23 July 2009

See the man with the stage fright . . .

It happened when I was nine years old, which would make it the summer of 1955. Having been fed lunch my brother and I were invited by our mother to spend the rest of the afternoon outside. Actually, it wasn't so much an invitation as a declaration of what was going to happen. She had cleaning to do; soap operss, Queen for a Day, and Liberace (the last two were different) to watch; and she didn't need two young boys doing their best to distract her.

To be honest, Mom did not really have to say very much to get us out of the house. The last thing nine and seven year old boys wanted to do on a nice summer day was stay inside. We had ants to watch, a tire swing to break our arms and/or necks on, and a cardboard rocket behind the shed to fight invading Martians in. At the very worst we could sit on the back steps and watch our cat taunt our dog by staying just an inch or so beyond his reach.

That afternoon, however, our backyard seemed a little confining so we decided to explore the semi-vacant lot behind our neighbor. There was often priceless treasures along with a lot of just plain junk to be found hiding in the weeds, and that afternoon we hit the jackpot. Behind a pile of old tires we found a set of mattress springs.

One of the more lethal fads to sweep the country was the 50s' mania for backyard trampolines. My brother and I tried to talk Mom and Dad into getting one, but they decided the tire swing gave us ample opportunity to kill or maim ourselves, and a trampoline was not needed. This was, of course, unfair. If Mom and Dad wouldn't provide a trampoline, perhaps we could build our own, and the mattress springs were just the thing we needed.

First we had to test them.

My brother got on and started doing some tentative little hops, and while he wasn't getting the altitude we had hoped for, the results were positive. I got on and started jumping. It was great. It was better than a pogo stick. (For one thing you didn't have that stick threatening to smash you in the face.) Pretty soon Mert and I were jumping for all we were worth and laughing with the sheer joy of it.

Then as I was coming down, he was coming up and his head hit my chin and slammed my mouth shut. Everything would have been just fine if my tongue hadn't been in the way.

We picked ourselves up, and pretty soon the ringing in our ears stopped. Except for a bit of a lump on his head, Mert was okay, but I was bleeding like gang-busters from my mouth. We went back to the house, and Mom started to ask us what we wanted but then she saw me and just said, "Jesus Christ!" All through my youth I had a penchant for smashing my face in rather messy ways, and at least two or three times a summer (and maybe once or twice in the winter) I would enter the house to the shocked and amazed sound of "Jesus Christ!" This was, however, the first one I remember.

Mom scribbled a note to Dad, threw us in the car and drove to the family doctor's office. Our local doctor was one of the few, if not the only, small town doctors to keep a supply of AHG on hand. AHG was the dreadfully named Anti-Hemophilic Globulin, and was the wonder serum of the 50s. The fact that its efficacy was slim to none a great deal of the time was beside the point. The alternative was nothing, and AHG was occasionally better than nothing.

The doctor examined my tongue, and was mildly surprised because I had bitten through it on both sides at the back with my molars instead of at the front with my incisors. I remember him saying something about it being too wide for my mouth. He gave me a dose of AHG, and said that should keep it from bleeding, and then stitched up my tongue.

That night my tongue swelled. The stitches didn't. They pulled through my tongue, chopping up whatever bits I hadn't managed to bite through.

When we got to the hospital the next morning I was bleeding like crazy again and the intern who first examined me said the back of my tongue looked like hamburger. I was quickly installed in a bed on 6-East (Pediatrics, ages 1 to 11) with my right arm securely taped down to an arm board for an IV, and a rubber cover on my pillow. Over the head of my bed was a sign that said "NPO" and told the world I wasn't allowed to eat or drink anything; and on the foot of my bed was another sign that went on to say that I was also not allowed to talk, sing, laugh, cry, swallow or anything else that might involve my tongue. For some reason they also put me on complete bed rest, which meant I wasn't even allowed to sit in the chair next to my bed.

For the next few weeks they put some real foul tasting gauze on my tongue, gave me AHG every few hours, and cleaned up the blood on my face and pillow each morning or whenever I took a nap. Eventually some large, squishy clots formed and I started waking up with a much cleaner pillow.

One Monday or Tuesday during the third week one of the doctors came in and asked me if I was getting hungry. I didn't have the vocabulary at that time to express either my hunger or the intelligence of first year residents, so I just wrote "Yes!" Because I had to write everything my mother had brought in several "Magic Slates" for me to use. That way I could just lift the page and have a fresh surface, and didn't have to worry about throwing out a lot of paper. I kept one on my night stand, and one on the bedside table, and ever since I had attended a Catholic Mass because I couldn't reach either of them in time I had started keeping a couple on my bed.

He said he understood, which I really doubted, and was sorry I wasn't going to be able to eat yet, BUT he thought I might like this. Then he showed me this 'thing'. It was a rubber bulb like the one on the sprayer my mother sprinkled clothes with when she was ironing. Connected to it was a piece of glass tubing about four or five inches long. The tubing was bent in the middle, and tapered to a rounded end.

"What you do," he said, "is fill this with water or maybe some clear soup, and then put it so the end is way back in your mouth. Then you squirt the water down your throat so you don't have to swallow."

My brain was still considering all of the ramifications of the word "soup"—I was very hungry—and I didn't think about the actual mechanics of the process. To be completely fair, I don't think he had either. Nevertheless, he proceeded to help me try it out. Now at the time I still wasn't supposed to swallow, so he carefully slid the tube as far back in my mouth as he could. Then he squeezed the bulb.

They tell me you don't have taste buds that far back on your tongue. Maybe it was odor or the bulb that caused it—I don't know, but that water tasted just like rubber. I didn't care. It was something going into my stomach, and I happily swallowed it. He yelled, "Don't swallow!" I tried not to, but then I just gagged. Eventually we reached a compromise where I almost didn't swallow but still avoided gagging. Later, at lunch time, a nurse filled the bulb with some broth, and I tried squirting that down. It didn't go over very well though because even though everyone said it was impossible, it tasted like Consommé of Rubber to me, and after a squirt or two I would always start choking.

A couple days later I was sitting in my bed pretty much minding my own business, When that same first year resident came in. He was asking me how I felt, and how things are going without really even looking at the replies I wrote down. This irritated me because by that time they were using my left arm for the IV (I was, still am for that matter, left handed), and I was kind of proud of the writing I was doing with my right hand. By that time he had transferred the saline and dextrose bottles over to a pole attached to my bed. I liked to use a separate pole because I felt it gave me more freedom. I could move about the bed and not worry about the length of the tubing because I could just move the pole where I needed it.

It may not seem like much, but that 30"X60" mattress was my world and being able to move down to the foot and prop my pillow there was some sorely needed freedom of movement. I had seen a couple kids who were able to move around with ease and were relatively pain free go a little bonkers after being confined to bed for several weeks. It got to the point for one kid that he, this was a couple years later, did a nearly perfect swan dive off of his foot rail, diving the 3.5 feet headfirst into highly polished granite. The headache he had for the next several days alleviated some of the sense of being confine, but not all.

Anyway, in just a couple minutes—those old beds didn't have all the connections you have worry about now—he had me out in the hall, pushing me at a pretty brisk pace.
While we were going down the hall he told me I should check my zipper, and maybe comb my hair. We turned into a corridor that led to an elevator that could take you up to the surgery suites. I sighed with relief when he passed it. At the end of the hall was the sacred entrance to the wing that had the private rooms, and for a second or two I wondered if I was going to sample their many splendors. They were said to have a TV in each room, and you could order anything you wanted to eat. I had also heard that each room had its own bathroom, and you didn't have to use a bed pan unless you were dying or something.

We went by the entry to surgery, but we never quite made to the LotusLand of the private rooms. By this time I thought I knew what was going on. A couple of other times I had been shown to a class to let them see what a swollen knee looked like (bigger than my head), and how the bleeding limited the range of motion. I figured this would be like that. Fifteen or Twenty students tops, most of them too scared to actually touch you in any meaningful way. Well, except for the Ben Casey wannabe's. They were always so cool you could use them to store medication, and this was all so blasé to them that they would take hold of your swollen joint and squeeze it like a suspect nectarine.

we pulled up to a door, and I sat up a bit straighter and smoothed my t-shirt, but when we crashed through the doors it was just an ante-room. He then had a small conference with that month's 3rd year resident and with Dr Hynes, who I usually only saw once a week during grand rounds, but she controlled every aspect of my treatment personally and completely. I was pretty sure she even decided if the residents could sit while in my room, and if so what the order was. After about twenty seconds they moved my bed into the next room which was ovbiously a stage and had a curtain along one long side.

Dr Hynes stepped through the curtains and said a few words to the students assembled in the room. She was an amazing Pediatric Hemologist, and with a look and a slight adjustment to her tone of voice could cause battle scared, toughened veterans to weep apologies. She was hard. She had no time for fools. Unless they were between the ages of 1 and 11. Those she would play with all day if she could. We kids loved her. In a place which seemed like every brick has been placed to accentuate hopelessness, and the room decor had taken most of its inspiration from one of Vlad the Impaler's darker playrooms, you wanted a tough, take-no-prisoners type on your side. We knew that no matter what the interns and 1st year residents might dream up, she was there to protect us from their more insane ideas.

She made her little talk, and then introduced today's sacrifice. They open the curtains, and there were at least three or four hundred people sitting in this large amphitheater staring intently at me. I stared back. All the ranks were there. Med students in their street clothes and white sport coats, interns, residents and even a couple department heads with their calf length lab coats. Also scattered about the audience were quite a few student nurses in their blue uniforms.

The 1st year resident then started giving my history including family tree, previous hospitalizations, and all that stuff. During his recitation the audience relaxed their inspection of me a bit to pay attention to what he was saying. Then he got to my current injury, and three hundred some people leaned forward as if to get a closer look. I was asked to open my mouth as wide as I could to give them a better view. I didn't know how someone sitting fifty feet away was going to get a better look just because I opened my mouth another half inch, but unless it's down right dangerous it's better to go along with interns and residents than try to reason with them.

Out of the corner of my eye I could see that Dr Hynes had a funny kind of smile and was shaking her head, so I figured he would learn soon enough how silly some instructions could be. The audience, however, was staring intently at my mouth and making all kinds of notes. It made me wish I had something interesting to do for them besides sit on my bed with my mouth open.

Then he picked up the bulb thingy and explained its purpose. He filled it with water and said, "Show them how you drink water, Guy."

I looked at him trying my best to convey the questions, "Really? Now? Do I have to?" He smiled reassuringly, or threateningly—I'm still not sure—and handed be the bulb. I shrugged my shoulders, looked out at the people, and went through the routine. After I was done choking he explained there still were some kinks to work out, and invited the audience to come down and take a closer look.

Everyone applauded.

Then for the next half hour or so I sat on my stretcher while the line slowly filed passed. Some just glanced in and went on. Some looked carefully from several angles and tsk-tsked. I felt like one of the less interesting monkeys in the zoo. A few gingerly pulled my cheeks this way and that to get a better view. Only a very few, perhaps two or three, said anything to me; and I noticed that they were all the older doctors whose lab coats, like Dr Hynes's, reached to just above their ankles. What they said wasn't much or earth-shattering, but it was comforting. The others were so busy being objective and scientific that all they allowed themselves to see was a 'patient.' A 'case' to be studied, and perhaps learn a trick or two from. The old guys with the long coats remembered that first and foremost, this was a kid—a person—sitting all alone on a stage wishing he wasn't drooling on himself.

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