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Saturday, April 25, 2015

Crisis Declared Finished!

I’d made up my mind; I’d had enough. Unless Dr. Roberts* or Dr. Schultz* could point to a flat blob on the x-ray film to prove they’d found the brain tumor, I’d be on my way home within twenty-four hours. Period. No more test. No more excuses or cautions. I’d already packed my belongings before leaving for the doctor’s office.

“I see by the set of your jaw, nothing I say will make a difference,” Dr. Roberts said, dropping the file folder onto his desk.

“If you can’t point to something I need to worry about, I refuse to miss one more day of work. I need my life back.”

“I understand that; I really do, but you live nearly two hundred miles from this hospital. You already experienced the lack of appropriately trained physicians at the very beginning of this whole thing. Who knows what the outcome may have been had the right exams and tests been done at the first sign of trouble. Are you willing to risk putting your life into their hands again?”

“I don’t see that things have improved any for the past several weeks. I’m willing to accept the way things are now and just get on with my life. I can see again. I lost a bit of peripheral vision in my left eye, but I can drive just fine. I have no trouble reading or anything else I need to do on a daily basis. The pain is more like gentle pressure now; I can bear that just fine. You can’t make it any better, so I don’t see why it would hurt to go back home.”

“I can’t say it would hurt you to go back there; but I can’t guarantee the whole problem won’t start up again as soon as you get home. You could crash the first night. Without being able to clearly identify the origin, I don’t have any confidence that it’ll not return—maybe even worse than the first time.”

“Are you saying that if I leave the city, you’ll consider me discharged ‘against medical advice’?”

“Going AMA isn’t the issue here; it’s a matter of prudence. I think you’d be better staying close by, just in case you needed us.”

“And, what am I supposed to do while I just wait to see if I’ll crash and need to come running back to you? I don’t have a job here, and who in the world would hire me now? My hospital board is willing to let me continue working as the administrator. They’ve been very patient in letting me try to carry on the duties from my parents’ home, but it’s getting old for all of us.”

“What do your parents say about you leaving? I see your mother didn’t come with you today.”

His mention of my parents surprised me. He’d made it clear during my hospitalization that I was an adult and could speak for myself, so he saw no reason he should consider what my parents had to say. Naturally, this caused no small amount of conflict between Mom and Dr. Roberts. Dad, being a military man, just submitted to Dr. Roberts’ authority, assuming it was the doctor’s right to exclude them. The suggestion that the neurologist now cared what my parents thought seemed like a last-ditch effort to make me stay.

“I told her she needn’t take another day off work. I’m of age, Dr. Roberts; I don’t need my parents’ permission to tell you I’m through with all the waiting and needles.”

I heard the physician’s exasperated sigh, but the thin line of his lips and furrowed brow, gave me hope he’d soon concede the issue.

“Okay, look. I’ll sign you out on one condition,” Dr. Roberts said sitting back against the squeaking desk chair.

“Anything! Anything except another painful procedure, that is.” I sat forward on the thin metal chair.

“I’ll discharge you today, but you’ll need to return in three weeks for another spinal tap to check the pressure. Sooner, if the pressure in your head gets worse or your vision changes.”

“Make it four weeks and we’ve got a deal,” I said with a huge grin.

“Okay, four weeks but you’ve got to promise me you’ll return if you notice any changes at all.”

I felt like leaping up and hugging the life out of the stiff, growling man.

“I’ll come back if I need to; otherwise, you’ll see me in four weeks. At the hospital or here?” I’d already stood, gathering up my things.

“I’ll meet you in the Emergency Room. Hang on a minute,” Dr. Roberts said, reaching for the telephone with one hand and waving me back into the chair with the other.

The excitement of my imminent return home made it hard to just sit still and wait for the appointment date and time to be announced. Hearing the click of the receiver settling back on the desk phone, I leapt up, slinging my day-pack over one shoulder.

“Four weeks from today. Four o’clock in the ER. Don’t make me wait and don’t cancel the appointment.” Dr. Roberts said, barking like an angry bear.

“I’ll be there! Don’t make me wait, either,” I said, grinning and giggling as I pointed my index finger right back at him.

The doctor dropped his outstretched arm and pointing finger, laughing as he did. "Four o’clock,” he said as I closed the door behind me.

Early the following morning, I pulled on to the highway for home. I planned to sing all 192 miles of the journey. God had brought me through the agonizing procedures. He’d kept me from dying at the hands of ill-equipped, caregivers in the rural setting, and He’d returned my vision to me. How I rejoiced in God’s faithfulness and mercy!

In just forty-eight hours I’d be working on those collection issues dear Lillian continued to present to me during every phone call of our long-distance office hours. I laughed out loud to realize that even trying to collect on long-past due hospital bills sounded good to me. I just wanted my life back and now I had it.

*Names changed

Saturday, April 18, 2015

Another Crisis Surprise

When the Radiology Department called to confirm my Monday appointment, the lady reminded me not to eat or drink anything after Midnight on Sunday. I’d not been advised of this by Dr. Schultz* at my Wednesday office visit. Her warning clued me into the sad truth; this test would be more along the lines of the dreaded arteriogram than a simple x-ray. Why shouldn’t I eat or drink anything, except that they feared I’d throw up on them?

Early Monday morning, when Mom and I walked into the Radiology Department, a uniformed tech came over to us. “Here you are. The doctor arrived ahead of schedule today, so we can already get started. You can have a seat over there, Mrs. Hawley. Or, you might want to go to the cafeteria for a cup of coffee. This test takes about an hour.”

It’s impossible to adequately express the physical reaction her cheerful words to Mom wrought in my body. Truly, the admonition to abstain from any oral intake had been warranted. I’d not left the waiting area and I already wanted to throw up.

I changed into the cotton, open-back patient gown and let the tech help me onto the cold, hard x-ray table. She brought me a flannel blanket to make up for the absence of my own long-sleeved flannel shirt and blue-jeans. It’s always cold in the rooms that have radiology equipment.

After several control x-rays had been shot and processed to confirm positioning, the neurosurgeon entered the room. I hadn’t expected to see Dr. Schultz until the results became available. Accompanied by the radiologist, the two specialists discussed the numerical settings and all sorts of other too-technical for me stuff.

“Go ahead and sit up on the edge of the table,” Dr. Schultz said.

I did as I had been told, all the while wondering what in the world for. X-rays had to be taken with the film near the head, not hanging out in the open air. Still, I let the tech help me arrange the blanket over my legs, as I felt the cold wetness of the antiseptic gauze wipe across the lumbar region of my spine.

“I thought you said I didn’t have to have another spinal tap,” I said, feeling the second wipe of the fluid now dripping down my back. The tech reached around and soaked the excess up with a dry gauze sponge.

“You’re not having another spinal tap. We use the same area for this test, but we don’t take anything out for the lab. Dr. Roberts* did that last week.”

“Then, what are you doing? This feels the same as the prep for the spinal tap. What are you going to put in there? Shouldn’t I be lying down?”

I felt his gloved hand on my shoulder. “Don’t worry. It’s just air. We put a little air in the same place that the other test puts dye. Then, you can lie down and we’ll take the pictures of what’s going on inside. Just relax so we can get it done.”

I felt the stings of the Novocain in my back. “Should I tell you which leg feels the sharp pain and how far down my leg it goes?”

I’d always done that for Dr. Roberts so he knew which way to move the needle to hit the exact position. In fact, I’d had so many spinal taps that the directional reports contained only a couple of words—right knee or left mid-calf—meaning the pain shot from my back down to the knee on the right or the mid-calf on the left. Dr. Schultz just grunted, but when the pain shot down my leg to my ankle, I spoke.

“You don’t need to tell me that. I’ve been doing these things longer than you’ve been alive.”

“You might have but not on me. This is the first time you’ve done it on me. Can’t I lie down? It’s hard to put my body in a ball and still stay on the edge of the table.”

Another stab, for which I shouted out the directional clue. He may not take my guidance, preferring to keep his pride intact, but I’d be hanged if I’d keep quiet about his mistakes.

“Hold still. I prefer the patient sitting. Just hold still and keep quiet.”

Finally, I felt the pop and knew he’d found the right spot. I also noted that, while he sounded like he ignored my clues, he responded to them in the same way Dr. Roberts had. That agony over, I relaxed—but not for long.

I felt the student tech who’d come to observe tighten her fingers over my clenched fist and knew something was about to happen. “Please, just tell me wha-a--“

Before I could complete my request, a thick, white-hot flash of burning steel shot up my back and filled my head with excruciating flames. One of my legs moved spontaneously and I felt the searing heat flash down to my knee.

“Keep your leg still,” the surgeon said.

“It moved itself,” I said through gritted teeth. “Down to my knee.”

The surgeon swore and moved the large needle. The relief to my knee was immediate.

“Get the first set!” he said with obvious annoyance.

They grabbed my shoulders and put me flat on my back in the exact spot they’d marked out on the table. Suddenly, all the heat rushed up from my back to join the nearly exploding fire inside my skull. Reflexively, tears poured down my eyes and pooled on the table.

The gang of professionals left me, except for the student who clung to my hand like she was the patient needing comfort. I heard the muffled communication behind the glass control booth, but couldn’t make out the words. Then, the doctors emerged to pull me up again on the edge of the table.

The second try at introducing the huge needle went better. The doctor listened to my now-whispered clues. However, the injection of air into my spine didn’t go better. The pain gave my mouth a mind of its own.

I bore the agony with shouts so loud, I wondered if they heard me in the rooms above this Department. Before I realized what had happened, I heard someone say, “What language is that? Isn’t she an American?”

Another voice said, “Is there anyone here who can translate for us? What’s she saying?”

Through the pain, I forced myself to listen. “Praying,” I said, croaking out the word between my own shouts.

“Anyone understand what she just said? It sounded like English to me,” the radiologist said.

I repeated the word, trying to gain more volume. The student nearest me said, “I think she said she’s praying.”

“Okay, we don’t need to know what language then; it doesn’t matter what she’s saying,” said Dr. Schultz.

I had switched to shouting my tormented pleas to my Heavenly Father in the unknown tongue that had become a part of my personal prayer language five years earlier. I had not been aware of the transition but I rejoiced that my inner being had responded in the only way that would help.

God could get me through this with my mind intact. Until that point, I felt like I’d surely lose it before the test had been completed. The pneumoencephalogram proved far worse than the arteriogram I’d had weeks earlier. And to think, the only reason I’d agreed to have this test was to get a release home.

Once I’d recovered, they’d better be able to show me the outline of a tumor or I’d be on the road home, period. No more tests to prove that I’d recovered as much as possible already.

*Names changed.

Friday, April 17, 2015

Ready to Leave Crisis Behind

Mom and I crossed the parking lot in silence, each of us absorbed in our own thoughts. I knew I’d made the right decision. The time had come to insist that the medical system stop playing around with my life. The doctors needed to just accept the slight changes as my new normal.

The serious pain in my head had dropped to a slight pressure inside my skull weeks earlier, but the dreadful spinal taps just wouldn’t normalize. I’d lost a bit of peripheral vision in my left eye, but at least, I could see just fine now. I still couldn’t imagine I’d actually walked into the fuselage of the small plane that had carried me the long distance to the hospital.

Relieved that the dark chapter in my life was coming to an end, I determined to repeat my pleadings for medical release to the neurosurgeon. The neurologist refused to discharge me without his approval; I set my jaw to get it.

“Step right over here,” the nurse said, pointing to the exam room. “Go ahead and take off all but your underwear and sit on the table. Dr. Schultz* will be here in a minute.

As I began removing my clothing, Mom looked for the paper patient gown. “The nurse forgot to set out the gown,” Mom said. “I don’t know if it’s okay or not, but I’m going to try to find you one.”

I looked over to see my little mother opening and closing drawers and cupboard doors. Meanwhile, my nearly-naked body chilled with the over-enthusiastic air conditioner.

I moved the footstool close to the exam table and climbed aboard. Crossing my arms in front of me did little to warm my freezing torso. My super-modest, Australian Mom’s frustration could be measured by the exasperated murmurs coming from the cupboard area.

“It’s okay, Mom. He’s probably one of those whacky rich surgeons who didn’t spend the money for patient gowns. Since it’s my eyes that are the issue, I’m not sure why I even needed to undress, but it’s okay. I just want him to give me the release to go home.”

When the surgeon came through the door, my irritated mother wasted no time in pointing out the absence of the patient gown. To which he simply said he regarded such things as unnecessary. Though chilled to the bone, I restrained my own sarcasm, figuring he’d not want to loan me his long sleeved shirt anyway.

Following the usual neuro exam—which by the way didn’t include anything that couldn’t be done with a fully-clothed patient—I expressed my request for discharge. His response let me know he’d been briefed on my pleadings to Dr. Roberts*.

“Yes, I know. Let’s go out to the eye chart. You say you can see, but I want to know just how much. The inside of your eyes doesn’t look like you should be seeing much.”

“She’s not going out there without her clothes!” said my mother.

I laughed, hoping for the doctor’s sake that he didn’t object. Mom always said that dynamite comes in small packages and this petite Mom chomped at the bit to show him. I slipped off the table and headed for the stack of my clothes.

“Oh, well, when you’re dressed come out in the hallway.” Dr. Shultz said, looking a bit startled.

The doctor acted like he’d not noticed I wasn’t dressed to parade myself through a hallway open to the waiting room. Maybe he counted a gown unnecessary because he never noticed the patient’s attire--or lack of it? I didn’t wait to find out; I dressed as quickly as I could, but still shook from the cold.

Leaving the exam room, I caught sight of Dr. Schultz near the eye chart at the end of the hallway. A nurse pointed to a strip of tape on the carpet. “Stand here,” she said.

As soon as I’d set both toes on the strip and aligned myself with the chart, the doctor began pointing to letters. One after the other, I correctly identified the letter. Fortunately, I’d remembered to slip my glasses on before leaving the exam room. With my corrective lenses in place, I had normal vision.

“Well, I tell you; I can’t believe this! You really can see! I don’t know how, but your vision seems normal now. I’d say it’s just a miracle.”

“You think it’s a miracle?” I said, eyebrows raised but a huge smile on my face.

“There’s no other way to explain it,” the doctor said while shaking his head and moving away from the chart. “Let’s go back to the exam room.”

Hope filled my heart. Today, I’d get that release approval; I just knew it. I grabbed on to Mom’s arm and we walked back into the little room.

“So, will you call Dr. Roberts, or do I need to wait for a paper to hand him to get his release?”

“I’ll call him, but I want you to have one more test first.”

“Not another spinal tap,” I said with a groan. “Can’t you just take the results from the one I had last week?”

“No, I’m not talking about a spinal tap, yes; I’ll use the results from that one. It’s a test you haven’t had yet.”

“But why? I won’t get any better than I am right now, so why do I need anything else? I really want to get back to work.”

“I know, and if this one last test is okay, you can go. It’s important to be sure we can’t localize the tumor that’s caused the problem in the first place.”

“Will it be like the cerebral arteriogram? That was awful and I don’t ever want to go through that again.”

“No, this test doesn’t inject any dye. You will need to go to radiology again, though.”

“When? Can I do it today?” I knew a simple x-ray could be done with little notice, didn’t take long to get the results, and I’d be willing to wait a couple of hours in their waiting room if I could do it that same afternoon.

“I’ll need to talk to the radiologist to see when he could do it. I can try to phone him before you leave, but I can’t be sure he can schedule it right then. I may need to get back to you.”

“Okay, please call him. I’d like to get home and back to work next Monday.”

Unfortunately, the specialized test required more lead time to schedule. I’d need to return to the hospital’s Radiology Department on Monday. Had I known what awaited me Monday, I’d have left for home right then.

*Names changed.

Saturday, April 11, 2015

Enough of This Crisis

I’d resolved to tell the neurologist my plans to return to work the following week. I’d spent two weeks at Cindy’s home just five minutes from the hospital, enduring two spinal taps a week in the Emergency Room. Then Dr. Roberts* released me to my parents’ home thirty minutes away for another two weeks and three spinal taps. Enough. This would be my last spinal tap-- for a while anyway. All the way to his office I practiced my little speech. You’re not going to chicken out, I told myself as my feet crossed the threshold into his waiting room.

By the time Mom and I reached the stiff, straight-back chairs, my stomach had tightened to a small, hard ball deep inside. My mouth felt like it’d been lined with cotton and swallowing proved difficult. Mom’s whispered words interrupted my concentration on the physical signs of stress.

“Can you believe this place? Just look at the clutter!” Mom straightened one stack of magazines after another.

“Well, he certainly likes National Geographic,” I said, noticing tall stacks of the magazine filled the small square coffee table.

“Hmmph! Doesn’t he think his patients might like to read something else while they wait for him? Just look at this. There’s not a single other magazine on the table.”

Since I had no thought of reading while I continued silently rehearsing my speech, I hadn’t really noticed. My attention drawn to the fact that the single reading selection totally filled every inch of what I assumed to be a wooden table, I had to laugh. Mom’s frown turned my laugh into a quieter giggle, but I couldn’t stop.

“I hope we’re not here long enough to read all of those issues; there must be ten years worth!” Mom continued straightening and harrumphing. “Look at it this way, Mom, you may find some good recipe from Borneo or other exotic place inside those pages; and I bet they’ll even tell you how to trap that warthog using only the offerings found on the forest floor.”

“That’s not funny,” Mom said. “I should have brought my Good Housekeeping. Do you see today’s newspaper anywhere?”

Before I could respond, I heard a door open at the front of the small room. To my amazement, Dr. Roberts came towards us. Okay, it’s not just the furnishings in his waiting room that shout, “low-budget program”; he’s his own nurse, too. The thought made me smile; I restrained my sarcasm fighting to spill out through my lips.

“Come on in,” Dr. Roberts said, without greeting my mother.

“And, good morning to you, too, doctor,” my mother said through clenched teeth. Clearly, the two had not lost the enmity that had grown to full-bloom during my hospitalization.

The neurologist stopped and turned towards Mom. “Oh, yes, good morning Mrs. Hawley. We’ll be just a minute.” He reached for my arm, leaving no question as to where he expected my mother to spend the time.

“It’s okay, Mom. I’ll tell you what he says on the way home.”

I managed to worm my way through the obstacle course to his exam room, but wondered if Mom’s adamant urging that I find another doctor might have some merit. I consoled myself by recalling things I’d read about other geniuses that worked in such cluttered disarray.

After the usual neurological exam, Dr. Roberts rolled his stool over to the desk and began writing. I cleared my throat and said, “I want to talk to you about something.” He looked up but said nothing. “I’m going home next week. I don’t mean my parents’ home, but my home. I need to get back to work.”

Now, I had his attention. Turning towards me, the doctor said, “What makes you think you’re ready to return to work? Did I say anything about you going back to work yet?”

I jumped in before he could continue. “No, you didn’t but I’m ready. I don’t expect you to think so because you never found the tumor; but I’m telling you I’m ready right now. I don’t think I’m going to get any better than I am right this moment, so why not just get on with my life?”

“What about the pain? Any change in your vision?”

“I’m used to the feeling of the slight pressure so it doesn’t hurt at all. I can see fine. I think I’ve lost some peripheral vision in my left eye, but I can even see to drive. In fact, I drove Mom’s car today because she gets too nervous in the city. I’m going home.”

“I’ve scheduled another tap for you this afternoon. We’ll see what that looks like and then decide.”

Since I expected he’d done that already, I didn’t object. I’d do whatever I needed to do to get his release.

“Okay, no problem. But, if there’s no change from the last one, I’m going home.”

He only grunted and opened the door for me to pass into the hallway, over-flowing with stacks of stuff. Only after we’d reached the waiting room, did the doctor speak.

“Okay, I’ll see you over there at one o’clock, sharp. That’ll give you time to have lunch.” He whipped around, returning to his personal sanctuary behind the door, without waiting for a response from Mom or me. I just shook my head and laughed, but heard mother’s menacing growl as I led her out of the office.

Later, I waited on the table of the Emergency Room for Dr. Roberts to return with the results. The spinal tap hadn’t been worse than usual, but I’d really not miss those painful procedures at all. Though I’d suffered through more than a dozen already, I knew I’d never get used to the torture of those spinal taps. The results this particular day would mean the difference in my release or rescheduling, so I prayed as I waited for the neurologist’s word.

“Okay, I’ve got the results,” the doctor said. “It is pretty much unchanged from last time, but—“

“No but’s, Dr. Roberts; I’m going home. I can come back in a few weeks for a check, if you insist, but I’m going home now.”

“If you’d let me finish… BUT, I want Dr. Schultz* to see you first. He’s a neurosurgeon who’s aware of your case. If he says you can go, then I’ll agree. If he doesn’t, I won’t and you’ll be on your own to pay the bill if you leave against my medical advice.”

“Okay, so when can I see him. Where do I go? Here, at the hospital or his office?”

The appointment had been scheduled for his office on the following Wednesday. I protested for an earlier time, but I’d wasted my energy. Wednesday, I’d tell the surgeon I’d be returning home as soon as he signed the papers. He just had to see how ready I was.

*Names changed.

Friday, April 10, 2015

Transitioning Away from Crisis

Finally, Dr. Roberts* had a smile on his face, or so he announced as he entered my room. “You’re probably wondering why I have such a big smile on my face today, aren’t you?”

Laughing I said, “If you’re smiling, that must be a first, isn’t it? I can see your form but not the features of your face yet, so I’ll have to take your word for it.”

“Your lab results are in. First, how does your head feel today?”  I groaned at the delay but responded to his question.

“It feels fine; nothing much happening in there, right? So, what did the labs tell you? Am I going home, at last?”

“Not so fast, young lady. Are you telling me that you are totally pain-free today?”

“I am if it means I’ll be heading home.” I heard his growling murmur, responding quickly. “No, really. Well, not pain-free, but it feels pretty good. There’s just a little pressure but not really what I’d call pain. Now, about leaving this place…?”

“Your lab results confirm your report. The spinal pressure is slightly elevated but it’s stable. I’d like to see your vision return more than it has, but I think we can begin talking about discharge.” I clapped, my mouth not wanting to interrupt the neurologist, but I had to express my excitement somehow. “Wait a minute. I’m talking about transitioning away, not total discharge. I want to be sure you’re close in case of emergency.”

“How close?” My clapping stopped, as did my grin.

“I’d like to see you staying within five minutes of the hospital. Can you swing that?”

Remembering that my dear friend Cindy now lived one-half block from the hospital, hope took root. “I need to call someone, but yes, I may be able to do that.”

“It’s too early for you to stay with your parents; they live a good thirty minutes away. Check into what you can work out with them or your friend. I’ll be back later. We’ll decide things then.”

The tall form spun around and left the room as quickly as he’d come. Before the sound of his leather soles crossed the threshold, I reached for the bedside telephone.

“Yeah, Cindy, the doctor said I could leave but not go home yet. Can I crash on your couch until my next spinal tap? I’m sure the pressure will stay down if I just rest like I do here. I think he’ll let me go to Mom and Dad’s, if I can hang out at your house for about a week. Is there any chance you could let me do that? I’d want you to ask Jack first, though.”

“I don’t need to; he likes you, but I’ll ask him first if you insist.” Cindy giggled. “I know the baby will be thrilled. One more adult to play with, you know?”

I pictured little Jessica’s never-ending smile. I’d enjoyed babysitting her when she was just a few months old. Now, the baby’s fast-track to walking occupied her daylight hours. I hoped my eyesight would improve enough for me to help care for Jessie while I stayed with the family.

Late that afternoon, Cindy came to direct my parents to her home. I still had the painful spinal taps—two more for the week I’d spend at Cindy and Jack’s—on the schedule, but this move got me one step closer to regaining my normal life.

*Name changed