I looked at the New York cardiologist, who was examining me for what was supposed to be a moderate problem. Gone was the smile on his face. His forehead was wrinkled. His posture slumped. The doctors in my small town in Connecticut had just examined me. Something was wrong. Christ, something was really wrong, I just knew it. I thought this New York Doctor just found something bad.
"I think I just heard a bruit-a sound of an obstruction- over your carotid" he gently said. "Let us get a sonogram of your carotids. The technician will be able to do it in a few minutes."
I was from Connecticut. I trained at Yale and Hopkins. Some how I spent my medical career in the rough and tumble of Brooklyn medicine. Because of that competition, my peers had voted me to Best Doctors in America. New York City medicine brought out the best in some Doctors. That was the major reason I was here in New York. I also could hide a little better here if I became a bad patient.
My health had been going downhill since my semi-retirement as an asthma and allergy doctor. I was diagnosed with diabetes. It wasn't too bad, at first. Diet and medication controlled it. Then it changed for the worse, I had to begin insulin injections and now I had blood-vessel disease. Most of my patients recovered. They needed to follow a long program of regular care. If they did, they usually got better. I had a long and happy career teaching young doctors, doing some research and helping people. This diabetic thing was not like asthma and allergies. This was going to kill me like it had two other members of my family.
I looked at my watch the time seemed to go slowly. My mind flew over the possibilities. Blood clots in my carotids-the arteries going to my brain! I was a walking time bomb. I could have a stroke at any minute! I decided to behave as I learned in medical training. Push all emotions aside in time of crises. I a trained physician had to be in control. I could not be embarrassed by my show of emotions. I thought this would help my family. I would not be the typical demanding doctor-patient as I had seen in some older doctors. They called for the nurse and aids all day long. They thought a lifetime in medicine exempted them from illness and death.
I would try to be pleasant to all the medical staff. I needed to stay in control. How did this happen to me? I had to have surgery on both of my carotid arteries NOW! I had to be a patient person to go though two surgeries. Being patient was against my nature. I had to have surgery right now! I still had a lot to live for a lot to live for - a great wife, maturing kids, and two grandkids. I never had major surgery. The family joked what a coward I was. They knew I gave needles to all my patients, but I could not stand any pain, not even stubbing my toe. Now, I had to have major surgery if I wanted to live. I thought about just forgetting about it. Let what could happen, happen. No! I would behave with courage and go through with it.
The Sonogram technician was in early pregnancy. I was told to strip to the waist and remove all metal objects. "Is this going to be your first child?"
"No, my fourth," she answered.
"You seem so young," I thought out loud.
As I took off my Catholic medal, I realized we were from different worlds. The wig covering her shaved head revealed she was an orthodox Jew. They have a lot of kids.
The differences in our backgrounds did not lessen her professionalism or her concern for me. We did not have these types of Jews in my years in Connecticut. I had learned to accept and even like some of these people from my years in Brooklyn. Yes, Brooklyn was a growth experience for me. The sonogram took a long time. It confirmed what the cardiologist had suspected. She called him in when she was finished. He explained the results. I had an 85% blockage in both carotids. He softened the news by saying a MRI might not confirm the sonogram. I knew he was just sugar coating the news. I was scheduled for an MRI in two days and a neurosurgeon in four.
In those two days I began to feel symptoms I had not felt before. I became dizzy at times and seemed to fade out for a few seconds. I could not bend over or I would begin having trouble. Was this because I was a worrywart doctor? Or were my arteries closing off for real?
The last closed MRI I had had been for a shoulder injury. They made me move my injured shoulder in that narrow tube. They asked me to put my arm at my side, above my head. The pain made the narrow tube close in on me. The procedure was stopping my breathing. It became too painful and uncomfortable to complete. Fortunately my shoulder improved with some exercises. There were no other options now. I had to have a closed MRI. The carotids had to be evaluated and repaired.
The radiologist, came out to pacify my fears. " I am afraid we have to use the closed machine for this. The open machine is not good enough for the carotids. Only twenty minutes in the tube," he said. I was placed on a table with a pathetic piece of gauze to cover my eyes. I was rolled into the narrow tube. I had to squeeze my eyes shut and block out the sounds of the machine. A Tap, Tap noise came faster and faster. Then silence. I heard nothing. Suddenly a loud clanging invaded my ears and mind. I created visions of caviar and champagne to help me though the study.
The radiologist said, " I am afraid the MRI confirmed the sonogram. We are putting you in the hands of a neurosurgeon. He is an excellent neurosurgeon."
At the neurosurgeon, my wife was by my side. The first surgery -- yes, there would be two surgeries would be on my left side to protect my dominant side of the brain in a week. My kids rallied around. Even the one kid I had the most friction with was very supportive. My son from my first marriage supported my second wife. I had made mistakes during my lifetime, but my family was not one of them.
The week was a bad one for this impatient patient. No smoking, no alcohol, and worst of all, no sleep. I was once the Doctor. Now the roles were reversed. I was just a patient waiting. I did Prayer and mediation. I always believed in god but had difficulty with organized religion. Going to church now would be hypocritical, but I could pray as I always did. I was one on one with god. Night after night I had no sleep. Finally, It was time. My wife and I checked into a New York City hotel room so we could be ready for the early hospital check in the next day. My sister -in -law came up from Philadelphia for moral support. My son from my first marriage took us out to dinner.
I think god took over and put this impatient patient on autopilot. I had a night's sleep before surgery. My fate was in the hands of my doctors and god who was guiding those hands. I strangely was at peace for the first time in a long time.
I was NPO nothing by mouth- no coffee- no nothing as I waited to be admitted for surgery. First I waited with my wife. Then stripped and dressed only in a hospital gown, I waited in a room with a small television. Thinking if I was going to the gas chamber at least I would get a last meal. They put me on a gurney and wheeled me into pre-opt.
A smiling Indian doctor greeted me. He explained he was the anesthesiologist. I asked about awaking with a breathing tube down my throat. He said, "I will remove it before you awake. I have to attend to another patient."
I smelled the familiar scent of alcohol and felt a cooling sensation on my arm. A Philippine female anesthesiologist was starting an intravenous in each of my two arms. An injection into the IV and I was off to la-la land.
I awoke with a slight pain in my neck, a dry throat from the breathing tube but worst of all a catheter in my bladder. Surprise! I did not think of worrying about a urinary catheter. The spasms would come every few minutes. The catheter had to stay in. When my Doctor would not tell me how long it would stay in, I knew I was in trouble. I told every one I could how my penis hurt. My wife and kids were embarrassed their proper Doctor husband and father was talking about his penis.
I could not move. I was attached to too many tubes. The world was closing in on me. I had to zone out. Remove myself from this time and space. I had programmed an MP3 player for this. My Haitian nurse was holding my player she had gotten from my wife. Classical, country and rock and roll music transported me away from the pain.
An elderly Russian-Jewish female volunteer offered me my first slip of ice water. 18 hours had passed since I had anything by mouth. The ice chips exploded with taste. Teasing her about her accent, I said it tasted like vodka and caviar. She joked that the crazy Americans do not know how to eat caviar or drink vodka. They have to have juice with the vodka and crackers with the caviar. The Russians eat caviar straight off a silver spoon. They drink the vodka straight. I noticed the numbers tattooed on her arm.
I did not want to embarrass her. I did not mention the tattoo. I spent the rest of my hospital stay thinking of her and the other caregivers. My volunteer lady must have been a small child when she saw all that suffering. Now as an elderly lady she was helping others as if to wash away the suffering she saw. She loved New York City and its tolerance of all people.
Most of the doctors and nurses I had seemed to be escaping from something. New York City and helping someone was their new chance. I could have been from Mars. They would not think any less of me. They tolerated me the impatient patient. My fears and pain were comforted. This was New York City not some small town in Connecticut. In Connecticut even at Yale there seemed to be one of everything. Medicine was good but not competitive. The label Connecticut Yankee was not an accident. I was from Connecticut and tried to become a Yankee. White- Anglo-Saxon culture dominated. I did not have much exposure to people with different cultures. That changed when I practiced in Brooklyn. I enjoyed the different cultures.
In New York City People could show their cultural background. Medicine in New York City was competitive. Race, religion, sex in the people; did not matter only quality counted. They were all good.
I am at home recovering from this first operation. I will try to be a more patient, patient for the second. Thanks to my friends and relatives. God, I owe you. Please guide my surgeon's hands for the second surgery.
