Defibrillator Man, Gunshot Guy and Dr. Slick

Me: Can I take my appendix home with me?
Nurse: No, no. If it comes from the body, it goes to pathology.
Me: Did I creep you out by asking?
Nurse: I’ve heard it all and seen it all. I once had a patient covered with swastika tattoos tell me he didn’t want a nigger to touch him. I say to him: Would you prefer death?
Me: God commands us to be colorblind
Nurse: This is what I think. He doesn’t exist.  I am from Africa. There is no explanation for the suffering of children you see in the third world.  American people don’t understand suffering. We quarrel over the smallest things.

Then she wheeled me into the operating room.

Last Sunday I woke with tenderness and discomfort in my lower right abdomen which spread outward during the day and grew more painful to the touch.  My belly began to distend.  As someone who goes to the doctor about once every 25 years, my first instinct was to wait it out.  Then I remembered my friend Paul.

Back in the aughts, he went to an ER in Los Angeles presenting with abdominal pain.  After a few hours, they sent him home with antibiotics and some medication.  His pain worsened. In the morning he returned to the ER, jaundiced. Overnight his appendix had burst and peritonitis had set in. They intubated him. A comic writer and actor, he entertained everyone with jokes on a small whiteboard. Five hours after walking in under his own power he was dead. His fiance was 7 months pregnant.

Mrs. UpintheValley remembered Paul as well and insisted on driving me to Valley Presbyterian which is how I came to lay in a gurney at 2 am listening to Defibrillator Man on the other side of the curtain bellow at the nursing staff for more Oxy 30.  D-Man is what is known in the medical trade as a frequent flyer. The fire department wheeled him in, along with his garbage bags, complaining of heart palpitations and squeezings and whatnot.

“It’s my own faults for skipping dialysis this week.”  He smoked Newport 100s up until his first heart attack.  He’s had four. Now he wheels his own defibrillator with him in his wanderings around the Valley.  Prolonged litigation ensued with the nursing staff over which arm to put the saline drip.

“Not the left. That’s where all the hard veins are.  You’ll never get the needle in. You have to use this one over here. It still good.”
“That one won’t work, sir.”
“You telling me I don’t know my veins? I asked for my Oxy 30 an hour ago!”

It had been about five minutes. This argument recycled itself.  There was a wet splash on the linoleum and a satisfied groan from D-Man.

“I told you so.”

Against my nature and my politics, I sympathized with him more than I should.  Pain changes you.  So does addiction.   It was not my finest hour, nor his. We were two men of similar age but very different lives separated for the moment by a wisp of curtain.

The nurse poked his head in to give me the results of the CT scan: acute appendicitis, not yet burst.

“I’m going to give you some morphine now. How much would you like?
“As little as possible.”

As little as possible flattened me to the gurney. For a precarious moment, I was Ewan McGregor falling through the carpet in Trainspotting.  A flash of paranoia: in all the mishegas they must have given me Defibrillator Man’s dosage by mistake. Yes, I must be O.D.ing. This is what it feels like. I am about to be a cautionary tale at a local nursing school. “This is why Kevin is working retail now…”

But no, it was just morphine doing what it has done for centuries.

They brought me upstairs to a private room with 12-foot ceilings and a window facing south, protected from the sun by a run of trees. Quiet as a monastery. Pleasingly asymmetrical. I was on the second floor of one of the two original circular pod towers designed by William Pereira in 1958, a groundbreaking innovation at the time.  The charge nurse was astonished to hear me praise my accommodation.

“Usually I have to apologize for putting anyone here. People hate this room. It’s too small. They prefer the new annex building. The bathrooms there are about as big as this room.”

What can I say? It was bigger than my bedroom. There were no bright lights and annoying beeps, no moaning effluence two feet away.  I was in God’s Hotel.

Valley Pres at its booster-ish conception was the epitome of mid-century modern cool. It was also, like the freeway system and the water pipes, woefully inadequate in size and scope for the city it served. A street grid for over a million people had already been laid across the Valley, and everyone pretended a hospital of this size was sufficient. Permits were easy then, planning negligible.  A third tower, twice as tall, was added in 1966, then support buildings, parking structures, the annex. Today the original building is stripped of its iconic metal shutters that kept the sun off the windows, a forgotten starter home dwarfed by larger McMansions, barely visible from the street.

Gunshot Guy was on the gurney to my left as we waited for our turn in the operating bay.   He lay fetally on his side, his foot poking out from the blankets, wrapped in a rugby ball-sized swath of bandages.

“Are you on cocaine right now?  It’s okay we don’t judge.”
“How much cocaine did you take?”
“How much heroin are you using?”
“Is that daily? The anesthetist needs to know before we operate.”
“We can remove the bullet, and reset the bones, but you will have difficulty putting any weight on it for a long time.”
“We have a physical therapist to help you re-learn walking.”

Gunshot Guy mumbled his responses from underneath the blankets.   The double doors opened and they wheeled in an obese woman, who recited her list of surgeries to a captive audience of nurses as though a reality show film crew were in the hallway with us, recording her every word.  First had been her ankle, then her hip, then her back, and now her neck. The injustice of human frailty was ascending her body like a clan of mountaineering trolls.

“This is so unfair. I’m only 48 years old. I’m too young for this shit.”

At this juncture, the African nurse bent into view to tell me with perfect colonial grammar and a baroque accent she would be shaving my groin. I wondered if she would use a straight razor. I considered all the comedic possibilities of my testes and Murphy’s Law.  Her face was filled with exactly the compassion one seeks at such a moment, and it was here we had our lovely conversation about God and suffering.

I was in the best hands, she assured me. Dr. Slick would be attending to me.

LBJ and his gallbladder scar
The day after Dr. Slick

I had heard of Dr. Slick from the E.R. nurse the night before. Also from the floor nurse upstairs and the attending physician. How lucky I was to catch him!  They all said how fast he was, a virtuoso with a laparoscope.  My only association with speed and medicine was Dr. Nick Riviera from The Simpsons, and the creepy lobotomist in the film Frances, so it was a relief to be greeted by a guy who looked like an accountant but had a roll in his step like a professional athlete.  I was easily his most boring case of the day. He would be going through my belly button and a 5mm opening on my left side.

“Count backward from 100,” they said once I was situated on the table.  I decided to recite the Lord’s Prayer instead. I got as far as “our father, who art in…”