13. Half Empty

  1. 01. Giving It Away
  2. 02. Mind Games
  3. 03. Customer Service
  4. 04. Getting Down to Business
  5. 05. …And Not a Drop to Drink
  6. 06. The Commission
  7. 07. Service!
  8. 08. Instant Celebrity
  9. 09. The Pinoy Diet
  10. 10. Life As We Know It
  11. 11. Doctors’ Borders
  12. 12. Poor, Poorer, Poorest
  13. 13. Half Empty
  14. 14. Me and My Leg
  15. 15. Always Be With You
  16. 16. Going Underground
  17. 17. Decisions, Decisions
  18. 18. I Shall Depart
  19. 19. A Volcano within a Volcano
  20. 20. A Nod and a Smile
  21. 21. Not Fighting City Hall
  22. 22. Stasis in Places
  23. 23. Fond Farewells
  24. 24. Parting Shots

It happened so fast. It was first thing in the morning. Most of the staff hadn’t arrived yet. The office lights weren’t even on yet. I scampered down the curvy stairs, you know, not a circular staircase, but stairs with a turn, the steps fanning out from zero width at the pivot point. My left heel didn’t make contact with a step where I had expected to find one. In less than the blink of an eye — the mind works with amazing speed sometimes — I hoped the next step down was the floor, because if it wasn’t…

It wasn’t. I cannot recall when, if ever, my right foot had come in such close proximity to my eyes. But there it was, not an inch away, if only for an instant. I could not see my left foot at all. It was directly behind me now, having found the bottom, four steps below eye level. Executing a perfect split, my crotch made momentary contact with the staircase before my entire being bounded back to a standing position at its bottom — a perfect dismount!  An old woman screamed in agony.

 

Or so a coworker explained, rushing to my aid upon hearing an old woman screaming in agony. I don’t know who that screaming matriarch was, but I am forever in her debt. I was in tremendous pain, a piano with half its strings snapped from being tuned two octaves too high. The sound whimpering puppies filled the office. I didn’t hear that either, struggling to find a stance, any position, that didn’t have me writhing.

The office manager, a woman of endless utility, finally got me to sit down. She started to wipe my overheated body with a cool damp cloth, as comforting physically as it was awkward socially. Frank arrived, leading a discussion about getting an ambulance. There was no way I was getting in an ambulance, having seen countless of them going nowhere in Manila traffic with their sirens wailing. No, get me in a taxi, I said, get me to St Luke’s alive. Frank rallied the others to lift me onto an office chair with wheels. They rolled me to a taxi.

As a return customer, St Luke’s treated me remarkably well. In an emergency room with at least fifty places to dispose of a body, they put me in the same quiet corner I had been placed a week earlier with my chest infection. Was this the foreigners’ corner? Or for those paying with credit cards? No matter, in minutes the doctor had a catheter inserted on the back of my hand to feed painkillers directly into my veins. The long suffering puppies went silent. I like St Luke’s.

The X-rays showed nothing had broken, as I had expected, but good news nevertheless. Something was wrong down there, though. I could move my right leg left and right, up and down, but I could not extend the lower leg — kick, if you will — a single millimeter. It was a very strange feeling. My brain would tell my left leg to kick, and it would kick. My brain would tell my right leg to kick, and nothing happened. I found it fascinating. I just kept trying to kick, giggling nervously.

Eventually an orthopedic surgeon arrived, telling me to relax. An MRI would answer all our questions, she assured. And so it did, although it took several days. “A full thickness high grade tear is seen at the distal attachment of the quadriceps tendon measuring about 2.0 cm. in length. Partial tear of the medial patellar retinaculum is seen with mild lateral patellar subluxation.” This technical jargon meant “You really fucked up your right thigh, prepare for surgery.”

Eight days after the slip, I checked in to St Luke’s for surgery. This time it wasn’t through the emergency room, but through central procurement and receiving, or whatever they call it.  The registration form gave me the option of declaring myself “Catholic” or “other”.  While only two staff confirmed they would be carving up my right (not left) leg, four staff double-checked my religious status. A little tired of answering this query, I asked “Is there a Catholic discount? I can be Catholic for a discount.”

“No, sir, no Catholic discount.”

“Then ‘other’ I am.” That ended that.

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“…as helpless as a kitten up a tree…”

The hospital lobby featured a grand piano. A pianist played schmaltz, tunes out of my own repertoire, tunes I had learned because they would placate my mother when she was otherwise fed up with my incessant improvisational poundings. I was wheeled to my room to the strains of Misty, Tenderly, and I’m In The Mood For Love.” Later I was told anyone was welcome to play — so I may have found a piano to use once I have recovered.

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The view from my private room

St Luke’s is a world-class hospital.in an ageing complex of buildings. Like the rest of the place, my room was spacious and spotless, yet dark and dingy. A cavalcade of doctors and technicians spent an entire day poking and prodding, testing and verifying, in the end confirming insofar as bodily fluids can that I was not Catholic. There was a presiding physician I had never met before, an anesthesiologist, a cardiologist, and three orthopaedic surgeons, including mine, who I had been led to believe would actually perform the surgery. There was a pack of eager young resident physicians who did rounds between their sexual exploits, a nutritionist, countless phlebotomists, and a psysiatrist.

A priestly chaplain stopped in to ask “What do you want to tell me?” I thought he was looking for a confession. “I haven’t got that kind of time, Padre’.” He left with a worried look. I realized he was probably trying to ask what kind of rituals my “other” religion might require in the event of my death. Perhaps not coincidentally, a psychologist popped in later to make sure everything was okay.

It was my first night ever in a hospital. In the morning I was wheeled into the operating theater at 7:30 am, right on schedule. It was an impressive production, everyone from the janitor to the surgeon oozing a pride of profession rarely seen in accountants. This was it, “the show”, the Big Leagues, Broadway. It was eerily reassuring.

I awoke at ten o’clock in a dingy alley off-Broadway called “post-op”. The first thing I noticed was a poster describing the “Universal Pain Scale” of zero to ten, zero being “no pain”, and ten being “Are you fucking kidding me?” I rated myself at seven or eight, well within the “more drugs, please” range. I noted that three was considered “tolerable”. As I completed this calculation a staffer in scrubs looked up from his crossword, puzzled, possibly irritated that I was awake. He asked me to place myself on the Universal Pain Scale, pointing to the poster “Seven or eight — but,” I continued, “I am not sure how universal that is. Are you in pain, too?”

“It is good that you have a sense of humor.” he patronized. “We will keep you here until the pain is manageable, tolerable.”

Six hours later I was still rating myself a five. Certainly, the pain wasn’t “tolerable” — but I realized they weren’t letting me go until I told them it was. “Three!” I shouted at a passing intern. “Hey, I’m a three! Can I go back to my room?”20160919_082124 Sure enough, in minutes I was back in my room, where I could demand more pain medication while enjoying good cable TV.

The parade of medical professionals intensified. It seemed as if something needed attention every fifteen minutes, day and night.  My first physical therapy session was horrifying. For the first time a full appreciation of the pain and struggle ahead washed over me. Unaccustomed to white patients, my therapist became alarmed as my color alternately flushed and whitened. “I’m fine!” I insisted. “This skin condition is called ‘Scottish'”.

A little later, the specialist in charge of panicking inpatients started a sentence with “When you are released tomorrow…”

“Released?” I shouted. “I can’t move. I can’t sit down, I can’t get up. With the splint I can’t even fit in my bathroom. How am I supposed to survive?” I began to make this case to every medical professional that entered the room. Eventually the presiding physician admitted they assumed I had a big house with family to take care of me. He assured me I wasn’t going anywhere until everybody, including me, agreed I could take care of myself. Whew.

A six-foot couch in my private room provided Frank a comfortable place to camp out. He stayed over every night but two; welcome company. I would be in hospital for a week, mostly because the painkillers caused my digestive tract to shut down, despite eating normally. It was six full days until I managed to crap, which was one of the most relieving experiences of my life. I defecated with the glee of a newly potty-trained three-year-old.

A week in hospital gives one a lot of time to think. I got to contemplating how Americans and foreigners alike decry the increasingly litigious nature of life in the USA. A favorite example is the three million dollars awarded to the idiot who spilled a hot cup of coffee in her own lap. Similarly, Australians love to complain about their over-protective “nanny-state”. Mandatory Bicycle helmets? C’mon, they say, grow up.

Forget, for the moment, that the three million dollar cup of coffee was served at a temperature well above the industry standard. Forget the award was reduced by appellate courts to a small percentage of the original amount. Forget the many fast food restaurants that ceased serving their coffee at such ridiculous temperatures as a result. Forget that bicycle-related head injuries plummeted after the mandatory helmet law.

It occurred to me my accident probably would never have happened in the US or Australia.  Fearing a lawsuit in the USA, or the WorkCover regulators in Australia, a railing to grasp would have been installed. There’s something to be said for that. When I previously wrote about the deplorable state of workplace safety here, I did not foresee becoming a victim of it. But here I am.

Construction sites are the most obvious examples. Nightly I watch the flow of sparks from the blowtorches of twenty-four-hours-a-day welders, molten metal cascading down the side of tall, half-built structures to the sidewalk. More than once I have watched electrical linemen teeter on aluminum ladders leaning only on the very wires they were fixing. Most distressing, I cringed watching conductor Maestro Alexander Vikulov tumble down the ill-constructed and railing-less stairs into the orchestra pit after taking an introductory bow on stage before a recent performance of Ballet Manila. Unlike me, he recovered.

The problem is endemic because there is no recourse for the injured. The next time I hear somebody complain about frivolous lawsuits or over-regulation, I will say “It is called ‘progress’, mate.”

Happily, there was no sign of such nonsense at the hospital. For the most part, the nurses were quite responsive, personable and efficient. Each had their own style and routine, a study in personality types.After a few days I knew what to expect from each. 20160919_072841Then, my last night, Byron appeared. Byron introduced himself with a floor show of precision and flare one rarely enjoys outside of a Southwest Airlines pre-flight safety briefing. He inquired about my likes and dislikes, allergies and pains, needs and desires. He reviewed the food service schedule, my physical therapy appointments, upcoming doctoral rounds, my pharmaceutical regimen, and my daily goal (which remained “control pain” for the duration of my stay). While drugging me up, he reminded me of the emergency evacuation plan, and pointed out the toilet I had been using for six days. By all appearances he was a marvel of comprehensive efficiency.

Before leaving, Byron refreshed the ice pack on my knee, placed the call button within reach, wished me a pleasant night’s sleep, shut off the lights, and closed the door. Drugs kicking in, snug as a bug, I dozed off. An hour later I awoke with a jolt, freezing cold water streaming down my elevated leg into my crotch. Byron had ripped the ice bag wide open, over-packed it with ice, covered it with a towel, and attached it, a virtual time bomb, to my knee. I squirmed to remove it, leaving the mattress below my buttocks cold and wet. Byron, it became evident, had no common sense.

Byron notwithstanding, there have been unexpected benefits from my involuntary intimacy with the Philippines healthcare system. For one, when I am back in a “developed” country with a whiz-bang healthcare system, should cost, bureaucracy, or a waiting list get in the way of, say, a needed hip replacement or dental work, I will hop on a plane back here to get it done, fast, cheap and reliably. I’d do it in a shot.

For another, ample time to ponder things has helped me confirm I am happiest when I let go of any last thread of optimism or hope. As volunteers we are told that the most successful of us are the “eternally optimistic”. I have no doubt that is true. Yet it doesn’t change the fact that such optimism leaves me eternally disappointed — and for me, disappointment is the most painful of feelings.

By contrast, I enjoy great satisfaction from adherence to the belief “Life is miserable, then you die, so you might as well try to get the most out of this journey of self-discovery.” Expecting everything to go horribly wrong, when it does, I chuckle, nod and say “Yup.”

And when things don’t go horribly wrong? I’ll let you know if that circumstance arises. I am not holding my breath.

Half Empty. Also, cracked and leaking. Yup. Heh.

SK