Tuesday, August 13, 2013

Hold On

It's Saturday and Mother is coming to pick me up. The Queen E says they will discharge me around noon, giving time for a dressing change and instructions on pain meds, home exercises and such.

I'll return next Tuesday and Thursday for physio, and we are to visit the surgical clinic prior to physio on Tuesday morning for a dressing change. Thursday I have a follow-up appointment after physio to see the surgeon, Dr. "2-Minute Mitch" Rubinovich. Apparently his secretary should be calling soon with  info about allergy testing, since I have reacted so strongly to the Proviodine. Believing this is mistake #2 from a laundry list of mistakes.

It's a new nurse this morning that arrives all grins for my bandage change. Smiley whips the curtains closed, dons gloves and sets to work. The stretched, blistered skin peels off with the gauze to reveal a pink/red/yellow oozy looking wet mess all down the inside of my calf muscle, which she says is healing nicely. Really?
The dime sized black spot right below the knee joint has now at least quadrupled in size within the last 24 hours. I feel absolutely no sensation as she attempts to rub it away with sterile saline and swabs. I sit up to examine this spot which has been insidiously growing while I ate prunes and porridge for breakfast;  made my way to the cigarette-smoke-filled tv room/solarium to witness Oliver North squirm during the never-ending Iran-Contra coverage; read Margaret Atwood from the Can-lit shelf I had stumbled upon at the school library and turned 3 shades of red when The Rez came by just to say hello. Geez he's cute!

The desiccated waxy spot has the appearance of a black tea-light candle with a crack running right down the middle, with this new string wick which has emerged in the center. If I had some matches or a lighter I think I might try to light it. My eyes tell me that this is  obviously a part of me, yet my brain answers "NO!". My stomach roils and churns.
I tell Happy Nurse that I cannot feel "the spot" at all and that it has gotten bigger since yesterday, a lot bigger. Her smile changes a bit as she starts to take a closer look too. I ask her what the "wick" might be, and she says she thinks it's a stitch. True enough, there should be a stitched incision running crossways below my inner knee about 2 inches long where the lower part of the Teflon rope ligament was stapled to the bone, but where is it? Just this one lone stitch in a parched puddle of dark mud. She happily shrugs and tells me to show it to the doc at the surgical clinic on Tuesday, and hands me my home-physio plan.
I pretend to listen to my Walkman to avoid having to talk to my roomate. There is no A/C in this ancient building. The triple whammy of humid heat, pain meds and lack of sleep due to the interesting night life in this place causes me to fall into a shallow nap. Lights out.

Though I sit sideways in the back-seat with my legs up for the 52 mile-ride home , my right foot and ankle are swollen in a cartoonish way by the time we get there. I begin to refer to it as my Miss Piggy foot, though I suppose Piggy would have hooves. Even each toe is a swollen little purplish sausage.
My weekend is mostly spent on the couch, with our ancient little-fart-of-a-dog with the breath to match, Rags, worriedly coming to check on me every hour, between his naps.
When my grandparents visit on Sunday, there is the usual 30-car-long, impatient procession trailing their's, as Papa guides his big brown boat-of-a-car at half the speed limit along the hilly road that does not give many chances to pass. This old retired dairy-farmer thinks he is still driving his rusty-red International tractor.
Gramma has made a cake, so I carefully make my way down the porch steps on my crutches, trying to avoid Rags who is tap-dancing with happiness and the possibility of some dropped cake. The green lawn is meticulously tended by Father. Yard work seems to be his only hobby. That and smoking his pipe.
My brother shows up in his patch-work-quilt of a car, with his 2 kids who can't seem to figure out why "Aunt Annie" can't run and rough-house with them as I always have. Despite the warnings from my mother, 3-year-old John-John jumps onto the chaise-lounge and into my lap, narrowly missing kicking me in the leg with his little canvas sneakers. 5-year-old Bobbie-Ann is more mindful of my "bobo" and gently sits on the arm of my chair to snuggle. How I love these two little blonde beings with their sun-bronzed skin, arms and legs covered with a light peach fuzz. It's good to be home.

It's Tuesday and we are headed back to Montreal for our appointments. At the surgical clinic I hop up on the gurney and a nurse cuts off the bandages. Under the flesh colored Ace bandage some golden seepage of fluid with a ring of  pinky-red around the edge can be seen through the gauze. The new, raw skin where the blister was is now an angry red with minute bleeding. There is a fine white/cream colored substance marbled over the surface, like a good steak at the butchers. Invisible air currents are causing a slightly painful tingling and I'm suddenly cold. The black tea-light has become even drier, having pulled away from the surrounding tissue at several areas around its edge. Mothers blinks and her eyes grow wider as she has never witnessed my post-surgery wound or "allergic reaction". The nurse says I need to see a doctor, and goes off in search of one. I lie back and count the water-mark stains on the dropped tiled ceiling.
Mother keeps checking her watch and muttering that we will be late for my physio appointment upstairs. She also wants to get to the Bouclair store for a material sale. I am starting to think that is the least of our worries.
Almost in one motion, the doctor enters, introduces himself, puts on sterile gloves, takes a quick history and asks me to lie back down so that he may examine my leg and is asking me, "Can you feel this? And this? How about now?"
What is he talking about? I don't understand. Sometimes I can feel a sharp little barb, and other times nothing. I sit up and see him jabbing my wound with a small, shiny silver object. I can't believe it when my brain registers a needle in his hand. He is probing my wound with a needle!

The word "burn" is said for the first time. Incredulous, Mother booms out, "Burn?" Why does she have to be so loud? It's embarrassing.
Second degree where the nerves are still alive, I can feel that. 3rd degree where the nerves are dead, I cannot. I think I am going to puke.
The surgical pair disappear behind the curtain. I ask Mother what they are talking about, and she shakes her head and checks her watch. The couple return with another doctor and the needle trick is performed again for this new member of the audience. There is a discussion and new words fly by; "silver dressings", "Flamazine", "broad spectrum", "4th degree", "plastics consult","eschar", "debridement", "split-thickness skin-graft", etc.

This feels very, very wrong. A switch has been flicked; something has shifted. This is not happening to the girl in the Sunday night movie-of-the-week.  I feel caught in a bad dream, but there is a lucidity to it all, telling me "This IS reality. This is happening to ME."
But what has happened?

Eventually, details close enough to the truth emerged, though I still don't know exactly what happened since I was unconscious and paralyzed by general anesthesia on an operating table. Numb and dumb to the world.
My surgery had been scheduled as the first one of the day. They had woken me early to have yet another antiseptic scrub in the shower with a sponge impregnated with iodine. With time to kill before surgery, but not allowed to eat or drink, a Word-find puzzle was my distraction. The nurse said she'd get me a Valium, but she never came back with one, despite returning several times to demand that I go urinate.  I didn't need to, but I tried just to please her. I thought I might like to become a nurse too.
Around 8am, already a half-hour late, the nurse came in and told me my surgery had to be postponed because there was a problem with the consent forms that had been signed by me the day before, upon admission. Though I was 16 years old, and the age for medical consent in Quebec is 14, I was now being told that one of my parents had to sign instead. We had asked several times before putting pen to paper with my signature, reminding the staff of this adult hospital of my age, and all said it was fine. Mother arrived within an hour of the long-distance call made to her, pleased with the record time she had made on the autoroute. In retrospect, if only she had gotten pulled over for speeding or had a flat...but then hindsight is 20/20, isn't it?
I was finally wheeled away around one thirty in the afternoon, having to sit through the smells of 2 meal trays wrongly delivered to my bedside table. Never one for waste, Mother ate my breakfast and lunch instead.
I remember joking with the surgeon as the O.R. staff finalized the preparation of the room, confirmed which leg was slated for the scalpel. "Mitch" is Jewish, had a beard and one slight wall-eye, and I was not quite sure where to look. He reminded me of Michael Douglas in Coma or Running, and wanted to get me back on the volley and basket-ball court. He said he would be performing a new surgical procedure using a fiber optic arthroscope. He said it would be less invasive, easier to rehabilitate from. And I believed him, put my trust in THEM.
Lights out.
The plastic surgery experts agreed that I had suffered a 2nd, 3rd and one spot of 4th degree electrical burn during that surgery, probably from the Bovey cautery tool and someone forgetting to ground my body. And the O.R. staff knew something happened, because on August 10th, at another institution,while undergoing my 4th of 7 surgeries that summer and autumn, it was discovered that the first surgery had never been completed. The Teflon ligament had never even been stapled in place, and the joint was still full of bone dust and chips from the drill holes. They had simply wrapped up my leg and sent me back to my room as though nothing had happened. Allowed my attempt at sleep that night while burned nerve endings in my calf muscle cried out with wild electrical shocks of their own, some living, some perishing. Allowed at least a cup of fluid to drain out of my circulatory system into a blister, guaranteeing that I would faint the next morning with low blood pressure; to bash my already traumatized knee against hard wall; my skull against hard floor. Passed off THEIR human error as MY allergic reaction. Told that the early signs of the stiffness and pain of arthritis were due to my laziness. Questioning my pleading for narcotics for dressing changes while they inflicted a secondary chemical burn on top of the electrical one, while secretly trying to provide inexperienced burn care with an inadequately diluted "1 in 4" javel solution for "wet-to-dry" dressings, which should have been at least 1 in 16, preferably 1 in 32.  Allowing student nurses, only a year or 2 older than I was, to practice on me. Wet-to-dry dressings are reminiscent of ancient torture, of the stretching-rack variety.
And yet not one of the witnesses came forward.
My nausea must have been due to anorexia nervosa or Edible Woman egg-foetus stories, not rising toxic wastes from failing kidneys forced to pass protein released from my dead tissues. Not one bothered questioning that the reason I was downing jug after jug of water was because the male x-ray tech performing the gallium bone scan had said that I should flush out my system of the radioactive dye if I ever wanted to have children. Allowing over-heard talk of an over-emotional teenaged girl, not one understandably crying from exhaustion and being so dizzy she could not keep her eyes open for more than a second without throwing up. Using a hole-saw to remove my charcoal tea-light and leaving a 2-inch by one inch deep gaping hole directly into my knee joint, like they were installing a door knob and had borrowed the instrument from the maintenance department.The hole allowed synovial fluid to squirt out when a physiotherapist  bent my leg while I laughed an insane laugh because I could not cry anymore.  Moving me from the orthopedic ward to the terminal cancer ward, letting my open wound to be fanned by the same germ-ridden air that wafted across human solid waste dripped across the floor on the way to the toilet by my dying roommate with rotted intestines. Or how about the old one-legged man who cruised the corridors all night in his wheelchair, who tried to climb into bed with me?
Mother had me transferred to an isolation room in the burn unit at the Children's, but it was almost too late.
I cried with hot shame every time I wet the bed with the urgency of urination so out of control, not able to lift my buttocks off the mattress enough to clear the edge of the bedpan because it felt like my femur was in a vice. Turning the old saying, "No skin off my ass" into another medical irony as squares of split-thickness epidermis were harvested from my left butt to be used as skin grafts on my right leg.
Yet, there was also laughter in those darkest days. My day nurse Suzanne, trying to remove bandage adhesive (to which I actually WAS allergic) with acetone from the itchy rash that had appeared around the skin donor sight, then gently drying my ass cheek with a hair dryer, praying aloud that I not fart and blow us both up. She instilled in me that I could say no to anything suggested, even tell the docs to go to hell if I felt the need.
Acadian Murielle, my evening nurse, always smiling and with a little joke no matter how tired she was with a little boy of her own at home. The rough night nurse, well she was another story, but I did get a private chuckle when I puked on her shoes. Oops.
There's talk that Dr. 2-Minute Mitch has quite the reputation as a party animal, and that the whole consent form fiasco and surgery delay could have been an attempt to buy some time and have him sober up, or come down from his previous day's St-Jean-Baptiste festivities. Who knows? He was being sued by 2 other patients, or their families, since one of them had died when his blood clot symptoms were ignored.

There was also a disturbing instance when 3 young plastic surgery interns or residents suddenly needed a consent form signed by me while I was in the tub room, having a bath in the stainless steel vessel lined with a gigantic plastic bag, where I was to scrub off eschar from the burn surface in preparation for skin grafting. They entered AS they knocked, and Murielle was just able to squeeze in beside them and throw me a small towel to cover my front half. The 3 Stooges stood smirking and elbowing each other, staring at my skeletal body. I had lost 35 pounds, and they had all lost their pens for the urgent signature. I believe Suzanne made a complaint against them on my behalf when Murielle recounted what had happened.
This girl, in so much physical pain from blood, bone and joint infection, was making desperate deals with God to just get her through, be able to endure the excruciating pressure of purulent pus until the next injection of pain killer was due. Mercifully, either one of them gave me "accidently on purpose" too much morphine, or it built up in my system, but there was a 24-hour period of relief where I did nothing but sleep.
Days and weeks had turned into months. I longed to sleep in my own bed at home.
The Friday night of Labor Day long weekend, my Cosby Show, which I listened to with eyes closed due to extreme vertigo, was rudely interrupted by an emergency surgery to evacuate the abcess that had formed in the joint. My temperature had spiked to 41 degrees C. They left drains in, irrigating with saline, and a pump to pull it all back out again. My friends prepared to start grade 11, our last year of high school.
Then kidneys too damaged to function at all, gone as dry as a well in a drought. They couldn't tell if the renal failure was possibly due to the very strong new antibiotics used against my hospital acquired resistant bugs and staving off amputation, or due to the circulatory collapse and rhabdomyolosis (muscle break-down) of the deep burn. The next day, Saturday, it was decided to withdraw all antibiotics as a last ditch effort to give the ol' beans a much needed rest before moving onto dialysis early in the week. My big burly mustachioed ortho surgeon, Wally "The Walrus" Masciuch, told my parents I had a good chance of dying by Monday, either from the infection or the acute renal failure.

But I didn't die.
He'd told me it wasn't my time yet, that I had more important things to do. He said I'd get sicker, much sicker, and that I'd want to give up, but that I had to hold on. So I did.


  1. Andrea,...This is so utterly unbelievable, I thought for a moment that I was reading a novel. Can't believe this is non-fiction.
    What gets to me the most is this part: "it was discovered that the first surgery had never been completed. The Teflon ligament had never even been stapled in place, and the joint was still full of bone dust and chips from the drill holes. They had simply wrapped up my leg and sent me back to my room as though nothing had happened." What???????? But... this whole thing, it's nothing short of a crime, no??? Like, what did this bastard write as a surgery report?????????????? He actually tried to cover it up????????? It boggles my mind... I re-read some of the events you went through, and it honestly seems to me this ass-hole should have done jail time!!!

    (This comment has been transplanted here from a private e-mail by L. to Dry Drowning)

  2. Dear Andrea,

    This is really a fantastic piece of writing.

    As your friend L. says above, it seems more like fiction than truth and yet... "[They] Passed off THEIR human error as MY allergic reaction".

    Ain't it the fuckin truth.

    I wish you would publish this and call out these (yes, real life!) characters for their medical incompetence and moral negligence. Shame on them.

    Thanks for sharing your story. Can't wait to read the rest...

  3. "He said I'd get sicker, much sicker, and that I'd want to give up, but that I had to hold on. So I did."

    Yes. You certainly did.