Undifferentiated Mush

I haven't slept in 44 hours. Oddly enough, I find myself fighting the urge to sleep. This tends to happen when I'm stressed -- but really, if this is stress, then I am one lucky person. The surgery on Monday, and the tedium of being in the hospital, probably in isolation again, is exacting its toll -- in advance.

How do I know I will be stuck on the other side of people floating in yellow paper gowns with shockingly bright blue latex-free gloves? Because I have assurances it won't happen from my internist and his Supernurse Sidekick, from the admitting orthopedic surgeon, his PA, *and* his nurse, from the Infectious Disease doctor and *two* of his PAs, as well as from the Director of the Infusion Center.

Each person is quite sincere and well-meaning -- and all of them make reference to "common sense." And yet, not one of them is willing to do the leg work of ordering cultures, then checking on the results, and writing orders implementing or discontinuing the innumerable ickitudes of isolation. I know this because of the previous four admissions during which we danced this same dance.

La Bonne et Belle Bianca Castafiore refuses the paper and plastic garb. She either sneaks in without them to begin with, or dons them with great fanfare out in the hall, only to rip them off like a cheap costume once inside the room. Ah, ah, ah! Je ris! Oui, je ris! Simplement de me voir, si si si, si belle dans ce sacré miroir, ah-ah-ahhhh! I know, I know! Out of the bonny blue she has begun to produce operatic riffs...

Anyway, I have plugged my nares with antibiotics, washed every inch of my body with Hibiclens, lanced the multitude of dark, oozing, stinking boils... just kidding about that last part. "Multitude" is kind of an overstatement, used for shock value.

So this afternoon, as the preregistration nurse is doing her thing an d swabbing the nares and the axillary hot spots, I will be smiling my secret smile, secure in the knowledge that Science is going to fail me, once again.

I bet you a dollar. The results will be negative, no growth -- but because hospital protocol requires two successive negative results, that is where the ball will get dropped. I can orchestrate the production before surgery -- but after? That's a different ball of sealing wax.

It is within the realm of the possible that you've no idea what I am babbling about. Don't worry, for you are not alone in falling short of perfection. I have a clusterfuck of medical issues -- lupus, avascular necrosis (which engendered three joint replacements and several pinnings, plates, and screws of fractured bones), adrenal (and renal!) insufficiency, and the everlovin' CRPS/RSD. Oh yeah, and a fair amount of aortic regurgitation.

Also an aortic aneurism.
And a partridge in a pear tree.

The short version of the pertinent? Somewhere along the line, pathogens moved into both of shoulder prostheses -- and then developed into a more classic osteomyelitis. Last August/September, my awesome orthopedic surgeon removed my right shoulder prosthesis due to massive infection and "replaced" it with a silly little antibiotic-impregnated spacer. This surgery did not go very well, and resulted in schtuff like ventilators, pressors, ICU, and an extra visit to the surgical theatre. Despite having lots of evidence for the lab to work with, nothing grew in the cultures. In December, he had to remove the left shoulder prosthesis, and gifted me with another spacer. The infection spread into the entire shaft of the humerus, which -- in ShoulderMan's words -- "pretty much exploded." Mid-February, he went back in on the right side, and put in another total shoulder prosthesis. We are hoping to repeat that achievement this coming Monday on the left side.

I know that my navel is not the center of the universe. Trust me, I am as disgusted as you by this constant worrying and teasing of details over which I have no control -- and about which you have little interest.



How did I miss that the Taliban are within spitting distance of Islamabad? Was it because of that navel thing, or maybe fever, pain? No. I was, quite simply, derelict in my duty as a Planetary Citizen.*

ISLAMABAD, Pakistan — Pushing deeper into Pakistan, Taliban
militants have established effective control of a strategically important district just 70 miles from the capital, Islamabad, officials and residents said Wednesday.

The Taliban pushed into Pakistan from the Swat Valley. We are assured that Islamabad is not in imminent danger, and yet:

Buner, home to about one million people, is a gateway to a major Pakistani city, Mardan, the second largest in North-West Frontier Province, after
Peshawar.

“They take over Buner, then they roll into Mardan and that’s the end of
the game,” a senior law enforcement official in North-West Frontier Province
said. He asked that his name be withheld because was not authorized to speak to
the news media.

My God. I think it is time to focus on what matters.

*"The beliefs I have to defend are so soft and complicated, actually, and, when vivisected, turn into bowls of undifferentiated mush. I am a pacifist, I am an anarchist, I am a planetary citizen, and so on." Kurt Vonnegut