the timeline from October, 1962.  It was Stevenson, then 62 years old and Kennedy’s ambassador to the United Nations, saying:

“Do you, Ambassador Zorin, deny that the USSR has placed and is placing medium and intermediate-range missiles and sites in Cuba?  Yes or no?  Do not wait for the translation, yes or no?”

It was an electric moment.  The students watched as he stopped the video, ducking under hanging yarn and moving to the middle of the room.

“This is the same spoiled rich kid who once shot a little girl in the face and never had any consequences at all,” he said. “You know, some historians believe it was Stevenson, not Kennedy, who was really responsible for saving the world from a nuclear holocaust that year.  Same guy.”

Suddenly the school fire alarm buzzed repeatedly in the hallway, and the projector dropped all its images except for moving arrows pointing to the doors. The students made a disappointed sound and began to rise from their desks.  History said; “OK folks, that’s it, single file, take your readers with you to the assigned location shown on your screens.”  And he sighed and picked up his teacher’s model and headed for the door. 

The hallway became Albert Hestry’s apartment bedroom, and the fire alarm buzzer became his alarm clock.  As his mind cleared, he reached out and tapped the button to silence it.  He sighed, and sat up in the bed, swinging his feet over onto the cold floor.  After a moment’s thought, he concluded; it’s Friday.  He stood; his feet hurt, his knees hurt.  He needed to lose weight, he thought.  He ran his fingers through what little was left of his graying hair.

He buttered his toast and poured milk on his Cheerios.  Munching absent-mindedly, he browsed through his teacher’s edition of US History Alive, mentally mapping it to the day’s curriculum plan.  Standardized evaluation tests were only a month away, and he had to make sure the students were ready.

Well despite moving very slowly and only with the aid of a chauffer, I have been out to visit a few of the good friends who visited me in hospital.  It has become clear that, when thoroughly whacked out on narcotic painkillers, I can be fairly entertaining.  Perhaps I may have disseminated some “not-true facts”. 

Sorry to disappoint, but when this is all over, my name will still be George, not Georgina.  I don’t have any new Vicoden connections that I didn’t have before.  And whatever anyone may have allegedly said, there is no truth to the rumors about a joint appearance on “So You Think You can Dance” by me and Federal Appeals Judge Sonia Sotomayor. I hear she’s going to be pretty busy for a while.

WARNING: PURE MEDICAL GEEKERY FOLLOWS.  As I said before, though my hospital stay wasn’t any fun, it was very interesting.  Lots of gadgets, new procedures, ways to not kill patients.  This (very long) post will deal with some icky stuff, so you might want to skip it unless you find that kind of thing as interesting as I do.

Second installment: a hospital is no place to get better.

I was plenty scared about the anesthesia among other things.  You don’t have to read very many sensational news articles about people being awake but paralyzed during surgery for it to play on your fears.  Fortunately (to say the least) that didn’t happen.

Anesthesia has really improved.  In the past, waking has been like fighting through a swamp, wandering this way and that to find a way out of a dark maze. But this time I woke up easily in a large room somewhere, my mind pretty clear right away.  That’s a neat trick considering what I had just been drugged into ignoring only an hour previously.

Well not entirely clear.  Someone said to me; “Welcome back, Mister Wiman.”  (all smiles) “You didn’t get a colostomy!”  Great.  I wondered: where am I, and what’s a colostomy?  But only a couple minutes later I had sorted that out and was fully awake and damn glad not to have one.  Story continues below the fold, with photos.

Gut-wrenching: the actual operation, what little I understand about it
What is a perforated bowel?  It’s a hole in the large intestine that allows bowel material to escape into the abdominal cavity.  When this happens you need surgery NOW.  My perforation was in the sigmoid colon.  I received a twelve-inch vertical abdominal incision, and the operation took three hours, roughly twice as long as expected.  The incision was closed with about 45 surgistaples.

I wasn’t able to find any videos of this type of operation being performed, or even any good pictures, but that may be just as well. From what I’ve been able to find out the surgeon has to lift out your guts, rinse them off and lay them alongside, rinse out the abdominal cavity, inspect and repair the guts, and pack them back into the abdominal cavity. Do they practice origami in medical school?  (If anyone with medical training can provide a more accurate description, I’d love to improve this post with it).

Post-op killers, considered
Clearly the medical community has made an effort to address some of the big ones.  These include infection, drug dispensing errors, blood clots from the legs, and fluid buildup in the lungs.

Respiration: Suck On This
Fluid tends to build up in post-op patients’ lungs, often with fatal results. There are several, painfully simple reasons for this.  A person who has just had abdominal surgery doesn’t like to cough OR even to breathe deeply.  It’s uncomfortable!  Another, when lying in a hospital bed, breathing is shallow because you are at rest.

The solution is for the patient to breathe deeply many times an hour, but telling them to “breathe deeply” is pretty vague.  So I was given a simple “incentive spirometer”, which is a little plastic flow-meter invented for asthma patients, that lets me know exactly if I was breathing deeply enough.  I was told to use it ten times an hour for every hour I was awake, and given specific volume goals.  It’s simple, cheap and effective if you can get the patient to cooperate, which I did.  It’s not like I had anything else to do.

Move, dammit! And self-managed pain control.
Patients used to be kept very still following surgery (or even childbirth).  They were supposed to “rest”, which made for poor circulation, shallow respiration, and the formation of adhesions between abdominal layers.  Now we’re advised to get out of bed as soon as possible after the surgery.  Get off that bed and walk!  My first walk, with someone helping, was from my room to the exit sign down the hall and back.  After five days I’d figured out that the hallway circumference of the recovery wing was about 400 feet, give or take.  One day, all told, I racked up nearly a mile over several walks pushing my own IV pole the whole way.

This is where self-managed pain control is crucial.  They WANT you to use the morphine.  It was very funny how several people took the time for a detailed description of how to operate the morphine pump.  (C’mon, folks; I’ve used them before and it only has one button.)  Dr. W. said; “We want you to move, we want you to cough.  You won’t do either if it hurts.”

To sleep, perchance to dream (forget it, big boy)
This is a non-trivial problem and they didn’t seem to have a very good handle on it.  Every one of the six (!) tubes connected to my body was an opportunity to wake me up and do something to them at regular, overlapping intervals.  In fact, the IV tube split off to multiple sources, which drained into me in sequence partly by gravity order (clever, that) and partly by computer control.

They were constantly checking my vitals too (and a good thing, because my blood pressure really spiked at one point). Charting involved waking me up to scan my wrist band, and ask me my name and date of birth to make sure they were not about to give me someone else’s drugz.  There was too much light and noise, and of course, I was very uncomfortable.  I didn’t get more than an hour’s continuous sleep for nine days; between sleep deprivation and drugs I literally could not track the passage of time.  I got online a couple times but nothing made sense to me.  I’m still coming back but the important thing is; you have a better chance of sleeping at home.

You really do need this kind of oversight after major surgery, so I can’t think of a ready solution. 

The nine-day massage
A major cause of post-op deaths and stroke is blood clots from the legs.  I woke up to find that a pneumatic device was squeezing my calf muscles at one-minute intervals, essentially pumping blood through my legs.  I’m told most people don’t like this machine but I loved it!  Because of my chronic pain condition, sitting or lying still for more than a few hours is a terror to me.  But this machine prevented the pain and here’s the cool part: if I can find a portable version, I’ll be able to travel by air again.  Several helpful people (including my boss) did some research and found that there are indeed portable versions of these machines.  Some time this summer I will be acquiring one, and here I didn’t even know they existed. If there is any silver lining to the whole experience, this is it.

The hand grenade and mega-weirdness
There was a tube protruding from the side of my abdomen ending in a little silicone rubber bulb the size of an orange.  They called it; “the hand grenade” and its purpose was to collect drainage from my abdominal cavity.  The tube was sutured to my abdomen, which was very uncomfortable.  Every few hours, they’d come empty the hand grenade into a cup, measuring and inspecting the resulting fluid.  Once emptied, they’d sqeeze it concave and then cap it, to maintain negative static pressure relative to the abdomen.

It was kind of a frightening little device, and when Dr. W. finally snipped the suture and pulled out the tube (which was about two feet in length) I could feel it sliding past my innards as it came out.  Ugh! 

Stomach pump and why I’m grateful for something I hated so much
I woke with a tube in my nose that ended in my stomach, connected to a stomach pump.  I’d munch an ice chip, and a few moments later the little bit of water would hop the u-turn at my nostril and head for the pump.  This was in place because the intestines wake up at different rates, and at first anything in the stomach would result in vomiting.  As this is the first surgery I’ve ever had where I didn’t vomit (thank doG!), it was a very good thing.

But also a bad thing.  I can hardly describe how unpleasant it is to have a tube down the back of your throat from your nose.  It’s like (and is) having a giant glob of snot back there which you cannot expel in any way whatever.  When after 40 hours the tube was finally removed – like all tubes a long steady pull with weird feelings as it slid past internal parts – it was nearly three feet long.  Apparently they want it to coil and lay at rest in the stomach, rather than poking the lining.  I stacked up five tissues, reared back and blew my nose, an action which has never felt so wonderful before.  Context is everything, I suppose.

Foley Catheter and mega-weirdness
This is the third time I’ve been ‘cathed’ and it isn’t my favorite thing in the universe to say the least.  Several years ago following a hernia operation, my urethra or prostate clamped down and I couldn’t pee.  The nurse said helpfully; “If you don’t pee, I’m going to have to cathe you!”  They waited a very long time until I was excruciatingly uncomfortable (your bladder can literally rupture) before inserting the tube into my penis up into the bladder to relieve the pressure.

This time and one of the other times, the Foley was inserted while I was unconscious, which is worth asking for, if circumstances allow.  On a previous occasion (kidney stone requiring surgery) I had a Foley for six days, and it permanently damaged my urethra.  Like the cartoon character Hank Hill, “I have a narrow urethra!” This one stayed in for five days, but seems to have left no ill effects.  Very, very weird when pulled out-and like all the other tubes, disturbingly long.

Farts and surreality
Sometimes it felt like I’d awakened in a Salvador Dali painting.  Beautiful, young professional women would enter my room and ask; “Hello Mister Wiman!  Have you passed any gas today?”  We joked about what it would be like if other businesses inquired of their customers about this bit of information.  “Hello, welcome to Sears!  Have you passed gas today?”

But it’s a really important, even crucial question.  After all that rough handling, the intestines shut down and there’s no peristalsis.  Until every section from stomach to anus starts functioning, you can have nothing by mouth – it would back up and you’d vomit.  The OK signal is repeated farting.

“What part of ‘nothing by mouth’ did you not understand?”
Recently I’d been thinking about experimenting with fasting.  I’d read an abstract of a study that found fasting one day every two weeks improved insulin response in overweight individuals.  Well I got my experiment: for seven days I had no food or drink by mouth at all.  My IV tube provided only electrolytes and glucose.  I’d question Dr. W. (who really didn’t mind using sarcasm, which I appreciated) about this and she’d say; “No, really, it’s OK!  You can just not eat for a week and it won’t hurt you.”  Or at least, hurt you less than the alternative.  She said; “We’ve had people who are very hungry lie about passing gas, then vomit and aspirate, and end up in ICU on a ventilator.  It’s an unfamiliar circumstance to them so they need to understand what it means.”  I told her I was only irrational, not stupid. Jury still out, perhaps.

Staples; not just for the office anymore
What can I say about staple stitches?  They certainly worked well but I was industrial-strength curious what it would feel like to have them removed.  “Oh, it doesn’t hurt at all – it just pinches a bit,” said the nurses.  That should have been my first warning.

My skin is super-sensitive to pain.  When possible, I take my own stitches out, chilling the area with an ice cube first.  I couldn’t reach these so the nurse cooled them with an ice pack and took them out with a clever little pair of special pliers.  As it happened, these hurt like crazy.  I basically screamed like a nine-year-old girl.  Sorry, but ice packs aren’t cold enough, so if there’s ever a next time (perish the thought) I’m insisting on direct ice cube preparation.  Apparently for many people, it’s no big deal.

Full incision image available by request.  Trust me, you don’t want it.