Friday, September 21, 2012

Big Tall Bob Used To Reek Geek

He's a giant of a man.  When I first met him, seven years ago, he reeked "geek." He's still shy, but now he's buff, tan, wears the coolest clothes, and his spirit seems to have grown into his height, and beyond it, hovering as icy blue aura, or just making the air shimmer..  He seems to move with grace, even in clunky exam rooms overcrowded with rolling stools and tables full of tape and bandages, and those cotton swabs that top only one end of long, thin wooden sticks.

He's never been paid for his part as "assistant surgeon" in any of the eleven or twelve operations in which he has helped.  The insurance companies write that my surgeries should not require extra assistance.  If I can, and that's a huge "if," I'm going to try and leave him some money in my will.  He would die of Extreme Blushing and Embarrassment were I to do it while alive -- and I love his anti-geekness too much to put him in danger of a return to stammering and crooked glasses.

That makes an elegant segue for my tale of yesterday's appointment with Bob, Brilliant ShoulderMan's Physician's Assistant.  Unfortunately, I need to take a break, grab some frozen strawberries, cover them with fake sugar, and splashes of milk.  This concoction has comforted me several times a day over the last few weeks.  I don't know why -- except that it does cool me down, and I'm starting today's fever.  So I'll be back.  It's also a chance to give Buddy -- who is looking after me this morning -- his favorite treat of bonito flakes, fresh from the one-pound package in the freezer.  (We got the "okay" from the vet to give him as much as he wants, and he wants, and wants, and wants...)

Bob listens to me, and hears me, too.  When I'm stupid, he ignores the babbling.  When I'm glossing over something difficult, he gets very still, a hard thing for a big man to pull off.  He has crystal aquamarine eyes.

We talk cats sometimes.

There have been late-afternoon appointments, over the years, where he and Brilliant ShoulderMan's nurse would both sort of collapse onto chairs or rolling stools, even putting their heads down on the exam table.  I was like a fixture, I guess, and attuned to their fatigue.  These are some hard-working people. Once, I think we all three dozed off.  I remember the nurse shaking herself awake, handing me some pre-op paperwork to sign.  She started to go over each document, then said, "Oh, you know the drill..."  Informed consent at its best!

In the hospital, it is Bob who rounds more than anyone else, so he was the one who got to witness most of my CRPS misery.  He'd drop by between 5 and 6 AM, and I'd be doing well.  Between operations, say around 11 AM, he'd pop in to find me writhing, jerking, cussing.  He heard it all, he heard me say I was giving up, he heard me full of bravado, he saw me when I could not even speak.

When they take me into the surgery suites, I'm always lost.  I cannot see, so I tend not to speak to anyone, whereas they all feel like we're old friends, and come up and crack jokes, say sweet things, explain what is going on.  ShoulderMan and Bob usually aren't in there then, they come swooping in as I am put to sleep, I guess.  But this last time, in June (has it been that long?), there was this unmistakably tall figure moving about the surgical suite, emitting a reverberating voice.

Moving from the pre-op gurney to the operating table is always difficult.  Normally, the surgical staff would help, and the patient would be grateful.  Me?  They knew me so well that should some Newbie reach for a leg to help guide me onto the table, a whole chorus of "Don't Touch Her Legs, Let Her Do It!" rang out.  (Why the nurses up on the floor couldn't grasp the concept, I dunno!)

But this time, my legs were seizing and out of my control, mostly. My left shoulder was shot, hurt horribly with any movement (we shall not intimate that the regional block FAILED miserably!), and that left my right arm as the only available appendage to see to this transfer from gurney to operating table.  Had there been a trapeze, I might have been able to just drag myself over with that one arm, but you can imagine how incredibly crowded it already was in that area... machine after machine, lights, tables full of instruments, and people, lots of people.

I had already led some of the nurses in a sing-a-long during the trip there, and even as we all pondered how this transfer was gonna take place, we were still humming.

Finally Bob's masked face came down to about an inch from my nose.  "Hi Bob," I called out.  I think he laughed.

"We're going to pick you up and move you, and we're going to be quick and gentle."  Before I could bitch and hem and haw, it was done, but not without Bob's face coming back into the one-inch-from-my-nose range.  "Are you alright?"

It would have been one of the easiest entrances into surgery for me ever had not the anesthesiologist screwed up.  I always ask that they please give me good warning before putting me to sleep, as I like to say "thank you" to everyone in the room first.  (Tevye: "Tradition!")  I asked the guy, he said "okie-dokie."

I am difficult to intubate, so much so that they have had to break my teeth in desperation.  I guess that is what he was thinking about.  Anyway, the bleepety-bleep-bleep gave me the paralytic and then couldn't get the tube in, and I was wide awake, unable to suck air for myself, having thanked no one, and was about to come off the table in panic.

Move along, prof, move along.  I am avoiding getting to yesterday.

So... yesterday.  I had an appointment with Bob, one of the interminable "follow-ups." He asked, first thing, how it had gone with World Famous Hip Guy, who was supposed to have done an ultrasound and/or fluoroscope-guided aspiration of my hips, tracking down that wily Propionibacterium acnes.  The journey that led to me losing a shoulder was to begin with my hips.

I picked a spot on the wall behind Bob's right ear.  I told him that World Famous Hip Guy refused to operate on "someone like me" and wasn't eager, therefore, to do the diagnostics.  I told him we were kind of like oil and water.

Then I told him that I was giving up, and relayed the info from the biofilms expert, paraphrasing his "first there is a wound, then they lose a toe, a foot, a leg, and then they die." He did some fast blinking, as did I, and I risked looking at him.  He made it easy:

"So we're going to concentrate on pain control, then?"  blinkblinkblink

"Yeah, I think that is what makes the most sense..."

I was proud of Bob and proud of myself, in that I did not do that awful thing of asking:  "What do you think I should do?"

Somehow, we started cracking bad jokes, the best kind.  And we talked about the carbon footprint of sending a power wheelchair I am trying like hell to donate to someone in Haiti -- where my orthopedic team does mission work twice a year.  There is a local agency that could use it but they won't get their act together and come pick it up and we cannot deliver it for lack of a stabilizing bar for the lift.  BlahBlahBlah.

Suddenly, Bob blew it.  "You're a very special person."  Aw, damn. I, who know me, cannot let that stand, it feels like acid poured on my soul.

I made a rote denial and then managed a "Thank you, Bob, and thank you for everything you have done for me."

More blinking, and that was it.  He made some recommendations for drugs that won't make my stomach bleed, made me promise to come back in 3 months, and blinkblink, I woke the sleeping Fred in the waiting room, where people seemed to be guarding his snoring frame from disturbances.

"Awww." murmured the people, the Greek Chorus, as Fred struggled back to consciousness, cute as the dickens.

We did not speak of the appointment during the long ride home, and I was able to pretend to be bothered by the sun in my eyes.

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