St. Mary’s Hospital: A Love Letter
by Bruce Anderson, September 28, 2011
The morning of July 23rd I woke up with a stomachache. By noon the stomachache was bending me in half but, like a true child of the 50s — no blood, no injury — I thought it would simply go away. All I had to do was wait it out. I also couldn't help but notice that I was unable to evacuate, and I don't mean evacuate in the sense of emergency exits. Finally, about five in the afternoon when the stomachache had gone from painful to excruciating, and as my poor wife threatened to call an ambulance if I didn't go to the hospital right now, I drove myself to the emergency room at St. Mary's Hospital on Stanyan, a quick couple of miles from our apartment.
The waiting room was full, but the nurse responsible for sorting the poly-ethnic, multi-lingual sufferers seemed the equal of a medical Napoleon. Almost at a glance she had us accurately assessed.
There was an ancient Chinese woman groaning in a wheelchair, a stoic Mexican kid in painter's coveralls with blood oozing out of one of his boots, two black men of my vintage, an elderly white woman, her son vigilant by her side, and a young Chinese man, perhaps a frequent flier, who the RN generalisimo quickly sized up as a psychosomatic case. "Honey," the black woman doing the sorting said, "the best thing you can do is go home and get some sleep."
This intake RN radiated good-humored authority, which, while I was there, was not disputed. St. Mary's promises a free pizza to anyone who has to wait more than 30 minutes in emergency; I wondered if anyone ever re-appeared to claim one. Madam General soon had each of us preliminarily diagnosed and cubicled, although It was so crowded I was laid out next to her office where I could listen to her work her assessment magic. I'd never seen anyone do high pressure work with such intelligent dispatch, and mentally kicked myself for not having my notepad to memorialize her by name.
A male nurse appeared bedside. "You need to be drained," he said. "You're bladder isn't working." He explained that he was going to insert a catheter into that organ that causes strong men to cringe at the very thought. "Whatever you do," he warned me, don't grab me." The nurse explained that men often reflexively lunge for the person doing the inserting. I assured him I wasn't a lunger. The pain of the insertion was mild and over in an instant, but the relief it provided me from my treacherous bladder was instantaneous. For the next two weeks I was urinating through a tube into a see-through bag strapped to my leg. The nurse told me that bladder dysfunction was common to lots of older men including, as it happened, my two black contemporaries I'd met in the waiting room. They were also catheter cases.
The place was hopping. Another nurse said the emergency room would stay busy until 1 or 2am. People groaned from the wall of cubicles. An Aargh (street drunk) petulantly demanded, "Now you tell me exactly how I'm supposed to get from here to there." The police bring lots of Aarghs to the emergency room from nearby Golden Gate Park and, it seems, lots of Aarghs make their own way to temporary succor before resuming their headlong plunges to extinction. I heard an exasperated staffer exclaim, "And they all have cellphones!"
My urologist, a jolly young man named Dr. Grady, put me on some meds that he thought might get my middle kingdom plumbing fully functional again. Avodart! Flomax! Is there a male over the age of 60 unfamiliar with these frontline prostate prophylactics? I'd be on the catheter for two weeks until I saw Dr. Grady again.
And when I saw him, the catheter had come out. I went home optimistic that the Avodart and the Floman had freed me. I did some celebratory push-ups and went for a bike ride in the Presidio. But my waterworks remained jammed, so jammed I again hit the road for St. Mary's emergency room, this time at 3:30am. Other than an Aargh strapped to a gurney in one of the cubicles, I had a doctor and a male nurse all to myself. The nurse pointed to a stack of catheter apparatuses. "We keep a stack of them right there. That's how common this is." And he got one down for me and in it went.
The meds having failed to unblock me, Dr. Grady scheduled me for laser surgery at St. Mary's sister hospital in Daly City called Seton, named after the famous saint Mother Seton, as is the Catholic church in the Anderson Valley at Philo. During the check-in I was asked my religious preference. Noting the pious iconography everywhere around me, I said with all the authority I could muster, "Catholic!" I half expected one of the statues to fly down from its creche and crack me in my lying head, but the Filipina clerk simply checked the Catholic box.
The laser expedition up my penile canal took almost an hour. As I probably misunderstand it, the laser chips away at the overgrown prostate to restore one's flow. I thought of it as removing the dams on the Klamath. A pair of tiny Asian nurses shoved me one way then another as they stuffed me into a paper hospital gown, a simple task I was unable to accomplish on my own. "Good thing this isn't an IQ test," I said. "Happens all the time," one of the nurses said. The anesthesiologist, wearing a Cal headdress, explained he'd be putting me out for almost exactly the time it took Doctor Grady to steer the laser to the prostate's coal face, so to speak.
I felt zero pain during and zero pain afterwards. There was some blood in my urine for a mere two days before my stream was again running into my catheter bag as clear and true as Jimmy Creek high in the east hills of Boonville.
I was home by noon, me and my post-op catheter, and god how I'd come to hate those things. My wife, much more anxious about all this than her lout of a husband, became the equivalent of a live-in nurse.
A week hence Dr. Grady would remove the catheter for the last time and I would be free. I was weak after the operation and slept a lot, but I anticipated full recovery, and a fast one, too, fast enough to get me back to Boonville in a week.
But then something went terribly, almost fatally awry.
Dr. Grady was going to retire the catheter at 9am Tuesday, a week after the successful laser surgery. I was almost home.
But at 9am Monday, after a night-long malarial assault on my entire operating system, I was so weak I couldn't get off the floor; I was alternately suffering from a teeth-chattering chill and sweats so severe they soaked through my blanket. I was vomiting and I'd lost all control of my bowels. I seemed to be passing in and out of consciousness. I couldn't stand, and soon my apartment was filled with EMTs.
"Shoot me, please," I half-joked to one of them. It was all so embarrassing, so purely pathetic I couldn't quite believe it was happening to me. I'd never been so completely powerless, so systemically deficient that I couldn't stand or even get my feet under me to begin to stand. My years of daily hill hiking and push-ups had been negated in a few hours, although the doctors would later tell me that for my age I had "a very good foundation. No pre-existing medical conditions, no diabetes, no nothing. That helped you a lot."
As the Korean lady across the street at her coffee shop stood on the sidewalk with a shocked hand to her mouth, I was lifted into the meat wagon and carried off to St. Mary's Emergency.
When I arrived at the emergency room, I was pretty much out of it but still oriented, as they say, as to time and place. I still had a firm grasp of my name, age and address. But I was getting sicker, weaker. A young nurse commented, "You old guys always think you can tough it out, don't you?" I had to plead guilty. "Yep, another old fool lies before you."
Soon, I was hooked up to an array of IVs and other mysterious apparatuses. One multiple distribution center had been inserted into my collarbone. The doctor explained it was a rather delicate procedure that required him to accomplish it so deftly that it avoided my heart, a piece of information I really didn't care to hear. Another distribution center was inserted into the area of my left elbow. My doctor told me that over the next few hours they put "more than twenty pounds of liquids" into my ailing bulk.
I wasn't sure how much I was understanding, but I certainly understood that two female Asian nurses were pulling my toxic clothing off, pushing me up on my side one way then the other as they swabbed my unexplored regions with cleansing salves. "I apologize," I said, "for exposing you to these grisly vistas." They laughed. "Grisly vistas," one said. "I've never heard that one." I'd never seen those remotest of areas myself, and now total strangers, and whatever they're paid it isn't enough, were not only risking permanent visual trauma, they were gently scouring the fetid regions with great soothing strokes of antiseptic cloth.
When my trousers were finally off, one of the nurses said, "Are you aware there was a stool in your pants leg?" I was not aware of that, I said, mildly irritated at the question. Surely she didn't think I maintained a pet turd. "Oh, you must mean Bob. Yes, he's been with me for years." For all I was aware the Boonville Chamber of Commerce was holding a wine tasting in my pants leg. I was debilitated way past knowing or caring how fetid I'd become.
So commenced three days in ICU. The first night, as I learned the next day, it had been touch and go. All my vital signs were way off — white blood cell count ominously high; blood pressure ominously low. In the middle of the night a nurse had come in and read the numbers posted behind me where I couldn't see them. "This guy is very, very sick," she said to herself. The next day the same nurse said, "I thought about you driving home. I was worried. You look so much better today. You're going to make it.”
My primary physician, Dr. Yoss, soon appeared. "That was a sleepless night for me," he said. "Some day I'll tell you how close you came." Close as I may have come to buying the store, at no time during my prone helplessness did I ever hear the tumult of angel wings, the harps tuning up or those long bright white avenues the almost dead say they enter.
There isn't much time to think morbid thoughts in the hospital because every few minutes, even if you've managed to fall asleep, little nurses with big needles are perpetually injecting mysterious antidotes, taking your blood, your temperature, your blood sugar, your blood pressure; and there's always someone, or a group of someones, clustered at the foot of your bed reading the numbers. Several times, suddenly waking to a cluster of doctors staring in on me, I felt like the Macy's display window.
The doctors said there are a lot of fancy terms for what had happened to me but they all added up to old fashioned blood poisoning, probably from the catheter backing up.
Promoted from ICU to a room upstairs on the 8th floor with a kaleidoscopic view of the Bridge towers to the blue Pacific, the round-the-clock poking, puncturing and prodding continued as if I were still in ICU. But these people had saved me and I wasn't about to complain. My appetite gradually returned and I was not only finally able to totter around the room, I began to fully appreciate just how good the St. Mary's staff was. "Can I get some ice water?" Coming right up. "Extra pillow maybe?" How many do you want?
In ICU, a saintly little bundle of energy, Aeme, had even relayed the Giants scores to me. I'd never experienced anything approaching such a level of genuine concern, and all of it delivered with an unfeigned cheerfulness from the busy men and women charged with caring for a whole floor of very sick people, some of them senile and quite demanding, especially at night. I often heard one old boy demand, "I want a cop now!" Then a soothing voice, "Now Mr. Smith. Everything is fine. Would you like some juice?"
One afternoon I could hear a Russian-accented voice approaching my door. He was talking to himself, I discerned, about "Getting da hell outtahere." And darned if he didn't walk straight into my room. "Who are you?" he demanded. I said I was Count Brusco of Upper Mendonesia just as two nurses hustled in to retrieve him, and I could here him complaining all the way to his room far down the long hall.
I don't see how a hospital could be more accommodating. The doctors and nurses were angelic, the superlative that best fits my experience at St. Mary's. They saved me and then they made me strong again, and I knew that soon I would be back in Boonville in plenty of time to get my winter garden in.