I am looking, for inspiration, at this unlovely medical encyclopedia image of how literally intertwined are stomach, pancreas, liver, and bile ducts. I’m winding up to tell you the story of my stay, with much bellyaching, in the hospital this past Monday thru Friday. Stomach, pancreas, liver, and bile ducts. I had an apparent attack, an acute inflammation, of them all. Therein I discovered life inside a hospital. And it is, unless you’re dying, or having surgery, a place you’d not want to be. I wasn’t dying. More sort of “livin like I was dyin,” as per country music. “But I’d a rather die, I’d say, /than go through much more a that.” I’d take a different tack next time, I’m certain. Could a would a should a.
‘Twas late the evening of Superbowl Sunday. A little while before Beyonce Knowles and Destiny’s Other Children did their Kung Fu Thighs dance for our halftime, uh, mmm, delectation. Yeah! Those are some thighs! They’ll surge the powergrid! Know what I’m sayin? And this dance she does, yeah, it goes good with snacks. And lemonade. Goes with everything that makes a man merry. The Ravens were crushing my team’s hopes — this is what the Ravens do, they crush your team’s hopes, its bones and sinews too — and I was stickin to lemonade. Wyler’s no-cal powder mix in a big koolaid fridge jug.
Made no matter today was a major amateur drinking holiday. I was being sober today. I was also in no mood to have anything to drink of my usual evening beers, nor in any mood to go out for a half case of brown longnecks, as I was ill. Also hungover and ill. Hungover from whatever I was doing Saturday. Don’t remember now. But it involved tavern food, pasta and meatballs, garlic bread, sports on TV, and having quite a few beers. More than a sixer, short of a twelve, I’d say about nine max. What the writer John O’Hara called getting “steamed up.” (Like the windows of a car in a bar parking lot? Or as a mighty engine of barroom yackety that exhales steamed hot air? Don’t know.) In any event, alcohol abuse.
Yeah. My name is Mack Maroney, and I’m a drinker! Though not much of one. You’ll never see me throw back a shot, for example, nor drink for more than a couple of hours; by then I’m buzzed thoroughly and I’ve toddled off to bed. I’m never more than a mile or so from home, I just go home and retire. Often I’ve brought a six-pack home for “just a couple more” while surfing the net or watching the late night news, chucklin at every incongruity in the world, before sleep. Eventually I give it up and go to snoozin. I think you could say I’m a closeted drinker who acts — the other 22 hrs of the day — like he thinks he’s normal. A musician I know wrote a parody song, Secret Drinkin Man (to the tune of Secret Agent Man.) That’s me.
I was quite ill too this particular Sunday night, more than I knew. I thought I was just somewhat hungover from Saturday and extra-ugh, blah. Disgusted would be a good word. I was “treating” my supposed hangover with weird nutrition — jalapeno nacho cheese plus smoked oysters, from a tin, stuffed into split open salty green pimento olives, also succulent dill pickles — just the snack a sixty five year old with practically lifelong hypertension should be having. Next time, some light cottage cheese, maybe some berries, some hot mint tea with honey. A little reason, please.
Really, I think I was in the beginnings of some acute liver inflammation already, as I now can see, and not just hungover. I thought I was just a little ill, like tummy ache ill. I had taken an extra Prilosec, and was hoping for a popped pill solution, a wipe away of distress. Instead, I became really ill throughout the ballgame. Though I caught every play and every iconic commercial. My fave: The elderly eating Doritos while breaking bad, havin a good ole time tearing up the town, in the style of don’t give a shit gang delinquents, even attracting police suspicion, while on an outing away from the retirement home. I even caught the post-Beyonce power outage of about forty five minutes duration between halves.
The tinned smoked oysters were very unfamiliar and odd tasting “food,” and this ugly snack was not going well with my stomach ache. My stomach was getting to be a hot zone! It was goin nukey leer!, as G.W., our clown prez, mighta put it. And I was starting to get weird persistent hiccups. I never get hiccups. I was “dry” and constantly drinking water. During the halftime power blowout I tried some more “treatment” from the bat room medicine cabinet. Damn, outta Zantac. Mighta really helped to take a good double dose. Will need more. Tried a couple Simethicone chewables. Considered the milk of mag, which might have been best, but I wasn’t thinking slowly and calmly enough, and demurred, not sure. Distracted. Didn’t know what was to come. And I don’t mean San Francisco’s stunning second half resurgence. (Maybe the coach had had them catch Beyonce’s act ?? )
I was getting quite ill, I was a right sick Ole Mackey D. Maroney. Sick as a dog. Sad Maroney Dog. Woof! Morose Mackey Doggy. Dull Woof. No wag. YUCK! Hic! Hic! By the time of the postgame analysis — Fuckin Ravens! They iced my SF Forty Niners and crushed their hopes in the last ten minutes! — I was in the bat room vomiting yellow stomach bile, something I never do. None of that awful “food” came up. That would have been such a relief, but no.
I felt I was maybe having some kind of stomach flu like the dread norovirus of this season, the one you can’t prevent with the flu vaccine. Not sure. But I was feeling flu like, aching back, over-warm, heavin, hiccin and yuckin. Though it was midnite I bundled myself into the car real quick like and tootled the mile to the all nite grocery. The outdoor air felt good. Didn’t even think about the beer shelves, went straight to the OTC meds, and got economical small packages of Ranitidine (Zantac), Simethicone, and a new cherry mint Maalox which seemed to offer hope.
I took two Zantacs the moment I got in the car. I swigged the Maalox, a double, as soon after. Ewww! Nothing makes this stuff tastes good! At least not today! I almost threw up right there. Gag. A half hour later, now back at the abode, I was in the bat room throwin yellow rains of stomach bile, across the tiles, waterward. Ahoy! It was like LIFE OF PI with Three-D Chrome Yellow Bile Rain! God, I was sick. Also panicked.
When I’d been out on the road for a minute I had thought about going to Urgent Care. I live right in the hospital district and I’m a retired hospital worker, and I’m very familiar with the emergency rooms of numerous local hospitals (from my many years in social work assistant roles, also mental health aide work.) Four of them, ER’s, within a mile or two of me here on Park West.
Tried to lie down. Could not get peaceful. I was agitated, scared. Searing abdominal discomfort. Lower back pain as discomfiting. Maybe those awful smoked oysters were “bad.” Not good, I’m sure. What had possessed me to try them? After lying down and then sitting up repeatedly, I could not settled down at all, I got up again to pee, for about the fourth time, and to drink more water. I got to the tiles and yucked again. “This is getting bad!” I bundled up again, resolving to go to the big metro hospital closest by, to its nifty handy 24 hr Urgent Care which I had never used as a patient. By the time I was in the car, defrosting the windshield of its pointillist dots of rime, I decided, uh, “Nah! I’m not going to that zoo. Always very busy there on a weekend late night,” I knew.
I redeployed ! I went to the quieter and more orderly Catholic hospital, Santa Rita’s Family Health Partners, a little further up the same road. “Well played,” I told myself, as I parked in the car garage and entered a waiting room that had in it … no one waiting. This waiting room! It’s waiting only for me.“Is it possible for me to see Urgent Care?” I had my netbook with me, I’d get a little online work done, while I was consulting and being assessed medically. I thought I’d get a good quick Dx — then a licketysplit Rx! — then jet outta there and fill the script at the all nite CVS pharm. (I like to call it the pharm and to think of the pharmacy students who work there assisting as “pharm hands.” I like to picture them in blue jean bib overalls and straw hats, harvesting the pharm produce of Big Pharma.) I’d be back in bed and comfy before dawn, as it was about 0230 or so.
Uh, not so. I was seen right away. And seen right away to be in a dire medical crisis. And I did not see the out of doors for a week. I was interviewed and examined, and I told all about the whale in my abdomen, Reverse Jonah, as above. I was candid about my usual evening diet of heavy foods and beers. They knew they were looking at someone who never comes to the Emergency Department. Last time I’d been there as a patient was fully twenty two years earlier. I had also been in the building for elective surgery — in and out, same day — a couple years ago. They had records of those history blips in their system. I had never had a real hospital stay for acute illness, though as a retired health care worker I had witnessed hundreds of such up close. My god, I was unprepared for what it’d be like. Only the actual patient really knows the experience.
They did my labs, vitals, an EKG. And an abdominal sonogram depicting organs of my epigastrium. Who knew men had abdominal sonograms done? So unexpected. I really liked the sonogram lady, she was indulgent and practically holding my hand. She seemed a kind of needy lonesome plump Catholic temptress. Our Lady Madonna of the Sonogram. She’s rubbing jelly on my belly, squeezing up next to me on my gurney, and running the electronic wand around in the jelly. I wanted a date, my hand on her fine fanny. My hand, in fact, was resting awkwardly athwart her haunches as she would unexpectedly squeeze up against my hip with hers and manipulate the sonogram wand way around The Other Side of Pot Belly Mountain. My hand was trapped, mute, against her ass, between us. I remained “appropriate,” motionless, but sort of secret smilin, lovin it, feelin would-be pervy. Wand me, maybe! Wand me, baby! I was like Carlie Rae Jepsen, just a little exhilarated! I wanted my hands on that ass. She was my type!
I was telling her jokes, “If you find a baby in there, I want at least half the money from The National Enquirer.” She lol’d for me and her hips were shakin and jigglin against the back of my hand. And she never stopped talking, chippering away, normalizing what could have seemed quite awkward. That bustling heinie of hers! It got into your path, and in a real nice way. Not a perfect Beyonce exemplar Size L tush –but an honest XL fanny, a warm and lively one all the same. Not a XXXL enormity, though. Moderately XL, and awful nice. Really my type! Her biology-chronometer was a ticking-fast timebomb of need. She was nearly forty and “truly beautiful” in my codger’s eyes. My codger’s eyes/ Saw paradise/ My shakin hands/ Was, uh, in her pants… Well, they coulda been.
In no time I was admitted to the hospital. I barely had time to say I had Medicare. Parts A, B, and D. And I lost track of Miss Sonogram 2013. I have to find a way of looking her up. But how to explain to her now how I knew her? “Hi, I’m Mackey, the guy you completely restored to sexual functioning by having me on my back covered with jelly, while you rolled over me a hard plastic wand in the jelly for about forty minutes. If it had been four hours, I’d a still been lying there smilin and murmurin jokes. Are you sure what you do is covered by Medicare? — ‘Cause I want it done to me all the time; I want redundant needless billings for your services constantly! Whatever you’re doing with that wand thing, it’s really good for me.”
My Admitting Dx — PANCREATITIS! — Whoah! And I was told by the night doc, “You’re being admitted for inpatient treatment. ” “Pancreatitis? I had a brother in law who died of that,” I quailed. (What to hell is pancreatitis?) “No joke, he flat-out died at about age 50, I think.” “Don’t worry, you’re not that sick, Mr. Maroney” Like he cared! I said I did not, you know, really “get” what pancreatitis even… is ?? It was explained: “Your drinking is slowly killing the cells in your pancreas.” Straight talk! “One of the essential things to do is quit using alcohol.” Catholic therapy! Also true, I learned. The only treatment is to go dry, to stop consuming, once such an organ failure is found. “You know,” I said, ” …Well then I will quit completely, permanently.” One of my rarer, seriouser moments. I am usually not thus straightforward, earnest. I usually “tell it slant,” and with tongue in cheek.
I was asked, “Mr. Maroney, have you ever been told you have elevated blood glucose levels?” “I have never had high glucose.” I am blown away again! My mother and both her parents had had various degrees of diabetes, from mild and age related to severe and lifelong. But not my dad. I always thought I had his genetics. Fortunately, my mom had had the mildest and most late onset case, which she managed with her very abstemious dietary customs. Woman ate like a bird anyways, figure conscious, always slim and fitting into fashion. Someday soon I’ll have a bizarre dream of Mary S. Maroney at the backyard feeder nibbling on a single seed held in her elegant pale steno’s fingers, her bony aquiline nose alert to the taste and smell, and eyes vigilant.
I have another brother in law, Ole Murph, still thriving, who has very difficult, very severe, hard to manage problems with diabetes. “Yikes! I was just told I’d need insulin coverage. My God!” “Your pancreas is having a breakdown today, and it’s not making insulin as it should,” quoth my smug expert interlocutor, Basil Exposition (docwhatshisface of the ER night shift.) “I get my labs done every 90 days or so, by my prescriber Dr. Schlomo Fuhrlicher,” who also works at an Urgent Care affiliated with Santa Rita’s, who has to be reminded he knows me — he has known me more than a decade — by looking me up in the chart records. I guess I’m unremarkable medically thus far. I guess he has too many patients he doesn’t know. This is not a reassuring experience for the patient, I can say. “He has never found high glucose.”
He’s supposed to remember everyone he’s digitally examined for prostate health? “If I see BOTH your hands on my shoulder, I’m screaming! You know, we haven’t even been out to dinner.” Heh heh. He chuckles, fingering. “You like me! You really like me!” “Heh!” Then Fuhrlicher starts in with his cracks, wiping his hands after ungloving, “I lose all my best friends like this,” he fake-laments, woeful. Jerk! He can never even recall my name, let alone my history, without the records in front of him, and he always gets the nuances way wrong. “He’s a doctor like a foot doctor’s a doctor!”
He’s on the outer margins and lower slopes of medical acuity. He’s an urgent care clinic owner and administrator, a money maker who offers every imaginable service. He’d clean your ears or trim your toe callouses if he could charge your health care plan for the work. And he has done so! But for all his eagerness to get involved in the minutiae of my medical care…. “My doctor has never found elevated glucose levels!” I repeated, insisting. I was asked, Did I know my BP was elevated at about 157/99? “Christ!” At Santa Rita’s one feels inclined to prayerful ejaculations this day! Though I ain’t no real religionist, for a certainty.“My BP is always well controlled. Fuhrlicher prescribes me two blood-pressure meds, Amlodipine and Lisinopril. Two, not just one. Mix and match. Take em both every day upon arising. Like a sacred rite, never fail.”
I remained in the Emergency Department for almost 18 hours (they were having trouble getting a bed freed up in med-surg.) During my time in the ER, 0230 on early Monday a.m. to 2030, when my bed’s previous occupant ultimately got taken home by family — or died ? — I went through every kind of med test. “Open Donut” CT Scans of the chest and abdomen, my somehow strangely erotic sonogram, a Full Body MRI Scan, which was very damn strange, being sealed inside a cylinder for a half hour. (I really hated it, but I managed to tolerate it sufficiently well. Ugh.) I also had to drink quarts of “contrast” for the full scan — it tasted oddly like my Wyler’s lemonade, come to think of it, and I sucked it down in no time. Plus I did repeat blood labs and repeat glucose fingersticks. A permanent “dwell,” an intravenous line, was put in my right arm vein near the inner elbow. I was given a med for nausea, Zofran, via the dwell. (They didn’t want me throwing up on their nice expensive hospital.)
I was also told I had signs of liver inflammation — a hardened, painful, and distended liver was palpated for me on the right side of the abdomen, see! — and of dilated bile ducts and of possibly migrating gallstones. “Mom always said, ‘You gotta lotta gall, Mackey!'” I was told I had been Rx’d a choice of Oxycontin or IM Morphine for pain — “My God!”— as they didn’t want me taking Nsaids or Acetominophen, the latter being particularly bad for one’s liver at a time of inflammation, I’m told. It was then said I had elevated liver enzymes on my lab results and signs of a fatty liver on the scans — “I’ve never had lab results of that kind!” …not in all my years with Fuhrlicher. Today was a day of reckoning. A day of the proverbial hitting bottom, running aground. I was The Wreck of The Hesperus. “I have, though, recently been treated for a fairly sharp rise in triglycerides. Too much laying around. My only exercise is jumping to conclusions. I take Fenofibrate every day to keep my triglycerides normal.”
I took note of the oxycontin and morphine mentally, but I couldn’t really imagine taking narcotic substances. Why couldn’t I? Well, it seemed out of the question to me, as I never had used them in the past. They seemed quite unnecessary. I was miserably uncomfortable, yes, but I didn’t need such heavy duty pain meds. I was also told I had been Rx’d Ativan. Why was I being offered ativan? I guessed my elevated BP was being seen as a sign of withdrawal from alcohol. I knew so, because I had done such evaluations myself in my working days, charting an alcoholic in withdrawal’s heart rate and blood pressure, and telling a nurse in charge that a person’s pulse and BP were rising. They were getting this all wrong, though. I hadn’t had anything to drink all day, and I was not in withdrawal. I also knew my lifelong high blood pressure could spike simply because I was “stressed out” emotionally. I knew I had never experienced withdrawal symptoms of any kind, and I wasn’t very likely experiencing them now. I had no shakes, for example, nor sweats. No delirium tremens, whatever that is exactly. And I had never taken a benzodiazipine, nor ever needed to.
When it got to be about bedtime up on the med-surg floor, though, I was firmly urged to try the morphine and the tranquilizer, urged by a nurse that was so “permissive” with her med arsenal she was practically throwing a party, it seemed. I hadn’t slept well the previous night in the ER, due to terrible degrees of discomfort and restlessness and I had been sleeping poorly at home, too — so I gave it a try. But I should have simply requested a sleep med, such as Ambien or even Benadryl. Boy, was I surprised, as the morphine made for bizarro, crazy-vivid, briefly psychotic dreams; and the benzodiazipine (ativan) made for a pure blizzard of calcium snows! I was now officially a hospital patient! I was snowed in! “I was out of it!” These were treatments I had never tried before, and they made for extensive recreational snoozing, but also for some degree of loopy disorientation, which I eventually learned to dislike heartily. People woke me up repeatedly at all hours, checked my intravenous line carrying water and NaCl, tested my blood glucose, did repeat labs, measured my vitals with finger clips and pressure cuffs, listened to my bowel and breathing sounds via stethoscopes, whatever, and then I’d roll away again into the whacked out fun house mirror distortions, the insane morphine dreams. I was allowed to sleep and sleep, way past breakfast and lunch — I was allowed no food nor fluids by mouth anyhow, as I was being “watered” like a hydroponic lettuce through an IV line — and I really didn’t do my re-entry of the ward until Tuesday afternoon.
By that time I truly smelled and looked like a bum. Unshaven, wild bed hair, dressed in this short exam gown rag with — yikes! — openings everywhere like low rent ghetto lingerie, and in bare feet. A most unseductive nightgown wearer, I got myself unhooked from the watering can — Lettuce Alone! Laissez Nous Faire! — I struck a blow for lettuces everywhere! — and went down the hall to find a shower and I watered myself, quite self-sufficingly, and got all the rust spots off. I showered sitting down on a chair, being a little weeble wobble in bare feet on soapy tiles. I shaved, brushed teeth, and mouth-washed, all while sitting, and I combed my terrible long hair, now clean yet much in need of a trim. God, I looked awful! Damn, if I wasn’t …YELLOW! Jaundiced! … in the unforgiving fluorescent light of the shower room. Another symptom I had not had before. These past two days! I won’t soon forget.
I scrounged some real hospital clothing items from the staff, some scrubs pants — “All people need to wear pants!” I demanded, a tinpot Hammurabi on a dripping shower chair, and the staff complied with my lawgiving. I also got some of those great traction socks, and a decent scrubs shirt. YAY! Joining the human race, though in the merely provisional category. I no longer looked exactly like a street person. I looked “like a surgeon” in scrubs, a Weird Al Yankovic parody of one, a “surgeon” who had taken quite ill, one who had an intravenous line in his arm, one who had a jaundiced complexion (and outlook), a bad hairstyle, and weird socks for footwear. Clearly not a real medico. You can’t dress this stuff up, try as you might.
The previous afternoon I’d texted Shannie, my former wife, and Zachy, my young son, saying I wouldn’t be able to attend Zachy’s performance — guitar and vocals — at a local cafe, his first, at age 21, because I was ill and I was “visiting the Urgent Care.” So sorry. And I texted Shannie’s sister Chris to say I couldn’t help with her dog’s vet visit. Tuesday I sent texts saying I was admitted to Santa Rita’s — my texted headlines were coming about a day after what they were announcing — and, no, I didn’t want to see people really. I was feeling “out of it” and unlikely to be cheered up by visits. I’d just fall asleep in the middle of conversations, that kind of thing. I was in no mood. And I looked like hell! I’d be out in a day or two, I said. I asked how Zachy’s night at the cafe had gone. He had had a great time being a performer, something he had finally screwed up the nerve to really do! And he had partnered with a friend, they gave each other courage. Sorry, I missed it. ‘Sokay, there’d be more such evenings in the future, he assured. He was gracious. Nice.
Shannie texted back, Did I want anything? Didn’t immediately realize what to ask for, so I let that pass. A word to all readers about hospital stays: What any person admitted to a hospital wants, whether they quite know it or not, is something decent to wear (the full kit, p.j.’s, robe, underwear, socks, slippers) and something serene and pleasant to listen to, a radio. They don’t want any damn magazines or flowers, as nicely intended as those might seem. Naturally, Shannie showed up the next afternoon unauthorized, flowers and magazines in hand. She’s a good egg. The nurses, especially the foreign ones, were impressed: “She wants you to be her Valentine!” Their reading of the red flowers, heart shaped tulips. Shannie is a flower person. She would’ve welcomed flowers, it it were her in the Big House of the Sick. She is a painter, and she had just completed a sequence of 26 flower blossom paintings ala O’Keefe. She had flowers on the brain, and she has always been an avid gardener. She didn’t need no stinkin Valentine! Certainly not this bum.
I had brought with me my smart phone (I’d rate its IQ as undistinguished), my netbook, and my device chargers, but I couldn’t focus to read on the internet. I’d get tired and “out of it” right away. “Out of it” was my heraldic motto, a discharged dripping morphine syringe needle rampant, leaning insouciantly against a bottle of tranqs, that was my coat of arms on a field of gold stars, silver moons, shimmerin auroras in a dark blue Klondike skyscape of 24 hour midnight. A little of my roommate’s TV news channel, between my tossings and turnings, and soon it was night again. I was passive, and I again didn’t ask for a mere “sleeper.” I took oxycontin and ativan. Hmm? What was I up to in acquiescing to this hospitalism, this g’night my snoozy baby routine? I was asked, How would I rate my pain? What to say? “Uh, about 7 or 8 out of 10.” Whatever! I was on the snoozed cruise, after having been sleepless a lot in recent days at home. It seemed the pragmatic opportune thing to do, take the proffered pills and erase my discomfort. Turn out the lights. Maybe, while thus resting and being watered, I’d get better. Lettuce Hope!
Communicants of Santa Rita’s, Lettuce Pray! Pray for improved labs upon the morrow for all our old and abandoned sons of the working class, and especially for one Mackey Maroney! May he be discharged into the Lettuce Fields of the Lord where he will want for nothing — except for beer, it is a serpent’s poison — as he harvests the bounty of the Social Security and the Medicare. Parts A, B, and D. And may he have pajamas with him, slippers, drawers, socks, robe, maybe a nice sleeping cap with tassels — and, lo, comprehensive cable TV! — next time he’s in these precincts. Ora pro nobis.
Ora pro nobis. Nunc et in hora mortis. Ave Santa Rita! Benedicta tu in mulieribus!
THIS STORY UNDER CONSTRUCTION. More when the story is published.