Archive for the ‘Hospitals’ Category

I really like my University of Michigan clothing. My son has sent me a sweatshirt and heaven only knows how many different T-shirts in maize and blue emblazoned with Michigan swimming and diving on them. In fact, it was just such a combination of sweatshirt and T-shirt that I was wearing Tuesday morning as I prepared for my morning exercise routine at Planet Fitness. The muscle ache on the right side of my chest and in my right shoulder, I attributed to lifting one too many weights.

At the gym, and before working out, I sat at one of the client tables in one of the hand-shaped chairs, feeling that this shoulder and arm pain really weren’t getting any better. “Aw, to hell with it,” I thought and headed to my car instead of to the bike awaiting me at the gym. Home I toddled, laying down beside my sleeping partner carefully in order not to rouse her from slumber. After a few minutes of restlessness, I decided that the pain might just not be the result of a muscle pull or tear. Time to get this checked out.

At 6:15 in the morning, one does not go to the local physician. Instead, I took the direct route to Newton-Wellesley Hospital. In a situation not dissimilar from going to the dentist for a toothache only to have it disappear just before you get there, the pain began to subside…and I began to feel like a damned fool. Nurses came and nurses went. Doctors came and off they went. Blood was drawn and it too disappeared into the ‘who-knows-where’ cloud of something or other.

“I’d like to run another test,” said the attending physician, who shall remain nameless to protect the innocent. This one, I knew, was to determine if there was somewhere, floating around in this magnificent 81-year old body, a nasty little thing called a blood clot. These are fine unless they happen to wind up in your brain where they can cause a stroke or in your lungs where they can cause the ultimate step.

“The scan is clear; the x-ray is clear, but the blood enzyme is borderline,” said the doctor. I was acutely aware of what he was saying, having been through three prior heart attacks. “Are you saying this is an infarction?” I asked. “No, he replied,” obviously impressed that I could use such a terrific technical term – no dummy, this kid – but the troponin level is such that I think we should do another test. I will pause here to tell you that enzyme testing is an excellent way of diagnosing whether or not what the patient is experiencing is heart related or not. The only problem is that enzyme tests have to be performed six hours apart. By now, it was getting nigh on to noon and that meant that it would be well into the evening before the results were known. Now, I don’t know about you, but I don’t care to spend any more time in a hospital than absolutely necessary. They’re filled with germs and sick people and they are real morale busters. “You want to admit me, don’t you?” I glared with steely eyes (like that?). “Yes,” he said, with a look that matched my own. After arguing the advantages and disadvantages, I had to admit that his case for staying was somewhat stronger than my own arguments for leaving, thus I was taken to a bed in the main hospital, prepared for a sleepless night. Who the hell can sleep in a hospital?

Sometime after dark, this same emergency room doctor came smiling into 543A and proudly announced that my enzyme level had risen, thus indicating a heart “concern.” Translation: You have had a heart attack and we have stabilized you. Okay, that was heart attack number four, but the first one where any semblance of pain had occurred. Heart attacks are funny things. They don’t always behave as we have been told time and time and time again. Pain is not a necessity. Radiating tingling in the left arm doesn’t have to happen. Symptoms of a heart attack are all over the place, bear witness that the muscle ache (I thought) was on the right side, not the left, and while the muscle ache extended to the shoulder, it hardly “radiated” down the right arm. Still, it was a heart attack.

The following morning, there was no pain and I was ready to get in the car. It was over and all was right with the world, right? Young doctor whozit abused me of that idea early on. “We’re sending you in town for a cardiac catheterization,” He said. For those unfamiliar with this procedure – I had been there and done that so was fully prepared (yeah, right), a needle is inserted into the femoral artery [mistake one] in the groin and is threaded up through the heart, looking for blockages. If everything is clear, so is the patient. If a blockage is found, it is cleaned out and a stent implanted. A stent is a tiny piece of wire mesh that is used to keep the offending artery open. “Piece of cake,” I thought. “No pain; everything should be clean and clear [mistake two].

Late Wednesday afternoon, I was taken by wheelchair to the “cath lab.” They prepped the groin area and when the surgeon came in, he announced, “We’re going through the wrist.” I had heard of this procedure, but the radial artery seems so much smaller than the femoral that I didn’t understand how this would be possible. In addition, having a probing needle thrust into my wrist was not something to which I was looking forward. “Don’t worry,” said one of the nurses, “you won’t feel a thing.” While I was conscious throughout this ordeal, she was right. Whatever Kickapoo joy juice I had been given put me on cloud 9 and 10 and 11…good stuff.

I have no idea how long I was on that table, but it seemed like forever. When it was all over and the lights came up, I remember asking if everything was clear. Hardly, replied some doctor from somewhere. It seems that one artery was blocked 99.9 percent and a few others needed some plaque removal. Ergo, I was one lucky sumbitch that a doctor in the emergency room at Newton-Wellesley refused to let me make a fool of myself and go home.

To Doctor Adam Lurie; to Ryan Flanagan; to Doctor Colin Hirst and his team; and to all of the wonderful people I met at both hospitals, thanks for your dedication, patience, warmth, and understanding. Nursing care at both hospital was fantastic and guess what…I even liked the meatloaf lunch I was served just before departing for home on Thursday…in my Michigan sweatshirt and T-shirt.

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Say goodnight, Dick

Okay, okay, I get it.

I’m a little bit nervous; that okay with you?

It’s just surgery. It’s not even considered to be major surgery…matter of fact, they probably consider it to be minor surgery.

Yet, here I am on a Sunday evening, sitting at the computer, typing like some kind of drooling idiot. “It’s no big deal,” I keep telling myself. It’s what I call “dry-cleaner-surgery;” you’re in by nine and out by five…yeah, right, so I have to be ready for a cab at five in the morning to take what would normally be a twenty minute ride to the hospital to get me there before 6:50 a.m. That’s almost two friggin’ hours in a taxicab. “Why so early?” you may ask. Welcome to the realities of traffic patterns in the Greater Boston area. I had to see a doctor at 9:00 last Thursday. It was a similar trip to the one I’ll take tomorrow. I left at seven-friggin’-thirty in the morning and got to the doctor’s office and five minutes to spare…five minutes; can you believe that…and this on a highway that has just been expanded and had another lane added…within the past six months! I feel like I’m caught in some kind of Parkinson’s Law thingie: if work expands to fill the time available, then traffic expands to overfill the lanes created for it.

Everything would be fine except the pre-op nurse was very specific…you get there at six-fifty or before, or they start without you. Well, we all know that’s not quite true…be interesting to see, but I’d just as soon not chance it. Back, however, to the realities of why I’m sitting at this @#$%&* computer on a Sunday evening when I should be watching 60 Minutes or something.

You see, I’ve had over fifteen surgeries in my life where they’ve had to knock me out…they call it general anesthesia; I call it knocking someone out. “Hey doc, how ya do….” that’s it; then you wake up an hour or more later, not remembering one damned thing. I must admit that I do enjoy some of the new anesthetics. You just go and that time in your life is gone forever. You don’t remember a thing.

This is all well and good, and I’m quite certain that I will wake up, and that my eldest will arrive and drive me home in her tank, but…what if? I mean this 81-year old bod has been knocked out by anesthetic for a few years now. Suppose I don’t wake up; suppose this little nap becomes the big sleep. Worrying about it the night before isn’t going to do a whole hell of a lot of good. If anything, worrying could be bad…it would really screw up a night’s sleep, and the night’s sleep is going to be short because I have to get up so early for the damned cab, so…why worry? Wait a minute; why not worry? You don’t wake up; that’s a pretty big deal. Hell, even if I do wake up, it’s a pretty big deal.

So, here’s what I’m going to do…I’m going into the bedroom; put on my Breathe Rite strip (I snore like a freight train and a jet combined if I don’t wear one…ooh, you’re a mouth breather…screw you…and then I’m going to say my prayers as I try to do every night. After that, I’m going to lay my head on the pillow; pull the covers up to my chin, and sleep like a baby…until that friggin’ alarm goes off and tells me it’s time to get up…in the dark…to catch a cab…and I can’t have breakfast…and, and, and…

“Say goodnight, Dick.”

“Goodnight, Dick!”

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The Ebola epidemic in Africa appears to be creating a panic on the part of certain people in the United States. The talking heads seem to be putting on their “disaster” faces when talking about the death of Thomas what’s-his-name in Texas and the two health care workers who are currently showing symptoms of the disease at the hospital. It’s not that I don’t remember Mr. Duncan’s name; I just don’t give a damn about it. He can probably now be called “US patient zero” for bringing a disease which I believe he knew he had contracted into this country. You don’t give a damn about us; we don’t give a damn about you.

Ebola is a terrible disease. Doctors in Nebraska and several other states are knowledgeable about it and how to prepare to receive anyone with symptoms. It has become all too apparent that the staff at Texas Presbyterian Hospital in Dallas cannot be rated as knowledgeable, and that is unfortunate. It is also clear that Dr. Thomas Friedan of the Centers for Disease Control (CDC) is tap dancing faster than Gene Kelly or Fred Astaire in an effort to demonstrate how poorly prepared the CDC was for what has taken place. Training does not mean sending out a bunch of instructions that you hope hospital personnel will take the time to read. Whenever he said, “We have a team ready to go anywhere to train hospital staff,” I damn near pissed my pants laughing. Excuse me sir, but we have nearly 320 million people in the United States. In addition, we have 5,273 hospitals in the country…and you have “a team;” what turnip truck did you just fall from?

Ebola kills people…but…it doesn’t kill everyone. Ebola can be treated and steps can be taken to prevent the spread of the disease. The CDC and nearly everyone else in a position to know say that Ebola cannot be spread other than by contact with an infected person’s bodily fluids. So, if an Ebola patient sneezes while I’m inhaling, can I become infected, or, if it happens to be a woman, do we have to “swap spit,” so to speak?

New diseases seem to crop up on a regular basis, and Ebola seems to fall into that group. Notably, it has chosen to arise in some of the poorer countries of Africa. This doesn’t appear to be unusual. From Africa, it will normally descend on Europe and then on to North and South America. We have faced many epidemics or pandemics long before Ebola. We have conquered the majority of them without too much trouble, and doctors have shown that the fight against Ebola can also be won.

When Europeans first arrived on the shores of the New World, they brought with them something called smallpox. It wiped out entire tribes of Native Americans during the 1633-1634 periods. According to Healthline, “…the native population in New England dropped by over 70 percent.” The last reported case of smallpox in this country was in 1949, and that was someone who had never been vaccinated.

If you’re looking for something a bit more recent, how about the Spanish Flu that infected soldiers fighting in World War I and who were from any number of countries. This epidemic/pandemic left 20 million dead in a matter of months before its spread could be stopped. In the United States, this flu killed an estimated 675,000 men, women and children. Today, a flu shot is available that will prevent or ease our chances of catching the flu in one of its many forms.

The peak of the polio epidemic in the United States was around 1952. “The first major polio epidemic in the United States had occurred in 1916. In the 1940s and 50s, polio outbreaks created frenzy, frightening parents and prohibiting travel from city to city within the United States. Some towns were quarantined to protect the public from affected individuals. It reached a peak in 1952 when over 58,000 cases were reported, including 3,145 deaths.” One of those deaths was a kid I had been working beside on a Saturday. By the following Tuesday, he was dead. Thanks to Jonas Salk, we no longer worry too much about polio.

There have been many other epidemics in America’s more recent history. The one with which we have the greatest familiarity is perhaps the AIDS epidemic that started in 1981. “…the epidemic we now know as HIV began to appear as a rare lung infection characterized by a weakened immune system. It remains the leading cause of death in the United States among people age 25 to 44. Research has found many ways to put AIDS into remission and I, for one, have no doubt that the time will come when a cure will become possible.

There is, of course, one disease against which we are continuing to fight with only moderate success. Cancer is the most insidious of the diseases we fight; yet, that’s not fair. Multiple Sclerosis, Muscular Dystrophy, Cerebral Palsy, and a ton of other diseases that could be named are still out there to be fought and research is ongoing. However, I don’t believe there is a single person in the United States who has not been touched by cancer in some way. Whether it was a member of the family, a friend, colleague, teammate, or the neighbor across the street, we all know the tragedy of cancer. It killed my Dad, my wife, my grandparents, and too many other non-family members for me to count. Just when the researchers think they’ve found the answers to a particular cancer, it mutates, and they have to begin their fight all over again.

Ebola is not cancer. A cure will be found. The big question mark becomes how will the manufacturers of the vaccine to cure Ebola get into the hands of those who need it? Countries such as Liberia, Sierra Leone, and Guinea are too poor to be able to afford the price of the cure. Here’s another opportunity for the world to show its humanitarian side and not be concerned about the bottom line.

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Yesterday was something new, totally unexpected, and yes, rather frightening. Picture this, if you will; I had finished my workout and was heading to the counter to grab some Tootsie Rolls and to say my goodbyes to the young woman behind the counter. As I put the candy in my pocket, I started to get dizzy…again. “Oh, shit,” I said to nobody in particular, “not again!” You see, about a week before, I had a slight dizzy spell at the same counter, performing the same ‘grab the Tootsies,’ and say goodbye. Evidently, I hadn’t learned my lesson, whatever lesson was being taught by whom or what was doing the teaching. This time, the dizziness did not pass, and I woke up in an ambulance headed for God-only-knows-where.

Waking up in an ambulance isn’t necessarily a bad thing. The most important is that you wake up. I’ve been trying to figure just how long I was out, and it appears that it was one hell of a lot longer than I first calculated. Figure it out: I fainted; they had to call an ambulance service; the service had to arrive and check me out. They then had to load me into the ‘bus,’ strap me in; start an intravenous line, and start on their way…that’s when I woke up…with a mouth so dry that desert sands would blow through and leave not a grain. That’s the way I remember it…not a friggin’ grain of sand would have stuck inside my mouth. Oh, and of course, I pissed my shorts…that was a lovely end to all things that were happening.

Now, when something like this happens, gym personnel are to notify your emergency contact. That’s all fine and dandy except the only number the gym had was my cell phone. Later in the day I listened to the message. “Hello, this is Planet Fitness calling. Richard Bishop fainted and an ambulance is taking him…where are you guys taking him…oh, they don’t know where they’re taking him, but he’s going to some hospital, somewhere and he’s talking.” I’m quite happy it was my phone on which the message was left. Can you imagine getting a message like that when you’re at home? Juli doesn’t panic but even so, I consider that to be the message from hell.

The “I don’t know where we’re going guys” finally agreed that Beth Israel Deaconess Health Care (BIDHC)  hospital in Needham would be a good place to drop their bundle. I must have passed out again because the next thing I knew I was laying in the emergency department of a hospital where I had only been a visitor on other occasions. It’s a small community hospital…or it was a small community hospital. It still has only 29 beds, but since it became part of the BIDHC, construction is going on daily…upward, downward, and outward. I was surrounded by nurses, residents and who-knows-who-else and being asked to tell my story over and over and over again. It must be wonderful to be able to tune out if it’s not your question that’s being answered. Of course, it could also be a sneaky way to learn rather or not I’m actually compos mentis…still sneaky.

It appears that I answered everything to the satisfaction of the group, most of whom I didn’t see for the rest of the day, but who cares. The nurse, who was mine for the day – isn’t that a great way to put it – was Erin, but to protect the innocent, we won’t use a last name. Let me just say that the hospital is blessed to have someone with her degree of professionalism and with such a wonderful personality [She doesn’t know it yet but I will be crashing her wedding reception]. The ER doctor on duty was Edward Ullman, M.D., and I give you his last name because it’s one of which to be proud. Doctor Ullman loves the emergency room; he lives for the moments of excitement when he can stabilize a patient and pass them on or send them home. His dedication to his task is enviable. He’s witty without being condescending; he’s thorough without being pompous; he’s everything you want to see and hear when you go into an emergency room situation. Throughout the day, as I waited for this test or that test, in corridor after corridor and in room after room, the staff was terrific. Having to wait even a few minutes for a test to begin brought apologies for the delay. One cardiac test required the injection of thallium. Thallium is a chemical element with an atomic number. It’s a minor radiation makes it, at least at this hospital, something you order only when you need it.  Mine had to be schlepped in from Attleboro, some miles away. This particular wait was worth it because the technician was a lovely Japanese lady named “Mako.” It seemed to shock the daylights out of her when I thanked her in formal Japanese. I may not know much, but there are certain things you learn when accepting gifts at a college, and one of them is how to say “thank you” in many, many languages!

I could go on and rave about Mike who transported me all over the hospital, first on my gurney and later in a wheelchair; or talk about the professionalism of Doctor Meghan York, the cardiologist who never appeared to stop moving. There was Philip, the retarded desperate child of Satan – he had the initials RDCS, after his name but I never did learn what they meant. All-in-all, the people I met during my lengthy stay at BIDHC were the same folks I’d like to have sitting in my house, drinking a few beers and just chatting away an evening.

Did they find my problem? No, they did not. However, they eliminated so many potential problems that I left there feeling a whole helluva lot better than when I was wheeled in. Doctor Ullman and I identified potential problems, and I will be following up with my primary care physician. As a piece of advice, I would offer the following: If you work out be sure to keep yourself hydrated. I’m not saying it was the cause for my fainting; I’m not saying it wasn’t. Who knows, but from now on, I will finish an entire bottle before leaving the gym.

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Republican members of Congress scream for smaller federal government involvement in the rights of states and the rights of citizens. Know what, they are absolutely right. We, the American people have allowed the federal government to become too much a part of our lives. There are too many living off the government teat and, in the long run, everyone suffers.

Yes, I collect Social Security and I have Medicare. So what? The Social Security program was started under Franklin Roosevelt. Like everything else about the federal government, it has become too large and too bureaucratic. It appears that every federal program has become a dumping ground for someone’s brother, sister, aunt, or uncle. While the federal – and the state governments as well – claim that they are streamlining and getting rid of red tape and bureaucratic bullshit, the tape line grows longer and longer and the bullshit piles higher and higher. Bureaucracy breeds caution and contempt at a time when the country should be throwing caution to the wind and acting a little more humble in its dealings with the average American citizen.

The scandal at the Veteran’s Administration is nothing new. In 1929, Herbert Hoover proposed bringing the agencies that were administering veterans’ benefits together under one roof. On July 21, 1930 the three agencies, the Veterans Bureau, the Bureau of Pensions, and the National Homes for Disabled Volunteer Soldiers were brought together as the Veterans Administration. Remember when this was, i.e., the period of the Great Depression. I am willing to bet everything I have that not one person in any of those three bureaus lost his or her job when the consolidation took place. From that point on, the Veterans’ Administration did nothing but grow. It was Topsy reincarnate The Selective Service Act was passed creating more members of the military. The Japanese attacked Pearl Harbor throwing us into World War II and creating greater need for veterans’ services. How does America solve this greater need? Throw more money and more people into the mix. It doesn’t matter that the people may not know their butt from a hole in the ground, they will learn by doing. The bureaucracy just grows and grows and grows. It is not dissimilar to the Massachusetts Bay Transportation Authority. Started over two centuries ago, It was an amalgam of railroad companies often chartered by the state legislature, and anyone knowing anything about the Massachusetts state legislature will tell you that one of the key words to describe it is ‘patronage.’  In 1947, the MTA was created. Government agencies began to take on transit services, consolidating many separate routes into unified system.  In 1964, the MTA became the Massachusetts Bay Transportation Authority, serving a greater number of communities and creating an even larger bureaucracy.

Perhaps the best way to describe the Veterans Administration, the MBTA, and many other organizations that have expanded rapidly without closely examining needs is to use the old cliché, “There is never time to do it right, but there is always time to do it over.” When it’s being done over, a new layer of bureaucracy is added to ensure that it’s done right.  Once whatever the task to be completed is finished, the layer of people, money, supplies, buildings, vehicles, etc. remains even though they are no longer required…”Well, we might need them again and if we get rid of them, we’ll never be able to justify bringing them back.” Eventually, the original purpose of the entire organization grinds to a halt because no one remembers precisely what the original purpose was in the first place. That is, without question, an oversimplification of the situation. However, in the case of the Veterans Hospital Administration, putting off the treatment of veterans appears to have taken a back seat to saving money in order to pay bonuses to the major decision-makers in the organization. The VA has identified the wrong problem for solution. At some level in the VA, the decision has been made that rather than solve the problem of increasing service to the customer, we have to solve the problem of appearing to increase the service to the customer without actually doing so. If we make the problem appear to go away, it will do so by a process of attrition. The hospital will look good and those eligible will receive bonuses because the hospital will appear to be well managed. In other words, “If you can say smoke and mirrors, you’re hired!”

Will firing Eric Shinseki solve this problem? No, it will not. The bureaucracy is already too ingrained in veterans’ hospitals across the country. Problem solving 101 says that the first step is to identify the actual problem. There may be many perceived problems, and everyone employed by the VA will have his or her own idea of what that problem is…and they will be right…and wrong. It will take an independent management group to determine the first problem to be solved; how to solve it, and then determine the next steps to be taken to solving the second greatest problem. Right now, General Shinseki is sitting atop a pile of bullshit surrounded by red tape that is not of his making. One might say that he is the heir to the bullshit and red tape fortune. By not knowing how to cut through the red tape and not knowing how to dissolve the bullshit or by being blind to both, he does bear some responsibility; however, to lay the entire mess at his door is unfair. There are a number of criminal layers between him and getting his job done. If his subordinates have been keeping him in the dark, it may well be because they have been kept in the dark. Somewhere in this vast bureaucracy that we call the Veterans Administration, there is a criminal layer. That layer has put its own welfare before the welfare of the customer, the veteran. The same has been true of the MBTA. CEO upon CEO upon CEO has been hired to “clean up” the MBTA and the job has yet to be completed. It’s one of the great truisms of bureaucracy: “Bureaucrats in numbers can generally beat down any attempt to destroy them.” They will lie, cheat, steal, and yes, they will commit murder, if their fear is great enough.

Republican leader of the House of Representatives, John Boehner, says that he is withholding judgment on whether or not General Shinseki should be forced out. I’m with Congressman Boehner on this one – don’t faint – Shinseki just might be the solution once all of the facts are known. His military background could be the key to eliminating long-time bureaucrats who feel protected because of their tenure. Shinseki knows that if the job isn’t done properly on the battlefield, soldiers die; the same could be said here…if the job isn’t done correctly, former soldiers, sailors, marines, airmen, and coast guardsmen and women will die. No military man worth his salt is ever going to let that happen, not on his watch!

Perhaps it is time to take a hard look at every government agency and to pare them back; force them to do more with less; eliminate all of the red tape and bullshit. Yes, it will cut jobs and it will inflate our jobless rate and no one, no one wants to see that. I would argue that it’s more important to be doing the job correctly than having a bunch of people collecting pay checks for doing nothing or for emasculating the jobs they are supposed to be doing.

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[When last we left out intrepid senior citizen, he was becoming well acquainted with the ‘Johnny House,’ doing what all colonoscopy preppers do in the porcelain cloakroom.]

Sunday has come and gone. After a restless night’s sleep, I arise early to begin the task of consuming a half gallon of the lemony oil we call ‘go lightly,’ a charming name for a viscous and vicious liquid that, as has been said before, must be consumed by 9:30 am.

To describe this right of preparation in detail would definitely be TMI, so we will skip all of the ugliness…use your freakin’ imagination!

Midway through the morning, Juli has an epiphany. Instead of driving to the hospital, we should take a taxi. Following a discussion of the economics of such a move, a few bouts of dizziness, and more trips to the ‘Necessarium,’ I am finally convinced that this is probably the better move for this afternoon’s adventure.

For those of you living in the Norwood area, I heartily endorse Family Taxi. On time, reasonable prices, a cab that was spotless…and I intended to keep it that way…and a ‘good guy’ driver who was a wonderful conversationalist at a time when I really needed some friendly chatter…well, I need something; let’s just say that we got along.

It’s wonderful to sit in the passenger seat of a car and see all of the things you miss when you’re driving. Truly, it’s an eye-opening spectacle; the tree colors are more vivid; other drivers appear to know what they’re doing – we hardly came close to anyone, but then I couldn’t see what damage we might have left in our wake. The remarkable thing was that we pulled up to the hospital surgical center three and a half minutes before we actually left; I didn’t realize we were moving that quickly although the one time I looked at the speedometer it was registering somewhere between 85 and 90. As I say, It was all pretty much a blur; perhaps the trees were going by so quickly the colors lingered; perhaps the other drivers were just making way as we approached at warp speed.

After completing some paperwork, my nurse, Mary Ann, who was a character, issued a four-word directive: “Take it all off!” Hospital johnnies are stored in freezers – you should know that in case you are planning a trip to your local medical facility. Blankets, however, which are available seconds after you don the arctic wear, are kept in a 212 degree oven. I’m not certain why this practice is allowed. There has to be some deep psychological reason that hospitals do this…freezer-broiler; freezer-broiler… it must make sense to someone.

Once I was comfortably situated on the trolley, came time for the IV.  At the end of a long hose attached to a bag of some kind of liquid; I kid…this was saline, the nurse attempts to find a vein of sufficient size into which she can stick a hollow harpoon. As a lad of 40, my veins were like sewer pipes, huge and just popping out beneath the skin. Nurses loved them for their “poppiness” and availability…just one little tap and veins would jump, almost shouting, “Stick me; stick me.” At nearly 80, the veins (along with a number of other bodily items) have gone into retirement. Today, they timidly weep, “Not me; not me,” and they’ve been suck enough that I can understand their pleas. Suffice it to say, the first stick, puncture, stab, or whatever you wish to call it, did not work. As much and as quickly as Mary Ann wriggled that needle under my skin, my old veins were quicker. I don’t know whether they’re just getting back at me for having them stuck so often in my youth – giving five gallons of blood, you idiot; nothing else – or perhaps they’re just plain tired. After twisting and turning the needle for about five hours – it was probably less than 15 seconds but I’m a coward about such things – Mary Ann called an IV nurse who arrived, found a vein and started the IV without any pain or problem.

While all of this was going on, the gastroenterologist came in, dressed in his usual black turtleneck and sport coat, appearing as if he was off for a trip to the museum. “Hey, how’re you doing?” he asked and before I could say, “Shitless,” he was pulling the curtain aside and leaving. I kid about him, but he is a highly respected professional and a very funny man who has the ability to put patients at ease in what otherwise might be viewed as an embarrassing situation.

Looking down at the IV after the doctor’s quick visit, I noticed that there were four little ports where needles could be inserted. Mary Ann was fussing with one of the ports and after a moment, asked, “Sleepy yet?” I responded – and this I remember – “Did you put something in that port?” She replied with a grin, “Yes, I did,” and she drew that last word out so that it sounded like “diii-iiid.”

Waking up in the recovery room with absolutely no memory of what has taken place over the last hour or so is just a bit mind-boggling and terrifying. “Hi, I’m Pat, your recovery room nurse; can I get you anything?” was said about three inches from my face. Had I been forty years younger and single, I might have made an unintelligent comment; however, seeing that I’m 79, have just had my empty colon prodded, poked, and snipped, I asked for graham crackers. It’s a poor substitute for what briefly flashed across the frontal lobe, which by the way was now laughing hysterically at my presumed abilities, but graham crackers would have to do.

Half an hour in the recovery room appeared to be all that was allowed. I want you to know, however, that in that half hour, I damn near emptied their supply of graham crackers which, as Pat reminded me, probably tasted like filet mignon after my fast…dammit, she was right.

Once more, Captain Kirk was there to drive us home. Once more, the foliage was fantastic, and once more, cars just seemed to disappear before us. This time I really did not dare to look behind us. Safe and sound – as much sound as possible – we arrived at our door. The Domino’s pizza arrived about five minutes after we did…damn, that Juli is good; she’d ordered from the hospital or the cab…nah, had to be the hospital…our cab was traveling at warp nine!

Next time your doctor says, “You probably should have a colonoscopy,” don’t run for the hills; just think that you can call Family Taxi and learn what the time travel is truly like; you can lay on your side in a hospital johnnie, freezing your ass off; you can be enveloped in a blanket that will heat up the johnnie and burn your butt; you can get stabbed, probed, and offered graham crackers…but remember, one slice of that hot pizza will make the whole damned thing worthwhile!  

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This really sucked! The day and my mood were running along parallel tracks. As for the day, the temperature had dropped to somewhere in the low to mid-thirties from a high of about seventy the day before – that sucked – and the clouds were so low it looked like you could hit them with a rock. Drizzle interspersed with a few snowflakes reminded me that the better days of this year were far behind. If you can translate all of that into my mood, you might just understand that this wasn’t going to be one of the better days of my life. Even after turning the clocks back – daylight savings time was over; another indication of how dark things were becoming – I still slept an hour later than usual. Maybe I just didn’t want to face the prospect of apple juice for breakfast, lunch, and dinner…not to overwork the word, but that also sucked.

Tomorrow is colonoscopy day…unplanned colonoscopy day. At my age you gotta figure that a few things are going to get somewhat fucked up with your body but when you haven’t had a bowel movement in over a month and the emergency room doc freely admits that you’re FOS, you just know that you’re in for a bad time to come a calling over the next week or so. In a telephone call the night before, my own doctor had suggested that I might want to get to the emergency room for an x-ray to see what was going on in my gut; I’d already told him that I hadn’t shat – is that really a word – in a month, but that just seemed to sail over his head; either that, or he wasn’t surprised that my blue eyes now had a brownish tint…who knows?

I went to the ER the next morning after my workout at the gym – a weak workout because of the way I felt – arriving just at shift change. Do you have any clue what happens at shift change in an emergency room? The doctors, nurses, and techs who have been there since the evening before want nothing more than to haul ass to the warmth of their beds, and the crew coming on wants nothing more than to hope that all of the ER beds are empty and remain that way. Thus, the former attempt to procrastinate bringing in a new patient for fear of getting stuck in the ER beyond their time, and the latter would like to have their ‘cuppa’ before they have to begin the day’s work. I’m kidding, of course, but I really did have to wait for about half an hour before I was taken to an ER bed.

First to my bed was a don’t-talk-to-me-I’m-not-awake-yet-nurse. She was nice enough I guess, yet largely lacking in a sense of humor. She never saw my eyes – so she didn’t notice the brown tint – because her face was glued to the clipboard she held while asking inane questions. She was followed by a fourth year medical student who asked the same questions – I guess they didn’t know one another – but with a sparkle in her blue eyes. Next came the doctor who, thankfully, was one I had known for ten years. We talked about his children, now 8, 6, and 3, and about my situation. He sent me for an x-ray that showed nothing of consequence and then he told me to check with a gastroenterologist – GI, not to be confused with a soldier by the same initials – as soon as possible. I guess I didn’t expect a whole hell of a lot more, but his ‘diagnosis’ certainly didn’t help my mood to any positive degree.

A visit to the gastroenterologist is always an experience. People in the waiting room avoid looking at one another because there’s something about having a problem with your asshole and upwards that creates a certain amount of embarrassment or tension or something. Thankfully, I was the only one in the waiting room when I walked in. The child behind the counter – she has two degrees and is working on a third – looked to be about ten years old, took me into an examining room and began asking the normal questions that one would be asked when they are FOS – you haven’t figured that one yet? It means full of shit, and surely, I am – and she was talking about these things as though she was asking about the weather. It’s difficult for older people to talk about these things with children whom they do not know and who appear so blasé about the whole thing. I was just thankful she didn’t tell me to drop my drawers while she stuck a finger up my butt…ouch…yuck…holy crap! “The doctor will be in in a minute,” she told me, rousing me from my horrific thoughts. Whew, just the memory of it leaves me weak.

The doctor is Swiss; he’s a wonderful man…funny, brilliant, and completely at ease with everyone. What the hell, he sees more assholes in a week than any of us do in our lifetime. He explained to me that my symptoms warranted an immediate colonoscopy. The thing is that you don’t walk into a doctor’s office and just have a colonoscopy. This is a process that requires preparation. The doctor indicated that the procedure would take place on Monday. He explained this as I was sitting in his office on Saturday. Guess what this means, sports fans? Tomorrow will be prep day; today in this case since this is when I’m at the computer. No food all day and at noon, the preparation will begin; twenty plus minutes ago since it is now 12:22, and I am already feeling the effects of having drunk ten ounces of citrate of magnesia.

Let me tell you about citrate of magnesia. This is not your normal Exlex, Dulcolax, Miralex, or any other ‘lax’ which you may have taken. If you can picture swallowing a very large fire cracker to break the dam, while having a cherry bomb explode just inside your butt, you have some sense of citrate of magnesia. It is a nuclear weapon as compared to a BB gun….and you have to drink thirty ounces of this stuff [I was going to say “shit” but that would be overkill]. In addition, you should know that this stuff is not your gentle, stool softening agent that works overnight. Oh, no…I’m back at the computer now having just launched the first of many citrate of magnesia bombs into the bottom of the porcelain war god. I told you this stuff was fast.

The frequent trips to the toilet will continue throughout the afternoon and evening. Eventually, I will crawl into bed, wearing Depends and praying that being in a horizontal position will prevent any accidents. I know, however, having been down this road before, that sleep will not come easy. Tomorrow morning – the procedure is scheduled for 1:30 pm – I will further prep by drinking have a gallon of slime known in the trade as “Go-lightly.” What a horrible fucking name! And I must do this before 9:30…aaarrrggghhh!

End of part I…

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What, you think it’s easy coming back from shoulder surgery? Like the operation was on a Monday and I should be writing on Tuesday? Give me a break. I hadn’t had greater readership on Wednesday since the first time I said “fuck” in an article…geez, what a bunch of sickos!

It should be noted that since I’m having some problems with a couple of the kids right now, I decided that I would spend a bit of their inheritance by treating myself to and from the hospital. I hired a livery service to escort me in style…and style it was; bottles of water; snacks, and drivers in little black-visored caps. Oh, man, I pulled up at the entrance to the surgical center and all eyes were staring at the tinted glass? You know the drill: “Ooh, is that someone famous? A movie star perhaps? Certainly, a celebrity of some kind.” Then I climb out in my ratty shorts and a big old PMC shirt, and I could feel the disappointment in the crowd. Perhaps if I had worn dark glasses and a baseball cap pulled down just above my eyes, but, you know, 20/20 hindsight and all that nonsense; I just wanted to get in and get it over with.

Anyway, I guess from the surgeon’s point of view, all went well; from my point of view, I’ve known several days that were quite a bit better. Don’t get me wrong; everyone was very solicitous and smiling. One nurse – not attending me – came by and said, “I know you,” and we recalled another time I was in pre-op and she had been my nurse. She remembered that my name was Dick because that had been her late husband’s name. They called him “Big Dick.” At that point there had already been some “relaxation juice” administered and, I really didn’t want to go there. You never know what’s going to come out of my mouth at the best of times and I just wasn’t going down that road for love or money. My nurse, Kat, was laughing so hard she was shaking, and Suzanne, the widow, was on a rant trying to get me to make a fool of myself. It’s easy enough to do that when I’m fully alert; never mind tempting me when I’m groggy!

While I cannot remember the ride to the operating room – rather like on television when the ceiling tiles and the fluorescent lights are whizzing by – I do remember being asked to roll on to a table in the “OR.” The way my little brain was working, I figured if I got rolling, it was going to take a hell of a lot more than a few nurses and doctors from stopping that train from going right off the track. The analogy I’d use would be, “See that 44-pound curling stone hurtling down the ice. Why don’t you just go out there in your leather-soled shoes and grab the handle.” See ya! After they’d schlepped me onto the table, it was lights out until I woke up an hour or so later feeling better than I had in a long time. One of the drugs used in anesthesia today is Versed. Its principal benefit is one of amnesia; you wake in the recovery room asking, “How did I get here?” Terrific drug!

Going home was even better. The driver was standing by his Cadillac Escalade with a sign that had my name on it, and I was being wheeled to the chair by a perky young volunteer. If that isn’t an ego boost for a 78-year old, old fart, I don’t know what is. And a Cadillac Escalade…you take a freaking elevator just to get into the front seat; hell, you look down on the drivers of those cross-country 18-wheelers! I think we drove over a few Porches’ and never scraped their roofs!

The first day home was great. I had completely forgotten that it takes anesthesia some time to wear off, particularly if you’ve had general anesthesia plus what they lovingly call a “block” in the area on which they are going to operate.  I ate drank Pepsi, had some ice cream, and even chowed down some chocolate covered raisins…mmm, good.

Tuesday and Wednesday were spent putting everything I had eaten on Monday evening back…onto the sheets; into the toilet; almost into the toilet; into a waste basket by my bed, and; at one point, all over my shirt. Oy vey, such a mess! I didn’t believe I had eaten quite that much on Monday evening; it felt like a family vomit. Okay, enough of that. Let’s just say that by Sunday, I was back to soda crackers and room-temperature water.

That was a few weeks ago. The memories of the first few days are still very fresh in my mind. I’d like to think that if I need more surgery, I would just ask to be given a bullet on which to bite, but who’s kidding whom? The biggest surprise of all came a week after the surgery. It was during a “follow-up” with the surgeon’s physician assistant. Jokingly, I asked when I could resume my gym workouts…”Today, if you feel like it,” she said. Suffice it to say that it was the following Monday that I went back to doing some cardio, but think about it; one week you’re getting cut, and two weeks later you’re back to a routine; today’s surgical procedures are  truly remarkable. It makes one wonder just how far can we go in terms of a) repairing the human body; b) doing it with a minimum of disruption, and; c) doing it without the entire process costing damn near as much as a year’s salary. I can hear it now…two workers discussing lunch and the first one says, “Sorry, can’t make lunch today; having the knees replaced on my lunch hour.” Somehow, I just don’t think I’m gonna be around for that one.

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I said that I wouldn’t be writing for a while….however…

…The sun hasn’t quite hit the horizon yet; who the hell am I kidding; the sun hasn’t even begun to approach our horizon at 1:30 in the morning. Yep, that’s right; I’m actually writing this scary piece just on the am side of midnight.

I have had eleven surgeries in my life, the last one just last year…and that was to put a stent into a triple ‘A.’ That’s what they – you know, the ones who are known as ‘professionals’ – call it. We laymen refer to it as an abdominal aortic aneurism. It’s the tenth leading cause of death in the United States, largely because it often goes undetected. Unless you happen to be having an ultrasound or some test that includes an inside look at your gut, chances are you wouldn’t even know if you have one…ain’t that a bitch! But, anyway, that’s behind me. That one was done in the morning, but I didn’t lose any sleep over it. This one’s different.

I can’t sleep. I went to bed around 7:30 last night because I wanted a good night’s sleep;  are you kidding? I lay there  tossing and turning like a bloody dredel at Christmas time…wait, those two just plain don’t go together; ah, what the hell; let’s be ecumenical about this. Anyway, around 12:30 I woke up from my less than satisfying sleep. I figured that if I couldn’t get back to sleep by 2:00, I’d get up. Two’s not a bad time, right? Toss, turn, toss, turn; are you seeing a pattern here?

At 1:30, I said…you don’t need to know what I said; let’s just say that I got up. Evidently, the computer would like to sleep also, because I couldn’t win a damned solitaire or any other kind of game…the computer was “against me’” it was “out to get me.” Paranoid, me, paranoid? Nah, nothing like that. A little ‘tetched’ in the head, maybe but paranoid, hell no!

At 3:30, I finally said, “That’s it!” Of course, no one was awake to ask, “What’s it?” but it was it. My significant other is a light sleeper…snores like a freight train, but is a light sleeper. I tiptoed into the bathroom, stripped, and turned on the shower; waited for the water to become reasonably warm and stepped in; damn, it felt good. While it was exceedingly difficult to restrain my operatic excellence, I managed to control myself and soaped up, rinsed off and was out in about ten minutes – I told you it felt good; a ten-minute shower for me is like the 45-minute showers the kids used to take; gimme a break, will ya? I even toweled down as quietly as I could.

“Ya’ll right?” I heard as I slipped on underwear and shorts. “Sorry, honey,” said I. “Shhh, I’ve gone back to sleep,” she responded, and I swear that in less than ten seconds, the train was back on the track and speeding away. I figure I’ll shave around 5; have to look good, ya know?

By now you’re probably thinking you know what’s going on, right? Yes, I’m going for the big dozen in surgical procedures this very day. You see, my right shoulder has been bothering me for over a year. Upper body workouts have been a bitch, but two Alleve in the morning and a couple at night had been keeping things relatively calm. Several weeks ago, they stopped working. I went through the traditional x-ray and MRI “stuff” and then went back to see the orthopedist. When he pulled the MRI up on the computer, I said, “Uh-oh, looks like it’s time to sand and sew.” He agreed. I have a number of bone spurs in my shoulder; one that is pushing up under the clavicle and another that seems to be tearing away at a tendon. Can you ask, “Hey, stupid, how come you were continuing to work out?” or any other derogatory questions that will embarrass me no end? Whatever it is, you’re right; I violated Voltaire when he commented, “Common sense is not all that common.” Thanks, “Volty;” rub it in a little more.

I have no idea why I’m concerned about this. Same doctor worked on the left shoulder five years ago. He’s just switching sides. How do I know he’ll be doing the correct shoulder (notice I didn’t say “right shoulder,” because it is the right shoulder but if I just left things…ah, ta hell with it!). I’ve even requested an anesthesiologist I know, and I have great faith in my surgeon. What could go…oh, no, no, no, one never, ever says that. It would be the kiss of…whoops, can’t use that one either. Well, you get what I mean.   As I said last week…”See ya when I see ya!”

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Generally speaking, once you past the age of 70, the bulk of appointments in your day-planner, Android, Ipad, smart phone, or whatever electronic device you may use begin with “Dr…..” Once you past 75 – hope ya make it, dude – You begin to add such things as “radiology, blood lab, GI lab, cardiology department” but, hopefully, not “chemo pr radiation.”  There is no humor in having a calendar filled with these appointments. It’s a bitch to get old. Everyone talks about the Golden Years; about the only thing that’s golden about these years is your pee, and it just means you should be drinking more water so you can obey one of the Boy Scout mottos, i.e., pee until it is clear and copious.

I’ve been to my local hospital so much that I wind up giving directions to people who appear lost. Doctors and nurses greet me by my first name when we meet in the hallway. It’s rather awkward if Juli is with me…she’s all over me like a cheap suit after we leave. It’s so bad that I can request a particular IV nurse by name. If Michelle isn’t on duty, I can go two deep on names. That, I believe is when you know you’re in trouble. I don’t believe it hurts but if I’ve had a good experience during one of the many surgeries I’ve had in the hospital, I will take a minute to write a letter to the hospital administrator, complimenting people by name that took care of me. Once, I was waiting to go down to surgery and a nurse glanced in as she was passing the room; she stopped, came back, and said, “You’re Mr. Bishop, right?” I acknowledged that I was, and she said, “Thank you for mentioning me in your letter. It made me feel good.” Hospitals like supermarkets and department stores and who-knows-what-else are always receiving letters of complaints. Few people take the time to compliment someone who went out of his or her way to help them.

All of the above being said let me tell you about my most recent visit to one of U.S. News & World Report’s 100 best communities. My first appointment was at one o’clock and the second at two. Because it was required that I “prepare” for the exam, I could not eat any solid after nine in the morning. The first test was a contrast angiography. A laboratory technician inserts a needle through which will be pumped a contrast dye. Unlike a regular angiogram in which a catheter is inserted through the femoral artery and x-rays are taken of the areas of concern, the angiography uses magnetic resonance imaging and no catheter is required (whew). After the third attempt – I kid you not – at sticking a needle in my tired old arms, success was finally achieved. Well, that’s not quite right; the sticker had used the wrong sized needle on the stickee. Therefore, it was back to await an infusion nurse…at somewhere around three-thirty. Being concerned about my second appointment for an echo cardiogram in another department, I had asked at about 1:30 that a call be made to say I’d be late. Having been assured that I would not be late, I asked again that the call be made; this was at two o’clock. This time, a lab tech said she would call. The tech called every half hour and when I left the radiology lab. I would call this a comedy of errors but for one thing; getting stuck by a large bore needle is not the same as getting stuck by a small bore needle…IT FREAKING HURTS!

My knowledge of the hospital came in very handy as I was about to leave. The lab tech directed me in a way that would have been so round about that I couldn’t possibly arrived at cardiology within an hour (Note: slight exaggeration…but not much!). Instead, I took a couple of shortcuts and was there in about seven minutes. Walking to the receptionist’s window, I merely said, “Hi, Judy; I’m home.” To say that I was whisked away in one hell of a hurry is something of an understatement. The test lasts about half an hour on a normal day. I think that I was in and out in about 35 minutes. I stopped by a couple of offices on the way out just to say, “Hi,” but the biggest problem was that I left the hospital at the height of commuter traffic.

To say that this was an unpleasant visit would be like saying that yes, it’s been warm in Boston for the past couple of days…master understatements, both. Will I write to the hospital to complain? No, probably not. To do so would be to cause problems for some people I’ve known for some time. Screw-up’s happen and this was a beaut! Had things gone perfectly, I wouldn’t have written. These were people trying to do their jobs and having a very, very bad day. It’s easy to write when it’s right, but if you write when it’s wrong, hold your letter for a couple of days and think about it.

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