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June 11, 2013
Column: Aided case was a scary episode, but it did not stall my trip
This is the story of my “aided case,” although this was not to ELIH via the Shelter Island Emergency Medical Service. This was to Lenox Hill Hospital on the Upper East Side of Manhattan on the arm of my wife, Jane.
It started the night before, after a dinner of scallops Provençale on a bed of pasta. Pretty good stuff, I might say, for amateurs. Later we retired and, as is my habit, I got up around 1 a.m. to hydrate with some OJ, although I don’t remember getting up to hydrate. The only thing I remember is Jane tending to me. Upon heading back to bed, I had fainted, falling like a sequoia, skull-first into the hallway baseboard, where Jane, having been roused by the thumping sound, found me unconscious and bleeding at a good clip. In these digital days, of course, she took a photo. It looked like a murder scene. After several minutes I came to, we staunched the bleeding, I lay down and she began the ungodly cleanup.
I resisted going to the hospital in the middle of the night and I can’t say exactly why. But by 7:30, we were on our way to Lenox Hill, an easy two-and-a-half block amble to the ER on an exquisite morning. It was quiet there. The greeter, or whatever this person is called, gave us the obligatory pink piece of paper for the basic information. As Jane was filling out the bottom part of the form, the greeter says you don’t have to do that part, and the intake nurse was already coming around from her glass partition to hear our story. I simply wanted someone to look at the gash to see if stitches were needed but I told her about the fainting. She made notations and led us to a bed on the main floor of the ER. She pulled the curtain to shield us from the adjoining bed and returned to her post.
Soon a doctor, the size and mien of a 16-year-old, appeared and quizzed us in more detail about the previous night’s bloody adventure. I was swaddled in detectors to ascertain the condition of my vitals and he called for a head scan, just to be sure. Instead of sutures, he “glued” the wound shut and I was wheeled up to the CT scan people for a look-see.
After I was wheeled back down to the ER, Jane informed me that I had suffered a subdural hematoma, a pooling of blood on the brain, which does not like that in the least. I was going to be admitted for at least two days in the ICU, for if things go awry with these things you can die. Spoiler alert: I didn’t.
Jane and I ask, nearly in unison: Two days? What about post-discharge recovery? We had a highly vaunted 25th anniversary Mediterranean cruise coming up in a week. Francis (his and other Lenox names have been changed), the neurological assistant who had taken over the interrogation, shook his head and said probably no way. A kind of helpless despair descended. Jane had to go to work. I was wheeled to my fine room in the ICU where the great nurse Gwenda sticks in the IV tube, applies the chest sensors and slips on the inflatable tubes for my lower legs to prevent blood clots. All will be my constant companions, making sleep impossible.
Of course, even if I found sleep, the hourly checks for blood samples, “finger pricks” for blood sugar readings and flashlight scans of my pupils would have made it short-lived. Because I was a “fall risk,” I was confined to my bed; because of my hematoma, I was not allowed food or drink. This went on for two days. On the third day, I was allowed to eat. I was ravenous but two hard-boiled eggs and pancakes that had no known connection to edible food norms? Pitifully, I scarfed.
Each day entailed a new brain scan. They wanted to see stability in the size of the hematoma. If it grew, it would be a drill-and-drain event. I had three good scans and got out of there on a mid-day Friday. But the cloud hanging over the cruise remained dark and churning. My being able to travel was in serious doubt. We had travel insurance so I begged Jane to go without me to ameliorate my guilt for having screwed up this exceedingly important marital trip. She said no way but occasionally would call out the temperatures in Istanbul and Mykonos.
On Sunday, I went back to Lenox Hill and fortunately was able to find Francis. It was his boss, whom I had never seen or spoken to, who was against travel. Delmore, a doctor who had visited me at 6 a.m. one morning in the ICU, had been open to it, given it was a 25th anniversary trip and all, though it was not without risk, he said.
I asked Francis: what if I got a fourth “good” out-patient brain scan on Monday? If you were me, would you go? Yes, he said. Two-to-one for travel!
Monday was frantic, baffling and a touch Kafkaesque, but I got the scan (it was good) and I even got a CD of all four scans so that other neurologists could weigh in, if I was so inclined down the road to get other opinions. Sometimes it works, even in a complicated organism such as a New York hospital. We left for Venice that Wednesday evening.