Tuesday, December 30, 2008

not myself

“This is not me,” I tell my husband. I have been crying, loudly, with choking and spasms and caught breath, for an hour, since he came home to tell me that no one called in my pain prescription refill.

These days it’s hard for me to solve problems without first sucking lots of air through my teeth, turning red, and shaking. Yesterday, I got a lab work bill for $300—something that should have been taken care of by my insurance. But a computer glitch defaulted to some ancient policy, despite my having given the tech my card and license and waiting for him to make a copy. So I went through a few histrionics before calling the billing department. The problem was solved easily, painlessly, and immediately.

This inability to deal without a prodrome of drama began the other day, after I had my staples removed. Thanks to the marriage of technology and networking sites, I was able to gross out a few of my closest Facebook friends with Serena’s home video of the procedure. But I haven’t been the same since. Maybe it was the subsequent car ride that wrecked me. Or perhaps I twisted excessively while trying to put on my underwear. Never take for granted the putting on of underpants; you never know when you will need to enlist your mother, husband, or daughter to help you pull them up.

The beautiful progress I was making, back when I was annoyed by a bit of leg pain and a lot of nerve damage in my left foot, has now given way to excruciating stiffness. I’d stopped taking pain pills during the day, going ten hour stretches with not so much as an Ibuprofen. By the end of the first week, I could pick up my guitar and sit in a straight chair for twenty minutes to strum it. I could pour a glass of water, and stand up from sitting on the toilet without holding onto my legs.

Now I can’t lean slightly to raise a glass of water from a table. My back is arched excessively backward. Today I missed my first walk around the block in a week because I just couldn’t make it. And I’m back to taking one step at a time, both up and down the stairs, which I haven’t done since day two.

Instead of weaning off the meds, I take my maximum allowable dose. Anyone who knows me knows that this is not me.

Yesterday morning, I called my surgeon’s office to ask about a refill. I was nearly out of pills and had begun rationing them, bargaining with myself about how to manage the pain. I know that it often takes two days for the office to call in a prescription, so I sent Marty today. He returned at 4:45 without pills, telling me that no one had called it in.

The teeth sucking and shakes began while I tried to figure out what to do. I sent Marty for the phone and my pill bottle so that I could call the doctor’s office. They were closed, so I pressed zero to reach the on-call physician. A woman answered. I calmly explained that I'd had surgery and had called in a prescription, but no one refilled it, and now I'm out. She replied that if my medicine had been so important, I should have called earlier in the day. She could not write me a prescription, and what did I want her to do about it? "I want you to call the physician on call," I told her, and she said, “Yes, ma’am!” as if I were the one with the attitude. A man came on. I told him I'm in pain and out of meds, and he said that pills are not an after-hours emergency. He has strict orders to ignore patient requests for refills. If doctors can’t manage their time well enough to approve prescriptions at the end of each day (or keep patients from having to wait two hours in a waiting room), they don't want to be reminded about it at 4:45, when their office hours have ended. I can hear the conversation when he hung up from me: fuck that crazy crying bitch on the line who’s insisting that the doctor is actually supposed to work for her.

My home care nurse was furious on my behalf and tried to charm the answering service, but he had no more clout or luck than I.

So between pain and fits of ferocious spasms of tears and breaths, I tell my husband that this is so savage, so undignified: for patients to go through what doctors insist is “major surgery," which requires we suck up our disdain for mind-altering meds and ease our pain, because pain is dangerous to our mental health; and those same patients to be treated like criminals by the doctor's answering machine, the pharmacist, and the insurance company.

My hydrocodone prescription calls for 1 to 2 tablets every four to six hours. My doctor allows only sixty pills per refill. But the pharmacist, without any knowledge of the patient or her condition, determines how long that prescription should last. My first prescription, three weeks prior to surgery, contained sixty pills and instructions that would have the pills gone in seventeen days. After surgery, when Marty took my new prescription to the pharmacy, they refused to fill it for an extra week, because that's when the pharmacist determined I should be finished with the first bottle.

That's right. A pharmacist can refuse to refill a bottle of pills that, had I taken even the minimum amount in the maximum time, would have been depleted half the time, even when my condition has changed, and I am now a post-op patient. When we finally got our refill, the pharmacist decided it should take me ten days to use them, even though the instructions allow me to finish them in five, if that's what I need.

Marty says they just don’t give a fuck because it’s not their job to care. There are a million other patients out there with the same story, so they are simply indifferent. And he’s right—frankly, my dear, I don’t want them to give a damn. But that means I can take 12 pills a day, without being subjected to their judgment. As long as I'm not taking more than the doctor allows, it’s none of their business whether I’m swallowing them or stockpiling them for a night of partying when I’ve recovered, a year from now.

“I am not me anymore,” I tell Marty, sniveling, while he massages my head. I have to go to the bathroom, and I reject his offer of help, maybe stubbornly. But when I get to the top of the stairs, I see the most amazing sunset in months. I call, but he's gone downstairs, and I can’t wait. I take those one-at-a-time steps quickly back down, sling my camera over my shoulder, and pull myself back up, crying with every painful yank, until I am in the attic, and the window is open, and I’m shooting up. It's no hydrocodone, but capturing that beauty helps in other ways.

So maybe I am me. A little.

Sunday, December 21, 2008

doable things

    yesterday they carved a space in my bones
    dug out pieces of me that my own body
    had already evicted
    and now these fresh cut nerves
    can feel you on the porch
    knocking the mud from your boots
    they buzz with the open g of your guitar
    rattle with the wind
    and hum with the dog’s snore
    your breath

    I recline in the electric chair
    a post-op sentence exclusive of verbs
    except knit, purl, sit, stay, and ponder
    today the demeanor of a stuffed seat
    the way its open arms call to me
    the way its lap pats itself
    come here, bubbala
    implores me to rest awhile
    secure in a gentle
    upholstered hug

    today NPR celebrates Keith Richards
    older than my mother and still jamming
    while I can only rock a size 12
    circular Susan Bates needle
    pink plastic soundlessly
    whipping moonlight mohair
    and variegated bouclé
    into scarf-ness
    cutting lengths of yarn
    into yards of lunatic fringe.

    soon they will come for the chair
    a bittersweet goodbye
    so tomorrow I will lay down
    this comfortable wool and practice
    navigate the dogs and lighted tree
    inch closer to the miles of steps
    I’ll traverse to climb back
    into the skin of the sunset chaser
    and crow spier and the fierce doer
    of all her doable things.

    Friday, December 19, 2008

    goodnight nurse

    Note: photos are for illustration purposes only and are not depictions of actual nurses, night or day, described in this essay.

    Maybe nurses are like refrigerators. During visiting hours, when the quality of your care is on display, they are a pleasing mix of pep and sympathy. They check your IV fluids on time and change your dressing gently. And before they even walk into your room, they know your name and which leg’s been amputated.

    The night nurse is special. And morphine, while not particularly kind to the colon, is kind to the night nurse; it makes you lax when it comes to taking down names.

    But I could never forget Kathy, who entered my room with that cheery, plump smile and said, “Let’s see, you had a knee, right?”

    “Yup,” I said. My mom’s eyes bugged out. She knew what I did not: that Kathy wasn’t just pulling my leg; she had the wrong leg entirely. Mom gave her the wet fur. “No, uh, my daughter had back surgery—a laminectomy and discectomy.”

    Kathy was flustered and embarrassed. How could that have happened? She looked at the room number again, then at her chart, apologizing and promising to return after she helped the lady with the bum knee.

    When she did, I’d been in the same spot for hours, and I was beginning to brown unevenly, so I asked for some help. Kathy pushed me forward on the pad, then yanked me backward, then rolled me over, like I was some kind of stiff gingerbread cookie dough she was flattening. It hurt. I moaned. I asked if I would be getting Neurontin—because it helps me get to sleep—and she said it would be coming at ten with my oral and I.V. ibuprofen, as well as my I.V. antibiotic. The names of the medications were confusing both of us, but I was pretty sure I’d not taken an I.V. and oral version of the same drug. Well, I would be this time, she said.

    Nuh-uh. When Kathy came back, she acknowledged her mistake, said she’d had a long day. She did not have a cup of water with her, and she wanted to save some time, so she added water to the ice chips I was allowed to have, the chips that kept me able to swallow. And with water in my cup, the ice would melt, and who knew when she’d come with a replacement cup of chips? I felt a little scared. “Oh, please don’t put water in that cup. If I have no ice, I can’t swallow.”

    “You’ll be able to swallow. Take two sips of water before you take the pills.”

    “That’s not what I mean. I can’t swallow. In general. And if you put water in my cup, it will melt all my ice chips.”

    She went on and on about how it’s OK for me to have water to take pills, not understanding that my concern was that she’d not return all night with more ice chips. When I’d finished with the pills, she dumped the water out of my cup and returned the remaining ice. “That’s all I wanted,” I said with exhausted breath. “I just didn’t want my chips to melt, or I’d not be able to swallow until you brought them back.”

    Adding to my concerns that night was my insomnia. I knew I wouldn’t be able to sleep with all the nurse’s and tech’s comings and goings and the noise in the hallway outside my door, but I asked them to close the door anyway so that I could try before the Ambien arrived. Every time I did drift off to sleep, Gerald, the tech, would knock on my door before entering to check my IVs or change the bag from my drain—things for which I did not need to be awake.

    “Why do you knock?” I asked him.

    “Well, I don’t want to disturb you.”

    “But it’s eleven o’clock! I’m trying to sleep, and knocking is the thing that’s waking me up!” (I add exclamation points here, but I doubt my voice could have risen to that level of excitability.)

    Gerald says he can put a note on my door, if I prefer, but it’s common courtesy to knock before entering a closed room.

    Dude, I just had back surgery. I can’t walk unassisted, and I have a catheter. What could you possibly disturb besides my sleep?

    I had forgotten my ear plugs, but I managed to fall asleep for a moment before the IV fluids ran out and started beeping incessantly. I waited a full five minutes before buzzing the nurse. Twice. It had been beeping nearly twelve minutes when a different nurse yelled in to me that my nurse was taking care of something and would be down in a few minutes.

    I started crying. “What’s the matter with you?” she asked. How dare I.

    “Well, let’s see,” I said without a trace of sarcasm. “I had surgery today. I’m in pain. Every time I fall asleep, someone knocks on my door or lets my IV run out, and now I’ve been listing to this beeping at midnight for the past fifteen minutes.”

    Nurse Kathy came in, once again apologetic and full of excuses about her busy day and busy night. She brought my Ambien (if I’d been asleep, she’d have awakened me to give me a sleeping pill) and roughly rolled me over, while the other nurse attempted to remove my catheter. Had Kathy gotten her handiwork in the mix, I’d probably be peeing into a tube for the rest of my life.

    The pair of them threatened to cut off my morphine, too, and would have, if I’d said I was farting.

    Some time in the middle of the night, a new nurse came in. I think she was followed by the clatter and pomp of a marching band. She began erasing my board and announcing loudly that she was Nurse So-and-So, and this was her shift.

    She was erasing my hospital phone number, my room number, and all the information previously written on the white board, where most of the nurses just erased the spots after Nurse: and Tech: to put in their own team’s names. “Why are you erasing that?” I asked in my middle-of-the-night stupor.

    “This is the way I do my board,” she said. She needed to awaken me to announce her exalted presence is all. And I got her just in time to save my PT appointment times.

    In the morning, Lisa and Stephanie, the picture perfect nurses, were camped outside my door in a mini nurse’s station designed, it seemed, to undo all the damage done by the renegade band of evil night nurses and make us all believe we were simply the victims of a bad morphine drip.

    Friday, December 12, 2008

    ol' reliable

    Every day, a squirrel climbs the ornamental cherry tree between my yard and my neighbor’s. I've been spending the afternoons on the living room sofa and am often startled by movement outside my side porch door. The squirrel makes his way down the limbs to the berries at the end of the tree, right outside my window. On the third day, I started noting the time: 2:45.

    Last winter, between 3:00 and 4:00 p.m., crows partook of these berries. I remember being astounded by them while Serena and I were decorating the Christmas tree. They would let us watch them from the window— me, every day for a month or so until they'd moved on—but if I got the camera, they'd fly off. The crows have returned; 3:20 is berry time. They shoo away the squirrel, who sometimes comes back when they depart.

    Few things in this world are reliable. Immanuel Kant’s walks around K√∂nigsberg were said to be so regular that neighbors could set their clocks by his passing by their homes. But that’s a legend, like the one about Mussolini’s trains running on time.* Swiss watches are more dependable than most. Seasons don't change on time; sometimes spring and winter miss Baltimore altogether. At least the planets still revolve around the sun, which rises and sets every day, sometimes with pageantry. Mankind hasn't found a way to interfere with that yet, unless you count pollution, which makes the skies better but the air worse.

    We want to count on things, but we’re damned if we do. In my old days of cynicism, I kept my expectations low, but even that didn’t stave off disappointment. Because deep down you just want to trust even the untrustworthy things, like weather or your lover. You can rent the gigantic tents, but rain on your outdoor wedding is a bummer (it's not, however, "ironic"). You can prepare to be forgotten on Valentine's Day, as you are every year, but when there are no flowers, you feel both worthless and foolish.

    It’s not your daughter’s fault that she’s sick three days before your surgery or that your best friend, whom you’re counting on to come down from New York to help with recuperation, is coming down with something herself. But it’s still disappointing. It’s disappointing that the B and E strings of your brand new guitar—the one—buzz annoyingly, so much that the guitar has to be returned for repair.

    Right now, I’m still counting on surgery to restore the feeling to my outer thigh, my calf, and three numb toes on my left foot, as well as take the kick out of my butt, the hunch out of my back, and the hesitation out of my bladder. I’m not expecting it all right away, and I’m only asking for the minimum. I know it won’t rid me of all the pain or restore my strength or make me able to run five miles—ever again.

    I’m counting on spending the next two weeks in my living room, perched on my electric recliner, which I had counted on to be one of the most hideous pieces of furniture ever, right down to the tufted back, the antimacassar, and the dark wear spot on the seat. I was not disappointed. Every day around three, I will wait for the squirrel and then the crows. This time, I will be the unreliable one. Instead of chasing the birds and beast away by running to the door with my camera, I’ll only be able to sit there and watch.

    Unlike me, the crows will not be disappointed.

    *False. Though the railroad system was better than ever under his reign, it was spruced up just prior to fascist rule.

    Monday, December 8, 2008

    the one

    My husband is serenading me with “Angel of Harlem.” I tell him how I love this unofficial ritual, this regular Sunday morning worship of the guitar in the Miller Kitchen, as it has come to be known. (On other Sundays, I have taped the two of us doing Springsteen's "No Surrender" and the three of us playing Joan Osborne's "One of Us.) “This is my prayer,” Marty says.

    He can’t think of the words to the U2 song, so he improvises: “Snow fell on the avenue, I stepped in some doggy doo, got that shit all on my shoe, wiped it off on the carpet for you, angel, angel of Harlem.”

    Marty’s good at that—that improvisation of lyrics. He’s as quick as anyone I know and smart, too, so I shouldn’t be surprised. I count on him to replace the words to our favorite songs the way I count on him to poke me and say, “Vanagon,” every time we drive by one on the road and to exclaim, “Oh, look! Some old whore left her workbench in the alley,” every time we pass a discarded mattress. (Don’t tell him you have a weak back; he’ll ask, “When’d you hurt it?” and answer, “Oh, about a week back.”)

    My husband makes me laugh at loud—we make each other laugh out loud—so often, even when life is shit for both of us.

    As it is right now.

    He’s a teacher at a Catholic school, and I’m a stay-at-home writer with sporadic freelance gigs and 2/3 of a book advance already spent. The Archdiocese has announced the need to consolidate due to under-enrollment, so we’re shvitzing.

    The worst part of our lives right now has nothing to do with the economy. It’s my weak back, which has been killing me since summer—way longer than a week back. After three painful cortisone shots, acupuncture, physical therapy, and various forms of hocus pocus, I’m having surgery next week. I can’t drive now or for a month after, and I can carry nothing heavier than a carton of milk. Afterward, I will be able to eat, sit in a recliner, and walk. I think I can go to the bathroom but am supposed to wipe using tongs. (Don’t ask.)

    Marty works about ten hours a day, with six preps, all-day teaching, and after-school commitments. As sole driver, he also must take our daughter to her basketball practice, ballgames, guitar lessons, and show rehearsal. He must walk our two dogs, shop for groceries, and clean our house. I can still cook and do the dishes. I’ve also become an expert kvetcher, moaner, pill taker, and cryer. None of these things has enhanced my appearance, my talents, or my self-esteem, and they don’t pay.

    So I am surprised by the random kindnesses my husband shows me: the impromptu back rubbing, the chocolate donut, the lustful winks. Sure, he’s bitching a bit, but I have to let him. It might be just as awful to be the able spouse of a temporarily disabled person.

    Since I’ve been cooped up for so long—except for doctors’ appointments and Thanksgiving dinner—I decided to join Marty and Serena yesterday on a trek to the guitar store. Weekly fliers are so tempting to them; sales and giveaways and coupons litter our kitchen. This week’s includes a $29 distortion pedal and a free guitar with the purchase of a case of strings. While they were shopping, I could spend quality time with my dream guitar.

    Guitar Center is set up with a big main room full of electric guitars and amps stacked high. Every time they go, my daughter falls in love with something new. This Saturday, it was a bitchin’ black Gretsch hollow-body electric, with dual f-holes and a shiny whammy bar, which my daughter grabbed and dragged around the store with her like a toddler drags his blankie. Behind the open main room are doors to the acoustic room, where the cheap and mid-price acoustics are kept. And all the way in the back is a small, climate-controlled room with the expensive, quality guitars—mostly Taylors and Martins. A few high-priced Gibsons, Takamines, and Breedloves hang there, too (there goes the neighborhood, some would say).

    While my family was out front, I was in the back making time with “the one.” Even if you don’t play guitar, you know “the one.” It’s not exactly love at first sight; it’s more reasoned than that. It not only looks glorious (ebony fret board, mother-of-pearl inlays on the frets and around the sound hole, sexy cutaway style), but it feels good in my lap and sings like an angel. I’ve played nearly every guitar in that back room, and some are nice, yes. But none of them are the Gibson Songwriter Deluxe. I never set out to love this one. Gibson’s not known for sweet and ringy acoustic guitars.

    Ethan waited on me, and I wanted to know if this model was one of the Gibsons on sale for $500 off. It was only 10% off, but he said, “Want me to see if I can do better?” I had no idea that this worked like a car dealership, but I was game. He returned with his offer: $1,900 out the door, tax included.

    I was excited, doing head math, playing with the numbers. With credit, I could have a year, interest-free, to pay it off. I calculated. One hundred sixty a month. Some good tickly stuff coursed through my veins. But Marty was a party-pooper. Number one, he said, I don’t deserve it until I can make a Bm smoothly. Number two, we’re broke. Number three, how many guitars do we need? I’ve already got a decent Guild. And then, of course, there’s the impending surgery.

    I pouted and closed the door to the climate-controlled room. While I was fondling the Gibson madly, Serena was running through her repertoire on a curly maple Ibanez, on which she's had designs for about as long as I've loved the Gibson. She played snippets of “Crazy on You,” “Lola,” “Satisfaction,” “The Kids are Alright,” “Bus Stop,” “Surrender.” But she left in a snit when she learned she wouldn’t be taking it—or the Gretsch—home that day. A man stopped us to say what an incredible guitarist we have in Serena, so I blushed and gushed a bit, then went out to occupy her while Marty arranged to buy her that icky-sounding Ibanez.

    I found Serena kicking the carpet sadly. Never mind that since April, she has gotten a classical Yamaha and a brand new Fender Showmaster, as well as having access to my acoustic Guild and Marty’s Strat. To keep her from chasing after her dad, I brought her the Gretsch and had her plug in and repeat her set list on the electric. I like to listen to her play, but I also like to watch people do a double take when they see that a kid—a girl kid—is at the helm.

    When Marty came out, Serena became dejected once again. And I was moping, too, when we got in the car. Mostly I was tired. I hadn’t been out for this long in weeks. Marty said, “Well, you're gonna be upset, but while I was buying the amp, someone bought your guitar.”

    I knew he was lying. It had been there for months and months, and no one had touched it. Except for some string wear, it was pretty perfect.

    “Here, you wanna see the receipt?” he asked me, tossing the folded up paper in my lap. Why would I want to see that? I knew the total. I had done all the math—a $69 bass amp for my nephew, a $249 Ibanez acoustic, and a box of strings for a hundred bucks, which included a free Silvertone acoustic (which sounds better than the cheap shit Ibanez!). I heard the crinkle of paper as Marty smoothed the receipt and stuck it in my lap while he drove. The first item on the list: Gibson, $1,900.

    I cried my eyes out with joy. The tears just busted right out of my eyeballs. It was like the nicest, most unexpected thing.

    So now we’re in the kitchen on Sunday morning, singing together, and he’s changing the words, and I’m laughing, thinking how much I still love him, a little surprised that after 26 years, we still have this good thing going on. I wonder, in my defective state, how much I deserve it and the guitar. Are they both too good for me?

    I take Serena out with my mom to a craft fair and buy him a chocolate-covered caramel apple and a chocolate chip cookie. He goes out to buy some guitars for his girls. And when we return, it’s there on the dining room table. “Well, aren’t you gonna play it?” he asks. I was going to wait until Christmas. “What for? Play it!”

    I know that trick. He just wants to play it himself, which he does, several times, while I cringe and reach out to protect it as if it’s a baby being held by an ogre. When he goes to work after dinner (which he does frequently, in addition to his other duties), I take out the guitar and pose with it for some goofy Flickr CD cover group. My daughter comes up from the basement while I'm adding the CD title. "Oh my god! You took a naked picture with your guitar already?" she asks, as if I've, like, done this before or something.

    Today, while I am at the doctor’s office going over surgery instructions, I note that I can’t pick up anything, but I wonder whether things can be put in my lap—things like, say, a new Gibson Songwriter Deluxe. “Sure,” the nurse tells me. But, as has happened with other guitar-playing patients, I might get a spasm when I try to put my arm over it. Oh, the indignity!

    I give the news to my husband when he comes home from work, exhausted enough to pass out in the chair next to me (which he does). “Guess I’ll take it back and get myself an SG, a Taylor DN3, and some more strings. I’d still have a couple hundred left.”

    “Go ahead,” I tell him. “I don’t deserve it anyway.”

    “OK, I’ll do that tonight,” he says. “I also need some hot Vietnamese chicks who can bend over.”

    “That’s going on my blog,” I tell him.

    “They can be Burmese,” he says. “Or Cambodian.”