Dancing with Doctor D - act two
30 July 2021 | Second movement – Accelerando, Doloroso
Three hours later I was wheeled into theatre. (Calling operating rooms 'theatres' is a peculiarly British practice, which confuses the hell out of foreigners.)
They stuck a line into the venflon and started squirting in the propofol. I always find the actual going under a tad unsettling. No longer having the blind confidence of youth and its concomitant sense of immortality, I'm never completely sure I'm going to come round again. The possibility that this sterile technological tableau vivant of bright lights and beeping machinery could well be the last thing you ever see or hear is a weird sensation.
"Good afternoon, Mr. Newbury."
"Good afternoon, Death."
"Please be so kind as to follow me."
"Do I have any choice?"
It's the sound that comes back first. Low, murmured voices and the hiss of ventilators gradually became clearer and more distinct as the sounds of corridor and ward traffic joined the melée. Then came vision, at first just a white haze, like flying through cloud. This slowly resolved into lights and figures, windows, doors, and furniture. Last to return were self-awareness, movement and finally speech.
I felt like I'd just been on a bender with Oliver Reed. My lips hung open slackly and a skein of dribble trickled out of the corner of my mouth. My tongue lay swollen, loose, and unresponsive. "Boa Tarde" I said thickly to no-one in particular. "Ah! Boa Tarde, Senhor Robert" said a lilting female voice, later identified as belonging to the unlucky nurse who had been charged with ensuring the wellbeing of the drooling foreigner in recovery bed three.
It took her nearly an hour to make me presentable and fit to be trolleyed out of theatre without causing mass panic and waves of revulsion in the corridors. I know I was in a state of advanced befuddlement, but even I could see that we weren't going back the way we came in. It turned out that someone else had disobeyed standing orders and read the case notes. "Because of your heart condition", the nurse informed me, "we have decided not to take you back to your room. You're going to the SO". The Sala de Observações is a sort of halfway house between the ward and Intensive Care. I was taken there and ensconced in bed J, where I found myself sharing the SO with three elderly gentlemen, none of whom looked at all well. It didn't occur to me at the time that there were four of us there fitting those descriptors.
The unexpected change of abode posed a couple of problems. My personal belongings, medications, toiletries, wallet, smartphone, clothes, dentures, glasses and wedding ring were all stashed away in the locker in room 36. I was in no fit condition to traipse halfway across the hospital flashing my bum at all and sundry, but I managed to sweet-talk one of the nurses into getting me at least my phone. When she came back, I rang Liz who was, I'm sure, greatly comforted to receive a call from someone who purported to be her husband and was obviously in the advanced stages of either tetanus or strychnine poisoning.
Most people, or at least most sensible people, are afraid of surgery. This is a perfectly rational response. What is not quite so rational, however, is which aspect of surgery they are most afraid of. Slips of the scalpel do occur, but the one you've really got to watch out for is the gasman. The anaesthetist's job is to poison you to within an inch of your life without quite finishing you off. Almost dead enough for you not to wake up halfway through and sue the arse off him, but not quite so dead that you stay dead and your next of kin sue the arse off him.
They're pokey buggers, anaesthetic agents. They sod about with all sorts of basic physiological processes, and they can hang about in the system for ages. So I laid back and dozed, waiting for my well-toned liver to metabolise the crap out of them. About half past midnight, everything turned to shit. All my usual medications had worn off, but the anaesthetics were still hanging on in there. I went into a cracker of a post-anaesthetic crisis. In the absence of my bisoprolol my heart went into atrial fibrillation and my pulse rate climbed to 200 bpm. Blood pressure soared uncontrollably to 195/150 and alarms started beeping, flashing and wailing, prompting ill-natured grumblings from my fellow internees. The nurses came hotfoot from their station to be confronted with the bridge of the Starship Enterprise after a surprise Klingon attack. Very sensibly, they turned all the alarms off. No-one can think with that racket going on.
I looked at the dials, and then at the pair of perplexed young nurses looking uncertainly at the readouts and muttering darkly about sending me across to ICU and dumping this shitstorm on some other poor, unsuspecting, sucker. The BP measurements climbed inexorably upwards to 200/160. BPs at this level cause the blood vessels to leak like a garden hose after a wrestling match with a porcupine and the subsequent collapse and shut down of systems throughout the body. I felt a tap on my shoulder:
"Good evening, Mr Newbury."
"You again, Death. You don't give up easily, do you?"
"Comes with the job. Sorry."
My thoughts turned to Liz and a wave of hollow emptiness and unbearable loss flooded through me as I contemplated the awful possibility that the view from the bus window stood a good chance of having been the last time that I ever saw her. I contemplated phoning her, but dissuaded myself on two grounds; it would do her mental equanimity no good to be woken at two in the morning by a hysterical phone call from a pathetic blubbering husband feebly blathering on about how much he loved her. On top of that, if I didn't die I'd look a right tit the next morning.
The on-call medic arrived. She didn't look much older than the nurses - a hell of a lot of responsibility on young shoulders. She squatted down beside me. "We've got to get your blood pressure down." she said. "No shit, Sherlock" I replied. She looked understandably confused by the idiom.
She tried captopril to no effect and nitro-glycerine, which fared no better. Then a thought struck me. My meds had been locked away in room 36 for hours. I've had atrial fibrillation for decades. I can recognise the symptoms and the ECG trace of a severe attack, and this one was a cracker. "Try bisoprolol, 5mg," I suggested.
She thought about it for all of five nanoseconds before dispatching one of the nurses to pharmacy. I chewed it to speed up absorption. I was expecting it to take two hours to take effect. It started to kick in after less than half an hour. By three in the morning everything was stable. Bp 125/67, pulse 75.
Act three follows ↆ