Celery Horseshoe

I spent New Year’s Eve of 2007 in the neurosurgery recovery unit at Cedars-Sinai Medical Center in West Hollywood.  Earlier that day, my neurologist had overseen my transfer from the ICU after brain surgery three days prior.  As you can imagine, I was pretty drugged up (intravenous Dilaudid, sometimes called “Hospital Heroin,” is amazing!) but I was aware of my surroundings and the comings and goings of people.  What I couldn’t do was talk; that needs explanation — I did not forget my language or vocabulary, in fact I was thinking all sorts of things, in English with words; what I couldn’t do was turn those thoughts into the spoken communication that would convey them.

Cedars-Sinai

Cedars-Sinai Medical Center, West Hollywood CA

So the first order of business once transferred to a recovery room was to establish ways of communicating with the medical staff.  Obviously, a pen and a pad of paper was one method, and worked well for simple things like “water,” “bedpan,” or “cold.”  Pain management is a big part (if not the biggest) of recovery from any surgery, and to that end hospitals employ the Wong-Baker FACES Pain Rating Scale.  Originally created to help children communicate with their doctors about how much pain they were in, the scale is now used in a wide variety of settings with people ages 3 and older where communication is inhibited (say, for example, from a stroke).

Wong-Baker FACES® Pain Rating Scale

After getting settled in, as it were, and pressing the emergency call button which had been taped to my right hand to alert the nurses a helicopter had crashed on the roof (it hadn’t — my room was on the top floor of the south tower, just below the medivac helipad, but I was higher than a kite on the Dilaudid so how was I to know it was just a routine chopper landing?) my doctor noted that I had a runny nose and a slight fever so ordered me to be given some Ibuprofen (I’m allergic to Acetaminophen, which is the usual go-to to reduce fever and treat the common cold) and told me that as it was New Year’s he’d be leaving me in the hands of a new resident and he would see me in a couple of days.

After a delicious bag of IV nutrition that evening, the nurses came in and put a party hat over the bandages on my head making me look like I was wearing a fez made out of gauze and tinsel; it was silly, but I really give nurses a lot of credit not just for their skill but for the ways they try to find some good in what otherwise was a pretty horrible place to be to ring in the new year.

Sometime in the early morning hours — I have no idea what time it was, just that it was after midnight — I got a sinus headache.  I pressed my emergency button, and tried to say “sinus headache” which came out as “celery horseshoe,” so one nurse turned to the other and said, “page the resident.”  When Dr. Kim (I don’t remember his name, just that he was Asian, and handsome) arrived I said it again:  “celery horseshoe.”  He looked very worried.  He asked one of the nurses why I had been admitted, and when she said “brain surgery” I saw a wave of panic rush over his face; I felt for him, I really did, and wanted to reassure him that it was no big deal, so I just kept saying, “celery horseshoe celery horseshoe celery horseshoe,” over and over (remember, in my head I think I’m saying, “sinus headache”).  So he points to the Wong-Baker scale hanging on the wall next to a whiteboard on which the nurses had drawn a little stick figure with a goofy grin and 2007 written under it, and says, “make a face.”  Obviously, I couldn’t see myself, but I must have grimaced at least an 8, because he turned to one of the nurses and barked, “call imaging, I need an emergency MRI to check for a brain bleed.”

Now I know he’s overreacting, so I just start shouting, loudly and more insistently, “celery horseshoe celery horseshoe celery horseshoe.”  It made no difference.  As they were wheeling my entire bed and me out of my room, I heard him say, “page his neurologist and his neurosurgeon stat.”  Great!…I’m thinking, now we can ruin their holiday too!  We whizzed down hallways as stationary lights in the ceiling appeared to me like bright, glowing birds flying by.  Then into an elevator the movement of which gave me motion sickness, so as I felt myself getting ready to hurl I clocked Dr. Kim, turned my head toward him, and projectile vomited all over his clean white lab coat, which was now no longer clean or white.  Into the imaging suite, which I had been in a few days prior to my surgery for preliminary scans, two orderlies lifted me off my bed and onto the cold hard surface of the MRI’s conveyor belt like mechanism that moves patients in and out of the machine, and screwed my head into a vice-like apparatus that holds the head perfectly still.  I know what’s coming next — 30 minutes of the loudest, most annoying banging as if two heavy metal drummers were warming up next to your ear lobes — so I tried, one last time, emphatically, to stop this nonsense and screamed at the top of my lungs, “SELL HER REE HOAR SHOO.”

mri-machine

a typical Magnetic Resonance Imaging (MRI) machine with nifty head vice

I got about halfway into the tube-like MRI torture chamber when I heard the distinctive clack of dress shoes hitting the linoleum floor of a hospital corridor, and a voice that was unmistakably that of my neurologist shouting, “STOP STOP STOP.”  The conveyor belt clicked to a standstill, with me half in and half out of the MRI.  Then I heard my neurologist, Dr. Young, say to the resident, “did you not read the notes from my rounds this morning?  He has a cold.  You don’t give a patient the most expensive test in the hospital for the sniffles!  It’s probably just a sinus headache.”  By the time I got back to my room the sun was coming up, so Dr. Young got us two Starbucks coffees from a kiosk in the lobby and read the newspaper in my room till he left to do his rounds.

That was certainly one New Year’s to remember.  Sadly, the one just past wasn’t a whole lot better.  Around two in the morning I woke up with a — wait for it — sinus headache, and spent all of yesterday wheezing, coughing, aching, and blowing my nose raw.  The healthcare team where I live were not overly concerned that it might be COVID because my temperature never spiked above normal, but they did offer me a test if I wanted one.  I still feel lousy today, but better, so I think it was just a 24-hour bug.  But it did give me an opportunity to reflect on my disease odyssey and how easy it is to take things like your health for granted until it goes very, very wrong and you find yourself yelling “celery horseshoe” at handsome Asian residents in the middle of the night.

And given what we know about Omicron, things are going very, very wrong for some people, especially the unvaccinated.

With time and distance, I can look back on some of the more surreal experiences I’ve had like that New Year’s at Cedars and even find humor in it, but the people getting sick and hospitalized today with COVID-19 aren’t as lucky.  You’ve seen the numbers, you know the outcomes, particularly amongst the unvaccinated.  Chances are, they will not have a chance to “look back.”

New Year’s is a time for resolutions.  So how about this?  Let’s resolve to stand with science, medicine, and the facts.  Let’s resolve to stop accommodating those spreading misinformation and lies out of some kind of misguided defense of “free speech” or “liberty.”  Let’s resolve to stop turning COVID into a political hot potato and call it what it is:  a deadly threat to life, no less imminent than terrorism.  Let’s resolve to turn mitigation efforts like masking and vaccine mandates from a point to be made into a unifying national goal.  Let’s resolve to care about the health of the Americans who voted for the other guy as much as we care about the health of those who voted for our guy.  Let’s resolve to acknowledge and be grateful for the selfless, courageous service of doctors, nurses, care home administration, cooks, cleaners, and orderlies/caregivers who risk their lives every day to protect ours.  Let’s resolve to turn the talent, ingenuity, and resources of our country into victory over COVID-19.

Of course you could give up smoking or promise to eat more healthy foods or reduce your carbon footprint in the new year — those are good too.

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