In 1990, the President of St. Mary’s University asked me to direct the institutional self-study for reaffirmation of accreditation. If you are an academic and someone asks you such a seemingly simple question, follow Nancy Reagan’s advice: JUST SAY NO!!!!!!!!!! Not only would I direct the thing, but I was also the chair of the self-study committee and the editor of the document that would go to the Southern Association of Colleges and Schools [SACS] and the Visiting Team. PLUS: SACS was on the first few schools under the new “Institutional Feedback Loop”—the then new regimen of judging a university by its use of assessment.
This is really all about my medical adventures so I won’t belabor this but…I wound up leading a team that did the research on every aspect of university life from academics to student life to university governance to physical plant and deferred maintenance and financial soundness (kind of like S&P with the United States) and personally wrote a two-volume, 1,200-page document with twenty file cabinets of supporting documents (I didn’t write these, just assembled them with links [not HTML computer links but parenthetical links] from the documents to the files), and had the two-volume document printed.
My work day moved from 8 hours to 14. My edited collection of essays on librarians came out in late 1990 and my collection of poems by Vietnam veterans on the first Persian Gulf War came out in early 1992. I was much, much younger then.
I discover that I need surgery (ies)
One day in early 1991, surrounded by administrivia about the university, editing this and that, drowning in paper, my urologist discovered that I had a tumor in my right kidney! My internist almost simultaneously discovered that I had a hernia in my left…whatever. I had actually gone to see the urologist with a different problem for which he had already done a series of ultrasounds but when I got into his office he said, quite abruptly, “Forget the reason you came here; let’s focus on your tumor.” We did. The solution was to have a nephrectomy of my right kidney: just take the kidney out. “You don’t need two of them and this is much safer than trying to get the tumor out.” He had done hundreds of kidney removals for the transplant hospital and felt there would be no problem.
Meanwhile, my internist was finding a good general surgeon to repair the hernia. My urological surgeon was a rock star; my general surgeon was more of a roadie. The urologist, learning about the second surgery I needed, suggested that we do both at the same time…that way, I would have to have anesthesia only once. I agreed.
St. Luke’s Baptist Hospital
Of the hospitals I have been in, I personally rank St. Luke's at the bottom.
Susan gets me to St. Luke’s at 5 a.m. for prepping. Let me explain something first: Had this happened ten years later the whole nephrectomy would have been done with laparoscopic techniques. Unluckily for me, my doc would have to use a scalpel to cut into my side, cut through muscle, shave a bit of a rib off and then extract the cancerous kidney. That process would avoid having to penetrate the abdominal cavity. That piece of surgery went well. For all practical purposes, I wasn’t there; so, I can’t really talk about it.
My hernia surgery must have gone well also. When I met with the general surgeon, all he could say was “Fine, fine” And then he added, as if he were hero-worshipping: “He let me assist with the kidney!!!!”
I woke up in the Recovery Room feeling no pain. A morphine drip drip-dripped down into a vein and left me feeling as Coleridge must have felt when writing “Kubla Khan.” No mysterious visitor woke me up; the poem was fantastic, but I neglected to write it down. Coleridge failed to finish his. Whenever I started to feel pain in my side, I pushed the wonderful button that released additional morphine into my vein (NOTE: there was a fail-safe device that kept me from sending too much down into my veins, but I didn’t know that and there seemed to be a placebo affect tied into pushing the button).
Susan tells me that I appeared to be keyboarding through much of the morphine haze, sending and receiving odd emails around the world. I have no remembrance of that but am grateful they didn’t get out into the world of what must have been BITnet in those days.
I develop an Ileus
I was supposed to leave the hospital in three days, but an unfortunate thing happened on the way to being released: my whole upper body started swelling up. Someone with drum sticks could have paradiddled all over my extended stomach! My general surgeon, we assumed but could not prove, seemed to have bruised part of my intestine. This caused me to develop an ileus…the ileus caused all the build-up of fluids in my abdomen that caused the swelling. From Wikipedia: “Paralytic ileus is a common side effect of some types of surgery, in these cases it is commonly called postsurgical ileus. It can also result from certain drugs and from various injuries and illnesses, i.e. acute pancreatitis. Paralytic ileus causes constipation and bloating. On listening to the abdomen with a stethoscope, no bowel sounds are heard because the bowel is inactive.” That’s what I had.
“We”—odd how it’s all “we” in hospitals until it’s time to get paid—decided to just “watch it” for now. It was really not all that difficult to see the damned thing. Mostly, though, I was in my own fever dreams.
I Scream at a Nurse (1)
As my hospital stay extended into a full week, I got to know one nurse fairly well. My morphine drip had been replaced by something just as wonderful (to avoid addiction, I suppose) and this young, dark-haired, 30-something nurse had asked to be transferred to the late shift so she could care for me. Extremely nice of her, I thought. We chatted about things I had no memory of the next day. She did all the nursey things. But a week passed and I was still hooked up to an IV. I could not drink water. I could not eat even jello. I grew cranky and crankier.
A little wet sponge across the lips does not a good glass of water make! A small ice chip is NOT a meal. [More about this a few paragraphs down.]
Finally, my urological rock star decided to take matters into his own capable hands. He asked if I wanted to be anesthetized when they put the breathing tube back down my throat or have anything more than a local when they cut back into me to relieve the pressure from the ileus. I remained hooked up to my pump and, in a very drugged-out, macho way refused general anesthesia. I still remember, quite clearly, the tube being pushed down my throat. Doctors call this a “tracheal intubation” and hospital shows always have plenty of them…probably second only to Codes and the use of defibrillators. When the urologist finally cut into me to relive the pressure, he tells me green, slimy gunk shot almost to the ceiling! I was wheeled back to my room and someone else had to clean the OR.
Nothing else went wrong except that I remained in the hospital for another full week, hooked up to IVs, neither eating nor drinking through my mouth. Ice chips across my lips…a sponge to moisten them. My fantastic nurse, at whom I should never have screamed, got me vertical and helped me walk the corridors of the hospital using my IV pole as a cane.
The Night of Almost Unendurable Pain
One night, she took off and that’s the night I learned her value though it did not keep me from screaming at her later. You see, I was still catheterized though I did not know it. My nurse had taken care of the bag without my noticing. While she was away, I slipped closer to normalcy and realized I needed to go to the bath room.
I rang for a nurse to assist me. I rang again and then again. It seemed like hours and no one came. So, I got up, leaning on the IV pole and pulled myself out of bed. Then I truly screamed. The pain was incredible. The catheter collection bag fell from the mattress and was suspended above it by, oh, the catheter itself which was, needless to say, connected…well, that’s needless to say. Finally, a nurse came and got me back into bed.
The next morning, the doctor decided I no longer needed the catheter but that the nurses could measure my rate of, uhm, flow by collecting it in something very like a measuring cup used for cooking.
NOTE: Whether a hospital is a good hospital or not is less a matter of having good doctors available than it is of having superior nurses on staff and enough of them to do their jobs well.
Back to Normal in the Hospital except for one thing
The last few days of my hospital stay were in front of me. All I had to do was have a BM. It would also help, the doctor said, to develop a healthy dose of flatulence. I was off all the good meds. But I was still connected to IVs and was munching on ice chips. No food. “How the Hell am I supposed to have a BM (I used the ”s” word, if I can’t have ______ food????!!!!!!!!!!!!!” I demanded of Nurse Wonderful. I really went into a primal rant, unloading on her. She left my room crying and did not come back.
The next morning, a Friday, I finally had a BM. I had to wait until Monday morning to be released. Nurse Wonderful did not return.
Aftermath
Susan took me home and we spent days just walking, building my strength back up. I was not allowed to drive for three more weeks. My urologist told me the tumor had been very malignant but had been totally encapsulated in the kidney. I was okay.
The first thing I did when I could drive, was buy a box of chocolates and a dozen roses to take to my special nurse at the hospital. She forgave me.
I went back to the university a month later. The institutional self-study still waited for me. I finished it and got copies off to SACS and to each member of the visiting team. Our accreditation was reaffirmed.
My apologies that this was such a long entry. I promise the next will be much, much shorter.
parallels about 60% of my experience with kidney cancer-i"amazed you recall so much
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