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Post Transplant

Post Transplant

by Vera Mehta, Ed. D.  |  June 2001

First, an explanation and an apology. I did not realize there would be such a long gap between the last Chronicle and this one. I had fully expected to write one in between, chronicling my experiences as a patient while awaiting the big day when my son and I would finally have The Operation. Well, as they say, the best laid plans…

Second, I had not intended The Yaffe/Ruden Chronicles to become a private vehicle for writing some Job-like tale in installments of ‘The Trials and Tribulations of Yours Truly’. It appears to have turned into that, at least in these last two issues. However, since readers’ response to the March issue was so encouraging, I felt there was enough interest indicated to warrant one more Chronicle telling how it all turned out. Also, in these several weeks past I have had a lot of time to ponder on what I venture to think are such general interest subjects as: The Practice of Medicine, Varieties of Pain, Hospital Waiting Rooms and Institutional Food, among others. I will include random musings on some of these.

The great, amazing news is that it is over and that my son Rahul and I are both alive to tell the tale. I am still in awe of the fact that one of my kidneys has been removed and successfully transplanted into his body. Despite whatever quibbles we have about specific medical practices and procedures encountered during these extraordinary past ten weeks, there is absolutely no doubt in my mind that we were most fortunate to have been able to avail ourselves of what is surely one of Western Medicine’s most triumphant achievements at least in the last century-the ability to transplant healthy organs from living donors into the bodies of recipients whose own organs are unable to serve them any longer. I cannot begin to express my gratitude to Pat, the Transplant Coordinator, who was always accessible and never got impatient no matter what hour of the day or night you called with a question, and the brilliant team of doctors and surgeons who made it possible for my son to get a renewed lease on life, and who gave me the gift of being the instrument through which it came about. Many of you who wrote me such touching and wonderful letters after the last Chronicle came out, expressed it as the opportunity “to give life again”. That is indeed what it felt like and I know that I have been both humbled, and forever changed by this experience.

 There are also many unexpected insights one receives into the nature of health and illness and the specific culture of hospitals, when one views them entirely from the patient’s vantage point. (I should add that it greatly facilitates the acquisition of such wisdom to have several hours a day in which to do absolutely nothing except lie on one’s back staring up at the ceiling counting the hours till one’s next Percocet). Forthwith some nuggets that might be helpful to both providers of health care and current and future patients:

#1: A Poem about Waiting

I have come to know this hospital well.
It is not in a distinguished part of town
Nothing much but fast food stores,
Shops with cheap, shiny clothes,
A few street vendors selling plastic toys and vinyl wallets
And, of all things
Giant bras.
Do the Valkyrie shop here?

When I enter the doors
I stride purposefully down the long corridors
Barely a glance at the signs on either side.
Their colored arrows pointing you to different “zones”
Silver for X-ray is the one I know best
I cannot remember the pictures on the walls
Some vaguely impressionist landscapes
A TV that keeps running the same programs over and over
Happy people smiling through cancer and diabetes and broken bones
Are they cured?
What are they saying?

We slouch into our favorite chairs
I like the one next to the wall
Because I can fall asleep waiting
It does not matter what time you come in
You will wait, and wait,
And wait.
Agitation and upper Eastside hysteria
About pressing other engagements
And the importance of one’s presence elsewhere by 3 o’clock
Elicit neither sympathy nor interest.
In this room the clerk is king
Or queen.

Oh, we have all tried the usual tricks,
Eagerly looking up every time the door swings open
Trying to make bright, eye contact
Smiling desperately
At the brawny fellow in scrubs
Hoping against hope
That flirting with him will get us out of here
Before we become as old as the shrunken skeleton
In the wheelchair
In his corduroy bedroom slippers,
A bored nurse’s aide standing impassively behind
Holding a bag,
Pink bunnies on the outside
(Diapers, towels for wiping drool?)
Perhaps he was once an astrophysicist,
Or translated Dostoyevsky into Chinese,
Or maybe he gave great inspiring speeches from the pulpit
Where he was once revered like the Pope-
Until he turned into this wrinkled two-year old

Ah, my turn now
The sexy girl with clouds of black curly hair
Cascading down her back
And the long slitted tight skirt
Calls me to the desk to state my purpose.
I meekly answer and stare
Fascinated by the perfect bow shape of her glossy Chanel red lips
As they bid me return to my seat and wait
Another hour
Finally,
I jump up to follow a little bald man
Through the gates of the Forbidden City
Pathetic in my need to please
And prove I have the lungs of a fifteen-year-old.
I put on the gown with the three armholes,
Scrunch into the machine,
Hold my breath.
He takes the pictures.
It all takes about ten minutes
He says “Good luck”
And then I can leave.
I am exhausted
From four hours of doing nothing But wait.

#2: The Colonoscopy

I have worked for a gastrointerologist for fifteen years but I never had The Procedure. Then, when I proceeded with the work-up necessary to prove I could be a kidney donor, I was told I had to have one. Could not somehow get used to the idea of my boss and people I work with face to face every day, looking up my ass. They said I had to do it in the hospital anyway. Thank Heaven. My prep sheet was duly faxed over.

Why does it tell you “You can drink all the liquids you like” after you drink the first glass of Fleet Phospho soda? Do they seriously believe that unlimited quantities of Oxo cube broth, lemonade, apple juice, ginger ale, lime Jell-O, etc. (you’re not allowed red or purple liquids) with no solid food, somehow constitute a special treat that you are oh so lucky to be allowed? Why not just tell the simple truth? All this drinking will make you feel like a bloated elephant and you will NEVER, EVER want to touch lime Jell-O again in your whole life.

And then, there are those endless trips to the bathroom. I am convinced the true French genius lies not in its overrated (in my opinion) cuisine. It is in its invention of the bidet. I would gladly have parted with my liver or one of my lungs to have had one of those as I rushed frantically between living room and bathroom, kitchen and bathroom, bedroom and bathroom about two thousand times in twenty-four hours.

The day of The Procedure. My anguish continues. Since I could not get a ride to the hospital, it took me two hours by bus and subway to get there. Our commuter bus service, probably the most notoriously unreliable in the country during non-rush hour time, got me to the George Washington Bridge about an hour late. Although nothing left of my insides to expel any longer, my body was out of control. I cowered in one corner of the subway car, feeling a little like Ben Hur’s mother and sister in the Valley of the Lepers. By the time I crawled into the G.I. section of the hospital I was reduced to a wild-eyed, sweating hysteric. Temperature outside was 96 degrees Fahrenheit. The receptionist whose office I wandered into by mistake, was on the phone, and gave me an icy stare when I started furiously gesticulating to ask where the nearest bathroom was. She sternly admonished me to wait. Couldn’t I see she was on the phone? I wanted to kill her. I think she thought I was a particularly annoying insect.

When I was finally wheeled in for the Procedure itself, it seemed to take about three seconds. I remember a brief conversation with a sympathetic nurse who told me she hated the prep as much as I did when she had a colonoscopy some years ago. Then a handsome doctor who wasted little time in idle chitchat, showed up. Something was pushed down my throat (oh yes, they threw in a gastroscopy as a bonus since I was getting my rear end examined anyway). All of a sudden I was looking at some weird blobs in hideous shades of crimson on the TV screen in front of me. At first I thought this was some well-meaning but ill-timed effort to educate me in the subtleties of Modern Art. Then realized I was looking at the inside of my esophagus. Mercifully passed out. When I came to, I was in another room altogether, looking at my younger son Jyotin, sitting on a stool next to the bed writing some notes on a yellow pad. He had come to take me home. Can’t remember what I spoke about but he swears I repeated an entire speech five minutes after I made it. I guess it wasn’t that interesting. Because it wasn’t what he was scribbling on his yellow pad.

It’s nice to have a son who wears a suit and tie to work and writes important things on yellow pads. Especially, when it gives him enough clout to take his mother home in a chauffeur-driven Lincoln Continental. The boy has a real job. Almost makes up for having to go through with a Colonoscopy.

. TIPS FOR THE UNINITIATED:

In preparing for a colonoscopy

1. Keep a very large tube of Vaseline or any good diaper rash ointment by your side at all times

2. Consider adding a bidet the next time you decide to remodel your bathroom. You will never regret it.

3. Cultivate the friendship of people who own cars they can put at your disposal in the middle of the day if you live more than ten minutes away from the hospital or doctor’s office where you are going to have The Procedure.

#3: The Night Before and The Morning Of

D-Day is almost here. Rahul and I have been admitted. All pre-testing is finally over and we go out for a last lunch to the Irish pub across the street. I order Shrimp Creole and he orders Chinese (?) Goulash. Both are valiant attempts to be what they say they are, but obviously cooking is not at the top of the list of the many wondrous accomplishments to which the Irish can justly lay claim. We go back to our rooms and admire the view from his. Mine looks out at the hospital’s parking garage. (After the operation this changes-I get a room with a lovely view. (Perhaps a reward that comes with my new, temporary but very agreeable status as “heroine”?)

Somehow the evening goes by. The night nurse assigned to me is a lovely, warm woman from Antigua. She tells me that she has always liked the night shift because it gave her time to take care of her two daughters when they were young. Now one is in Medical School and the other is training to be an investment banker. They don’t need her to pack lunch boxes or supervise homework any more but she’s used to these working hours and has opted to keep them even when offered a day shift. I don’t know why these details about her life move me so much. But they do. Her touch is gentle when she attaches the IV to my arm. In the morning she helps me on with the white support stockings and some sort of leggings that stimulate circulation and prevent you from getting blood clots during and after the surgery. She tells me that they want me on the operating floor at 7:30 AM and assures me “We’ll be ready”. I feel as if I’m going to my execution. I suppress the urge to cling to her neck and weep.

A young Mexican guy wheels me down to the waiting area where patients are brought just before being taken into the operation theater. I wave ‘Goodbye’ and ‘Good luck’ to my son as we whiz past his room. When we get to the waiting area I am a quivering jelly of terror mumbling the Avestan prayers of my childhood over and over again. The Mexican guy seems to understand and gives me a comforting smile before he leaves. Across from me is an elderly woman also apparently waiting to go in for an operation. A young man, her son, comes in and asks to stay with her before she goes in. There is no objection and I watch fascinated as he murmurs to her soothingly and strokes her brow. What a good boy, I think. I am getting nauseatingly sentimental. The anesthesiologist comes over and introduces herself. I pay no attention to what she is telling me. Ditto the three young Residents assigned to follow me through my stay in the hospital. The mother and son have hypnotized me.

It is time. I am now wheeled into the operation theater. “Theater” is a good word. Nothing could be more dramatic than this room with the fearsome overhead lights and all these people standing around in their green scrubs and shower caps talking over and around me as if I’m a slab of meat. They don’t mean to be unkind. First, it is not an inaccurate description of how I must look and feel in this room all trussed up like a turkey, and where the temperature is at least 10 below zero. And second, it is wholly unreasonable to expect they would want to include me in their conversation and hear my take on why the anesthesiologist’s daughter woke up complaining about a pain in her knee at 5 o’clock that morning. My teeth are chattering and I can’t stop shaking.

This is my last memory of life with both kidneys intact.

#4: Hospital Food

Giant stuffed shells? Fossilized chicken breast with fried rice? Melted ices? The only thing I manage to eat is some wonderful soup that Gracie (from the office) brings me (one of Mama Leonida’s specials) and, for breakfast the second day, some French toast. The syrup is poured by no less distinguished a personage than the Director of the Transplant program himself. Looks like an Indian version of Cary Grant.

I look like shit.

#5: Pain

I never knew there were so many different varieties of it. There’s the kind that takes over your entire body and every tiny movement is exquisite agony. Then it gradually narrows down to the area of the incision and the skin surrounding it. I keep trying to think of metaphors to describe this to my Residents who are very conscientious as they make their daily rounds and tell me how I’m progressing and what I will feel as the days go on. But I keep wondering as I gaze at their fresh young faces, how can they really know what I feel? Is my pain the same as the pain of the patient who occupied this bed last week? What do they teach them about pain in the textbooks? Do they tell them that sometimes your insides feel as if they’re being pulled by dozens of tiny hooks with strings attached to them? Or at others, as if somebody went over your skin with sandpaper? And then there are the mornings you wake up and one part of your back feels like there must be a dent in it from the stone you were sleeping on all night. Or when you have the misfortune to cough or laugh too hard at a joke someone is telling you “to cheer you up” and you think, “Ah, now they will truly be able to write my epitaph as: Here lies Vera who lived a reasonably contented life and died laughing”.

The worst part of it is that for everyone else except you the patient, pain is a dull subject. Riveting as you may find it to concentrate on how accurately you can describe all its little nuances, your audience will not be similarly riveted. All too soon you will catch them stifling yawns of dismay when they politely ask, “How are you feeling?” and realize you are not going to say “Fine”. My honest advice is: Save this stuff for the Support Group. That’s what its there for.

#6: Convalescence

My daughter has made the bed up for me in her room. The ceiling glows at night with scattered stars and the signs of the Zodiac pasted on it by her father so long ago. Most of the time in this room I don’t wear my glasses. Actually I am going to remember this entire period of my life as one where I hardly ever wore my glasses. I cannot get away from the strangely blank, yet malevolent stare of Arnold Schwarzenegger as The Terminator, a poster given to her many years ago when she had a crush on him. She no longer does, but no one has the energy to take it down.

I spend a lot of time sleeping between painkillers. I was looking forward immensely to the three weeks following the operation so I could read the many books piled up by my bedside table, watch all the movies I had missed when they first came out on the VCR, catch up in some way with family and friends whom I never seemed to be able to enjoy in a leisurely way because there were always chores to do, classes to prepare, papers to grade, on weekends and days off. As for reading, because it hurts my back too much to sit in any one position too long, I rediscover the pleasures of the short story. I did not realize Herman Melville could be so funny, nor did I know Katherine Anne Porter writes so well that it hurts. I have no interest in movies or music. The only show I want to see is a sitcom called “Seventh Heaven” that my daughter has got me hooked into. The reruns are on every Monday night and its about this perfect family that we all wish we lived in. Right now, Mary, the oldest daughter, is being a real bitch and breaking everyone’s heart.

I go for a walk around the neighborhood every evening. I discover for the first time in seven years that although this is just another ordinary suburban block like many others throughout America, every house has some little thing about it that gives it personality. In one front yard, a blue woodenTyrannosaurus Rex stands under a tree. Another one has what looks like a small Roman garden with a crumbling stone wall on one side. No one ever sits in it but I always expect some lovely creature in a one-shouldered dress and sandals will come out any minute with an earthenware pitcher of wine for the menfolk. I rarely see the people who live in these houses except for someone occasionally mowing a lawn or taking the garbage cans out on the street. But I smell trees, listen to the different birdcalls and feel how neglected my education was because I never learned any botany or zoology and can barely name a single flower in the gardens I pass every day.

Two days ago I saw an amazing thing. A turtle was making its way very, very slowly down the block. I saw it as I was leaving for my walk and, by the time I returned about a half-hour later, it had moved two feet. The next day it had managed to get off the sidewalk and edge its way into some wild grass and bushes, still only about another foot away from where it had been the previous evening. By now I am beginning to think our fates have to be linked. I spend a long time looking at its unmoving, mournful head. I do not know if it is dying. I wonder if it would offend its dignity if I were to tickle it under the chin with some grass so at least I could tell if it moved that it was still alive. I finally do it, and it moves. It looks like some strange, sad priest at prayer.

Today, I can hardly wait to look for my friend. Sure enough, there he is (notice, I have now endowed him with gender), but just his tail is sticking out. I can’t bear it. If he is lost, I have to help him find his way home. Fortunately, one of the neighbors, a large tattooed man with a red beard, is outside working on his trailer. I tell him about my friend’s plight. He agrees to walk down with me to see him. He picks him up by the tail and announces that this is a Snapping Turtle who appears to have lost all desire to snap. However, the creature shows he still has some fight left in him. After he’s picked up he tries to bite my neighbor’s leg. My neighbor doesn’t seem particularly upset by this ingratitude. We walk down to the creek and he puts the turtle down in the water. The turtle swims away. I am so happy. He got another lease on life too.

I spend a lot of time thinking how generous and kind and thoughtful so many people have been before, during and since the operation. Not just my family and close friends who phoned and worried and visited and prayed and checked up on us both constantly. Also, my Yaffe/Ruden family of both staff and patients who sent so many good wishes, loving messages and prayers. And how can I forget my colleagues and students at Empire State College and Touro College for the same?

Thank you for the beautiful flowers, the fruit, the home-made pizzas, the good luck charms and stuffed dolls, the Swiss chocolates and aromatic candles, the pretty nightgown and blouse, the homemade soups, the books, the vitamins and creams and soaps, the lovely cards, phone calls and e-mail messages. I cherish every single one of them.

Thank you for your prayers. God must have been deafened on May 30, 2001.

And thank you above all for the heart that came with these offerings. Rahul and I have no choice but to get well.

-Vera Mehta