Saturday, July 16, 2005

Hospital tales 3: The ambulance ride

When life sends you into a tailspin, tell the tales.

I’m worried as they wheel me into the ambulance for the hour and fifteen minute ride to St. Francis in Peoria.. What if part of the blood clot breaks lose and makes a mad dash for my heart, lungs, or brain? I’ll be a goner.

“Can I use my cell phone?” I ask the EMTs.

“Sure,” they said. “We don’t have anything on board that it’ll interfere with.” I felt like a free man because I could use my cell phone without sneaking.

I called my parents first. I thought of starting off cheerily, “Hey, I’m calling from the back of an ambulance.” But that didn’t seem like a good idea. At 81 and 77 they’ve had enough shocks in life. I reminded Dad that I had told him about my sore leg the day before and then told them about the blood clot. We were several minutes into the call before I communicated that I was calling from the back of an ambulance.

“It’s a good thing you are strong, Richard,” Mom said. Wow. Mom thinks I’m strong. I never knew that.

The head of the stretcher could be tilted up. Good thing or my back would have been screaming by the time we got to Peoria. The tilt also helped me look out the back window. Once stopped at a red light a young man pulled up right behind us. I wondered if he could see me. I thought of waving to him to see if he would wave back.

After talking to my parents I called my daughters Hannah and Heidi and my son Jon. Once in awhile my anxiety would begin to rise like a muddy creek in a rain storm. To keep at bay the worries that the rough ride was going to shake lose a blood clot and kill me, I concentrated on the conversation of the moment,

When I talked with Heidi she was in a motel in Atlanta writing an outline for her master thesis study. Her Ethiopian husband was a mile away enjoying watching a soccer match between two Ethiopian teams.

A nurse practitioner student, she would like to do a study on why pregnant women at risk of acquiring AIDS refuse to get AIDS testing. I knew she’d eventually like to work with AIDS patients in Ethiopia.

“Design the study for Ethiopia,” I said. “It’ll be a challenge to find someone to collect the data for you but that’s where your heart is so go for it. It’ll be a challenge but if you work your connections I bet you can pull it off.”

She’s done the literature search and she knows of a similar study in Los Angeles and one other county but none in Ethiopia.

I had one other suggestion. Design the study to uncover the reasons pregnant women in Ethiopia choose to be tested or to not be.
Heidi immediately recognized the value. Such a study could teach health workers how to encourage more at risk pregnant women in Ethiopia to be tested for AIDS.

After talking with my kids I called Lynn Reha at Plow Creek to make the final arrangements for hosting another Mennonite church the next day. “Don’t worry,” she said. “We’ll pull it off.” It was like she was singing to my soul.

Talking with Lynn and each of my family was much more fun than thinking about a bit of my blood clot breaking loose and making a mad dash for my heart, lungs, or brain.

I am a blessed man.

Hospital tales 2: And denial comes tumbling down

When life sends you into a tailspin, tell the tales.

A week ago today I laid in the hospital bed with a blood clot in my left leg and read my patient rights in a classy folder handed to me by the nurse. That brought back memories of the last time I had been in the hospital and the first time I had tried to exercise my rights as a patient.

In the mid 1970s Congress passed a law on patients’ rights. As I understood it I could now see my chart. Having spent lots of time in a rehab hospital starting in 1968, I was eager to read my chart. I asked to see it.

The next thing I know I get a visit in my room from the assistant administrator. He was as smooth as a knife cutting through butter as he chatted me up. After a bit he gently let it slip that I had a good relationship with the medical director and that he was sure I didn’t want to do anything to jeopardize that relationship by asking to see my chart.

Needless to say my patient rights melted like butter on a hot griddle.

Thirty years later, early in the afternoon I met Dr. Norris, the young on-call doctor, who had ordered the ultrasound that revealed the blood clot and who had put me in the hospital.

She did a great job of keeping my denial in place, saying that if my insurance approved Lovenox, a new blood thinner, for home use, then Sarah could inject the Lovenox at home and I could probably go home the next day. In the hospital one day and out the next. Piece of cake, I thought.

I called the insurance company and left a message (they were closed for the weekend) asking for approval of Lovenox at home.

A bit later Dr. Norris returned and said she’d like to consult with a vascular surgeon from Peoria. Wow, what a conscientious doctor I have, I thought.

Next thing I know she’s back explaining that she and the Peoria doc think that I’m a good candidate for lysing, a procedure where they inject a chemical directly into the vein to break up the clot in hopes of saving the valves in the vein which work very poorly if the clot stays in there too long.

Then sweet Dr. Norris took two swings at my denial with a sledge hammer. “IVCH doesn’t do lysing except in the emergency room when people are having a heart attack,” she said, “so if you decide to have the lysing we’ll transfer you to St. Francis in Peoria by ambulance or by air.” Then she let it slip that Dr. Debord said that I’m a “high morbidity risk.”


Around here patients who are about to die get shipped off to Peoria. And high morbidity risk? Fancy way of telling me I could die at any moment.

Dr. Norris left the room to allow Sarah and me time alone to decide about being transferred to St. Francis.

My denial tumbles down like a ragged old pair of pajamas. I’m tearing up. I’m choking up. “I’m not ready to die,” I tell Sarah. “I mean, I’m ready to see Jesus but I don’t want to leave you all alone. I don’t want to disappear on you. I’m sorry, Sarah, for putting you through this. I know it’s crazy to say I’m sorry--I didn’t choose this--but I’m sorry to put you through this misery.”

Sarah, the love of my life, lost her father before she was born and a step-father when she was 18-months old. I don’t want to be another loss in her life.

Sarah lowered the bed railing and sat on the bed. We hugged. We kept looking in each others eyes, Sarah looked away, trying to control her emotions. We held each other and when we parted she had tears in her eyes. “I’m trying to keep my emotions from taking over,” she said. If she went down her trail of losses she’d be too sad to think straight.

Poor Hannah, our eldest daughter, calls then and I choke up on the phone with her.

Sarah and I decided--lysing in Peoria it is. Staff tells us that the transfer will be by ambulance within an hour. Sarah heads out to bring a few things home and pack in order to stay the night with me at St. Francis.

Hospital tales 1: I’ll just keep on working

When life sends you into a tailspin, tell the tales.

“What can I do for my leg?” I questioned the Lord in my journal on July 9.

Admittedly, asking the Lord a direct question is a dangerous practice because I might hear wrong, but that doesn’t keep me from trying.

“Swim and sit in the Jacuzzi and let healing time pass," I thought I heard.


“Baby it with hot packs and cold packs. Ask Sarah.”

A few days later Sarah, my beloved, read my journal while I was lying in the hospital. “You sure didn’t do a very good job of hearing the Lord,” she said with a laugh.

“That’s true,” I said, “the only thing I got right was asking you.”

When I asked Sarah, a nurse, if I should use hot pack or cold packs under my sore knee she asked to look at it. “There’s a reddened area above your knee and it’s hot to touch,” she reported. “That could be a blood clot above the back of your knee. You better call your doctor.”

Now denial is a wonderful thing. It keeps us from spending too much time thinking about the fact that we can die at any moment.

I vaguely knew that blood clots in the leg can break off and be deadly but I didn’t spend time worrying about that. I called the doctor who ordered an ultrasound. “If it is a clot,” she said, “I’ll have to put you in the hospital.” I felt my denial slip a bit but I quickly pulled it back up.

In radiology at the local hospital I watched beautiful, color, abstract patterns on a screen while the tech pressed the ultrasound by my groin. “What’s that?” asked Sarah.

“That’s a clot,” the tech said. My denial was very good. I wondered how she could see the clot beneath my knee from by my groin. Only later did I realize the clot went from below my knee to my groin.

True to her word the doctor put me in the hospital.

I wasn’t supposed to use my cell phone because it would mess up the telemetry, the nurse said. I sneaked and used my cell phone a few times to complete arrangements for hosting a sister church the next day at Plow Creek.

My denial firmly in place, I kept working in the hospital, making phone calls and studying The Top Ten Mistakes Leaders Make by Hans Finzel.