Vignettes From a Hospital Overnight

by Martha Culver

I stand up and pace around the hospital lobby again. We — my husband, my nine-year-old daughter, and I — arrived here at 11 for my surgery at 1. My implanted pacemaker device is malfunctioning and needs to be replaced, three years before its originally anticipated due date. The Information Desk lady tells me my procedure is actually scheduled for 2:45, and I won’t be called to the operating room floor until 1:30. She smiles and hands me one of those coaster things with red lights that buzz when your table is ready at a chain restaurant. Great, I think, having heart surgery is now just like going to Applebee’s on a busy Friday night.

What to do for two and a half hours? I can’t eat anything and brought no phone/books/iPod as per instructions. There’s no use going anywhere. It’s January and 10 degrees outside. My daughter snuggles up to me and turns on her iPod. I play Scrabble on my husband’s phone until that gets boring. I look at people in the lobby and wonder what surgeries they’re having until that gets boring. I watch people leave the hospital cashier’s office and wonder what it’s like to be uninsured, but that gets boring and depressing. Finally I stand up and walk around the lobby, occasionally sighing loudly and dramatically, so everyone can see what a bitch I am. A hungry bitch having heart surgery. My husband and daughter get sandwiches and I watch them eat, enviously. Finally my Applebee’s buzzer goes off.

* * *

I’m in the surgical prep unit, lying on a hospital gurney behind a curtain and wearing only the ever-fashionable johnny and slip-proof socks. It’s freezing, but the nurse has thoughtfully brought me a warm blanket. The anesthesia resident has installed IV #1 in my left arm. Doctors and nurses stream in and out with random questions and comments.

My husband and daughter sit on chairs next to the gurney. My husband is attentive; my daughter got bored after they set up the IV and is now reading one of her 900-page fantasy novels with a dragon on the cover. We’ve taken her out of school for the “real-life learning experience” at the hospital, but so far all she’s learned is that hospitals screw up a lot and are more boring than school.

Finally it’s time to go. My daughter and I hug — me warmly, her a little offhand. I kiss my husband and we smile lovingly but nervously at each other. There is always the remote possibility I won’t be seeing them on the other side. My husband understands this all too well — has understood it for 20 years since my heart condition first made itself known, when I collapsed in our apartment. My daughter, thank goodness, doesn’t understand. She is too young to worry that this may be the last time she’ll see her mother alive. They exit and I swallow the lump in my throat. The nurse wheels me down the hall to the operating room. There, several residents move me efficiently from the gurney to the operating table. They don’t tell me when they administer the anesthesia, and the darkness is surprising, swift, and complete.

* * *

I wake up from the blackness of general anesthesia retching my brains out. There’s an almost unbearable weight over my heart that’s making it hard to breathe. After barfing I realize the one of the residents is pushing hard on my chest. Other unpleasant sensations emerge, made oddly more unpleasant by half-feeling them through the fog of pain medication. Time is vague but before I know it I’m retching again. “Give her 5 mg of Zofran,” I hear someone say. After a minute I feel a bit of relief from the nausea. They are wheeling me out of the OR, the young resident never releasing the pressure on my chest.

My doctor’s face looms in front of me in the hallway, followed closely by my husband’s and daughter’s. They’re pale and serious, and even my anesthesia-addled brain realizes I have to pull it together and be strong for them. “Hi, loves,” I say in a post-intubation croak, trying to be comforting though I’m sure I look a wreck. I barf again. My husband says it’s late and he needs to get our daughter home. It’s late? How late? Wasn’t it just 3 p.m.? How long was I under? Somehow (osmosis?) I find out it’s 10 at night. Everything is happening too fast, like I’m stuck underwater watching everyone else bustling about on the surface. My family disappears and a nanosecond later I’m in my room on the cardiac ward, retching again. At least no one’s pushing on my chest now. I barf for three hours. I get the maximum allowed daily dose of Zofran. It does nothing. The nurse finally gives up and puts a plastic basin by my head so I can just turn and heave.

* * *

The overhead light comes on and I jerk awake. It’s 6:30 a.m. and the overnight nurse is coming in to flush my IVs before she leaves at 7. They never actually let you sleep through the night in the hospital — someone’s always coming in to check on you. I guess this is to make sure you haven’t expired while they’re away. I look down at my body and take stock.

• Original IV in left arm
• Second IV in left arm
• Pulse monitor on left forefinger
• 6 sticky pads on chest and torso, connected by wires to heart monitor
• Foley catheter
• IV in right thigh
• Pulse monitor on right forefinger
• IV in right arm
• Arterial line in right wrist
• Oxygen tubes in nostrils

The skin on my chest is dried-iodine orange. I’m basically a mass of wires. I feel like I’ve been run over by a truck.

On the plus side, I’m not barfing anymore. In fact, I’m starving. When the day nurse comes in at 7, I ask her about breakfast and about getting rid of the catheter. Catheters are the worst. They are intrusive and uncomfortable, and more than just about anything else in the hospital, they rob you of your independence and adulthood. I will try for an hour to convince the day nurse to remove mine, with no success. “We’ll get your catheter out when you’re able to walk to the bathroom,” she says in a voice that’s simultaneously cheery and accusatory. Why aren’t you up and around already, you lazy sot? You’ve been out of surgery 10 hours. I decide then and there to get up as soon as possible.

But “as soon as possible” is clearly going to take a while. I’m hooked to a bunch of machines and IV bags that don’t look portable. The nurse tells me I must eat breakfast and endure some tests before I can get up. And my body aches, a mixed chorus of pain: the intense, raw soreness of my surgical incision, the persistent liquid throbbing in my veins from the IVs, the inflamed ache in my throat from the breathing tube. Every time I move even slightly I’m caught by spasms of discomfort. I ask for Extra Strength Tylenol. It takes the edge off and I sit up and eat breakfast: pancakes, bacon, juice, and a fruit cup. While I eat, the nurse and her assistant, a sweet young woman in nursing school, put pressure socks on my legs to prevent blood clotting. Between these, my wrinkled, sweaty johnny, and my assorted IVs and wires, I am now quite the sight.

As I finish breakfast a group of 8 or 9 med students comes crowding into my room. It’s obvious I’m the Main Attraction on the day’s Cardiac Learning Tour. They read my chart and ask me a few solemn questions but mostly they just stare and take notes. One young woman gives me a pitying, sympathetic smile. In those few minutes I shrivel into an infirm senior citizen. I’ve never felt so old in my life. I want to yell at that young woman. Stop smiling at me! You think you’ll be young and healthy forever, but you won’t. You’ll turn around and you’ll be 40 and achy if not actively infirm, and you’ll wonder where the time went. But instead I just take a deep breath as they shuffle out.

* * *

In mid-morning my doctor comes in. I pretty much worship my doctor. He’s a small, balding man of Indian origin with wire-rim glasses and a plummy British accent. I’ve known him for 18 years, and I’ve never seen him in anything but scrubs and clogs. Despite his size he acts with tremendous authority, and even my control freak nurse defers to him. By the time he arrives I’m de-catheterized (hooray!) and sitting in a big armchair by my bed, waiting for a sponge bath so I’m presentable to my family who are waiting outside. He tells me how the surgery took 6+ hours because of complications, how close I came to needing a new heart valve, how I lost two pints of blood at the end, despite the resident’s pressure on my chest.

It’s hard to hear this, to realize that my health has degenerated and that I have no control over that degeneration. But this is why I love my doctor so much — he takes the time to explain things in layman’s terms, to answer all my questions. And while what he says isn’t reassuring — in fact it’s damned depressing — his willingness to keep me thoroughly informed brings relief. I’ve had a potentially fatal genetic heart condition hanging over my head for 20 years, and his knowledge and authority have been a touchstone for me, helping to keep me focused on the business of living.

After my doctor leaves, the sweet young nursing assistant comes back and gives me a sponge bath. She tells me about her nursing classes at the local college, distracting me from the fact that a complete stranger is washing my naked, battered body. You have to give up modesty at a hospital — people are always poking you, or checking your catheter, or (when you’re a cardiac patient) putting stethoscopes and monitor patches on and around your left breast. They’re not judging your butt cellulite or your nose pores or that mole under your armpit, or if they are they know enough to keep it to themselves.

* * *

It’s 11:30 a.m., my husband and daughter have arrived and settled in. My daughter is still engrossed in her fantasy book but snuggles next to me as she reads. There is talk of sending me home. Apparently they’d rather I recuperated in my own bed than risk getting flesh-eating bacteria by hanging around the hospital. But before I can leave, I have to eat lunch, get an x-ray, and run the administrative gauntlet of discharge paperwork. The first two happen pretty fast, so by 1 I’m ready to get my wires removed and shed the johnny for regular clothes.

But then things slow to a crawl. Even after I’m dressed and ready, it’s ages before I can leave — there is paperwork, and more paperwork, and follow-up appointments to be confirmed, and prescriptions to be written, and incision care instructions to be given. I take a nap in self-defense.

Finally at 4:30 p.m. I’m released, left arm in a sling. I sit in the wheelchair and say goodbye to control freak nurse. I’m wheeled out to the car where my husband is waiting, and ease myself into the passenger seat. I’m exhausted and sore, but gear up for the traffic-heavy trip from Boston to our house in the suburbs. My daughter climbs into the back seat. I look at her little elfin face with its big blue eyes. She’s seen some pretty heavy things in the past two days for a nine-year-old, and she’s handled it all so well. In a few weeks we will get confirmation that she has inherited my heart condition, and will have to undergo the same surgery when she grows up. This will hurt me worse than any procedure I’ve ever endured. But now all that is in the future, and my daughter and I smile at each other as my husband drives away from the hospital toward the highway, and home.

Martha Culver is a former strategy consultant and thus unable to write anything without at least one bulleted list.