Post-Post-Op

 

            In the opening pages of Proust’s Remembrance of Things Past, the young Marcel describes waking up in a series of different rooms from the one he is used to sleeping in,  trying to fit together the objects which seem so strange to him into something he can comprehend.  That is what it was like for Brooke when he woke in the middle of the night in his hospital room after his operation, having slept for 13 months in a very different room at South Davis, one that we described in a blog not long ago.  The hospital room in the medical intensive care unit here at University Hospital seems utterly bizarre to him in the middle of the night, he says: a television attached high on the wall stares down like a gigantic surveillance camera, and the room is illuminated in a way completely different from his usual room: light filters in through blinds at the nurses’ station..  The sounds are different too: the alarms on the heaters in the ventilators, for instance, beep at South Davis, but here are set to make a kind of jingle, as if a malfunction should be amusing.   This room is much smaller, a kind of cube, but it has more in the way of medical supplies—not unexpected for a room in an intensive care unit, rather than a skilled nursing facility.  There’s a window to the outside, but it faces onto a blank wall; there’s no view, even though we’re on the fourth floor, except a tiny fragment of sky.  There are various signs: “Today: April 14, 2010” (though it was off by a day until Peggy changed it); “Frequent Oral Care Is Important” (with an indecipherable picture of an open mouth, perhaps with a cracked tooth, and with the oral-care policies in both English and Spanish); then there’s a high, empty shelf used for stacking pillows; and a magic-marker board with the date, the name of the nurse (as if Brooke would forget), the aide, even the housekeeper—names which are erased and changed every shift.  There’s a red plastic receptacle for sharps and a dispenser for gloves, blue ones in three sizes.  There’s a picture of a waterfall, but it’s hung so high on the wall that you can’t quite see any of the details, except the heavy fake-Spanish frame.  On the other side there’s the window that looks out through blinds to the nurses’ station.  Behind, there’s a wall with various apparatuses, which because Brooke hasn’t been out of bed since he’s been here he hasn’t seen directly, but which he can see reflected in the surface of the television screen: the vital-signs monitor displaying his heart rate, his respirations, his oxygen-saturation levels; panels with more equipment inside; the ventilator itself; and at the bottom of the screen his own face with the trach hoses at his throat.  Since the television screen is not flat but curved, everything reflected in it is distorted. 

 

            We are writing this at one of the few quiet moments in this room. During the days, it’s almost incessantly filled with people: nurses, aides, respiratory therapists, doing cathing, suctioning, turning, changing sheets, giving cough assist, and presiding over the controls for the newly-implanted diaphragmatic pacer.  Then there are the doctors, medical students, and other curious onlookers among the medical personnel interested in this new medical device, constantly pulling up Brooke’s gown to examine his incisions—(since the implantation was done laparscopically, there’s not much to see in the way of incisions except small bits of tape covering the four poke-holes for the electrodes) and especially the port where the connecting wires come out from his chest.  This is all there is to see of it, except for the external battery pack that gets plugged into the port and the slight jump in his abdomen when it fires each new breath; just the same, the medical personnel all seem very impressed by it.  They call him things like “hero” and “champ,” and tell him that he has made medical history in Utah. 

           

Unlike Brooke’s room in South Davis, where he’s spent over 13 months, this is a room you could easily go crazy in, he says, after about a week.  It’s better than many, many hospital rooms, and far more luxurious and well-equipped than hospital rooms in many countries around the world, and the nurses and aides and therapists are uniformly wonderful, but with the blank curved mirror of the TV staring down at him—which, after all, he can’t move to avoid; he can only stare straight at it—he thinks he could last maybe two more days before they’d need to ship him to the psych unit.

      --except that the prognosis for getting off the vent is very, very good, and that makes everything alright. Tomorrow, it’s back to South Davis for the next stages of vent-weaning, starting as he already has with 20 minutes on the pacer out of every two hours, and working up from there.   Sound familiar?  There's clearly more work for Brooke to do.