This is the end, and a beginning. My Health - Part I


"This is the end, beautiful friend, this is the end. . . " 

The story of my health - Part I

I generally like to quote literary or historical figures, but on occasion I allow for a bit more reality in appearance. And it seems to fit here. 

      Most of the stories in this section are based on my time in the restaurant business but it occurred to me that I haven’t gone into any detail as to why I am no longer in that business. I thought I would take a little space to tell you about some of the more entertaining parts of a very difficult situation. 

This idea was brought about by a now annual visit to my primary care doctor. A doctor who shows as little interest in seeing me as I do in seeing him, at least that’s what his face tells me when he enters the room. I am not aware of anything that has transpired between us to create any disdain or dislike but that is only my perspective. His monotone speech, delayed sentence structure and limited interaction may be merely representative of a doldrum personality. And as I consider myself an above average conversationalist, this really pisses me off. I believe I can drag a dead cat into a better discussion than my doctor, and I don’t like cats.

It was just over four years ago that I quite literally stumbled into his office. The pinnacle of a developing health issue that refused to be ignored any longer, no matter how hard I tried. And no matter how many people told me to get some help, having no health insurance at the time, being excessively stubborn,  I was reluctant to open that particular box of pandora’s in hope that it would take care of itself.   For the record, I was wrong.


One of the on going discussions and eventual divisions among my friends encircles my arrival  to this point. And I also mean that in a very literal way. My arrival at the doctors office, and eventually the next drop off point.  I finally made an appointment for the Wednesday after labor day since I was unable to get out of bed for more than 10 minute periods over the weekend.  I would walk to the end of the hall in my apartment to take a shower and be so exhausted when finished that I took a four hour nap. Not only was I unable to stay on my feet or stay awake, but anything going in me was reversing it’s path soon after. I was even returning the water I tried to drink. This was bad even for the “Italian Mom” standards that I grew up with. 

“You’re fine, go outside and you will feel better” 
“Walk it off, I’m busy” 
“You’re going to school today, I have too many things to       do around here”
“Stop all that yelling in there” - when my brothers (6 years older and 100 lbs. heavier) were tag team wrestling me the family room. 
I can remember falling off my bike racing down a hill one day and watching both wheels fly out from under me as I crash to the ground. I was about 10 years old, and the mention that we might have to go see a doctor to stop the bleeding was highly unnecessary and interruptive.  

My friend Ned agreed to take me to the doctor based on my concern about driving. I couldn’t see shit that Friday on my way home and I knew I was a danger to myself and others. I didn’t open o’Bagelo’s on that Monday or Tuesday and I had the staff run Baked & Carved. Ditto for Wednesday. Ned picked me up as he had a little more freedom with his daily schedule. He was leaving on a trip the next day and had some running around to finish up before he left. He waited in his car catching up on emails while I slowly crept up to the office. 

After a few minutes (I think) in the anterior office the nurse called me back into one of those little rooms. She sat me down and took my temp and blood pressure. She glanced up at me and and  re-inflated the cuff. She excused herself immediately after that second reading and said she would be right back with the doctor. My doctor came in within a minute and looked about as hurried as I have ever seen him up to that point or since. He also took a blood pressure reading twice. He was staring at my face while the cuff inflated and as soon as it was done, even he had a small expression on his face.

“Your blood pressure and your coloring tell me you need to go the the emergency room right now. I should call an ambulance but if you have a ride and promise to go directly to the ER, I will agree not to put that additional cost on you.” He knew I didn’t have insurance and that gesture seemed quite thoughtful at the time.

“From the readings we took you are at severe risk of a stroke, and frankly I’m not sure how you walked in here. My BP was well over 200 for that upper number, and over 140 for that lower number, well over.  I called Ned while the doctor called the hospital and we arranged both ends of the transport. He gave me a stern look and said you have to promise me that you will go directly there. “If you go home there is a pretty good chance you will not survive.” I was getting the point but I’m sure my physical appearance suggested I might be a tad noncompliant.  Combine that with how far I had let this go, throw in the possible inability to comprehend him with my fragile state, and I now understand his attempt at a threatening expression.

In hindsight he may have been taking on a large risk by letting me walk out on a promise. What if I didn’t go and didn’t make it? Would he have been liable for a risky decision? I am still not certain how he let me walk out of there. Maybe he just didn’t want his other patients to see a stretcher coming in and out of the back office. That can’t be good for business.
Ned was waiting for me right outside the office even after being scolded by a security guard to move his minivan (The original metaphor would work really well here if it was blue, but his "bus" was gray). When he got my call asking for a ride to the ER, he probably figured the situation was more serious than either of us believed. So I slowly climbed into his chariot, a chariot by the way we recovered together when it was stolen one afternoon. I made two phone calls on the way to the ER to inform a few someones where I was headed. First to a family member that I knew would complete the informal phone tree. The second to the girl I was dating. She had suffered over the weekend trying to help me out and pushed for me to seek any form of medical help. I thought it would be nice to let her know she was right.  She also worked across the street from o’Bagelo’s  and I knew that she would tell my friends in the neighborhood  why the store was closed. 

This is the specific moment where the division of my friends developed. Ned pulled up to the emergency room parking lot and asked me if I needed anything. I told him I thought I was fine and got out of the minivan and headed through the doors of the ER. He heard me make the calls and figured someone would pick it up from there. Later he told me he waited until I enter the building and then went about his day.  I walked up to the ER window and they were waiting for me. A nice woman gave me a clipboard and I started to fill out some information but before I could get very far someone came from behind those secretive doors with a gurney and called my name. I remember sitting down with my clipboard on that bed, but after that it’s just one big blank for a while.  It must have been time for my nap as I was awake for over 2 hours at this point, I think, and did more walking than I had for days.

Apparently leaving someone that sick at the emergency room parking lot and letting them walk in on their own, especially based on what followed the next 25 days, was enough to cause more than a small chasm among my friends.  

“How could he just leave you there?!!” 

“What is wrong with him?!!” 

“WHO does that?”

“ Does he have any empathy whatsoever?!!” Etc, etc., etc. 
I don’t need to remember the voices of my friends Joe and Margaret as they remind me using the same tone every time they hear his name, with the same amount of shock. Every time.

         And this continues to this day.  Recently Ned told me that when I got into his car, on both trips, he noticed an odor that he could only associate with the smell of death. I never asked him if he had a reference point for this statement but he seemed pretty certain of his metaphor. This only added to the anger and frustration with the the other group of friends. 

The next memory I have is waking up in a hospital bed with lots of machines and lots of action. A woman sat in a chair on my right and was staring at a dresser size piece of equipment with lots of tubes ands lights and noises. She was watching that machine with great intent and seemed very uninterested in my sudden consciousness. On my left was another chair and I’m pretty sure it was the family member that I had called on the way to the hospital. 

I was awake now and stated to get a sense of what was happening. Mainly because of the constant flow of medical personal in and out the room. I couldn’t tell you how long I was unconscious but backtracking I can figure out a few things. My doctors appointment was at 10 am. I wasn’t there for more than 10 minutes. I had learned that there were a few people out in the waiting area and they would only let one person (and that person had to be a family member) into the room at a time. I had learned an Uncle was sent there by my paralyzed father to check on the situation and report back, as my father was unable. One of my brothers was there also, which was interesting as we hadn’t spoke in about 2 years. The possibility of death changes those things.  And of course the girl I was dating was also in that outer room. Oddly, she hadn’t met any of the family members, as I often figure that is a disaster for any possible relationship. 

The effort to get in touch with all these people and  get them to the hospital would not have been an easy task, even with our technological advancements today. Several of those mentioned are prone to not answering or responding to phone calls in a timely fashion, especially from family. My best guess was that it was between four and five in the afternoon. 
I attempted to ask the woman staring at the machine but she wasn’t interested in having a conversation with anyone.  One of the higher level medical staff informed me that I was in ICU and hooked up to a dialysis machine. They had put a port into my chest that went directly to my heart, and I had a few IV’s hooked into my arm. All in an attempt to clean my blood of the build up of toxins.

It’s still unclear to me how much information was being passed on to me or how much I was comprehending. I think I was pretty happy to be awake and to know that something was being done about whatever had been the cause of my spiraling health. I’m not sure how much they knew other than my kidneys were not functioning at that moment and long enough before to turn me a dull yellow.  Cause uncertain.

I began to have conversations with those that were in the room and those through the revolving door. Family was starting to take turns coming in to get a visual image to add to the doctors information. This they would report back to their protective sections of our sorted clan.  Medical staff was in and out to check on any additional damage after I awoke. As so much time had passed I am guessing that this wasn’t the first time in the room for any of them. A quick check on my mental state and ability to communicate and they were back in the outer room certainly projecting the outcome of my fate amongst themselves. 

A short while after all this came to light (and a short nap I think), I could hear a commotion out in the anteroom. O.K., maybe not a commotion but certainly some sort of discussion that appeared to end with the entering of two friends who were still in their business suits. My memory has an image of the two of them pushing open two swinging doors and charging in with a conviction I had not seen in any of my other visitors. The body language and facial expressions made a quick change when they took in the vision of me in that Intensive care bed hooked up to some machine.  For the first time I had a complete sense of the severity of my situation. 

I have never seen the look that either of their faces morphed into, prior to or since that day.  Now even I was worried. After a few stumbling moments of conversation, they were able to pull themselves together and attempt to cheer me up. You know, the usual things like. “Holy shit, you look like crap, even more so than you have been.”  “Jesus, you look worse than the rumors we heard.”  
      
       They both smiled as Joe started to tell me that if anyone asked, they were both family. The commotion outside was the medical staff trying to withhold any details of my health and inform those two that only family members were allowed to see me, further enhancing their concern. When the woman protecting the door asked if they were family, Joe immediately placed his hand over the others chest to stop him from talking and confidently told her “Of course we are family”. They came through that door moments later, before their status could be confirmed with the others in the outer room.   

There was no way for me to know how much of an impact that decision would have on the rest of my recovery until many months later. The combination of the time spent and their great ability, put into research and communication greatly aided my recovery and my life after my month long stay in the hospital. When they left the room the woman who had encountered  Joe and Jon at the door came in and checked on a few medical issues but quickly asked if it was O.K. that she let those two in and if they were family. I smiled and said it was fine, and that they are both lawyers so it was best that you let them in. 

There is much more to the days between that moment and my eventual release 23 days later but this is really about my doctor and that last day of confinement. One of those friends that barged the through intensive care doors that day had found an an option for insurance for someone with a pre-existing condition (A preface to the Affordable Care Act) and the girl I was dating had helped me though the long application process. All of this was necessary for the hospital to release me. I had to have some insurance and a placement in an outpatient dialysis center or they couldn’t let me leave.  As the policy wasn’t going to start until the first of the month, both the hospital and I had to play a bit of a waiting game. 

I became accustomed to the same doctor doing his daily check on my now stable condition as we waited for the insurance approval and then the end of the month. I had become a resident of the floor and many of the staff would stop by and say hello or just check in on any needs I might have. One nurse came by every evening with hot tea, no matter what set of rooms he was assigned to that night ( I will expand on why in a more in depth post concerning my stay).

On the day before I was to be discharged the hospital doctor came to see me as I sat in one of the social rooms on the floor. He was giving me my last set of instructions for departure including contacting the dialysis center, getting  my medications downstairs at the pharmacy, and  making an appointment with my primary care doctor within a week for a follow up visit. 

I wrote everything down and when the doctor was sure it had all sunk in, he turned to leave the room. I looked up and saw that he paused and turned back in my direction. A smile creeped onto his face as he hesitated to speak.

“I probably shouldn’t tell you this, and normally I would not, but I think you will take this the right way. When I called your doctor to tell him that you were going to be released and would be making an appointment to see him, he responded with a little surprise in his voice.” 

“That guy is STILL alive?”

The doctor in my presence paused again and when he saw that I was smiling he turned away and left the room. 

Four years and many, many visits with the same primary care doctor later, I decided to try and crack him. Either I would make this guy show emotion or connection with me or I may have to find a new doctor. I decided I would confront him on this issue in person and gauge his response. I reiterated the story of my departure from the hospital and as I started to get to his reported remarks he became a little flush. When I had finished, with the qualifier that I neither wanted a confirmation nor a denial on the matter, he was full on red faced and smiling. “AHA!” I thought, maybe I broke him! His words were denying any memory of the interaction but his face was telling a different story. 


A few minutes later we both left the room to finish up the annual visit. He walked down the hall ahead of me and  I heard him say over his shoulder, “ See you next time. I’m glad to see your still alive.” Looks like I will stick it out with him for another year. 



3 comments:

  1. Say what you will Joe and Margaret. . . Ned was there, when needed and did what needed to be done. If more was needed, he would have done it. It's the way he is. He gets done what needs to be done and reconciles his own duties in the process with efficiency, diplomacy and tact. Maybe there is a course online on how to speak "Ned". . .

    ReplyDelete
  2. Aside from all of that. . . we are both so glad you are still with us John!

    ReplyDelete
  3. Copied from and email that was sent to me. Some problems posting. Hope this isn't an issue on the site..

    "I wanted to respond to LT leni - something like this -
    As Ned's mother, I thank you for being so insightful about Ned. Who knows how any of us would react in such a serious situation - there may be reasons why one might appear to be paralyzed or uncaring. This I know. Ned Kelley cares deeply about John Vito. He greatly values his friendship and there is nothing he would not do for his friend. And, I also know that John is more than worthy of such devotion.

    All the best John. I think of you often and pray for your health."

    ReplyDelete

What did you think of this recipe or story?