Sunday, July 8, 2018

Sloan Rangers

It all began when the phone rang on Thursday afternoon. It was Shmom* (names of my mom have been changed to protect me from her particular threat of violence if I named her) and she said that some of her blood numbers were low so she was going to have to go in the hospital in the morning. Shmom has cancer and recently when she has gotten chemo, her hemoglobin (really, Shemoglobin, because she's a girl) has dropped. This is frowned on in this establishment so the doctor types are watching closely and are concerned. She didn’t want to go in immediately because she had a guy coming at 9am and she didn’t want to reschedule. Some things are important. Going to the hospital can wait. Anyway, what are numbers anyway? Just numbers, Right? She was glad because she would be able to go into Sloan Kettering and not the local hospital. Lawrence is nice, but the food is no good and why else would you choose one hospital over another, anyway?

So I got to her house at 8:15 on Friday morning and fell asleep. That’s what I do, and I do it well, so don’t judge. We left the house at 9:20 and were in the city by 10. I dropped her off at the front door of the hospital and pulled into the underground garage. The attendant asked “how long are you going to be.” That might, sometimes, be a reasonable question, but at 10am on Friday it wasn’t. I told him candidly, “you’ll have to ask the doctor – either 2 hours or a lot longer than that.” This was not an answer he wanted to deal with. I don’t know exactly what happens after you leave your car with the guy in the garage so I just hoped that he wouldn’t take my sass out on my car.

I met my shmom in the Urgent Care Center. I was carrying my bag and a suit, just in case I had to stay. I hadn’t made plans for accommodations because I still wasn’t sure how long I was going to have my car in the garage, so I kept my stuff with me. I found my way into the back of the Urgent Care Center where shmom was getting checked in. We moved to bay 12 and sat there. Thus began the waiting part of the show. Sitting in bay 12, being visited by the various nurses, aides, orderlies, and even doctors, explaining the exact same story over and over. Most, she made up because last time she was in the hospital she wasn't paying attention, or being awake. Shmom confirmed and reconfirmed her name, birthdate and various other pieces of ID. By the end of this ordeal, even I knew her birthday! Crazy, right? By 11:30am they asked her to move into the bed in the bay instead of sitting in the chair next to the bed. Progress, I calls it. So shmom worked on her ken-ken and crosswords in the bed instead of a chair and I got to sit in either of the two chairs. Woo-hoo!

We met so many people there! There was the tag team of Trevor and Dana who were the nurses who did lots of stuff. And there was the Nurse Practitioner and the GI guy and other doctor and the ICU doctor and a bunch of other nurses, and x-ray technician who did a real nice photo shoot and the phlebotomist who phlebotomized all over the place. Shmom has a port so they took a lot of stuff from her via the port and added lots of other stuff right back into the port. Some stuff is not compatible with other stuff or the port so they started sticking her like a pin cushion and attaching things to her til she looked rightly goth. Her blood pressure was ridiculously low, consistently. In fact, the NP insisted on rechecking it with a manual cuff instead of the computerized one that was checking every 3 minutes because it seemed so low. Bottom line, the computer was pretty much right. Very low blood pressure. This, along with the relatively low iron count was cause for concern. Doctors checked for blood in places where there should not be blood and thought they saw a little and hoped that this explained, oh, EVERYTHING. So along the way, they pumped in whole blood, platelets and red blood cells, all contained in baggies affixed with codes and numbers, all that have to be double checked against her wrist band, her recall of her name and a set of secure codes carried around by a guy with a briefcase handcuffed to his wrist. Well, not so much the last one, but it seemed like it. I tried to be extra-special annoying so as to drive up her blood pressure but that was not as successful as actual medical approaches. Live and learn. There was talk of admitting her so I thought that I could make accommodations, but then the talk shifted. To a room on the 17th floor? Maybe, or not. The thing is that with each expert, there was the same uncertainty, so no one really had any idea what the next step was. Maybe some imaging or testing…but not if she doesn’t stabilize. Maybe the ICU…but not if she does stabilize. How long will it take to see if she stabilizes? We don’t know. And anyway, no one does imaging after noon on a Friday. Or on a Saturday. Or Sunday. So hang tight…bay 12 in the Urgent Care Center, over and out. Had we come in Thursday night, we would have been sitting around for longer with the same "no one is around today" result. Three cheers for inaction.

In this hospital, it is important to remember that there is a hospitality room for those of us who keep kosher dietary laws. Now, before I go any further, let me apologize to those of you who are less familiar with the various laws of Judaism, food and otherwise, and caution those of you who ARE familiar that my actions and decisions are mine – I am not issuing edict, making rules or passing judgment. I did what I did and you are free to do what you do. While mo—- I mean shmom was sitting around with various bags of stuff and tube and wires attached to her and a techno-IV pole with machines blinking and beeping like some sort of living Christmas tree I figured that that would be a fine time to go and get some food. Off to the hospitality room with its door code and hidden mysteries. The room, a small kitchenette with 2 refrigerators, 2 microwaves and on Friday evenings and Saturdays, two warmers of food actually smells brown. I got there early in the afternoon, while stocks were running low, and grabbed some tuna and egg salad sammiches for me and mom. I also filled my pockets with cakes of various sorts. Shmom likes cake but I couldn’t know which one she would prefer so I got 8. I also got water because I didn’t need all the calories of soda or vegetables. We shared a light lunch in that I ate most of it. Because I’m a good son, that’s why.

When it became clear that, one way or another, we were staying for the sabbath, I made the call to get a room at the Friendship house. This took some time because they generally don’t answer their phones after 2PM and it was 2:30. Eventually, they called back and I sent the necessary information and all was resolved. The Friendship house is a building next to the hospital that makes rooms and food available to sabbath observant families who are stuck in the hospital, even on Tuesdays. There is a dining room with all sorts of food (I grabbed some cheese and roasted almonds) and some games, and books and very large teddy bears which I did not take because you can’t eat them. Well, at least you shouldn’t eat them. That’s a mistake I won’t make again. My room was in suite 6. This was a 5 storey walk up on narrow stairs and I’m really, really (really) out of shape. In the olden days, they didn’t have elevators so people had to walk up stairs like this every day and that’s just plain N-V-T-S nuts. I vowed not to leave and return very often for fear of anything resembling exercise. It was brutal. I also forgot the combination to the suite so that took a few minutes. Last time I was there I was a floor lower but the room had no windows to the outside. This time, I had windows so I could look out on 66th street. It wasn’t very interesting. I ran some soap and water over my face and through the place that used to have hair, and headed back to the hospital, ready for Shabbat. I had davened though it was only 7PM because, what else was there for me to do. But I was decked out for the evening -- this means I tucked in my shirt and put on proper shoes. Back to urgent care and my chair and a whole lot of waiting. I ate more cake. I saw that she was now on oxygen because when you get too much saline, you need oxygen (I learned that this isn't the same as Saltine). It’s a vicious cycle as all cycles are wont to be.

Another couple of hours passed and I took a walk back to the food room. What else is there to do? I got some grape juice and made kiddush, had some challah and ate a fine entrée of chicken with two starches. There was potato kugel and couscous under a piece of roasted chicken, all wrapped in a layer of plastic and snug in a plastic container, tasting like brown plastic. The main ingredient was oil. Then more cake. I went back and reported this to my mother and in an hour, she sent me to get her a similar meal. Along the way, I confirmed with the nurse that it would be OK to being in food for her. She said that she thought that one of the many doctors had limited shmom’s food intake but she was sure that it wouldn’t be a problem – she would have it resolved by the time I got back. So I walked, collected food and returned, entrée and orange juice in tow. My mom got one bite in before the nurse (this was Nicole, I think) came in and told her that she was restricted to clear fluids, so as not to exacerbate any potential GI issue. She left. Shmom snuck a bunch of her dinner with a casual “to hell with all of this.” I heartily ran away. I’m not getting in trouble over this. I came back and saw that she was done with the little bit she was interested in and dutifully ate the rest. Because I’m a good son.

Long story somewhat shorter, the numbers crept up and eventually stayed up. The constant infusion of saline (some more rapidly than others) and who the heck knows what else got her to be as stable as shmom ever is. By 9PM I decided to And true to the name “urgent” care center, they had a room ready for us at 11PM. Thirteen hours in the Urgent Care Center. We went upstairs to the 12th floor and settled in to a semi-private room. “Semi” means “not.” She was hooked up to whatever needed to be hooked up (and unhooked from the various things going in to her arms). And I wished her a good night. I walked down the 12 floors and headed back to the hospitality apartment where I had left no lights on.

A digression – Sabbath in the hospital:

If you are strictly sabbath observant, there are some challenges to being in this hospital. The biggest one has to do with the elevator. A religious Jew will not go into an elevator and push a button for a floor. Fortunately, the hospital has one elevator which it puts on Sabbath mode, which means that it stops on each and every floor on the way up and down, no matter what button is pushed. Many authorities accept this as an option on the sabbath. Those authorities are as out of shape as I am and I thank God for their lack of interest in getting into shape. But this mode makes the elevator very slow. Eighteen floors (1-19, skipping 13). The elevator takes about 15 seconds to get to a floor, open, wait, and close. This means that if you are on floor 1 and miss the elevator, you have to wait about 36 iterations of 15 seconds until it comes back to you. That’s like 8 or nine minutes of waiting. And once you get in (and are going to the 12th floor) that’s another 3 minutes of riding the elevator. Food you collect for everyone in the room often gets cold, or more likely, eaten before you get there. And pity the poor non-Jew who rides, not knowing. This is how blood libels start. I would recommend having it stop at every floor on the way up but go express from floor 19 to floor 1 on the way down. I have done the math. It is much faster and reduces wait time and I’m OK walking DOWN stairs with the whole gravity assist thing going on. But no one asks me, so things stay as they are.

The next issue is that of the electric eyes (I am ignoring the video cameras everywhere – those are passive and being filmed is a less problematic issue to me. If you don’t like this, stay in your house on the Sabbath.) The electric eyes and the motion detectors control most entrances, many internal doors and most every toilet and faucet in the hospital. So even if you take the Sabbath elevator to the 12th floor, you still have to wait until someone else triggers the door out of the elevator vestibule so you can get out of the area. The doors to the Urgent Care Center are opened with a big push button on the wall on one side, and a motion detector on the other. It is important to wait around not looking like you WANT the doors to be open, because there are legal concerns if a non-Jew specifically does a forbidden activity for you. It isn’t simple and the easier method is to know how to get around things. So for that:

1. The entrance on 67th has a regular ol’ door and was open late at night and early morning. They were going to close it because of construction this evening, but they let me use it anyway.
2. There are staircases that can lead you down to areas like the garage. Those areas also have electric eyes, but there is more foot traffic and there are guards who clearly know the Sabbath laws because they nonchalantly, and without being asked, wander past the doors when they see Jews coming.
3. There is one bathroom which I found which had old fashioned plumbing – S104 I think it was called, the men’s locker room. You walk past the back entrance to the UCC (I’m down with UCC) and past the Clinical Decision Unit (the famed CDU) and the radiation image reading room and then down a ramp and there’s a nasty door which says “Men’s Locker”. Of course, it is inconvenient to have to find it and sneak in (I don’t know if I am allowed to use it but no one stopped me) each and every time I want to use the lavatory, but the options are either religiously suspect or hygienically questionable.

I got back to the room at about 9AM. My reading material was primarily Kaddish by a guy named Wieseltier I think. It was recommended to me by The Maggid of Bergenfield so I read it. Meh. Five nuggets of gold surrounded by 500+ pages of stylized narcissism. Then I read a James Patterson book. Gratuitous and simplistic in its style but with a twist at the very end. The room has a big chair, and I looked forward to sitting in it and leaning back, listening to the whooshing of the air, and pretending I was on an airplane, unable to sleep there. Shmom’s room didn’t have that kind of chair. This one had a foot piece that could be pulled out and the chair could be converted into a bed, but it did not recline. So I sacrificed my back and knees for a place to sit. Unsure if shmom was still on a liquid diet, I remembered her request of the previous evening and picked up a bunch of corn flakes-esque cereal. When I found out that she was still limited in her intake, I grieved by going back down to the hospitality room, getting milk and a bunch of cake and coming upstairs to eat all the cereal. Because I’m a good son. Every trip downstairs was sure to eat up at least 20 minutes of elevator waiting and I’m sure that my walk down burned at least a million calories, right? More doctors visited and said much the same thing after asking the same questions. She’s feeling fine. The numbers are holding, pretty much. Nothing is being done today or probably tomorrow. She kept asking if they would loosen up the regulations on the diet. They said “no” but encouraged her to order some clear liquids. She asked for a menu. While we waited, I find the least-awkward awkward position and napped in the chair, looking forward to the aches and pains when I awoke. She had more blood taken and saline infused.

When I awoke I found that I had missed mostly nothing and took the opportunity to celebrate by going downstairs and getting more food. I tried the chulent and kishke main course and found that the chulent was brown and the kishke had the consistency of a sponge – I mean that it was like a sponge with consistency. It never got any better. Better have some cake. And a diet Coke because I don’t need the calories. When I returned, I learned I had missed the ICU doctor who came buy to reassure shmom that “they” were still watching her. Spooky and not at all reassuring. Hooray! Diana the nurse dropped by to keep shmom full of good cheer and clear liquids and we chatted about movies and books and why I’m a great son. She got into the spirit of aggravating shmom and shmom kicked us both out. Side note – the nurses are all uniformly awesome. Being serious now, they came in just to say hi, they listened to Shmom (which I stopped doing like 35 years ago) and they answered our questions recognizing our frustration. It is a thankless job (not really, I did say “thank you” once) and they take care of the people we want taken care of, and not in a mob-hit-man kind of way. So, super to them! Shmom was put back on one of her medicines that sounds like a dinosaur name (velociraptor, I think, but I don’t recall if that is the medicine or the dinosaur). The roommate spent most of her day complaining about itching, pain, and how she dropped her Chapstick. She also kept calling and video chatting with her extended family and her cat. I know more details about where in her bedroom her backscratcher is than I should.

Shmom got her menu and wanted to make choices off of it. I want to link to some pictures because I enjoyed the reading material and thought you would, too. This Clear Liquid Diet Menu

So we had some fun with that. When shmom ordered Jell-o, she made sure to get the stuff which had sugar, not fake sweeteners because that fake stuff can give you canc- oh. Oops.

Not much to say about the next 6 or 7 hours. The vampires kept visiting, extracting tubes of fluids that were all, no doubt, very important in order to ensure that shmom doesn’t have too much stuff in her. Shmom eventually took a couple of walks to the bathroom to produce more evidence for the boys down in the lab to test and confirm that she is still going to the bathroom. They want to rule out “not going to the bathroom” as a cause of her discomfort so she obliges. She has to poop in a “hat”. I find this troubling. I will try to do the same when I get home but I fear that the strange ways of the big city will not make sense to my small town friends. There are so many weird abbreviations and technical jargon in a big city hospital. For example, if I want to order someone to have only Clear Liquids, I might say, “you are on a CLD” but in the big city, the letters they use are NPO. Crazy, right? I went and had some gefilte fish and challah and cake just to help me absorb all this new information. As the Sabbath ended, I went back to my walk-up, gathered my stuff and headed home.

I’m sure I am forgetting stuff, or confusing the precise order of details. I’m certainly omitting little things, like the names of all the other nurses (like Anjuli and Cynthia) and helpers who transported shmom or answered her call bell. I didn’t even mention all the other people in the UCC (in the surrounding bays, and outside…I met people whose kids I know from work) and all their medical issues, or the in-house TV choices (videos on what a clinical trial is….excellent). Shmom is still there and we will keep visiting her and monitoring her victuals (no, that’s not a mistake).

Any questions? I don't care. I'm going to sleep.

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