Friday, May 8, 2009

Saved BY (not from) the Swine Flu

This is not a story of medical details, but one of people, their courage and the difference they make

My blog is not only for proclaiming my opinions (I probably do too much of that), but is a world-sized wall where I can write, for the world to see, of the bad and the ugly in search of a fix, and the good: my tribute to the people that cross my life and make a difference - sometimes the give the gift of living a better rest of my life.

What follows are facts with medical details only for context. All the names are true. To those whose names I omitted, I apologize for my poor memory and the hospital's policy to not give me the names.



On Friday May 2, 2009, in the midst of the Swine Flu scare; CNN maps H1N1 confirmed cases hourly and the CDC twitter line twits incessantly. I was paying little attention, but in the middle of the night I began sweating and chilling and running uselessly to the bathroom every 25 minutes.
On Saturday still sweating and freezing and with a high temperature I went to an urgent care facility where I was diagnosed with gastroenteritis and sent home. In a few hours the fever returned with chills and sweats so Darlene, my wife, drove me to Scottsdale Healthcare Hospital - North Scottsdale.

I exited the Triage Station with a mask on my face (not all new arrivals were so masked) and the sudden awareness that I may have become a statistic.
In ER an attentive nurse and assorted aids poked me for blood and other samples as to be expected. After an hour in that ice box of a room with no blankets and shaking uncontrollably (they were lowering my temperature) Dr. “One” gave the news: "you have the flu but won't know what kind until CDC in Atlanta analyzes the samples". I saw myself as the first infected citizen in the movie Outbreak.
After seemingly endless time Dr. “One” returned and started asking questions about my past health history. He ended with "you have a serious urinal tract infection that appears to have moved into you blood stream. This is more concerning than the flu by far. You can go home and tomorrow we'll have the reports from the blood analysis". I was so happy to get out of the icebox I almost ran out.
Perhaps mistakenly, I also believed that my flu in this age of pandemic made my examinations and tests the more exhaustive and lead to identifying the other issues. True or false it made me feel strangely lucky about the timing of my misery.

On Sunday after at best a mediocre night with lingering fever, sweat and exhaustion I spent the day lying around waiting to recover. In the afternoon the hospital called directing that I go back immediately.
Triage was faster, I already had my mask and for once not the only masked one. The ice box visitation room was as cold as before, but this time I had sox and two shirts. They took one of my shirts away - the reduce my temperature bit.
Dr. Marcuzzo eventually came in to give me the news: "Serious blood infection, requires IV antibiotics for possibly several days. You are being checked into the regular part of the hospital". I guess they had enough of me in ER.
Sue (?) the friendly nurse on duty elaborated how I should take this seriously - her boyfriend, 40 and in good health, got the same thing, did not catch it in time and ended up with two open heart surgeries and a pacemaker after the blood infection attacked his heart - But they got mine real early so I am in good luck. Small gifts look ever more appealing.

Moved to room 3332 I met Rebecca, nurse, and her aid Madara, both smiling at the arrival of my flu infected and otherwise diseased body. They did the usual patient care except that in my case, every time they entered the room they had to put on a mask and a plastic, single-use disposable, make-you-sweat-like-a-dog gown just so that I would not have to wear my mask - for my convenience and comfort. Through the night they monitored IV, tubes, fever as my infection got worse. At midnight, with increasing pain I stopped passing fluids. By 5am I was in real pain, then catheterized and life improved considerably. Rebecca, Madara and their colleagues continued their duties, my pain subsided and I was grateful although my understanding of what I was experiencing was still short of the mark.

On Monday I was moved to room 5332 - higher but no better view - a vacuum room designed to suck air in to keep viruses from going out. I was beginning to realize how unwelcome if not even dangerous I was to others. Yet they kept coming in, in their yellow miserably uncomfortable gowns, Kathy and Ashley throughout the day. A young nurse I named Queen of Needels came to poke me for blood samples at regular intervals – “Do you do the tests too?” “No I just take the blood samples”. “You must be the Queen of Needles”. She laughs and brightens the day.
Various doctors streamed by specialty in and out making me repeat the onset of symptoms - I expected them to come back all together shouting to ask my motive for any inconsistencies in my stories. The hours dragged on with Darlene in her yellow gown watching me worried with not much to say to a nearly dozing man. I always loved her in yellow but this was ridiculous.

As the sun set Serena (nurse) and Katelyn (aid) took over the dance of the yellow gowns. Gradually my fever was going away, the voodoo of the dance of the yellow gowns was proving to be good voodoo. In my naps I dreamed of yellow gowns I had seen in Africa a few years past: those were just pretty, these were powerful voodoo.

In the early morning I woke to voices in the next room, the only other vacuum isolation room. Two voices: one, of a tall doctor I named “Paulson” from a like voiced and sized and doctor I met at a medical conference last week; the second was mostly coughing - I called him/her “Cough” - and I guessed was an elderly person. Paulson spoke with the timber of a person straining to speak louder than usual to them, as one speaks to the hard-of-hearing. Questions ended with normal suspense, statements did too as if inviting reply, he seemed to have an endless patience and no hurry to leave. "Cough's" replies were too muffled to hear. The coughing kept going, it was almost painful to me just hearing it.
It was at this moment that I realized that doctors and nurses were entering Cough's space, sick and contagious as may be, with a courage I am sure I'd be hard pressed to find. They put themselves at risk just to help - it cannot be just a job like stacking books, it cannot be just for the pay, there is more to their mission.

As I reflected on what they were doing for "Cough" I realized I was just as contagious and dangerous, only not as loud. They knew what I was and had cheerfully continued to come in to care for me and help me put my fluids - infected and not, disposable or valuable - back on track. I have had more than half dozen surgeries in the past from sports injuries or corneal transplants. I've always been grateful for the care. This time I had witnessed more - the willingness to take a very personal risk of hanging around a patient, who is no family relation, that not only needs care but in addition is plainly dangerous to them. Cynics can say that the risk is low or managed or contained but that does not diminish the fact that a conscious decision must be made each time they enter the room for someone they hardly know. Perhaps with repetition it becomes the norm and only to an outsider it is impressive. Whatever! That so many did it for me was simply humbling and elating and amazing.

To all of you, named correctly or incorrectly or unnamed, that moved a hand anywhere around me in the last four days, THANKS

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