coming back slowly

sick man

I’ve been home from hospital for a few days, and I can focus on fine print. I’ve cut my fingernails so I can type again. Bread tastes funny and I can’t tolerate coffee. I’ve been away a lot longer than we expected.

My first conscious memory after my bowel resection is one of the worst things you can confront in a hospital – an apologetic surgeon. I’d been hit by a medical emergency which was fifty years in the making.

When I was very small I had some kind of unidentified infection, which stopped one kidney from growing. Instead, the bowel had occupied the space, which meant the spleen had moved too. Reorganising my unexpected gut design, the doctors nicked my spleen, which collapsed and had to be removed, while I bled badly.

Two days later, I responded to the trauma with a small heart attack.

The next ten days became a blur of disconnected vignettes, my bed a nest, pushed from scan to scan and ward to ward.

With all that morphine I made friends with a huge bear in the corner. I lost control of my visual cortex and lay for days in a muddle of spontaneous images, some viciously ugly, most collaged from shattered pieces of coloured Perspex cut with frozen, scanned memories. In my own naturally verbal sensorium, I suppose this was the pictorial equivalent of voices in my head. I puzzled for hours over the way that could happen but still be under control, which I guess is the way visual artists function, in a parallel to the stream of words coming from my fingers to this screen.

I twisted back and forth on a mobius strip of recursive identity, trying to work out who I was if the drugs had seized my brain. The “I” that I needed being a creature which could ask questions, organise my bedclothes and work out whether to put my hearing aids in or not.

I remember a man across the ward who was 86 years old, stone deaf, who shouted very loudly and was mentally flitting through the twilight zone. The doctors seemed to think he might have had a stroke in his fall at home; his family simply ignored his ravings, as if they had known his behaviour for a long time.

Next to him was a young man of Islander background who had been in some sort of fight. His mates came and he swanked around, making moves and swaying his hips, laughing about the violence. His big sister was on the mobile talking about someone else who had been arrested over the incident. But that night, when everyone else had gone home, I heard him sobbing in his mother’s arms.

Beyond the curtain at my side was a Czech chippie, who got away from the Russians in the fifties. Eighty years old, still smooth skinned and strongly built, he lives with his wife who is five years older on a piece of land somewhere in the hills. His eyes lit up when he talked of his two ponies. Lying there patiently, waiting for his heart to calm, I felt like he was an inspiration, a direction for a life well lived.

I rowed on through the hospital, my bed a dinghy, across rivers of knowledge. Bowels. Spleen. Hearts. I saw slices of my own heart beating, which were slowed down and repeated with their own sound track. ‘Beat’ is not the right word – the thing flutters, endlessly precise, fabulously fragile, each dancing move identical for every second from the womb to the grave.

They gave me some kind of terrible muck to drink on a fragile stomach, which tasted like roadside fennel cut with decaying mulch. Then slid me – without instruction – into a torus which told me to breathe in Korean-American. Some weird dye injection bathed my whole front in heat like I had been whacked by the transparent alien ray gun over my shoulder. Maybe I had. It showed me just how fast something pumped into my bloodstream can rush across my torso. It was the only time a harassed department really failed to communicate to its astonished patients.

I was trundled around because I stayed over a long weekend. They had seventy emergency patients tucked into every corner where the machines could service them. In the cardiac observation unit, we were the low needs gang. Our night nurse was first trimester pregnant. Hammered by our Evil Mouth of Noisy Doom across the ward, our doctor confessed that she was two weeks off full term to have her baby. That’s a staff shortage.

I opened my eyes one night to the blue glare of the helicopter headlights sweeping the room, making the walls incandescent as it looked for the pad across the next building. Carrying God knows what burden of suffering.

Gradually my tubes were taken out. My colostomy bag came off early, on a day when Susie now tells me I didn’t wake when she arrived but just lay there weeping. A couple of days later, the tube came tickling out of my nose. Then my drip. Then my oxygen pipe with its nipples tucked into my nose. They left the catheter in my bladder for most of the time. My drainage tube came out by simple force, with a doctor bent over and yanking what looked for a moment like an artery. I look at this list and marvel how I could possibly be so festooned but at the time it seemed not only natural but comforting. In our cosseted times, I can’t imagine doing this without the drugs.

Once I was mobile, I was sent off to walk the corridors with stern instructions to get exercise. Since I couldn’t put my jarmies on over my wound, I wore a pair of hospital gowns mounted both ways. Fluffed up with cotton, I staggered up and down like a huge, drugged dandelion. I’d lost all sense of personal dignity, and it didn’t bother me at all.

Since each patient is covered by three shifts, each with its own intricate roster, the day carries an endless routine of small visits. A nurse for morning, for afternoon, for night. A doctor for very early, who I gradually realised had been involved in the operation. Various doctors randomly for later. Gangs to have looks at the wound. Someone with a trolley to take blood. A squad for special blood tests involving ice.

Best of all was a ghoulish, smooth faced triumvirate called The Pain Team. “Hi, we’re The Pain Team. Are you in pain? On a scale of one to ten, how would you rate it?” They reminded me of creatures from Miyazaki’s ‘Spirited Away’. It all seemed very stupid until I realised they could use my early use of the pain button to correlate my idea of a three or four with the amount of morphine I had pumped into my body. Smart, huh?

You learn quickly to judge the carer. On successive days, different people take the same blood, deliver the same shot, dress the same wound. They fiddle, or hesitate, or push too hard. They don’t want to hurt, or don’t care. Some of them have a magic touch.

You pick laziness as well. The surgeon wanted me sitting up and moving, so the morning shower was a big deal. I was pulled upright, swayed across the room, and trailed my drip and bags and air hoses to sit on the plastic chair and be scrubbed in a confined room. A good nurse didn’t flinch at getting wet. A great nurse soaped a flannel and washed my back. An ordinary nurse shut the door and let me get on with it.

The secret is a simple but saintly combination of self confidence and the ability to acknowledge my individual needs.

A couple of times the system worked so the nurses managed a handover in my presence. I lost their names immediately, but I valued the teccy talk, which made no sense but reassured me they understood my processes in complicated ways.

Even before I went into surgery, I was fascinated by the power and status system. I reckon a big public hospital is probably the place where the Australian culture of control and authority is most clearly displayed, since the hierarchy contains a myriad of disciplines, a huge variety of cultures, and an omnipresent accounting system.

There’s a sense of twenty first century machismo about the whole thing, fed mostly by the doctors. You can see it being absorbed by the younger staff who are supposed to be An Elite, and to Live Up to the Responsibility, which creates a distinctively different sense of self compared to nurses, who may be the same age.

Here’s a vignette: nurse removes a cannula, the tube that puts nutrient and drugs in through a taped needle. There’s a bit of a thing about this because my veins are so hard to find and it takes skill to install one. Then I am shifted to another ward. It turns out I need another cannula, and the nurse in charge of the night station – an older woman – does the job with no fuss and bother, in a trice. Best one, in fact. Then a doctor arrives a few minutes later, and tries to take it off, to put in a new one. I stop her, tell her it has been done by the nurse. The doctor says: “Why did she do that? I do at least fifty of these a day..” and stomps grumpily off.

I suspect fierce clothing competition. Despite the racial diversity, and the occasional surly but efficient male nurse, the largest group by far is women in their twenties and early thirties, with shiny, shiny wedding rings. They all wear huggy trousers, little tops, and various bits of cardigan thingys over that. A look which I bet shows off any money spent, is reasonably practical for work, and cruelly exposes excess body fat. Particularly brutal because several of them had at least one small child. The women doctors were generally a bit baggier in the fit. I think I even saw a few skirts.

I guess each sector is defined by dress. My favourite was the X-ray unit on the top floor, which is a completely inhuman zone, all empty corridors with glimpses of chairs in the distance, with the occasional cluster of patients waiting like bean bags in the Bauhaus. I floated through on my bed, early in my stay, festooned with plastic bags slopping with very very ikky things from inside my body.

Somehow the trolly clipped a corner, and one of my waste bags fell off with an ugly splash, breaking across the floor. I just sat there, drugged to the eyeballs, while three immaculately dressed young technicians in high fash black and white flapped around, calling for help, exclaiming about the smell. Stalk-like and horrified.

The cleaners were a sad group. Silent, bent, almost all black, wiping, dusting, mopping, making no contact, they were invisible and unregarded. Each seemed to work in a private bubble of despair, proving with every step that bad things are happening at the bottom of our economy. For the first time, I really saw how big households maintained an army of servants by simply treating them as if they did not exist as human beings. To me, they were an endless reproach.

At the end, with the emergency patients cleared away, I was transferred to the Alfred’s very own Medihotel. Wards with a bit less equipment, with patients able to move around by themselves, needing less direct care.

We are so used to patients being sent home as soon as possible, this area was a sort of anti-space, with its very own ghost population of patients who simply couldn’t get away. People who had endured inspeakable things on other floors, and were in for endless mysterious “tests” and “monitoring”, sometimes for weeks on end. The man who left on my first day in this blood test gulag had been there for 22 days.

As I was wheeled into my final four bed dock, I was confronted by the sight of a vast, hairy man, almost naked, cross legged on a bed, in hospital for his psoriasis treatment. It was the only moment when I wanted a private room. He was a sort of self-appointed den host, who spent a lot of time on a seat in the corridor, talking happily to anyone who came past. I picked him for one of St Kilda’s many street identities, who probably lived in a boarding house. He had a thing about fluoro lights, and told the staff which ones were dead or dying. I figured he knew a lot about institutions and maintenance staff.

It turns out he has four grown up kids, and is a full-time carer for his wife who had a stroke. He worked for Spotless for 35 years in the plastics division, making bathroom fittings. They supplied hospitals. “The toilet seats here, I probably made them”, he said.

In the other corner was a neat man who proudly informed me he was a veteran of the Royal Australian Navy in World War Two, and had lived in Albert Park down the hill since 1976. He never married, but stayed close to his mother until she died at the age of 93. She lived two blocks down from our flat. “You know that Hyacinth Bouquet woman on the television? That was my mother. She was a good woman but she had her traits, you know..”

He was a complete hoot. 84 and still entertaining, addicted to ships, ecstatic about the shape of a bow wave on a cruiser, happily telling me about ship interceptions outside Vladivostok, but discreet about his social life on the bay after the war. He went to work for the SEC in Melbourne power stations, hung around the docks looking at ships, helped in the kiosk at the end of Station Pier, was a volunteer at the National Gallery and knew old gossip back to the days when Roy Grounds designed the new building.

He was in Portsmouth, my home town, during the blitz, and watched it burn from tents on high ground outside the city. The sailors were trucked in each day to work in the docks. They were fed in the seamen’s mess, where hundreds of men queued for their plates of egg and chips and bread in a fog of steam from the urns. Down the end of the line, they stirred their tea with a single teaspoon on a chain.

The day I left, the nurse, a clipped voiced Chilean man, pulled 29 staples out of my stomach with a specially designed pair of pliers. My wound was clean and he was able to leave it open.

While I packed, men came and fixed the fluoros.

——————————

A good friend of ours has just had her second hip replacement in Cabrini Hospital, with her own room. She knew her surgeon, had continuity of staff.

I am sure her food was better. She had wine with her meals. When she left, someone said goodbye. Her fellow patients were probably prosperous, and propertied, with reliable cars and educated relatives. Not too many of the patients I met at the Alfred have a command role in our economy.

The Alfred is a vast institution, with 3,500 staff, a staggering array of diagnostic equipment, a burns unit, a transplant unit, and community outreach programs. Tucked in amongst the spectacular stuff is a spleen registry, which will help to keep me up with the vaccinations I now need.

I joke about the other patients, and sometimes I was glad of my hearing aids. But the one night I spent by myself, I felt lonely and abandoned.

It has taken me three days to write this post. I’ve been on a tough journey. I think death touched my cheek and passed on with a smile. I know something more of mortality, of compassion, of friendship and love.

Tucked up now in my dressing gown, heater going on my socks, slowly, slowly finding my writer’s voice, it seems to me that The Alfred is one of those places where we can find the essence of our civilisation.

93 Responses to “coming back slowly”

  1. Francis Xavier Holden Says:

    Good to see you back. And writing.

    It’s a funny thing. I hate sharing a room in hospital and would pay a small fortune to have a private room – hell I’d do without care even – well not the drugs. But “surveys show” most, not all, people prefer to share rooms. I’ve gone public and I’ve gone private. My basic rule is the worse it is, the more important it is to go large public.

  2. elsewhere Says:

    Thanks for that beautifully, graphically written post. I’m amazed that you’ve found the energy to write so much so soon when it seems that you’ve been (and still are?) so ill.

    Hospital is a bit like a descent into a Bosch painting. I think you were lucky to hearing aids (maybe just this once).

  3. Elayne Riggs Says:

    Wow. What an amazing story. I’m very grateful and glad you’re still with us. (After reading this I don’t think I’ll ever complain about my hospitalization again…)

  4. Phil Says:

    Your writers voice obviously recovered well David, beautiful post mate, and at risk of embarrasing you, another example of why you are the best writer in the Australian blogsphere.

    So glad to have you back.

  5. Dan Says:

    Good to see you back David, albeit minus one spleen. (Nobody’s ever been able to tell me, incidentally, why we have one. Well, I have one.)

    Sounds like you were on some serious drugs … none of my (mercifully few) experiences in hospitals could possibly have left me writing lyrically about them. Were you able to line yourself up a continuing supply?

  6. peacay Says:

    Thankyou.

    How dare you complicate your carers’ lives by getting sicker than was called for by the script! No wonder they didn’t all have a magic touch.

    FXH has it right with the public/private hospital choice being proportional to sickness level. And you would have only had your own experiences to retell if you hadn’t been sharing in a public hosp. They are our greatest institutions. (Disclosure: I have fond professional previous connections. And they are also the basis for my politics.)

  7. Nabakov Says:

    Ouch!

    Though your ordeal seems to have improved your writing, if that was possible. That was something quite rather beyond an essay.

  8. Francis Xavier Holden Says:

    I’ll take up a collection for a kidney removal or some other serious cutting on you nabs – just to improve your writing. I’ll just get that paypal button fixed up.

  9. Gerry Says:

    Too many words…

    Welcome back…

  10. saint Says:

    Can’t find the words for this post…
    Missed you.
    Welcome back.

  11. zoot Says:

    Yeah.
    Welcome back.

  12. dk.au Says:

    You’ve just reminded me why I read blogs, David – I’ve been allowing my feedreader to swell of late.
    Sublime post.

  13. Link Says:

    Geez David, do try to stay out of hospital eh? You survived and the polyps needed to go, but what a dehuminising experience modern medicine now is. It sounded like science fiction, but all know its not. Fucking scary stuff.

    The Pain Team “that ghoulish triumverate” Sheesh. What a hoot. The world in microcosm. I’m so sorry you had to go through it.

    Welcome back.

  14. biddy Says:

    welcome back
    i missed you too
    hope your recovering well
    biddy

  15. cos Says:

    welcome back. i’m sorry you had to suffer so much for our reading pleasure (so to speak) – that was a fabulous post, though.

  16. Guy Says:

    Glad to hear you are okay and sorry to hear that not all went to plan. What doesn’t kill you, etc…

  17. Pavlov's Cat Says:

    David, welcome back. I’m so glad you made it through all that, back home and back to your computer. Thanks for the stunning post.

    But … ‘can’t tolerate coffee’?

    However will you manage?

  18. Laura Says:

    So glad to have you back and in such moving and marvellous verbal form. Thanks for the post. Take care of yourself.

  19. John Hardy Says:

    wow. youch. wow.

  20. megan Says:

    Welcome back – I had missed your writing. And best wishes with your continuing recovery (back to normal?).

  21. Canoe Says:

    “I think death touched my cheek and passed on with a smile.”

    Such a beautiful description.

    Amazing post. Hospitals really are a place of extremes: vulnerability and strength, courage and fear, both compassionate and dehumanising.

    Glad you’re back and on the mend.

  22. jellyfish Says:

    Holy fucking hell. Excuse my french, by this is terrible news. I’m so sorry!

    Do you need books? DVDs? Who Magazine’s Sexiest People 2006 Issue? Can I/we do anything to help? Can we visit you at home?

    *hugs*

  23. euan Says:

    It’s great that you are recovering. Anyway, spleens are overrated. I lost mine 38 years ago and haven’t noticed the lack.

  24. dj Says:

    Wow. As was said before, this is the kind of stuff that makes blogs worth reading.

    When you know what goes on in some hospitals, it amazes you that people survive to tell the story. I always found going into the RAH when I was an outpatient there quite depressing, drab and dreary wards full of sick and depressed people. It was magnified even more by the fact that I was the only person that I ever saw there apart from the staff who was under 30. Even Emergency had a more lively feel to it, even if more people were facing a more immediate threat of dying.

  25. Ian Says:

    Not to be all dramatic, but it’s great to hear you’ve made it out the other side……there’s always that spectre hovering in those places…..best wishes for a comfortable recovery :-)

  26. David Taft Says:

    Lovely peice of writing David. Sorry that it took such a momentous experience to generate it. All the best.

  27. Kate Says:

    I’m glad you’re recovering David, and I’m sorry to hear about your ordeal, even though the post it inspired is quite luminous. Where can we send a care package?

  28. Brownie Says:

    Through something personally overwhelming, you assess yourself at only 3 or 4 on The Scale, still notice the people having a bad time ‘at the bottom of the economy’, and present us with this account I cannot find an adjective good enough to credit … ‘drugged dandelion’, ‘beanbags in the BauHaus’ … you are a blazing Star.

  29. Kent Says:

    Great to have you back :-)

  30. a different phil from the earlier one Says:

    Add my congrats and best wishes also. Having to visit hospital several times a week nowadays as father slips from us – yuck, I’ve always hated ‘em and I still do.

  31. Sylvia Says:

    Gee….the things they do to you.
    Great writing. Wishing you a good convalescence.

  32. Helen Says:

    Relieved doesn’t even begin to describe it, seeing a new post from you.

    But what you’ve been through, Jesus christ on a bike. And having your spleen removed… if something really annoys you now, how can you vent it..!.?

    Take care of yourself David!

  33. Helen Says:

    Oh, and you knew your blog was worth bottling.

    But did you know it was worth this much? Personally, I’d pay more.

    My blog is worth $106,698.06.How much is your blog worth?

  34. Helen Says:

    That should be, “your blog…”

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  36. judith k Says:

    Hi David, welcome home!
    Obviously there were many of us anxiously checking a couple of times a day! A powerful piece, terrible ordeal that you seem to have been able to somehow step outside (bet it wasn’t that easy) but best is you are on the mend.
    Take care, feel loved and valued

  37. shiralee Says:

    That’s such a beautifully written post, David! So glad you’re up and at it… love

  38. tigtog Says:

    I’m not surprised this took you a few days to write, David. It took me right back to my days working in public hospitals (I was one of those awful folks who chivvy people like you to exercise). I’m so glad you’re back at home and back writing.

  39. dwayne m Says:

    Oh, just checking in and read this remarkable peice…

    Thank the gods you’re back, on the mend and writing (beautifully).

    .d.

  40. ThirdCat Says:

    what everyone else said. really.

  41. Cristy Says:

    Good to see you back David. All the best with your recovery and thank you for the beautiful post.

  42. Zoe Says:

    Three cheers for Barista!

    So very happy to read this, and wishing you well. You must have scared your loved ones half way to their own bed at the Alfred.

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  44. Ampersand Duck Says:

    I’m in tears. A wonderful post. I’m so glad you’re recovering.

  45. BigBob Says:

    Wonderful piece and wonderful news that you are safely home again.

    As you can see, we have all missed your presence in our lives.

  46. TimT Says:

    Good on you, Mr Tiley. Glad to hear you’re back. Now STAY back, d’ye hear?

    Ahem.

  47. Graham Bell Says:

    David:
    Happy it’s over …. surprised and even happier that you got home bagless!

    A lot has been written about hospitals – much of it not worth reading – but rarely from the patient’s perspective and almost never with a social context. What you have written here is absolutely brilliant ….. your insights, your observations, your descriptions, your comments. David, please have this published on paper so that it reaches more people and not just this small circle …. perhaps even medical, nursing, physio, science, economics and business administration students. :-)

    Best of luck. Just get better.

  48. Alan Says:

    Nothing, trust me, has effected your skill with a pen. That’s glad news but not as glad as the news you’re on the mend.

  49. Mark Bahnisch Says:

    Trackback.

    Hope you make a full and speedy recovery, David!

  50. Sedgwick Says:

    You’re incorrigible Tiley, you’ll do anything for a cracking blog posting won’t you?!

  51. liam Says:

    Glad you’re better(ish). If only they could let you take the morphine home as compensation for the spleen.
    You’re exactly right about the radiology units. I think the obsessive cleanliness and the sterility of the whole place is there to take your attention away from the danger you can’t see.

  52. Geoff Honnor Says:

    What can I say? A superb story. You’ve captured “nursing” and hospital culture in a kind of lovingly, laser-lit relief.

    Sante!

  53. Brian Bahnisch Says:

    What a journey! It makes my triple-bypass experience a few years ago seem like a walk in the park!

    It will take time, David, to get your strength back, but bit by bit it will come. The path from here will be different, but with your acuity of perception and gift with words you will find a way. I’m sure every day will be rich and full and may you continue to enrich ours.

  54. Margaret Soltan Says:

    Beautifully written post. Brought tears. All best wishes.

  55. Nicholas Gruen Says:

    Thanks for the wonderful post David.

  56. harry clarke Says:

    A moving post. All the best.

  57. Tony.T Says:

    Bloody hell, Tiley. Where’s the part where you drone on and on and on about “hospital food”? Did they remove your cliché generator, too?

  58. Jonno Says:

    Thanks very much – I read your blog entry referred from Club Troppo. I work in the health department and am going to send it around as a reminder to us why we are there.

  59. Rex Says:

    So glad to know you’re back Dave.

  60. Georg Says:

    Wonderful post. Thank you.

  61. Peter F(uller) -prefer full name not published. Says:

    David,
    I’m in awe of the quality of this piece of writing, and moved by your extraordinary experience. Get even better, the blogosphere and its hangers-on like me need you.
    I concur with Graham Bell’s suggestion that your account should be published for consumption beyond your privileged readership.

  62. genevieve Says:

    Agree with Peter – we are a privileged lot.
    Tony, he never had a cliche generator to start with. Drugs in bed are always an interesting experience in the hands of a good operator – I think you’re just jealous.
    Very, very glad to hear all is improving, David. Regards to you all, take care now.

  63. Pete Says:

    Dear David
    I’ve never commented on your blog before, but read it avidly. Can I second or third the motion that you publish this excellent post more widely. It should be required reading for health care professionals, and I’m also showing it to some of the people under my charge as an example of what truly good writing looks like. The word pictures you painted are vivid, insightful and moving. Congratulations. I wish you a full and speedy recovery, and a return to rude good health.

  64. jen Says:

    ‘like bean bags in the Bauhaus’
    what a picture!

    and ‘ugly splash’
    ‘ugly splash’ is good

    So a spleen = this piece of writing huh Nabs?
    David I’m not sure about this business of exchanging body parts for the muse. A little less than Faust.

  65. Jane Crawley Says:

    Hello David
    thankyou and congratulations and love x

  66. Yayo Says:

    You must survive before you thrive. And, now you have survived.

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  68. Gabriel G. M Says:

    i just stumbled on this by accident and i am not a big fan of blogs. reading small chunks of this i know why. only the web can support this kind of self-indulgent tripe. stick to the facts.

  69. barista Says:

    What a peculiar thing to say, written without caps during the day, from an IP address which suggests you work for the NSW State Government.

    If you don’t like blogs, don’t read them. Since we clearly don’t provide a quick belt of reviving recreation, you should go back to what you are paid to do.

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    It should be required reading for health care professionals, and I’m also showing it to some of the people under my charge as an example of what truly good writing looks like. The word pictures you painted are vivid, insightful and moving.

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    You survived and the polyps needed to go, but what a dehuminising experience modern medicine now is. It sounded like science fiction, but all know its not. Fucking scary stuff.

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