Back at it

How bad can any day be when both the New York Times and the Philadelphia Inquirer (yes, I read actual newspapers, you should try it) have nearly identical pictures of Chris Christie and Donald Trump front and center. Isn't that enough to banish your blues?

The first week back at work was surprisingly difficult for me. I can think of at least two reasons, both of which may have contributed to this. Because life has been pretty low energy recently, it's taking me a bit of time to ramp up. For the most part, I was able to think quickly enough to conduct a math class, but it was harder to do that than when I'm in the flow. Also, I think I underestimated the strain this whole experience put on me. I feel like I haven't been doing much of anything and therefore should be rested. But I'm not feeling rested. More on the other side of the spectrum.

Meanwhile, everything's going well at home. Steady progress on all fronts.

I'm just waiting for some nicer weather so I can take longer walks and eventually some bike rides, but that'll come. I have a lot to do and no energy to do it with, so we'll have to see how it goes.

I should at least give you the intro to the recipe I submitted for the school Drama Department Cookbook. I can't divulge the actual recipe, of course.

This is my dear departed mother’s recipe for Chocolate Diamonds, handed down to her by her mother. These were my absolute favorite cookie as a kid and were very popular with my college friends as well, especially at around 1:00 AM Sunday morning, after watching the debut season of a show called Saturday Night Live, whose first show was on my 20^th birthday.

Chocolate Diamonds are like very thin brownies. They are best if ever so slightly undercooked so they’re still a tiny bit chewy, but they’re great when done crispy as well. They do burn if overcooked. This recipe is copied directly from the index card handwritten in my mom’s perfect schoolteacher handwriting, which I seem to have not inherited.

I should also note that even in the generally happy world of licking batter off spoons, this is the absolute best batter.

Well...How did I get here?

It's been 2 weeks since we came back from the hospital. And just back at work, which seems strange and exciting and a little bit nervy. It feels to me like there's a big difference between having been gone for three weeks and instead of being on for four.

As it turns out, the timing was pretty fortuitous, because we were approaching a tipping point between my being helpful and my being in the way. It's stressful not knowing how much to help. My nature is to always step in, but in many cases that's completely wrong in this instance.

Looking back on this experience as a whole, the hardest part was clearly the first week or so, when I needed to be present almost all the time, while at the same time not really having anybody to talk to. I guess that was lonely. I'm not sure I identified it as such all the time, though I did think about it a bit. 

Towards the end, we went to a period of apprehensiveness about getting home and what that would be like. It made the last day or two in the hospital kind of exciting and kind of scary. And fact when we got home it was very difficult at first. Everything seemed a challenge, and I mean everything in the realm of ADLs, as physical therapists call them (stands for Activities of Daily Living).

It's actually worth a moment or more of thought to think about how miraculous it is that we are able to do everything we do and to be grateful. So many things have to work together to make our daily lives happen. You don't really notice them until you can't. I remember when I broke my hand, seeing how many things I did that required using my full right hand. My pinky and ring fingers were immobilized with a splint because they were attached to the broken bone, which had 2 pins holding it together (looked kind of like really long push pins). I had 3 fingers going, but gripping things hurt and I wasn't supposed to do anything that would, as they say, insult it. Then, when they removed the pins, I couldn't close my hand. Anyway, I stopped taking basic ADLs for granted.

But healing happens, both on its own and with help, and we've been approaching the tipping point where the help may no longer be helpful. So back to work it is.

Reflecting, I think whatever advice I have for people is pretty limited. I think the two things that helped me the most for mindfulness and fitness.

I never lost track of where I was and what I was doing. As long as I knew that, everything seemed to be in place. The other thing was the objective value of being fit, because at my semi advanced age, I definitely found myself pleasantly surprised with my stamina. That I was able to essentially do two weeks of 16 hour days without any break to speak of in kind of amazing looking back at it. But that was what I was there for. 

During that time I never felt myself missing what I usually did or even being home. My mind was just on what I was doing. Once I got home, I start thinking about my usual life this time of year, and how much I missed it at times.

Now back at school it seems both completely right and completely disorienting. We'll see how it goes from there.

Shoot the trouble

For the second time in 2 weeks our heat has gone out. On the coldest day of the year, of course. The reason has nothing to do with the cold, but it's just one of those things, where it couldn't go out on a day when it's in the 40's or 50's.

It was a fortuitous blend of luck and logic that allowed me to figure out that this was going on before it got really serious. We've been spending most of our time in the den and have an extra heater in here to keep it warm without having to heat the whole rest of the house. So it wasn't cold where we were sitting.

The lucky part is that I decided to work out shortly after this had occurred. The first thing I noticed was that the temperature on the thermostat was down a degree, but that by itself didn't tell me anything. But when I went upstairs to change, I noticed that the radiator in our bedroom was cool, which it should not have been when the thermostat was down (logic there). So after I changed and went down to the basement where our Airdyne is, I peeked in the room where the boiler is and saw that the display was red.

Red is a nice color. I like red. But usually when some sort of electronic display is red that is not a good sign. So I went in and looked at it said a pipe was blocked and that the system had shut down. I pressed Reset, as it suggested, and it started up but quickly shut off again.

This was not good. So I immediately called and emailed our plumber, who called pretty quickly and came over. He was able to unblock the pipe. He said the boiler probably needed maintenance, but that it would work fine for the moment (which it has been for over 12 hours now).

I stood and watched him because, you never know when you'll learn something. I had no illusions that I'd know how to fix a boiler, but I wanted to watch his process.

One of the summer jobs I had when I was in college was working for my father's company in California. Most of my duties consisted of what is called bench tech work. I sat with a few other people along a bench with a soldering iron, a voltage tester, some spare parts, and a meter. I would take a non-working amplifier from a pile, check it on the meter to see if it needed fixing or merely adjustment, and then check the individual components with the voltage meter to see which of them were no longer behaving as they ought to. Once replacing the non-working parts (transistors, capacitors, little electronic stuff) I would test with the meter and adjust settings inside the amplifier to make the readouts look right for putting it back in service.

There was nothing interesting about this job. I grew to hate it after a while. But I did learn something from it, a basic life technique called troubleshooting. Anything, be it an amplifier or a boiler or a vacation, that requires some sort of process should be fixed by troubleshooting it. At it's most elementary, it means understanding the process, seeing how something has to get from beginning to end, then checking the key points along the way to ensure that it all works properly.

This is why any troubleshooting guide for something electronic starts with the question, "Is the unit plugged in?" Because that's the most basic thing. Electric things won't work without power. From there it can branch off any which way, depending, but there's always a logical progression of locating where the problem is.

So what does that have to do with plumbing? Nothing. Everything. I watched the plumber as he worked through finding where the blockage was, and he started at where the first hose attached to the boiler itself. As soon as he did that, a bunch of water poured out and he was able to restart the boiler. The hose was fine, so he moved on to the next section and found the blockage. He put it back together and it seems fine now.

So what did I learn? Generally, that troubleshooting is troubleshooting. If the readout says drain blocked, you start at the beginning of the drain and follow it through. If the people who "fixed" it last week had followed the pipe all the way through, piece by piece, they would have found that the blockage they released had lodged in a subsequent pipe. Before leaving the plumber watched that water was draining through to the pump that eventually moves all the drained water to the sink.

The specific thing I learned is how to make the heater run when the drain is blocked. Just remove the hose from the boiler, let the water spill out, and the worst you'll get is water on the floor. A better alternative than no heat when it's 8 degrees outside.

Get it while you can

One thing I don't think I mentioned while we were at the hospital is that I'm a situational hoarder. When I get put in a position where I'm not in control of my environment, some weird instinct kicks in and I start hoarding food and related items. This usually shows up when I'm traveling, and any sort of food that's offered in a package, I'm getting as much as I can and sticking it in my bag. By the time I'd gotten off my (coach class) trip to Italy, I had enough food for a day and 2 bottle of wine.

While we were at the hospital, this manifested mostly in my taking anything packaged that Ronnie didn't eat or utensils she didn't use and sticking them in a bag for potential use later. At some point, it clicked in for me that Ronnie wasn't eating much of anything that she got, so I started ordering her meals with hoarding in mind. As a result, I arrived home with a couple of single serving packages of cereal, two cups of Oikos plain yogurt, an orange, a package of apple slices, 4 small slices of cheddar cheese, a dozen little cups of peanut butter, and 3 individually wrapped slices of whole wheat bread.

And this doesn't include what I left in my room, which were several sets of plasticwear, a strawberry yogurt parfait from which I'd already removed the granola, 2 half pints of milk and 3 whole wheat rolls, and assorted other bite-sized goods.

I know this is a tic of sorts. As with many of my tics, as it seems however, it came in handy on numerous occasions, such as making myself a peanut butter sandwich or a yogurt on short notice, prepared and consumed with the available plasticwear and neatened up with a napkin.

Second morning home feels better, if only because it lacks the drama of the leaky radiator. But it's also pretty (though cold) out and I've already started a fire at noon. I don't feel like I have my usual energy level back, but maybe today I won't need to nap an hour after drinking a cup of coffee like I did yesterday. Just like everyone is telling Ronnie that she needs to take her time and let herself recover, I kind of have to do the same thing, though I won't have anyone reminding me.

The visiting nurse came this morning. She was very complete and well-informed and probably repeated some variation of that stupid cover letter space-filler, "please don't hesitate to call" (I remember a writing teacher asking us to try to picture someone hesitating to call) 30 times in the hour she was here.

She left and next was the physical therapist. We didn't know she was coming, but the nurse told us she was and it's all fine. She talked about a few things and then said she'd be back tomorrow to do some exercises. Then rug cleaners are coming to take the stained rug away as well. Don't know if we'll be having any other visitors.

It's way more quiet here than in a hospital, in both good and bad ways. They say that people feel like some kind of safety net has vanished when they leave the hospital, because they get used to there always being someone at the ready to take care of anything. At home, I'm the safety net, which seems to be okay with both of us.

Morning after

I was honestly expecting to really crash today. Two weeks in a hospital, even if you're not the patient, is exhausting physically and emotionally, and it's hard to tell when you're in it whether you're running on adrenaline or whether you're actually staying within yourself.

And then to start the day with the radiator exploding and requiring a solid hour of cleaning up before I could even have a cup of coffee was a rough start. But somehow, with the help of an afternoon nap, I successfully navigated the day.

I've yet to face any of the more difficult things that I need to face. After the getting through the all-consuming experience I just had, anything else seems overwhelming, especially the things that I find difficult, like processing paperwork in general and dealing with the IRS in particular. Or even school stuff. As much as I love school and teaching, it's been completely out of my head for a while, and I'm strangely hesitant to dive back in. I know it'll be okay once I do it, but it's just a big change.

And then of course we must at some point soon retrieve our little pup, who will demand a fair amount of attention that I'm not particularly in the mood to provide. Hopefully I'll feel better in the morning. Things to do tomorrow.

Back in our own place.

So we're home now. All that hospital stuff is over; there were times when it seemed that was never going to end. Today was very different from the rest of the days there. Nobody came early, the doctor eventually came by to say "See you in a week."

The rest of the time there was physical therapy and a lot of waiting. Eventually a nurse came in and started listing off all the things that we needed to do over the next 6 weeks or so. How and when to take medications, how to treat surgical sites, not to drive or operate heavy machinery, especially if you are taking narcotic pain relievers. The nurses repeatedly told us that Ronnie needed to sit in the back seat. The doctor told us that he considered that to be a lot of crap, so we went with him on it and the drive home was much more comfortable for both of us as a result.

We got a bit of a late start because the parking lot had a lot of trouble finding my car. Somehow, they were not able to quickly make the conceptual leap that my saying "I parked it 2 weeks ago" meant that it had been parked there overnight, as opposed to cars that had just come into the lot. When they finally asked me after 10 minutes if I'd parked today or yesterday, it all because clear. It took about 15 more minutes, but they did eventually locate it.

As you may have noticed from my pictures, the hospital is near the George Washington Bridge, which is nice if you're looking for a way to get to New Jersey. Which we did. It finally started to snow just as we approached our house and it never affected anything. Getting in, getting settled, it was all easier than we could have thought. Ronnie was able to climb the stairs without extreme difficulty and is comfortable on our den couch, which is the normal place we hang out. It was very nice to sleep in our own bed.

The next morning began, before I had my coffee mind you, with one of those portable radiators exploding and leaking its entire contents of oil onto the floor. Took me over an hour to (mostly) clean it up. Probably ruined the rug, though I pulled it into the kitchen (hard because it was hot) onto the wood floor before most of the leakage. Finally cooled down enough that I could take it outside. I'm just glad our dog wasn't here. because she would have been a big problem to deal with in this kind of situation.

So the house is no longer slippery and no longer reeks of petroleum products. I can't say that I'm completely used to it yet; the past 2 weeks were too intense and far too disorienting to recover from in less than 24 hours. But today feels better than yesterday and the mantra for this kind of thing is "one day at a time." So I'll gladly settle for being where we are now as opposed to yesterday. Maybe by tomorrow I'll be able to face schoolwork and some of the stuff that needs to get done around here. But that's another story. As is, how much did this actually cost. I'm kind of fascinated by that, because we haven't paid anything yet. 

Time to go everyone!

Yes, I know that there should be a comma in that title, but it looked awkward and I'm all about appearances.

Today is clearly different.  When Ronnie was in the ICU I would be down in her room at 6 to catch her doctor on his early rounds. Even yesterday, when she was in our current step-down unit, I was down at 6, though the doctor didn't come in until 6:30 or so. But Ronnie had been up and had gotten some sort of wash-up. Today I came down at 6:25 and the room is dark and she's still asleep.

So I guess the point is, they're not doctoring us any more. I'm sure we'll see our doctor  more than once before we go and in a week (later note: we saw him twice and after the second time he just turned and said, "See you in a week."), but for now we go from having a 24/7 group monitoring to just us. At least we won't need to disconnect any wires to move around the way we do now. I'm not doing anything about things I won't miss. That would be everything except what I put in the last post. But I especially won't miss all the wires and stuff hanging off Ronnie, though not with nearly the intensity that she will not miss them.

So now it's just waiting for them to give us our final instructions, at which point the message will self-destruct and we'll be off on our mission.

The idea of going home after such a long time is stranger here than when we've been away on vacation. Some of it's the same. Usually by the end of a long trip we're craving the familiarity and looking forward to not having to eat every meal off a menu. The food aspect of this is definitely attractive, and the supermarket is a similar distance to the ones I've used around here (I've used all 4, Key Food, Bravo, Associated and Gristedes- Bravo is the nicest but my favorite is Associated because they always have salsa music blaring over the PA system, which gives buying yogurt and cereal a festive feel) but now if I go out I leave Ronnie alone instead of in the care of nurses. At some point in the next day or so I will do that, and it's going to feel weird for me and probably even more for her.

Having the dog around will be a challenge too. She's very cute but she's an attention whore, and will not leave us alone. She'll stay with our friend who's been boarding her for a couple of days until we get acclimated.

But it will feel less and less weird as time goes on. And in a few of months, this will be mostly a memory and Ronnie will be feeling better than before we got here. But have no doubt, this is a big reminder of how important it is to appreciate the journey and not focus solely on the destination.

What I'll miss

I promise not to wax rhapsodic here, because I'm a fan of neither wax nor rhapsodies, but I am really grateful to a lot of people here at the hospital that did everything within their power to make this as bearable as possible. I know we had great doctors, but as I said in the last post, most of the work is done by nurses, and they do amazing work. Can't say everyone was great, because one in particular was pretty awful, but overall the quality of care here is high.

I won't really miss the nurses, much as I liked and respected them, but I'm going to miss some things.

First and foremost, I've been completely taken with this neighborhood. I'm hoping its funky diversity can survive the forces of gentrification. I know it's called Washington Heights, but only part of it is on the high ground. The topography is really fascinating and the idea that I'm sitting here maybe 500 feet from the river horizontally, but also another 200 or so vertically, makes it a fascinating place to walk around. I walked today on a section where there are 3 streets running sort of side by side, all called Riverside Drive. What the hell is that? It's beautiful is what it is.

I've posted lots of pictures from up on and under the George Washington Bridge, which could not be more right here, but it's not all scenery. Even going beyond the medical school, which fills the neighborhood with young smart people at all hours of the day and night, there's also the premier indoor track in New York, with competitions pretty much every day. How can you not love an area where, when you're going out to pick up some pizza, you see 20 high school students in track suits emerge from the subway and start jogging around the block?

And Broadway is absolutely hopping at all hours of the day and night. One of my few regrets here is that I never got out really late in the evening to see what it's like, because at 10:30 it's very much alive. Nearly all the restaurants are open and many of them, I notice, are open 24 hours. And they all deliver. Maybe nobody around here cooks (though there are 4 supermarkets easy walking distance from here) because the streets and sidewalks are all but choked with delivery bicycles, buzzing pedestrians and running red lights, running here and there with insulated bags.

And some of the food is really good. The only thing I couldn't find around here was decent Japanese food, I needed to go downtown for that. But I ate very well and got almost nothing at the hospital cafeteria except for coffee.

But I didn't gain any weight, because I walked so much. Part of that was because I went out for walks almost every day ranging from 1 to 5 miles. But also, I walked an average of 3 1/2 miles a day inside the hospital. The place is huge, and think goodness I started taking the stairs, because I'd had it with the elevators. It helped keep me strong, and as I wrote about earlier, being fit paid both me and Ronnie significant dividends, because I was able to put up with everything swirling around me in a high stress environment on limited sleep and come out feeling tired but pretty healthy.

And lastly and maybe not very interestingly, I'll miss New York. I love where we live and don't regret for a second moving there, but I grew up in New York is and it will always be in my blood.

What I've seen and learned

So we're leaving tomorrow. At least that's the plan, pending a couple of pre-discharge tests that have already begun. We will depart around the same time as we arrived, almost exactly 14 days later to the hour. And we'll head home into a snow storm as a bonus.

I was noticing last night that I've only been on a couple of floors in all the time we've been here. All four of the rooms Ronnie has been in are on the 5th floor and I'm staying on the 9th floor and the cafeteria is on the 2nd floor. And the rest of the world is on 1. So those places and a single stairway in between them (I've all but stopped using the elevator) is pretty much all I've seen in here.

Hospitals seem to work on a few basic levels. There are doctors and their cousins, the surgeons. The doctors figure out what's wrong and it's up to the surgeon to fix it. You never ask a surgeon if you need surgery because they will say "yes," because that's what they do. They're also treated like some kind of deity, as if there was a mythology where there was one god who only gave life and then lots of other gods and demi-gods who take care of all the other stuff. When our surgeon walks through a ward, the waters part.

The doctors report, at least here, to the Dean of Medicine, because this is a teaching hospital. Our doctor is the chief of cardiology and our surgeon is chief of surgery, so I presume they report directly to the dean. My father knows the dean well. This has been useful at times.

Once your condition is no longer acute (and often even when it still is) you see your doctors once or twice a day and you are cared for by a second, more intensive level of skilled staff. That consists of nurses, aides, physician's assistants and nurse practitioners (I need to learn what the difference is, from a patient's point of view they seem to serve the same function) who give a full examination and can prescribe stuff (but not administer it). The nurses do most of the heavy lifting, except when it's literally heavy lifting, in which case they're aided by and aide. They are ubiquitous. There are probably two dozen of them in and around where we are. The nurses within a unit seem to be managed by what's called a charge nurse, who makes the assignments and is a good person to be friendly with.

The nurses do not in any way, shape or form report to the doctors. As long as they do what the doctor has prescribed they are complementary, teammates even, but separate. Nurses vary from the doctor's orders at their peril, but doctors can't fire nurses and their overall performance I presume is evaluated by some head of nursing that I am not familiar with. But the point is that if you have an extended stay in a hospital, 90+% of your contact with the hospital is with nurses. And in the vast majority of cases that's a very good thing.

There is also a huge supporting cast of technicians (we've seen portable x-ray and ultrasound) and phlebotomists,  pharmacists, physical therapists, food service and cleaners. There are also social workers who help you with the transition from here to home, which I presume is a more pleasant job in our circumstance than in others.

I have no idea what the administrative structure of a place like this is. There have been mess-ups here and there but the place is so massive, it's amazing it runs as smoothly as it does.

This time from Under The Bridge.

You hope going into something like this that you'll have support when you need it, but I've never really known what that meant until dealing with an actual serious medical issue. Support has come in many different forms from many people, and every single bit of it has been incredibly appreciated.

I also must say, I have kind of fallen in love with this neighborhood. I presume it's called Washington Heights because George was here at some point (the bridge name is another clue. Maybe he crossed the Hudson here on his way to the Delaware. I'm not sure why one would pick a spot where the land slopes down steeply for a couple of hundred feet down to the river, but what do I know about these things?

I already wrote a lot about my walk over the bridge, but today I walked under the bridge, which I have to say, is an even better walk in many ways. I'm only going to put one photo here

because the entire album is worth looking at. The above is cool and dramatic, but some of them are really beautiful. Here's the link. I'm going to be editing them for a while, but wanted to put them up there.

I've gone on a lot of great walks in my life, and this one was up with the best. Did you know there was a lighthouse under the bridge? How about tennis courts? And as you can see in the photo above, the river is right there, with ducks and geese and everything and it's this incredible mix of natural beauty and powerful infrastructure. All along the walk, the din is inescapable. Cars speeding up the Henry Hudson Parkway and 14 lanes of traffic across the bridge, even as the river side almost glows with natural beauty.

You can ride or walk up this path all the way from the lower tip of Manhattan. I got off at 181st Street, but the path continued and I've seen people walking or cycling all the way up to the northern tip.

Hey, it Super Bowl Sunday! And we're still here.

This is very different. The first 10 days I was pretty much on my own. Now, Ronnie is fully conscious when she's awake, so it shifts the whole dynamic. Now there are decisions about "What are we going to do now?" that hadn't existed before. It makes going home feel a lot closer, which is both exciting and terrifying.

I learn more each day about what'll be involved when we get back. I think the big key is having lots and lots of pillows available to make sure we can find a comfortable position. Probably will bring our air bed downstairs, so we don't have to go upstairs every time it's necessary to lie down. Don't really think the couch is an option at this point, though it would be nice if it were.

I'm also wondering what we're going to do with the dog. She is going to be a (very cute) problem, because she is demanding of attention and from my experience here will not completely understand when I explain the situation with her. Seems silly to have a dogsitter while we're home, but it may be necessary.

Watching someone heal is a little like watching plants grow or paint dry. It isn't exactly boring, for me anyway, but it's slow. And plants and paint do not have opinions on how things are going. Actually, I don't know if that's true, but if they do, they don't express them. Yeah, so now I'm discussing plants and inanimate objects like that. Think I need to get out of here soon.

And the Super Bowl is today, right? No wonder they had nachos and chicken wings on the dinner menu. So weird. I don't follow football very closely, most likely because I don't like it, but I've always watched the Super Bowl, since the very first one. We'll see. Maybe a trip to the lounge is in order. Here's the TV that's in the room.

Not quite 4K HD

This is not a test

So I think I've said all I need to about how good math is for life, but I also wanted to get in a plug for being physically fit. Everyone knows they ought to exercise more and I know I'm odd in that I enjoy doing almost any kind of exercise. But one of the points of staying in shape is that you never know what you're going to need it for or when you'll need it.

All I can tell you is that when you hit really difficult moments in life, you want to have as much physical reserve as possible. Between the stress and the long hours of waiting and attending, being in a hospital for this long cannot help but take a huge physical and mental toll on anyone. And I'm glad that I was as up for it as possible.

The fact that I like to walk is a huge plus, both because the hospital is huge (I've walked 4.5 miles today and have only been outside once for 15 minutes) and although there's are a ton of stores and restaurants on Broadway, the closest place (a Starbucks, of course) is a quarter mile away.

But more than anything else, this is an endurance test, except it's not a test. It's the real deal, a period of life that requires true endurance. The point isn't about the minutia of what I'm doing, it's that I'm doing something, anything stressful for nearly 2 weeks without a break. You can't do that if your body can't handle it.

So that's the whole message. Don't worry about what you'll look like in a bathing suit. I'm a 60 year-old man, I'm going to look ridiculous in a bathing suit no matter what I do. But as unsleek as I am, I do have stamina and strength and I don't regret a moment of the work I did getting myself this way.

Tomorrow is another day

Of course this, and not "Frankly, my dear, I don't give a damn." is the last line of Gone With The Wind. Movie and novel (or so I hear, I've not read it nor am I likely to). But don't remember anything in that movie actually leaving with the wind. That's puzzling.

In my current context, it just refers to the numbness that comes from being in a hospital for almost exactly 11 days from arrival. We're doing pretty well now, in the grand scheme of things. Ronnie has a private room with a nice view of the river and natural light, and it's much quieter here than in even the nicer ICU.

I've lost count of how many times I've been up and down the stairs. Okay, I was never actually counting that, because that would be weird and obsessive, but you know what I mean. I've tried to vary where I get lunch and dinner every day, but it's hard to differentiate when the days are structurally so similar.

There's a track meet at the Armory across the street, as there tends to be on weekends. Last week was high school. This week is college. On my way back from Starbucks (Ronnie may not be feeling good, but she still enjoys a (decaf) latte) I saw a pack of University of Arizona women jogging around the block. They're from Arizona, so they're all blonde and pretty but they can spit like pros.

I keep feeling like there's something else I wanted to say, but I guess later today is the same day, and that'll be okay.

TGIF

Several highlights today. First of all, a dietician came in, looked at me and said, "Are you staying here? I think I've seen you on the stairs." Told you, stairs culture is a real thing. Saw someone huffing and puffing their way up. I tried to be encouraging.

Second, and far bigger, we got out of the ICU and into a regular room. It's a huge step forward on our 11th day at the hospital. At first, it was into a semi-private room, which I guess is a nice way of saying you're not just out in the middle of an open floor, but there ain't nothing private about it. Two beds right next to each other with a curtain in between. It's a double, like what you get if you pick late in the rooming lottery in college.

But we've enjoyed occasional perks since being here on account of our foundation supporting research and providing fellowships. One perk is some super soft non-skid socks with the hospital logo on them. Another is access to the office of the dean, which so far has gotten me access to the employee fitness center, a couple of days of free parking (a $36.00 value) and a way of asking someone (as opposed to asking a bureaucracy) if it would be possible to get a single room. I really don't like asking for favors, but we have had people coming by our room every day asking if they could do anything for us, so after a while they wore me down.

So I asked if we could get on the list for a single room. I did it as gently as I could, but I asked for the favor. The lovely and helpful woman I've been dealing with explained that there were no single rooms available, but if one opened up that we would get it. No lie, half an hour later, a single room suddenly opened up. I presume they didn't boot someone out to make room for us, so I guess it was just right place, right time. Anyway, Ronnie is in a single room and we're happy about it.

Now it's just a slow build to discharge. Hopefully just a few more days. I wonder how deep in the lot my car's gotten buried. Oh well, that's a problem for another day

It's Friday again?

This week has kind of blown by. All kinds of turmoil around this and that. Major things, minor things, this place to that, crazy people, sane people. Life in a huge institution like this is weird sort of microcosm of the word, just with more sick people and a higher concentration of health care professionals.

One of the things I talk about frequently in my upper-level math classes when we study trigonometry is how many things in the world act in a way that can be modeled with what are generally called sinusoidal functions. Anything with waves- sound, light, electromagnetic waves, plus tides, annual temperature patterns. I also mention that when they say on medical shows that there's some kind of heart problem, "They've lost sinus rhythm." they're not talking about you sinuses behind your nose. It means the heart rate is not in a regular, sinusoidal pattern.

Having sat here staring at monitors for 11 days (actually, that's an exaggeration, I don't stare at the monitors, but 'glance,' while more accurate, doesn't carry the same kind of gravitas) I have a greater appreciation. Inhaling, exhaling, blood pressure, whatever. It's supposed to rise and fall within an acceptable range in a predictable pattern, and the one thing about sinusoidals is they are completely predictable. Their very boringness  and regularity is their power.

We're all so used to constant stimulation now that we may be losing our appreciation for routine and predictability. Nothing like being in a hospital for 11 days to remind you of how completely we rely on these uninteresting but essential parts of our world. When I teach about continuity, I sometimes say that a discontinuity in real life is almost always a bad thing- death, divorce, car crashes, even just getting lost- all kinds of discontinuities. All unpleasant or worse.

I miss my routine. Going to the refrigerator for food, walking the dog, sitting on the couch and watching TV. Getting up and going to work or reading the newspaper on the weekends. Regular stuff, comforting in its very predictability.

Forward to the past

Seems fitting that last time we were in this unit, Back To The Future was on TV, because now, 2 days later, we're back here again.

This floor has three adjacent ICUs. The most telling comment I heard about the one where we'd been for the past 48 hours was that it was a great ICU if you were unconscious. That came from our doctor. Thankfully, he had enough pull to get Ronnie moved back into a more familiar, much quieter setting.

It's only around 8:00 and we both feel like it's midnight. I guess not sleeping at all (that would be Ronnie) or sleeping badly for 3 hours, with an intense leg cramp interlude at 4:00AM (which would be me), can make the day feel long. I am hoping to get a good 8 hours tonight.

The day was also weird because I didn't go outside until after 6, so the whole thing was disorienting. Fortunately, the nurses we dealt with today were nothing like the human cyclone Ronnie had to deal with last night. It was just the place. It's over now.

So after all that, I finally got to go out and eat something. I never had gotten to eat lunch because I couldn't leave. I went to a local tavern (that's what they call themselves- there was nothing about it that suggested tavern rather than just plain old restaurant with a bar) and had a massive turkey burger, my first protein of the day. With fries. Yum. Now we're just winding down.

I'm hopeful that tomorrow will be much more productive and that we'll see some real progress. I'm certainly ready to leave, even though I have plenty of clean clothes.

Ah yes, the hospital food

How did I go this long without commenting on the food. You know you're in a huge place when they tell you that it's too late to order a particular breakfast for the next day at 2:00PM the day before. Not ordering yields a random assortment of meal-like stuff. That's the ticket on the right with a randomly selected breakfast.

I think my favorite part of the meal ticket is the 1 PKT GRAY DIET KIT - JR**.  That comes with every meal and contains a straw, napkin, and gray(!) plasticware. So little of this gets consumed that I've pretty much stopped ordering anything for Ronnie and try to make sure that at least one thing that I might eat shows up. From that breakfast I ate the turkey sausage. I always circle the peanut butter so that I can eat it with the WHEAT DINNER ROLL**. Also always get milk for my cereal and coffee, and Ronnie does eat some Cheerios, though I'm going to get her some other kind of cereal later today.

The food in the cafeteria (that's what they call it- it's essentially just a long line of people with food and beverage choices to your left and right as you walk through- no place to sit) is not all bad. They have good coffee and I had an okay fruit salad and yogurt with granola this morning. That stuff is salad bar style, where you pay by the pound. A lot of the staffers eat pizza from there, but I tend to go for the real pizza at Slice On Amsterdam when I want some of that. 

Plenty more cafeminutia to be had, but I'll give it a rest. I've heard you can order room service kind of food, and once Ronnie gets her appetite back, we might do that.

Well, that was a day (comma added for the grammar specialists).

It's hard to believe it's only about 30 hours since Ronnie's surgery was finished. It feels like an eternity. Can't imagine what it feels like for Ronnie. She had a longer day than I did and I started at 6 and finished around 10:30.

There are good things and bad things about being at a huge hospital. It's without a doubt one of the best hospitals in the world, and people come from everywhere to have the doctors we have. But hospitals are not just about doctors. Doctors do essential, highly technical, primary level work. But after that part is done, the place is run by nurses and support staff, like pharmacy. I'm not saying that's a bad thing, but I have a sneaking suspicion that the hospital's attention may be on finding the best doctors while not always keeping their eye totally on what makes the overall care good.

The best example I can give is that the information systems, in spite of scanning everything and sophisticated monitoring, is like a game of telephone. They have repeatedly gotten everything from prescription orders to my phone number wrong at times. Things have gotten messed up at every transition. And when I say something like, "It's 10:15 and we haven't gotten the meds we were supposed to have at 9, I get attitude because I'm supposedly attacking the nurses. It's not the nurses' fault if they ask for a prescription and it never shows up. They're just trying to follow instructions and if the instructions are unclear or incorrect, what are they supposed to do?

Anyway, I'm basically getting no sleep tonight because of this. Maybe I shouldn't be blogging angry, but can I at least blog frustrated?

Stairs Culture

That's what it's come to. I'm writing about the stairs.

Before going on, I (1) want to make sure that nobody got the impression from my last post that I don't want to hear from you, just be patient with me, and (2) want to state that Tasty Deli is the hands down winner for best place to get sandwich within a 10 block radius (of course, 10 blocks west is kind of damp). Had a Cubano yesterday and Hot Pastrami today and they were both winners. And the server recognized me on my second time in the place.

So I've been taking the stairs for exercise, though I now have access to the employee fitness center when I have the urge, which will probably come later this afternoon. The main elevators here are incredibly slow. One of the nurses told me where the staff elevator is and said it's less crowded, which I bet it is, because most of the staff seems to take the visitor elevator, at least when they're going to the cafeteria. Or if they have a cart.  Or to leave for the day.

So the stairs are by far the most efficient way to get from floor to floor. My stairs are labeled Fire Stairs E. I do not know where this falls in the pantheon of stairs in this hospital, but it is the stairway closest to both the main lobby, the ICU and my room. And it has doors that let you off at any floor, which not all fire stairs do. From floors 1-5 it's 28 steps floor to floor, and 5-9 it's 24.

Okay, so I don't want to overstate it, they're fire stairs- darkish and concrete. Used masks and other debris on the floors in a few places. But they're there and they're busy. I'd say that I'm one of the few non-hospital personnel using the stairs. Lots of doctors and nurses and administrators. Mostly going from one floor to the one below or above. Everyone is polite and holds doors. Lots of people go down multiple flights, but only the hardcores go up more than one. I've finally gotten to the point where I'm reasonably comfortable going up from the lobby to 9.

Very distinctive wear patterns on the floors and especially the bannisters. Lots of pipes. Phones for the Fire Marshalls on every floor. Signs with tips for good heart health that do not contain the phrase, "Take the stairs." As people go they talk about cases, about who did what to who, last assignment, next assignment. Shop talk. Sometimes weekend or evening plans. Banal things. I've not heard one exciting thing on the stairs. Which is good. I don't need to hear about someone emitting fluids in some inappropriate fashion.

The frustrating part

In general, the frustrating part is that there is a limited amount I can do to help. I mean, I know I'm helping a lot, but it's within a pretty limited scope. It's particularly limited now, because we're still so soon post-op, barely 12 hours. To some extent I can help keep Ronnie calm, but there's only a certain level of company I can keep at this point, and aside from that, my most important function was being a more articulate call button (though they do really answer those, at least here in the ICU- it's not like on an airplane), doesn't come into play yet, because it's still too complicated. I can get water and say her back hurts or move a pillow, but I'm not able to say something like "she needs 5ml more propofol," though we could all probably use that every once in a while. I know I could.

So at this point it's literally hand-holding. Which I don't mind at all until my knees get sore from standing. When I can sit bedside it'll be better. We're in a different ICU this time, just routine for a second surgery, and the rooms are smaller and the place is busier. I'm still taking the stairs everywhere- I've finally made it up to going straight from the 2nd floor (cafeteria) to the 9th, where my room is. No, I will not be getting a stairmaster when I get home. Using stairs to get someplace is one thing. Pretending to climb stairs is something else entirely. If I'm going to pretend to do something, let it at least be something I enjoy, like biking.

So we'll see how the day goes. She's doing well so far. It's raining so I don't think I'll do laundry, but I do need some supplies because I planned for up to 10 days and it's now day 9.

The age of instant communication

One thing I did not anticipate in this whole experience was the overwhelmingness of having to keep people informed. I've been sending fairly regular group emails out, but there are others who are not on some lists or any lists and some I communicate by text and even one by phone. Actually it's almost all done on a phone, so I guess you say by "voice."

The problem is keeping it all under control. It's a good problem to have, but that's not the same as not being a problem.bI've already made liberal use of the Do Not Disturb feature. Everyone means well, and considering how alone this whole experience is it's nice to communicate, but there are times when I feel besieged. Can't be helped. 

Waiting for the surgeons, Second Tuesday AM.

Of course, it makes it much easier to contemplate another week or so in this same ICU room knowing this is here.

According to my physician sister-in law, they call this a pantry, but it isn't really a pantry- none of the cabinets contain anything. There's a refrigerator for patient food, but that all has to be labeled and bar coded and dated.

The waiting room is strangely deserted this morning, but the people who've been living in the corner left the empty chairs and their pillows and bags of things arranged such that it's clear that nobody better mess with their stuff.

The TV is on in the room and the remote is buried in the bed somewhere, so I can't completely ignore what happened in Iowa yesterday. The TV news people were talking about how the big thing among Republicans has been homegrown Islamic terrorists. I understand their concern. Those terrorists have killed far more people than, say, right wing terrorists. Oh wait, that's completely, 100% false. 

Anyway, I know there's no room for subtlety, much less actual thought, in this. but this whole portraying the enemy as the personification of evil is just plain stupid. To defeat an enemy, you need to know what they want (and 'destroy our freedoms' is not an actual thing). You don't need to give them what they want, but you'll better understand what they're trying to do. Insight is not a bad thing.

I'm hanging in. Going out for at least two long walks and maybe a subway ride today. Have no desire to get in a car.

One hour processing

So 5 days after Ronnie's surgery, we just learned that it was not fully successful and that another surgery is required. It will be performed tomorrow, though we don't know when. The surgeon will come by and tell us at some point (afternoon, it turns out).

This kind of news is pretty much impossible to process in any knowable time frame. It may all be over before I've processed it. I'm not sure what a psychologist would do with that, but I'm sure they'd say I should come in and talk with them about it.

In the larger scheme of things (and I should say that this requires a particularly large scheme) this will be fine. I just want her to be okay and to be able to come home. That will now not be for another week. So I'll get to do a load of laundry on top of everything else. Another sampling of life in Washington Heights.

Everyone, including the doctors and nurses, are being very sweet about this. It's just a total drag, no ifs ands and buts (or schemes) about it. More pain and recovery for Ronnie and more time sitting in this room for me. But as long as it's okay in the end, that's something I can process.

Wake up!

Sunday was unbelievably slow. They try to empty out the ICU so when the do surgeries on Monday there are beds for them. There are 10 beds in here and only 6 are filled. They keep talking about moving Ronnie to a step-down unit, but every day it goes from maybe today to maybe tomorrow.

There's a huge difference in energy once Monday starts. I got down here at 5:55 and the surgeon had already been and gone. The cardiologist came by at 6:30, which is late for him. Change the IV, x-ray, this and that. Machines, people, nurses, breakfast, doctors. Curtains open, curtains close. Things are moving. Maybe even us today. Who knows?

I can't help feeling like I should tip the nurses. Probably not the protocol. They are presumably being paid a living wage, unlike servers. But some of them are so incredibly helpful and kind, you just want to do something special for them. I'm going to try to remember names, but it's completely international. Our nurse is from Hawaii. Her name is Jenna. Overnight it was a very sweet guy. I've already forgotten his name. There's a wonderful woman who's here just as a general helper. I have never known her name. Ugh.

Getting to the point where I am starting to crave information. It's hard to just sit here day after day. There has been slow progress, but nothing yet about next steps, aside from maybe today we'll move upstairs.