I order a tall Americano, sit by the window of the Starbucks on Memorial Drive with a view of the Charles, the river that runs through Boston, my new home. I pull out a five-page document from my bag — a document it has taken me twelve years to request, which I obtained from the Harvard Vanguard doctor I’d just been to see. I raise my coffee, drink a toast, dub him my new life protector.
I smooth out the document on the tabletop — the surgical notes from my second operation in a month — read from page one:
“The patient was taken to the Operating Room and identified. She was placed in a supine position on the Operating Room table …”
Tears prick my eyes. I sniff. Imagine my body on the operating table. Naked? Covered how?
“… Her abdomen was prepped and draped in normal sterile fashion. Her previous midline skin incision was opened sharply.”
Whoa. I close my eyes; picture the surgeon slicing into my belly, re-opening the same eight-inch vertical incision originally made ten days before. Like a “Carbon Valley” whiz kid, he rejiggered what God, what my DNA designed, repaired what had gone awry the night I was grocery shopping at Wegman’s in Ithaca, New York, and felt a stabbing pain so severe I knew something had gone horribly wrong inside me. Now that I’ve peered into the rabbit hole, I fall in …
Friday, November 31, 2001. I abandon my grocery cart and drive home, pain grinding up my abdomen. I collapse at home, on the bed. My husband, Jim, takes me to Convenient Care, where they call an ambulance to transport me to the hospital ASAP. The EMTs wheel me into the ER. I scream from the pain, scream bloody murder — something I’ve never done before, that I’ve only seen on TV. A nurse rushes in. I hear something about Demerol, feel a needle in my arm, sense an X-Ray machine clicking, whirring over my belly. Somehow I register: There needs to be an operation. NOW. At midnight. A surgeon has been called.
My small intestine has twisted, kinking it like a garden hose, shutting off the flow. Huh? How’s that even possible? My stomach’s in knots? I think it’s a metaphor, that it’s something else, that they don’t wanna give me the really bad news.
I wake up in a recovery room in the middle of the night, somewhere between three and four in the morning. Jim explains what happened to me. My small intestine indeed twisted at the intersection of my large intestine. It’s called a volvulus. Why? The surgeon doesn’t have an explanation, says it’s a rare occurrence for a woman my age, more common in horses. Huh? He explains he untwisted it, sewed it down. Oh, my god, I think, what thing burning inside me caused this?
I’m kept in the hospital for three days attached to a morphine drip I can administer to myself as needed by pushing a button. I get better: sip tea and munch on buttered toast. Back home I begin to eat normal meals; but three nights later, I wake up with nausea, in a fevered cold sweat that leaves me panting on the floor of the bathroom, then wrenching my guts up. Over and over. I can’t sleep. I lay in the living room staring at CNN, feeling waves of nausea rack my belly. Next morning, Jim takes me to see my primary care physician, who admits me back in the hospital. I feel so sick, I’m happy to be there.
A well-meaning nurse attempts to gouge a plastic NG (nasogastric) tube through one of my nostrils, down my throat into my stomach, snake-like. I’m told to bend my head over and swallow water while she’s trying to do this. I gag and gag. Water goes up my nose. Burns. I try not to cry. She can’t accomplish the task, gives up, gets another nurse — “She’s better at this.”
My stomach contents must be completely emptied, sucked out by the NG tube into a collection bottle on a continual basis. The stomach produces a brown sludge-like amalgam of digestive juices all the time, regardless of your food intake; and with my intestines blocked, there was no place else for this stuff to go. Who knew? Fascinated, grossed out, I watch my stomach’s contents build up in the glass collection bottle, relieving me of nausea — the only thing I care about at the moment.
The nurse tells me I’m “NPO,” nil per os, Latin for “nothing by mouth.” No food. She posts the NPO sign on the wall, above my bed, in case anyone is dumb enough to give me food. This goes on for days. No food.
But my intestines won’t clear up. Dense mats of adhesions — scar tissue — have clogged them up at the site of the surgery. Nothing will go through — my digestive system like a dried-up river, like some freaky Marquis de Sade torture.
One night I wake up from a fitful dream. I’ve literally pulled my NG tube out. It’s about two feet long. The night nurse is angry with me. She can’t get the tube back in. I try not to sob. I can’t remember how she got it back in, but she did because she had to.
Jim, worried, eager for resolution, researches my condition, calls other doctors across the country, tries to figure out if there’s something else that can be done.
Day five. Friday afternoon. Weaker. My surgeon, who was newly trained out of a residency in Sayre, Pennsylvania, decides another operation is necessary … that night. But not in Ithaca. He says he’s taking me to Sayre to attend another surgery with the surgeon who trained him.
I’m loaded in an ambulance for the hour-long ride. At Robert Packer Hospital, they prep me immediately. I lie on a bed in a hallway (I think), wait for some drug to numb my mind, my body in limbo between life and death, waiting to be taken into the operating room. Fear grips me at my cellular level. I fall asleep, thinking I might die …
When I wake up, they tell me the operation went well. I feel profound relief, like I’m floating above the bed.
They put me on the cancer floor, in a double room by myself, because the GI floor is full. A nurse unhooks my NG tube every day, so I can get up to walk down the floor, pushing my IV trolley. I see people lots worse than me with cancer — with no hair, with no hope — in-patients, their rooms packed with family.
Back in my room I gaze out my window that overlooks a park, the main square of the village of Sayre. The trees, the gazebo, a Christmas tree twinkle with white fairy lights, with colored lights like a life-size Christmas village. Jim and Isabel, our daughter, buy the Sweet Rock Candy Company for our Christmas village at home, but set it up in my room. I spend time looking down on the square and at the lights of my Sweet Rock Candy Company, at its glowing entrance to the Rock Candy Mountain Mine.
But days go by and still I’m NPO, though I can suck on a pink sponge-on-a-stick that I swirl in a plastic cup of ice water. I’m supposed to listen for the gurgling sounds properly functioning bowels make. I wait a week. Nothing happens. No gurgles.
I can’t shower because of all the stuff I’m hooked up to. My mom washes my feet. My sister-in-law washes my hair. My mother-in-law keeps Isabel. I have a procedure for a PICC line, a “port” — three holes in my chest above my left breast — hooked up to a bag of liquid that feeds me intravenously.
At night I don’t sleep well. Aides check on me, take my temp, draw blood. Entwined in tubes, I think about my hobby — figure skating — go over moves and ice dance patterns I’m trying to learn, picture the details of the positions, how I’m supposed to move my body, wondering if I’ll ever get to skate again.
Every morning, I watch the Today show in the dark. Then my Sayre surgeon visits on his rounds with a team of interns and residents. They toss around words like ileum, cecum, volvulus, ileus that make no sense to me, even though Jim does the research, explains. In some kind of dream-state, I register impressions, but don’t recall conversations the way I normally do, can’t put together sentences, can’t make sense of anything. I will go years without labeling what happened to me as a volvulus. I rely on Jim to safeguard the facts because it’s too frightening for me to think about.
I sit by the window to look at the Christmas village in the square or stare at the lighted Rock Candy Mountain Mine entrance or watch Bobby Flay on the Food Network, my comforts. The next best thing to eating is watching someone prepare food on the Food Network. Weird, huh?
Two weeks after my second operation, I’m not better, still can’t eat. A nurse weighs me. I’m five foot eight, now 103 pounds. I’ve lost thirty pounds. It’s a couple days before Christmas. I sense she thinks something has to be done or I’m a goner.
My surgeon schedules a CT scan. A nurse tells me I have to drink a juice-like fluid, the contrast for the test. She smells like cigarettes and rotted meat, like everyone does to me now who’s not a vegetarian. “I thought I was NPO,” I tell her. She says it’s okay to drink this stuff. A noxious green cloud blooms up in my room like rogue colonies of algae, chokes me. I drink. Eight cups.
The CT scanner — I remember a white metal cylinder — pulls me in on my back, feet first. I think of the Rock Candy Mountain mine tunnel. A Christmas card or picture taped to the scanner’s opening shimmers above my head. A red bird, a cardinal. A sign? I hope so. Or, am I making stuff up?
Back in my room, I feel really sick from the fluid I drank. I lean over the side of my bed and vomit it all up. A lake of sticky brackish liquid covers the floor. [I’m so sorry to tell this, but it was profoundly upsetting to lose control of myself, to be so totally helpless. I think this was the low point of my life.]
I push the call button for help. A tech cleans up the mess, makes me feel okay, tells me about the days when he was on TV — a professional bowler. “That’s so cool, man!” Wow, a former professional bowler, like on Wide World of Sports. He’s awesome, my favorite, makes me feel unashamed of my condition.
A day or so later, early, my parents come into my room. Christmas Day. They’ve been hanging around Sayre for a week. They tell me they know I’ll be okay, that they’re going home to check on the rest of the family. Back to Chattanooga. I’m sad, but heartened they think it’s okay to leave.
Later that day, I hear something. Gurgles. In my stomach, my bowels. Oh, yeah. The sound of life, my body a flowing river again.
I feel hungry. My nurse brings me a cup of hot tea, says I can take a sip every ten minutes for an hour. Then she’ll see how I do. This is the most divine moment of my life. After that hour, I get a cup of broth, then a popsicle.
The next day my surgeon from Ithaca arrives. He reads my chart, asks me a few questions, pulls the white tape off my face that holds the NG tube in place in my nose. He grasps the tube, jerks it out cleanly in one swift motion — a nurse’s job. He holds it up in triumph. Dumbfounded, I stare at the length of tube, the lifeline that kept my digestive system from eating me alive.
“Holy crap,” is all I can say.
He laughs, tosses the hated tube in the trash. He’s way too young a surgeon to act like a real doctor, to keep a team of people between us.
I later learn that dealing with the intestines is a sticky business, that touching them causes them to stick together. I’m told the Ithaca hospital’s equipment didn’t include a special film that could’ve been inserted in my abdomen before they closed my incision, making the formation of adhesions, the scar tissue, less likely … but not impossible. Maybe the adhesions happened just because. What I like to think is: That surgeon repaired what I’m made of, fixed a fatal flaw. That surgeon saved my life.
Three days later, Robert Packer Hospital releases me. Jim, Isabel, and I stop at an Italian market in Waverly, buy homemade pasta, sauce, and bread that I’m gonna get to eat at home in Ithaca. Can it be possible? Oh, yeah, man.
Back to the present. I force myself to stop staring at the Charles, to read all the surgical notes. I’m astounded at the two surgeons’ skill, at what they accomplished, how they saved my life. I think about how people spend a lot of time and money pursuing happiness, searching for it. I remember how gobsmacked I was to uncover it that day I could eat again after being NPO for weeks, gobsmacked to learn it’s at my fingertips every hour of the day. Free in sips of tea, in spoons of broth.
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