The Bright Side of Almost Dying (Part II, Nigel and the Jamaicans)

So Dr D left my ICU room, leaving me alone for the night.

Or so I thought.  It became abundantly clear, over the next few days, that there was a note tacked to the doctors’ lounge bulletin board saying, “Y’all? You ain’t gonna BELIEVE the what the guy in ICU 4-B has! Go check it out!”  Granted, I had far more docs on my team than just Dr D the urologist/surgeon (“The piss doctor,” as he described himself (I think urologists sometimes have an inferiority complex)).  We’ll get to them later.  But I’d lay odds that I was seen by at least 30 doctors, and I mean “seen” because they just showed up to take a look at my poor, 25% off nardsack.  I understood the plastic surgeons, of course, but the OB/GYN? The pediatrician? I’d swear there were even a shrink and a podiatrist who came in for a peek.  In whatever bar doctors congregate, I’m sure my poor nardsack was mentioned.

I should’ve charged admission, quite honestly.

My parents had endured a truly taxing Friday, with both of them driving an hour up, then waiting while their son was cut upon and treated for a truly nasty infection.  They hung out awhile in my room, ascertained that I was in good hands (and kinda trippin on the meds and residual anesthesia), then they went home for a rest.  I had my Power Book with me, and St Anthony’s had wireless broadband free for all of us guests.  Yay.  I was quickly introduced to my two night nurses, both of whom were Jamaican by birth.  They were hilarious, kind, and as much fun as nurses can be in ICU.  They brought me a sandwich and Diet Pepsi, since I hadn’t eaten all day.  They brought me a pitcher of icewater.  They brought me a blanket when I needed it, and got me a fan for my room.  They were like two smiling angels…

…until it came time for two words I grew to dread: “Dressing change.”

Sadly, a dressing change did not involve switching from 1000 Island to Ranch, or from cornbread to oyster stuffing.  It involved changing the dressing on my wound.  How bad could it be, right? Take off the old bandage, and put on a new one.  Maybe make sure the stitches were holding up.  No problem.  The problem is, I didn’t have any stitches.  There wasn’t enough left to stitch together.  Plus, my nardsack, although cleared away of the bad bits, was still somewhat distended.  The dressing change was a four-step process.  They had to untape and remove the giant gauze pads covering the wound.  Logical.  Then they had to remove the two giant rolls of something called Kerlix, which is gauze impregnated with a “biocide” solution that helps “prevent colonization.”  These giant rolls were not wrapped around anything, but packed into my nardsack whole.  Two of them.  Like two Ace bandages rolled up and crammed inside.  I didn’t know this when we began my introductory dressing change (probably about 0300, Saturday morning 22 Dec 07).  Once the two rolls of Kerlix were removed, they soaked two new rolls of Kerlix in saline, then stuffed them inside the wound (step 3).  Step four was recovering the whole area with gauze, then taping it down.

Freaking.  OUCH! Beyond the whole “being stuffed like a turducken” thing, there were two added bonus factors that made this all the more horrific.  First, there was one little nerve left exposed toward the bottom of the wound.  Anytime something hit that nerve, pain shot up my body and out my head.  The second fun part was that for them to get access to my woundpit, I had to roll over on my left side, grab onto the bed rail, and hold my right leg up in the air, like some sort of gymnast-pornstar.  My Jamaican soul-sisters got faster during my ICU week, but there was a learning curve.  For ten minutes, I had to hold my right leg in the air while they swapped everything out.  Yow.

The comedic part is that this procedure was just so off-the-chart awkward, it had to be funny.  It really was.  It didn’t hurt as much as it would have if I’d been able to see what they were doing–except when they hit that nerve, of course–and there was physical comedy in the entire set-up.  Over the next day or two, we developed a great routine.  About 30 minutes before dressing-change time, they’d come in and bring me two Percocets, and tell me to start pushing my button.  Wheeeeeee! It was like reverse rehab, with the medical staff TELLING me to do drugs.  Yay.

The height of hilarity during this procedure came when the Jamaican-born New York nurse had to run out to get another roll of Kerlix, and Jamaican born and raised nurse sat there, helping me hold up my leg.  The lights were on for the change, and she and I were chatting amiably about something, when all of the sudden she burst forth with, “Oh my God! I can see your testicles!” I pointed out to her that she had four kids, so it was likely she’d been acquainted with testicles before.  “No, silly.  I’ve never seen them in the open before.”

I don’t blush anymore, in case you were wondering.  I think that was the end of embarrassment for me.

Finally J/NY got back with the Kerlix, and she and J/BR were able to stuff me back up, leaving me to watch an anime marathon on Cartoon Network’s “Adult Swim.” (Anime on Class II narcotics rawks, btw)

On Saturday evening, after two dressing changes, a strange doctor came a-calling.  We’ll call him Dr P, both because he was a plastic surgeon, and because he became pissed during his visit.  This was a couple hours after my most-recent dressing change, and Carrie was up visiting.  He asked her to step out, which he didn’t need to do twice, and after she fled, he lifted up my gown and asked me to roll over.  He removed my dressing in a less-gentle manner than J/NY and J/BR did, and bent down low to look at my wound.  “I was afraid of that.  I don’t know why he didn’t take more.”

Gulp.

Turns out, Dr P was annoyed that Dr D hadn’t “debrided” more of my poor nardsack.  I felt like I’d done something wrong.  I didn’t know what was happening, only that J/NY and J/BR had to come back in, and we did our odd little ballet of pain and gauze.

That Sunday, 23 December 2007, was MRSA day in room ICU 4B.  When I was all the way back in the ER that Friday, the cheery nurse had cheerily taken several vials of my blood, mixed some of them with various chemicals, and left with them.  These were for cultures to see what sorts of evil stuff was running through my system.

I don’t know what happened, but they’d neglected to do the MRSA test on me when I first checked in.  Probably seeing whether I was going to be around long enough to waste the agar.  On Saturday, a nurse came in and said she had to do a “mersa” test on me.  I thought she said “Murtha,” as in the Congressman from Pennsylvania.  I’d read about MRSA, but I’d never heard it said aloud.  Anyway, while testing me for ABSCAM-implicated Congressman cooties, she got out a big Q-Tip, and said she was going to swab the inside of my nose.  “You may feel some discomfort.”  I just looked at her with raised eyebrows.  “Oh, no. Not discomfort!” She and I laughed.  She could’ve stuck the thing all the way up through my brain and out the back of my skull, and it wouldn’t have made me any more uncomfortable.

Apparently, the only way to protect my visitors from either MRSA or Rep Murtha was to require everyone to don masks and gowns.  This was funny.  Truly funny.  My friend Bill came, and brought me a little Christmas tree.

I took a picture of it, and used the Power Book to process the image so it better resembled what I saw.  I don’t think Moses’ desert bush was glowing more than my tree.

Anyway, when Bill brought the tree, one of the other nurses stopped him. “You can’t take that in there.”
“Why not?”
“Because he’s under quarantine.  If you take it in there, you can’t bring it back out.”
Bill barked back at her, “Lady, why the hell would I bring him a Christmas tree, then take it with me when I left?”

She grimaced at him, then made Bill put on a gown and mask.  Bill was a Drill Sergeant in the Army.  Remember “Full Metal Jacket?” That was Bill, except he looks more like Mr Clean mixed with Dwight Eisenhower.

My parents came to visit, and gowned up.  The only real ICU rule was that I could only have two visitors at a time.  I had two parents, and multiple friends showing up throughout the day.  Thus, my poor dad had to put on and remove his gown, mask, and gloves at least four times.  The good news is there was a Starbucks downstairs, and whenever he was displaced, he’d bring me coffee, after watching a quarter of the football game.

Around 1600 Sunday, the result came from the lab: John Murtha would not be bothering me.  Yay! Also, I didn’t have MRSA, which would’ve been almost as bad.

Before I knew it, it was Sunday night, and I was being given a sandwich and water, and being told that I needed to be done by midnight, because they’d be taking everything away after that.  “Why? Why take my water?”

“Because you’re going back into surgery at noon tomorrow.”

I called my parents.  “Oh, by the way, I’m going back into surgery at noon tomorrow.”
“Why?”
“I guess they realized they missed something.  Or this is how Jewish urologists celebrate Christmas Eve in a Catholic hospital.” No matter how sick, in pain, or drugged up I was, I never lost my ability to be an insufferable smartass.  Or to screw around with everything in sight.

I’ve always loved gadgets.  If there are buttons to push and switches to flip, I’m amused.  Thus, I was constantly fiddling with my bed.  This thing was awesome! I was able to raise and lower different parts of the bed, just to customize my discomfort into new and exciting shapes, like Gumby.  There’s were two buttons on the controls called “Trend.” and “Rev. Trend.”  These were especially fun, because whatever shape I’d made with the bed would either rock completely forward or completely backwards.  Again, my enjoyment thereof was heightened by the still-rampant delirium and narcotics. So around noon, a grim posse of doctors, therapists, and nurses came to wheel me off to the cutting room.  Between the five of them, they probably had 30 years of college, but they couldn’t get the bed to roll.  This one guy was pointedly angry about things; apparently, he’d come especially to wheel me away so he could watch the surgery or something.  He was stomping on the brake lock, then stomping on the brake release.  He hissed at one of the nurses that she wasn’t stomping on the brake release hard enough, and she hissed back that he was a doofus, and that her side was unlocked.  The one person uninvolved in this debate was the patient, who’d read everything on the bed (as well as the constantly changing flashing ceiling tile words), and knew that the bed would not roll unless it was completely flat.  I finally hissed at Murse Grumpypants, “Stop for a minute.” I calmly pushed the “Trend.” button.  The bed flattened, and we were (literally) ready to roll.  He humphed, apparently disgruntled that he hadn’t found the solution.  “For some reason, the bed was in a Reverse Trendelenburg position .”  He seemed suitably chastened; I was ready to be rolled away, plus I’d learned a new vocabulary word.

Away we went, me being rolled importantly through the brightly lit hallways like a parade float.  My nurses waved at me, and I waved back.  We got to the OR, and they wheeled my bed over next to the operating table.

The operating table was about as wide as a tongue depressor, or so it seemed to my whacked-out senses.  I am a very tall, wide person.  This was like a Surgical Barbie operating table.  I had to scootch over onto the table, which was a definite labor in my condition, and yet I didn’t let go of the bed.  “Let go of the bed, Tom.”
“No.”
“You need to let go of the bed.”
“No, I’m not centered.  I’ll roll off the table onto the floor like the meatball in the song.”
“What? Let go of the bed.”
“Fuck that.  Sorry.  Fuck that, sir.”
“Would it help if you moved over a little bit more?”
“Yes, sir.”
“Let’s try that, then you can let go.”

I did.  As soon as I was centered, this guy set a mask on my face.  I was out like brown trout.

Somehow, I skipped right over the post-op room.  My guess is I was there, and they pulled another tube out of my throat, then they wheeled me back to my new home in ICU.  Carrie was there.  My pain-med machine was there.  Life was good.

Except that nobody had bothered to tell my parents and brother that I’d finished surgery and post-op and was back in my room.  They were a little chagrined I think when they came in to find me eating a popcicle while Carrie and I watched “Christmas Vacation” on the little TV.

“How did it go?”
“Couldn’t tell you.”
“How do you feel?”
“I’m enjoying the popcicle.  Let’s leave it at that.”

It was Christmas Eve there in ICU 4-B, and Carrie had to leave to go to candlelight service with her mother.  My parents and my brother headed back to Sarasota to do the same.  I was alone.  Utterly alone, in pain, and sick as hell.  The weird thing is, I hadn’t worried during my hospital stay thus far.  I still wasn’t, really.  The meds helped, as did the delirium.  The infection didn’t seem to be spreading.  They did frequent blood tests, and the nearly constant antibiotic IV’s seemed to have stopped the infection’s spread, and maybe they were starting to beat it back.  That night was the first time I’d really felt alone.  J/NY brought me some Percocet and told me to start pushing my pain button.  I chewed up the Percs, just like when I used to take them for fun years ago, and I tapped out my Morse code on the Dilaudid drip.  I turned into wet sand.  J/BR stuck her head in and said, “T’ree minutes, hon.” I waved.  I wondered how the hell I was going to get through this thing–first dressing change after the new surgery–and that’s when Nigel reassured me that everything would be fine.

Nigel was my right middle fingernail.  For whatever wet-brained, infection-addled, panic-stricken, drug-induced reason, my mind hallucinated that my right middle fingernail was named Nigel.  A big, rough-housing yet kindhearted, rugby-playing English soul.  My right fingernail.  Nigel.  The reassuring Cockney presence.

I laughed my ass off.  J/NY and J/BR came in for the dressing change.

“Are you ready hon?”
“Yes, ma’am.  Let’s do this.”
“What are you laughing at?”
“Life is good, m’dears.  Let’s change my stuffing.”

I was still chuckling to myself as I rolled over, grabbed the rail, and stuck my foot high in the air.

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16 Responses to “The Bright Side of Almost Dying (Part II, Nigel and the Jamaicans)”

  1. I wish I could hallucinate that my fingers were cockney rugby players… Some guys get all the luck.

  2. I'd rather have hallucinated Emily Deschanel or "Sirens" era Portia De Rossi, to be perfectly honest. Still, I made it through, so I owe Nigel one. lol The whole thing sounds ridiculous looking back, but it was as concrete a realization as the fact that it's cold or how to shift from second to third gear.

  3. That must have been a lot of fun. I never even heard of that disease, Just as well. I'd have had permanent nightmares.

  4. I'm glad you had Nigel and the Jamacian Nurses to help you through your ordeal. It sounds like a nightmare… but I'm glad you made it, vox wouldn't be the same without you.

  5. Yikes. Reminds me a little of my first child… I had a doctor in training, who was almost certified to practice on her own, supervised by the real doctor, and 3 nurses, cause i was the only one in labor… so I was the one that everyone came to look at. With my 2nd there was a male nurse in training for the maternity ward, so another nurse was showing him where to press on my stomach… what to poke etc… wheee. At some point, you're in so much discomfort, that you cease to care who is looking at what! Hope all is allright with you now tho!

  6. Nigel!!! I love it!Your wonderful brain is one reason you survived! Those little twists, turns, actually, the twistedness of it! The humor. Well, none of us would survive without it. You are one tough customer, t!!!

  7. *Points up at your banner* BUGGIES!!!

  8. Peptostreptococcus, ftw!Dr Bugman, the infectious disease guy, was giddy with schoolgirl glee one day when he came into my room smiling and saying "Peptostreptococcus." That was one of the bugs partying in my toxic bacterial ballroom. (that last pun was just for you. 😉 )

  9. Heeee! That was one of the bestest puns eVAR! Toxic Bacterial Ballroom. It bore repeating! :)Peptostreptococcus is fun to say, not fun to have running amok in yer works! 😦

  10. Another one that is fun to say is one we isolated in our Micro lab. Burkholderia Pseudomallei. It's a lvl 2 bioterrorism organism, so we all had to take Rifampin and Doxycycline for six weeks and have antibody levels done to see if any of us got exposed. None of us did, yay, but one of the rules was no drinking while taking those drugs, so we all had to take a day or two off to go have some beers during treatment. Bad. Very bad. 🙂

  11. I was on IV Vancomycin, Flagyl, and one other IV antibiotics, so beer was definitely contraindicated. They thoughtfully provided narcotics, though. Perhaps you should've asked your taskmasters for a scrip of Demerol, just to smooth away the rough edges. 🙂

  12. Burkholderia Pseudomallei.It's a lvl 2 bioterrorism organism Btw, what the hell is going on in rural Michigan these days? At least here in Florida, we just shoot each other and move on. 😉

  13. I do believe the person we found it in had been in SE Asia 30 years ago. Funny how those bugs can travel!

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