Friday 27 January 2012

A Hip Chick - Part Two

Anna was terrified that I would die on the operating table or that Mr Who would replace the wrong hip. I didn't know. Given her fears, the fact she was about to leave me in the cubicle that had been our home these past seven hours for a prior appointment meant she was either very brave, trusting my life to the medical gods – or cavalier. Heartlessly callous even.

As I had no idea she didn't give a toss about me, I hugged her happily, waved her off and within 30 seconds the anaesthetist arrived, outlining the options. 

I had the choice of light sedation ('Are you out of your f****! mind?' I said) (no, but - thought it), heavy sedation (not really conscious but might hear some hammering) or general. Out. Under. Gone.

He was selling the sedative – fewer side effects, the recovery time is faster. He shrugged, politely.

‘If you’re in distress, we can ask how you are and switch to the general.’

I stared at him.  I said, blinking 'Ask how I am? I could TALK?' and he said 'Yes, more or less.'

I reached out, grabbed his collar in both of my fists, brought his face very close to mine and said, very slowly and very loudly - 'I don't want to be able to talk.'

That clinched it.

And as I was taking the Trip to the Bathroom they told me I Should Take, thinking about my happily-general anaesthetic, I suddenly had a revelation. 

All along, without knowing it, I had been associating this experience with my original injury. The injury that happened the December I was 22, on a perfect winter afternoon - a quiet snow falling, sunlight dim through white clouds – when my sister, then-husband and I went tobogganing down a popular local Ottawa hill.  Conditions were ideal and we had two hilarious runs. Our third attempt saw me, recklessly, crossing my legs under the bend of the sled (rookie mistake) and when we hit a bump and went over, my husband landed on top of me and my leg stayed behind. The head of my femur was shoved up into my waist. And stayed there for several hours because I was too stoic to scream in the ambulance or the halls of the hospital.

Even though I enjoyed a full recovery, the cartilage started to disintegrate four years ago and by the time I was walking to the bathroom at the Whittington Hospital at 2:40 pm on the 29th of November, the ball of my femur spent most of its time resting on the bone of my pelvis. Which doesn’t feel great (When Mr Who had first seen the x-ray of my hip he had squinted, breathed in deeply and said ‘Aarrrrrgggghh!!.’ I said ‘That’s not very professional.’ At which point, still staring, he said ‘Oooooooggghh!’ ignoring me completely. Things were obviously worse than I’d known.)

I washed my hands in the loo, remembering the accident and the agony of the medics trying to pull my leg back into place without pain killers and it occurred to me, out of the blue that - THIS WAS COMPLETELY DIFFERENT. I was going to be DRUGGED THE WHOLE TIME. I wasn't in pain now (well, only when I walked), I would not be in pain during the surgery and - I HAD DRUGS FOR THE PAIN AFTERWARDS.

I almost laughed.

I emerged and was met by the nice-but-firm Polish nurse who escorted me down the hall. We passed a sign that said 'Theatres' and I felt immediately at home. An orderly smiled at me and said 'Good luck!' I said 'Thank you. I'm going to a theatre!'

The nurse left me with the anaesthetists saying 'Have fun' and waved. The assistant anaesthetist was smiling under his mask, preparing things in the room. The head honcho anaesthetist – let’s call him Dr Feelgood - arrived and said, very jolly 'So - we're going for the light sedation are we?'

'No, we most certainly are not,' I screamed. Well. Said firmly with as much authority as someone on her back, naked under a gaping hospital gown can muster. 'It's all there in that form.'  I pointed. He looked and said 'Oh yes, I see. The general. Well, that's fine, we'll do that then.'

I decided not to be alarmed by this apparently casual attitude to my most fervent wishes, and instead allowed myself to be distracted by the expert small talk he launched into, pretending we were having a friendly chat at the canapé table before drinks at the opera. He asked what I did for a living. 'I'm a writer,' I said.

'Aaahh!' said the two men who were preparing to insert needles into my wrist and spine, in hushed and respectful tones. Men in masks who performed life-saving jobs every day of their lives. Like. 'You're a WRITER. That's - important.'

Dr Feelgood said he had 25 years of experience he wanted to write about but never found the time. We talked about Ian McEwan's Saturday, had he read it? 'Yes, about the neurosurgeon? Yes. But I'm not much of a novel reader. By my bed at the moment I have How to Tie Knots and ­Training Horses.’

'I want to learn to tie knots!' I shouted, trusting him immediately.

'Do you?' he said. 'I'll show you, I'll do one here now.'

The masked assistant raised his eyebrows but the chief seemed to have no inclination to actually make good on his promise. Instead he moved behind me and put a swab on my back.

'What do you write?' he asked.

'Plays,' I said.

'Ah! And where have your plays been put on? - Hang on, let's have another go, it didn't take there. Just try up here. Good thing you're thin, makes it easy for us.'

They moved the needle up a bit, although I didn't feel it go in.

'I've had plays at the Arts Theatre in the West End. And Theatre Royal in Bath,' I said. I could feel their attentive care, their interest, and thought to myself 'Yes, well, why not? I'm a verrrrrrrrry interesting person.'

I was enjoying this conversation, this sense of myself as someone to reckon with in the world. I was enjoying everything - did he just say I was thin?? – I wanted to hear more about training horses. Maybe he made the knots in the ropes he used to train the horses. There was much more about my writing I wanted to share. I liked these men. I liked horses. I liked knots.

And then I woke up.

***

Someone was holding my hand, very lovingly. Three doctors in blue surgical gear were at the foot of my bed, beaming. BEAMING. I suppose every day someone doesn't die on your watch it's a good day. I recognised Mr Who, even without my contact lenses.

'It went very well. No complications, we're very pleased. You've done very well.'

And weirdly - I thought 'Yes I have.' As if I had anything to do with surgically removing calcified and arthritic bone, inserting a titanium spike holding a ceramic ball into a ceramic socket into the pelvis of a living body. 'Yes, I've done WELL.'

The post-op nurse was still holding my hand as he said 'It's been a joy caring for you.'

I would like at this point to say if I ever hear anyone breathe a word of anything even remotely critical of the NHS I will follow them down the pathways of their life, reading my testimonial in a loud voice in public places, shouting out my unqualified devotion for everyone who is a part of this efficient and humane system.

‘It’s been a joy’ he said, squeezing my hand.

I don’t think health gets any better care than that.

And I was trolleyed away. I felt no pain. I had been surgically-and-post-operatively loved. It was over.

Apparently I waved at the nurses in reception when I got to the ward. I only know this because my friend Mark was on the phone with the nurse at reception at that precise moment, asking if I'd arrived. 'Ah, that might be her now. She is - she is - waving,' the nurse at reception said.

'Yeah. That's her,' Mark affirmed.

Five minutes later, having been set in place by a huge window, another friend - let’s call her – Lisa – because that’s, like, her name -  walked in, disguised as a ministering angel. Straight to my bedside, she put her arms around me and I almost cried. She sat with me for two hours, holding my fingers and, get this, putting her hand lovingly on my back as I proceeded to vomit not once, or twice but FIVE times in 90 minutes.  At one point I turned to her and said, weakly 'Are you squeamish?' 'Not in the slightest' she said. 'Barf away.'

She stayed until visiting hours were over. I fell asleep. And slept so deeply, so profoundly that when I woke and saw it was 12:53 – I assumed it was the next day. FAR into the next day. Seventeen hours into the next day.

But it was very dark. On the ward – and on the street. And even in my morphined-state this darkness was a clue; that and the fact there was no noise of people running to and fro, and making a great stir, as there unquestionably would have been if night had beaten off bright day, and taken possession of the world. As Dickens might have said.

I’d only been asleep for five hours.

The lamps outside glowed orange across my blankets. I lay, sighing, in a stupor of peace. Perhaps drug-induced peace, but, more convincingly, a product of every single wonderful, loving, prayerful thought that had been broadcast to me over the past 24 hours. A cloud of beneficence surrounded me and I felt bliss. And saw how my physical life had been given back to me.

Mr Who came with the same clip board attendant the next day to check my progress. I turned to the ghostly assistant this time and said 'Hello. I'm Stephanie.'

'Oh yes,' said Mr Who, looking at his colleague. 'We ALL know who you are.'

I decided this was a good thing.

Outside of two setbacks the next day when I passed out, trying to walk - scaring everyone around me apparently - 'It's always the young ones who give you trouble!' a nurse said later - I was sailing. Forty-two hours after surgery I was on crutches, doing the stairs. The physios grinned, my surgeon grinned.  This was a conversation between the x-ray technician and me, the Thursday before I left hospital:

Tech:    (hauling machine around) So when did you have the op?
Me:      Tuesday.
Tech:    A week last Tuesday?
Me:      No. This Tuesday.

She stopped.

Tech:    Tuesday?? 48 hours ago? And you're WALKING??? I've NEVER, ever seen anyone walking after two days.
Me:      Really? Oh thank you. I've been wanting a prize and no one has suggested I deserve one.
Tech:   The nurses will all be talking about it.

She saw me manipulate my leg on the table to get it back on the floor for the crutches.

Tech:   Does it hurt badly?
Me:     Nah.
Tech: (quietly) You must have a high threshold of pain.

And I thought 'Honey, until you've been tobogganing  and shoved your hip up into your waist - you don't know from pain.'. NOTHING is even remotely as bad as the original injury. No where near. 

I got home to my bed, 72 hours post-operation, and was already forgetting I had the surgery, it all felt so good.

I was able to walk with only one crutch - so I could carry tea to my room.

I had been given enough chocolate to re-sink the Mary Rose.

And Anna agreed – Mr Who was cute.




.


Friday 13 January 2012

A Hip Chick - Part One

When my friend Anna found out I was taking a bus to the Whittington Hospital the morning of my hip replacement, she called me names, shouted and said 'She was hiring a £”!!! car.' I said this wasn't necessary. She told me to - well - to be quiet - and when the cab picked me up in the darkness outside my flat on 29th November, Tuesday morning, 6:30 - I was very glad to know we were getting her next.

I had no idea just how glad I could be until she was still with me at 2pm. We waited for seven hours in a curtained cubicle for me to be taken into surgery. I was naked under two hospital gowns and wore purple slippers.  
I do not use the term ‘friend’ lightly.

Driving north from Bayswater in pre-dawn London, I felt a combination of mild hysteria and exhaustion. I hadn't slept more than about twenty minutes, although I put that down to the intense carbo-drinks they get you to ingest in the 24 hours before the operation. 'It's what athletes drink, before a marathon' a pre-op nurse had told me. I had taken mine religiously the day before, downing two more before the cab arrived. When we got to Anna I was buzzing.

She slid in beside me, smiling, took my hand and asked me how I was. I shouted 'High!' she said 'Good!', and we drove a dark, circuitous path to Highgate, arriving at 6:55 - five minutes early.

We walked up to the Day Centre and there were already a dozen people waiting to be admitted. 'Oh my god, maybe you're right Steph, maybe it's first come, first serve' Anna said. We tried to seat ourselves so we could elbow the more elderly-looking out of the way to make sure I got a good place in the queue. When the desk opened I was the last to be ticked off the list and I don't know if this was pertinent, but I was last in line for surgery that day.

We were escorted down hallways to the aforementioned cubicles. I changed into my two blue gowns (‘Good colour on you!’ Anna cried) and sat while she played me songs on her iPod and read me poetry. She brought work and marked papers; I did a bit of writing. We eavesdropped on the doctors speaking to the patients beside us and I recognised my surgeon's voice as he did his rounds.

'That's him, he's coming' I said. 'He has that – shy-but-friendly-scientist thing.' I’d also told Anna he was cute so this was our chance to see if she thought I was right.

In fact, it’s probably why she came.

We heard 'Stephanie Young?' and both looked up as – I’ll call him Dr Who -  pulled our curtain back.. In actual fact he is Mr Who because, in the UK, once you’ve reached the illustrious heights of consultant status, you drop that title you’ve worked most of your bloody life for and are no longer referred to as ‘doctor’ but ascend back to ‘Ms’ or ‘Mr.’ So orthopaedic surgeon, Mr Who, attended by someone so deferential as to hardly be corporeal (Anna and I agreed later we had no recollection of any discernible features or recognisable human characteristics in this ghostly attendant but who must have been there because we saw a clipboard) Mr Who, I say, smiled and asked how I was.

'I'm fantastic, I'm buzzing!' I said.

'Oh?' he said, smiling more broadly but also more unsure.

'Yeah, those drinks. I'm high as a kite.'

Anna nodded beside me. He glanced at her and seemed relieved. I was obviously demented so it was good to have someone coherent in the room.

He told us what the day might hold.  He looked well-rested, his blue eyes were sparkly and he was wearing a suit. (I said to Anna that I hoped he'd change before operating.  I had visions of pus and guts and effluvia all over his – well. Anyway. The dry-cleaning bill could be pricey.) He outlined again the risks of the surgery but confirmed I needed it, asked if I understood, got me to sign some forms - all of which I read. He started to describe what I was signing, assuming I was reading because I didn't understand.

'No, she does this,' Anna explained. 'She also reads terms and conditions.'

'Oh?' Mr Who said.

Anna gestured 'crazy' beside her head.

'Yes,' I said, not looking up. ‘I don't want to commit myself to loaning you £300...'

He is shy but laughs.

He said the procedure could take two hours, probably more an hour and a half. He asked if I still wanted to go through with it.

I was so keen at this point, if he'd had a Swiss army knife and a bottle of gin I would have suggested we have a go then and there. Instead I consented, he said 'Fine' and told us unfortunately there was a bit of a back log and I might not go in until after lunch. It was 9am. I felt bad for Anna but I knew she would hit me with the oxygen tank under the table if I suggested she leave me so just nodded, philosophically, at Mr Who.  He continued.

‘There may have been contraction of the thigh muscles while you have been accommodating this condition and if so, I will lengthen the leg slightly.’

I frowned but Anna’s eyes lit up.

‘Could you lengthen both of them?’ she asked. ‘Juuuuust a teeeeny bit?’

Mr Who gazed at us. I sighed.

‘She’s always wanted me to be taller,’ I explained.

Anna nodded, eagerly.  Realising we must have looked suspiciously intimate – not knowing that Anna was simply tired of bending down to ask me the time – and wanting to leave all lunching, dating, dining options open in Mr Who’s mind, I said, loudly ‘Not that we are actually lovers.’

The floor around our cubicle went silent.  Mr Who cleared his throat at which I point I noticed the ring on his left hand. It obviously didn’t matter what my sexual orientation was, he and I were having a strictly professional relationship. I rose above my disappointment as he gathered himself - maybe seeking diversion from the image of the two women in front of him engaged in carnal embrace - and asked if I had any further questions.

'Yes,' I said. 'I have just one.' He gazed at me, patient, blue-eyed, and attentive. I breathed in deeply, became very still and looked into his face. Then I said, slowly

 'Have you done this before?'

He laughed in a way that sounded as though he couldn't tell whether to be hugely offended or hugely amused. He almost sort of half fell over.

'No, you're the first,' he said, still making that almost-laughing almost-offended sound.

'Well, I'd like you to sign it, then' I said, indicating the scar on my hip. He looked to the intern (now a respectful vapour) and out of the mist came a felt pen.

‘It’s this hip, isn’t it – you confirm that?’ said Mr. Who.

‘Yessss,’ I said, thinking I didn’t want him to sign BEFORE the surgery. That was cheating.

He asked me to raise my hospital gown slightly and, witnessed by the spectral presence, put a big, black arrow on my right thigh.

Indicating ‘up’. 

Mr Who smiled.

‘Just to make sure,’ he said. I looked down at the greasy-looking road sign on my leg.

‘Does that come off?’ I asked.

‘Oh yes,’ he smiled, opening the curtain, about to leave. He looked over his shoulder. ‘In three or four months.’

I obviously wasn’t going to have lunch with him, but I’d encouraged his inner Jack Dee. My job was done.

Anna and I chatted. We read. She left for ten minutes, feeling guilty for being able to eat and drink, so having her lunch, decorously, in the cafe without me. At 12:30 she came back and overheard a surgeon in the cubicle beside us say 'The lady next to you is going in now'. She turned to me, beaming, saying 'That's you! you could be next!'  And I surprised myself by feeling uninterested, even slightly hostile. We'd been waiting five hours, hadn't seen Mr Who since 9:15 and I'd lost momentum. For the first time I wasn't excited, I was nervous. I’d been standing too long in the queue for the roller coaster, I was asking myself why I wanted to plunge 90 feet at 120 miles per hour. Straight down.

I was going to be cut open, bits of me were going to be removed and new, fake bits put in.

I know it’s something most Hollywood starlets have been undergoing since adolescence but it was a first for me.

Suddenly I wanted to go home.

If I had tried to bolt, however, I don’t think I would have got past the very pleasant, not-very big-but-very-strong-looking Polish nurse who pulled back the curtains carrying her own clipboard and a machine. She took my blood pressure (which was fine) (which was disappointing – with all the ruddy cycling I wanted her to shout ‘You have the most healthy blood pressure I’ve ever encountered in my life!’ – instead Anna’s was lower) and told us it would be another two hours. Anna asked, firmly, if I might have a drink.  The Polish nurse smiled, incredulous.

‘No,’ she said.

‘She’s thirsty,’ Anna said. ‘Not even a sip?’

The nurse considered. She left the cubicle with forms and the equipment. She came back with a paper cup.

‘You may have one sip,’ she told me. ‘A mouthful.’ I swished it around in my mouth as though it were a glass of Chateau Cheval Blanc 1947. I took ten minutes to swallow.

And I don’t know if it was that moment of hydration, or Anna’s love or the nurse’s compassion, but my spirits lifted. I thought of my happy future. I was going to roller blade again. Do yoga bends. I could return to every sexual posture imaginable. All this was possible because of the titanium spike about to be hammered into my thigh.  I chatted with Anna, buoyant; there was more reading, more poetry and at 2pm the nurse came back. I was next. She raised an eyebrow and smiled at me.

She asked what tune I was whistling. 

I was obviously ready.

 
Next instalment:

The anaesthetist outlined the options.  I had the choice of light sedation ('Are you out of your f****! mind?' I said) (no, but - thought it), heavy sedation (not really conscious but might hear some drilling) or general anaesthetic. Out. Under Gone.

He was selling the sedative – fewer side effects, the recovery time is faster. He shrugged, politely.

‘If you’re in distress, we can ask how you are and switch to the general.’

 I stared at him.  I said, blinking 'Ask how I am? I could TALK?' and he said 'Yes, more or less.'

I reached out, grabbed his collar in both of my fists, brought his face very close to mine and said, very slowly and very loudly - 'I don't want to be able to talk.'