My new room

On Friday, I was transferred from the ICU to the cardiac ward. Cooper wants to be the premiere heart (and general medical) facility in the Philadelphia area, a daunting task given the other fine hospitals around. They built a modern, new wing where my surgery took place and where the ICU is located. They still use their older building, so my transfer involved an elevator ride down to the basement, over to the older wing, and up to the 7th floor. I immediately recognized the place from my prior stay, last February. It's an odd layout, the rooms extremely cramped, and the staff reflecting South Jersey's cultural schism. When I was there before, I had a paranoid roommate who was obviously neurologically impaired from years of alcohol abuse. He talked on and on about some events that took place, in St. Louis, twenty or thirty years ago. He had an altercation with the police or some other men. Two techs were sent in to calm him down. As soon as they heard him, they went on for ten minutes, talking to each other, showing more empathy than I could, for his view of the world. "Know what you mean ... can't stand that shit ... they're gonna hurt you ..." going on and specifically recounting of their own grievances against the police, their neighbors, and society in general.

I recognized one of my former nurses, whom I liked quite a lot, and Toni, the hip hopping tech, who would say whatever crossed her mind. I don't recall the specifics, but she made some highly offensive and inappropriate remarks to me the last time. This stay, she was pleasant, upbeat, and playful, but nevertheless, inappropriate. She came into the room to see Maryka sitting on the side of my bed, holding my hand. She immediately admonished her for climbing all over me, suggesting we could display more sexual self control. She had actually come to take my blood sugar. After getting an unexpectedly low reading using a finger on my left hand, she tried again, using my right hand. When this number showed a higher, more expected reading, she tried to link difference to sugar in the hand that Maryka was holding.

Once in my room, I was placed on a heart monitor, this time one that broadcast the results, without tethering me to a physical device. I was given oxygen, this time at half the volume of what I had on the ICU before. The oxygen was now my only impediment, outside my physical strength, to getting around. This led to discussions between the nurse and me regarding how I should handle my bathroom needs. She left it up to me, whether to use a bed bound option or disconnect for a brief amount of time. She suggested she might be able to get me a mobile O2 tank. She then left the room, to return shortly with more oxygen tubing. She jury rigged two pieces of tubing to create an, which reached the bathroom. It proved long enough, so when I returned, she tried to tape these two tubes together. Her efforts proved futile, as she could not get the tubes to permanently stay together. Further, there was too much loss of pressure to get me the oxygen I might truly need. The next day, this nurse led me in a walk on the floor, monitoring my oxygen level along the way. I was extremely touched by how vigilant she was.

There is a dramatic difference in the quality of hospital beds between the ICU and the my present ward. There was also a noise which continuously came from a vent in the ceiling, which was far more disturbing than a mechanical valve could have been. I did not sleep either night in that room. Still, it gave me a change to get to know my roommate.

Except for one night, I had a room entirely to myself. I was glad, since my prior experiences with hospital roommates is not very good. In February, I had two hospitalizations, one at Cooper, one at Kennedy. My roommate in Kennedy was not much better than the one at Cooper. He was an active alcoholic, not as neurologically impaired, as the Cooper chap. Whatever got him to the hospital, he was clearly itching to get himself out. I similarly disturbed roommates during my 1990 hospitalization for endocarditis.

Jack was admitted to my room shortly after I arrived. My anxieties went up from the very beginning, when he asked the nurse if he could have a drink. When his request for alcohol did not pan out, he got the tech to go downstairs, to the coffee shop, for some real (non-hospital) coffee. My initial about Jack were soon allayed when I realize that he was a friendly and jovial man.

I got to know Jack late that night, while I was wide awake, unable to sleep. I had just returned to my room after walking in the hall, when Jack also came ambling back. I did not realize he was having trouble, too. Jack and I sustained a conversation for a good half hour, until we both went back to sleep.

Jack had open heart surgery about nine years ago, at Deborah. His surgeon had completed 10,000 operations with the implication that he was the best around. Following a mental "my surgeon's better than yours," I lamely found a way to interject that Dr. Rosenbloom was recently cited in the Top Docs edition of Philadelphia Magazine. Jack did not seem impressed, and went on to tell me that he came to Cooper because he needed a pacemaker, and Cooper is closer to when he lives (with the implication he would have gone to Deborah if he needed more serious, open heart surgery). Following this brief round playground banter, we got engaged in more conversation, about ourselves, about politics and the world. Although Jack had been a blue collar worker from the boon docks of Cumberland County, I found that many of our beliefs, were truly shared.

On Saturday morning I was seen by one of the cardiology residents (or fellows, I'm not quite sure about the difference) who examined me before Dr. Ginsberg arrived. I don't recall this doctor's name, but my immediate response once he opened his mouth was to inquire, "You're from South Africa?" He held his response until completing the examination, and then told me I was right and asked how I knew. He shared that it bothers him that people often think he came from London or Australia. I told him that my grandfather was South African, and that his speech mimicked exactly sounds I heard from relatives of mine. This seem to seed a closer than doctor-patient relationship. He later asked my advice about how his mother-in-law, who is a psychoanalyst in Johannesburg, could get licensed, if she moved to New Jersey.

Jack was discharged on Saturday, so I had the room to myself that night. I still could not sleep, and got increasingly impatient to get out of there. On Saturday, I had spoken to three different doctors, Dr. South African, Dr. Ginsburg, and Dr. Bowen (Dr. Rosenbloom's associate). They all disagreed on the day of my release, respectively Saturday, Sunday, and Monday.

In the middle of that night, my nurse came into my room, to do an EKG. The technician was worried by something that appeared on her telemetry screen. The nurse tried to assure me that it was nothing to raise concern, and that the telemetry technician was just doing her job. The blip that she saw, had already been seen and ruled out as a problem by Dr. Ginsburg earlier in the day.

I've known for years that there is a blip on my EKG. It reads as if I have had a heart attack. Years ago, when I worked at South Amboy Hospital, I was given an examination and told I had such a prior attack. I went immediately to Dr. Ginsburg who repeated the test, and then assured me that this was not the case. The blip was either an idiosycratically delayed beat, or a misreading caused by my prior heart surgery. Despite my nurse's efforts to reassure me, this raised my anxieties that I would not go home.

In the middle of the night, my nurse rolls in a portable EKG machine to begin the test. Something goes wrong, and the machine spits out graphs with large black lines, causing me to wonder if I were in cardiac arrest. She told me there was something wrong with the leads (reminding of the movie, Glen Garry Glen Ross). After considerable effort on her part, she finally got a reading, which she could use. She told me that nothing had changed, and despite my worries, I felt certain I would have seen a doctor that night, if something had.

I got up in the morning, following a poor night's sleep, waiting for Dr. Ginsburg to arrive. He had told me, the day before, that he would be here at 10 am. I decided to sit in my chair and read the Sunday Times on my Kindle. At some point, Dr. South Africa came in to do an examination. He told me that it was his understanding that I would be going home today. We had a friendly and cordial chat. He left, and I picked up my Kindle, to find its screen had frozen on that page. No matter what buttons I pushed, I had no way to get it working again, leaving me feeling quite panicked that this prized possession would never work again.

The Kindle has a special place for me. I don't care for TV (with the exception of surreal court shows -- The People's Court, etc). When I was in the hospital back in February, I mentioned to Maryka that I was getting very bored with the TV on. The message appears to have gotten back to Matt, so for my birthday (which is February 18), he sent me a Kindle. I certainly did not expect such a lavish gift, and was touched by his sensitivity to my plight. It also happens to be that Matt works for Amazon, and is involved on the Kindle project. So, this adds a special connection to him associated with this gift, and considerable concerns if I were not to have it.

Before I got the Kindle, I did not actually read very much. Although many know of me as a writer, I am actually a handicapped reader with a clear learning disability. The learning disability is a consequence of my operation when I was ten years old. Before that, I was an avid reader. Many of the historical facts I know today come from children's books I read before I was ten. I mentioned before that Dr. Gross had a worldwide reputation as a pediatric heart surgeon. One reason for his success is that he was able to do surgery at a rapid clip. Without today's technology, there is significant interruption of blood flow during the operation I had. The damage that is done may depend on how long. Although my operation was successful, my loss of reading skills was dramatic.

This has actually played a very central role in my development as a clinical psychologist. I was trained in New York which was heavily influenced by the psychoanalytic approach. I assumed that there were Oedipal themes and castration anxieties, associated with the fact that I suddenly stopped reading after my operation. My mother stayed in Boston during my surgical stay, while my father had to stay home to work. Undoubtedly, I feared going blind at my father's hand for sharing this intimate time with her. This, and other misguided notions about a whole range of health and emotional reactions, have significantly altered my views on psychoanalysis, and play a major role in the psychology I currently practice.

Coming back to the Kindle, I found it not just a thoughtful gift, but a remarkable device. It's small screen combined with its options to control the size of the letters, has dramatically increased my capacity to read. Whereas for most of my adult life, I have read just one book a year, on my annual summer vacation, I've read four since February, along with my daily New York Times subscription. The loss of my Kindle would be a devastating blow.

I tried to comfort myself, knowing that it had a one year warranty, but I also thought back to that time, shortly after surgery, when I dropped my Kindle, reaching for in with my numbed right hand. Would that invalidate the warranty? I looked over my Kinder for signs of damage, and shockingly found that some were there. There was a slight separation in the integrity of the seal between the front and back covers. Undoubtedly, it had separated when it had dropped.

With some difficulty, I was able to snap the pieces back in place, still unclear about whether I would be protected. It didn't fail after the fall. But there may have been phsyical damage to kicked in later on. After continuing to push the buttons, I figured my only option was to use the power cord. I did not have it with me, and would have to wait to get home.

I put this out of my mind until Sunday evening while Maryka drove Matt to the airport. Unfortunately, I had to wait for her return, she she had been carrying the cord in her purse. I told her of my plight, and she questioned why I didn't share this with Matt, who could have taken the device back with him, if it did not work. I did not want him to feel bad, and also figured that I could settle the problem easily from home. Anyway, I plugged the Kindle in which caused the frozen screen to be immediately replaced with one that indicated, it needed to be charged. I believe the charge ran down during that day. Within a few minutes, my Kindle was working again.

It's interesting how, during a period of vulnerability, small things take on major levels of importance. Certainly, the worst that would happen is that I'd have to buy a new one. I can certainly afford a $300 item, knowing Blue Cross Blue Shield is handling my quarter million dollar operation. But this was a very special gift.

The other, unexpectedly special gift is Sir Koff-A-Lot. Before going into surgery, I was given a device called a incentive spirometer. I was instructed to use this ten times an hour, and continue to use it after I got home. This is done to prevent pneumonia, and will induce coughing if there are fluids in the lungs. Before of the cracked sternum, it is helpful to hold one's chest while coughing. Although a blanket would do, Sir Koff-A-Lot is a specially manufactured Teddy Bear, indistinguishable from his Teddy Bear cousins, except for his straighter back. This explanation is clearly described on Sir Koff-A-Lot's tags. Not quite ready to read when the bear first arrived, it nevertheless proved to be a comforting pal. I truly enjoy having Sir Koff-A-Lott around, who is currently napping in my bed. I guess surgery creates a throwback to a more primitive time, depending on others, and experiencing pride in using the potty the first time. Sir Koff-A-Lot has earned a permanent place in my heart.