notes from the ward

I just found a little notebook I forgot I had with me in the hospital on a few occasions, and I'd like to share with you my narcotic-addled observations at both Vancouver General Hospital and St. Mary's in Sechelt. Unfortunately, a lot of it is illegible, but I was able to understand a few bits.

Roomie From Hell

Random comments from a middle-aged woman with whom I was sharing a room. I can't remember what she was being treated for, but heavier sedation would have been a blessing.

• My tuna sandwich was just tuna and mayo. Tuna and mayo, tuna and mayo, can you imagine?
• I got tea. I don't drink tea. This tea is awful.
• Those nurses spend all their time reading and gossiping. They should have raised kids, they don't know what a hard day's work is.
• Would you sleep in this bed? Would you?
• He won't come and see me because he knows he'll get the what-for, the lazy old goat.
• I know food, I cook. This coleslaw tastes like curry. If I wanted curry I'd go to Pakistan.

Dumb Questions from Medical Professionals

And the replies I prevented by biting my tongue.

• Is your pain good?Oh yes, thank you, the my pain today is absolutely lovely. And don't worry, if it starts to subside, I can always poke myself in the eye with this pencil.
• Are you having a good day?Yes, yes thanks, one of the best I can remember. I'll really miss all of this when I go home.
• Can I get a blood sample?Obviously you're going to drive a needle into my vein to draw something out. Do you think there's a possibility it might be something other than blood? Are you really a nurse, or are you an actor from "Just For Laughs: Gags?" 

Dumb Questions from Me

• Why do you call what you do "practice?"
• If you're going to ram a camera up my arse, why bother leaving the room while I undress?

Staff Analysis

There are three categories of staff, regardless of title, skill, experience or duties.

• Acers seem to know what they're doing, enjoy their work and make an effort to improve the patient's comfort. They all deserve raises. And flowers.
• Divas, too, are competent, but they want you to know it and want to make sure what a generous act it is for them to change a dressing or bring a glass of water. I feel sorry for their spouses and children.
• Culls simply shouldn't have been hired, for any job, but they show up at all levels, moving slowly and frequently changing direction for no apparent reason. Culls are especially disappointing when they attempt to insert a needle into your arm.

Voices from the Hallway

Scraps of conversation overheard from Culls loitering in the hallway outside my room:

• USA lost the cup. What can you do though? Yeah, it's just a game, eh?
• I've had it with him. As soon as we get back from Mexico, pfffft, he's history. But he owes me a nice trip.
• Auntie has a boy 32 and a girl 20. They're getting a little more mature, they're not teenagers anymore. They were good teenagers though.

The Valley Girls

I have no idea who these two are, or what they look like, but I'll bet they consult those cheesy "entertainment" magazines for paparazzi shots of Paris Hilton for fashion inspiration. I'm sure they both have little dogs that fit in their oversized Louis Vuitton cheap-knockoff bags.

They are indistingushable by voice. Same volume and pitch (a little on the high side), same breathless and perky delivery in the classic Valley Girl dialect (So I'm all like, you know, and so I go--" and the reply is invariably, "Shut up!").

I also think of them as The Giggle Girls because every conversation byte is ended with a near-hysterical, but thankfully brief, giggle. It is a good fit with most of their conversation, with subject matter such as What I Did on My Summer Vacation, Shopping, My Father is Soooo Old-Fashioned and the wildly popular Dumping My Lame Boyfriend.

When they discuss patient care, the giggles are somewhat horrifying.

• So, like, she wants to go home with her catheter, teeheeheehee!
• Shut up! She wants to go hoome with her catheter? Teeheeheehee!
• Yeah, like really! Teeheeheehee!
• Maybe I'll try that, teeheeheehee!
• It could be kinda good when you're watching TV and don't, like, you know, wanna get up, teeheeheehee!
• I'm always self-medicating too but I'm, like, well I'm a nurse so it's okay, teeheeheehee!
• Teeheeheehee!

Patient Communication 101

I'm convinced that every doctor learned these communication strategies at medical school. Thankfully, not all of them (most, but not all) choose not to use them:

1. Avoid eye contact.
2. Maintain a complete lack of facial expression.
3. When patient explains their symptoms and medical history, acknowledge with no more than an ambiguous, disinterested, vague and very quiet, "uh hum."
4. Strive to leave the patient wondering:
      1) If you have heard them;
      2) If you have understood them;
      3) If you even care what they said.
5. Answer all direct questions with, "Everyone is different."

bucket list

November is Lung Cancer Awareness Month, and here's the whole calendar, if you're interested:

• November ~ Lung Cancer, Pancreatic Cancer;
• October ~ Breast Cancer;
• September ~ Prostate Cancer, Childhood Cancer, Ovarian Cancer, Gynecologic Cancer, Leukemia and Lymphoma;
• June ~ Men's Cancer;
• May ~ Women’s Cancer, Skin Cancer; 
• March ~ Colorectal Cancer.

May is Cancer Research Month, April is Cancer Control Month, January is Cervical Cancer Screening Month, and we have a number of holidays of less than a month:

• Coaches vs. Cancer Awareness Weekend (January);
• World Cancer Day (February);
• Daffodil Days (March);
• Minority Cancer Awareness Week (April 18-24);
• Melanoma Monday (May);
• Women’s Cancer Awareness Day (Mother’s Day);
• National Cancer Survivors Day (June);
• Men’s Cancer Awareness Day (Father’s Day);
• Mammography Day (October);
• Coaches vs. Cancer Classic (November).

Hold on, is this a disease or a spectator sport? This cancer is just one great big celebration of wonderfulness, all year long.

You may know that it's not politically correct to refer to a cancer patients as cancer patients. Instead, they're cancer survivors. Well, that's what I thought too, but now we're no longer survivors either. The latest buzzwords have turned us into "champions" or "warriors."

We warrior-champions are supposed to maintain a hysterically positive outlook, to believe that we are going to beat our cancer and never, never ever, let a shred of doubt enter our consciousness. Bring on the cheerleaders!

We're supposed to live every minute of every day to the fullest, to spend quality time with our loved ones, to tour Europe, to go skydiving, sign up for ballroom dancing lessons and take up mountain-climbing.

It's expected that we all have a bucket list of things we want to do before we "kick the bucket" (die), and that we spending every day working on the list, doing all those adventureous things we always wanted to do but never got around to.

I don't know who came up with these rules for living with a terminal illness, but it sure wasn't the guy puking up his guts after yet another chemo treatment, or the woman nearly comatose from painkillers while she recovers from yet another surgery.

First of all, when you have cancer, you're not normally a happy ball of energy and enthusiasm every day. Sometimes you're sick, sometimes you're tired. And most of the time you're sick and tired of being sick and tired.

Then there's the inconvenient little truth that cancer devastates you not only physically but financially. Even if you have fabulous medical insurance that covers all your treatment expenses (many don't), you're likely missing a lot of work and not getting paid for it. You may find yourself unemployed. You may find yourself on welfare. Yet, you're supposed to be booking that Carribbean cruise.

Never mind all that. Let's pretend that you feel healthy and you're independently wealthy. Off to climb Everest then? Afraid not. Cancer is a time-consuming disease, with an endless schedule of appointments for bloodwork, x-rays, examinations, CT Scans and follow-ups. Unless you live in a major centre, travel is involved.

We're caught up in a machine, and it's a machine built to raise money for cancer research. Yes, funding for cancer research is a good thing, but let's cut the cancer patient some slack. Opps, I mean cancer champion. Let's not use the person as a success story to support the fundraising cause, because odds are he won't be a success story.

Cancer treatments, and thus the prognosis, are improving, but cancer has been the top killer in Canada since 2007, and one of three people gets cancer. Let's look at some more statistics:

The five-year survival rate for "cancer warriors" diagnosed in 2004-2006 is 62% of people not diagnosed with cancer. A diagnosis in 1998-2000 was 60%, so an improvement is being shown.

Let's look at the five-year survival rate for individual cancers. The percentage figure is the number of people out of one hundred who will survive for five years:

• Thyroid cancer ~ 98%
• Testicular cancer ~ 95%
• Prostrate cancer ~ 96%
• Skin melanoma ~ 90%
• Breast cancer ~ 87%.
• Bladder cancer ~ 73%
• Non-Hodgkin's lymphoma ~ 63%
• Colorectal cancer ~ 63%
• Brain cancer, ages 15-44 ~ 58%
• Leukemia ~ 54%
• Ovarian cancer ~ 42%
• Stomach cancer ~ 24%
• Liver cancer ~ 17%
• Lung cancer ~ 16%
• Esophageal cancer ~ 13%
• Brain cancer, ages 65-74 ~ 9%
• Pancreatic cancer ~ 6%

These figures are for early-stage diagnosis, and unfortunately not everyone is diagnosed quickly enough to meet the five-year survival percentage. For example, of 100 people diagnosed with lung cancer that has spread, only three will survive for five years. The average survival for someone diagnosed with Stage 4 prostate cancer is 1-3 years and, if they refuse treatment, only 6-9 months.

This year, over 76,000 people in Canada will die of cancer (over a quarter of them from lung cancer) and almost 174,000 new cases will be diagnosed.

But we're not patients and we're not survivors, we're fucking warriors and champions, and we're not going to think about dying of cancer, and we're going to put together a bucket list of adventures and other fun things to do.

But, if you can, please donate to cancer research. It's not going nearly as well for them as they'd like us to think, in spite of all the cheerleaders.

anticipation

Tomorrow is a big day, my first visit with a doctor since my surgery June 21, four months ago.

About a month ago I phone the Cancer Agency in Vancouver, a huge facility that tracks and manages treatment of every cancer patient in British Columbia. I tell a secretary my oncologist, Dr. Ho, won't be back to work for about ten months, off on a year's maternity leave, and I'm wondering about a follow-up for my thoracic lobectomy.

The next day, I get a call back from Dr. Ho's replacement, who came out of retirement to help with the abandoned caseload. He tells me he will send a letter to my doctor here in Pender Harbour. My doctor, unfortunately for me, buggered off on a year's sabbatical a couple of months ago, but his replacement will get the letter recommending an x-ray and blood tests.

I will meet him tomorrow, his first shift at the Pender Harbour Clinic. I have some anxiety about this meeting. I don't seem to have good luck with doctors, and the ones who work out well for me soon abandon their practice for long periods of time. For some unknown reason, most doctors are unable to properly diagnose whatever health problem I happen to have. I've had a few serious health incidents in my life, and every one of them was screwed up. For example, nearly 20 years ago...

After a lovely moonlight swim in Garden Bay Lake, I'm climbing back up the bank to the road where my truck is parked. I'm holding my jeans and shirt above my head, to keep them from dragging in the dirt. It's dark. I'm wearing "stupid shoes," those useless thong things that are really just a slab of flat rubber held on to your foot with a thin strap across your toes.

I lose my footing in the loose gravel, and you know how these things happen so quickly but seem to go in slow motion. I know I'm falling, but I'm determined to keep my clothes off the ground, so I keep my arm held high over my head. CRACK!  That was my arm and, damn it, my clothes are sitting on the ground.

So is my arm, and it won't move. I can pick it up with my other hand, but it won't move on its own, no matter how much I concentrate. I admire the large rock that my arm, with the weight of most of my body behind it, landed on rather abruptly. It occurs to me that this might be a reason why people are warned not to go swimming alone. A servant to carry my clothing and this might not have happened.

So, the arm is broken. No big deal, it doesn't hurt and my truck is right here. I fashion a makeshift sling from my jeans, and off I go to St. Mary's Hospital in Sechelt, about a half-hour drive. Dr. Estey is on duty in the Emergency Room.

"What happened?" he asks.
"I fell, and I think I broke my arm," I reply.

He lifts my arm off the counter, pushes into the flesh here and there, then announces, "Yes, it's broken, but it's a nice, clean break so we'll put it in a cast and you can come back in the morning for an x-ray."

So, before long, I'm sent on my way with a cast, a proper sling and four Tylenol-with-codeine for the pain I'm not yet experiencing. Just as well, it's not a drive I want to make while high on painkillers.

It's been a long night, so I'm asleep soon after my head hits the pillow. But not for long. About 4 a.m. I wake up with excruiating pain in my arm. I gobble two of the T3s but it's even worse an hour later. Down go the other two.

Now, between the pain and the drugs, there's no way I can drive back to the hospital, so I call Jane. She's one of those really good friends who always is available when I really need help, even though she would much rather be sleeping at this ungodly early hour of the morning.

Anyway, back to St. Mary's and into the x-ray room where I'm told to lift my arm up, vertically, against a metal plate. Problem is, it's really painful to move the damned thing, and lifting it in that position is not going well at all. I'm not happy because I don't like whining in public, and the x-ray technician is frustrated because she can't take her x-ray.

"Just grit your teeth and do it!" she orders. So, I grit my teeth and...

... wake up in the back of an ambulance, on my way to Lion's Gate Hospital in North Vancouver, high as a kite on morphine (apparently I passed out in the x-ray room when I tried to lift up my arm).

I ask the ambulance attendant if I can sit up front. I ask the driver to turn up the radio, and turn it up some more. I happily wave at people in their cars behind the ambulance. I generally make a complete idiot of myself, but decide that I like morphine.

I'm wheeled into Lion's Gate, into the operating room and, next thing I know, I'm waking up after surgery. Dr. Estey's diagnosis of a nice clean break was a little off. Turns out the arm was dislocated at the elbow and the bone was shattered. I now have a stainless steel shaft running from my elbow to my wrist, and the surgeon quips that I will never break that arm again. "You might bend it," he says, "but you will never break it."

So far, he's been right.
  

cancer chatter

Yikes, I haven't blogged since July and we're now halfway through September. I think about it, almost daily, and I even sit down here at the keyboard a couple of times and start an entry. Doesn't work, though, the flow is dry as an attic cobweb.

For me, writing is like sex. If you're not in the mood, you're not very good at it. Unless, of course the writing is of a technical sort, in which case it's more like a jigsaw puzzle; somewhat challenging, mildly entertaining but devoid of passion.

I have to figure out why my cancer blogging fountain of words dried up, and it finally comes to me: I'm thoroughly sick of cancer conversations. Not the back-and-forth, information-sharing, what-if exchanges that I love, but the inevetible tales of woe or faith that so many casual acquaintances subject me to. They knew someone who had cancer so they're an expert, or they're traumatized or they feel that they can forsee the future to tell me I will be cured.

I'm horrified that so many people know so little about this bastardly disease that attacks one of every three people on the planet. Some have cancer, are being treated for it, and they don't know what kind it is. They do not know what kind of cancer they have. Not a clue, and this floors me. Aren't they the least bit curious?

Jesus tapdancing Christ, this cancer may kill them, don't they have any interest at all? Apparently not but, in spite of this, they're eager to tell you all about it. I always listen politely and wish them luck. Sometimes, if I'm in an evil mood, I grin like an idiot and say, "Oh, you'll be just fine!"

I've already talked about the plethora of secret, miracle cures people let me in on. Oddly, everyone learned about them from a friend of a friend of a friend, on the Ophra show or read it in a magazine (I'm guessing an ad in a magazine). Anyway, I don't even bother argueing anymore.

I learned my lesson after responding, "Oh, that's reaaally wonderful, I had no idea I could cure my cancer just by taking some kind of hemp oil preparation. Guess I'd better run right down to the health food store and buy up a whole bunch of it, eh? Gee, you're so clever! You should be a doctor!"

And I may have gone on a bit longer, my voice dripping with sarcasm. Anyway, Miracle Cure Dude finally gets it, looks me right in the eye and snarls, "Fuck you, douche bag!" as he turns on his heel and stalks off down the Italy aisle in the wine section of the liquor store, heading for Kokanee. I smile, because I imagine yelling at him, "Hey buddy, you should quit drinkin' yer beer out of aluminum cans, it's killing brain cells."

Finally, there are those who lost a loved one of cancer and, believe me, I have great sympathy for anyone who has lost a loved one because we all do and it's always rough.

My sympathy dwindles when, on my first solo trip shopping after my lobectomy, a woman about my age but a bundle of energy and the picture of health, runs up to me to to say, "How ARE you!" I reply, "Not bad, thanks," and she launches into the saga of her mother who died of "female parts" cancer.

Really, that's what she called it, and I wonder if, at her age, she still does not know the names of female reproductive organs. Maybe she thinks these are bad words not to be uttered in public or, most likely, she doesn't really know much about what killed her mother and doesn't much care because it's really all about her.

I'm in pain, exhausted and stupid from Dilaudid, hanging on to the grocery cart to keep from collapsing on the floor of the IGA and struggling to get some air in my lung.

She prattles on about her mother who died ten years ago and she went to stay with her and she cooked for her and she cleaned for her and she shopped for her and she loved those little butter tarts and it was so hard and her mother ended up in the hospital but she stayed on with her sister to look after Dad because he was just beside himself because she had looked after him all these years, blah, blah, blah, blah, blah, blah.

There was something in there about getting a flat tire on Granville Street in Vancouver, but I missed a lot of the details. At one point, when she paused for a breath, just for fun, I said, "My mom was murdered by a rhinocerous with AIDS," but she never batted an eye, just kept right on about what a dedicated daughter and selfless person she was when her mother was dying of cancer of her female parts.

Next time I'm gonna turn around, yank up my shirt and show her my scar!

So for the most part I try to avoid cancer chats, but a few of them put an honest, happy smile on my face for most of the rest of the day. They are the ones who are honest and direct, the ones who say "cancer" instead of looking at their toes and mumbling, "the C word," the ones who don't treat me like an invalid or a freak, the ones who know they won't catch cancer by standing too close to me.

I think it was Scientific American Mind that ran an article recently that explained this peculiar behaviour in otherwise sane and intelligent people, tracing it back to early evolution when there was safety and strength in numbers. Be it fighting off predators or an invading tribe, a sickly individual is of little use so they weren't desirable as fellow citizens. We're getting better though, it's 2010 and today we rarely send our Stage 4 cancer patients off on ice floes.

Now I'd like to share with you a couple of Facebook posts I made while holed up at home in Kleindale, avoiding the stupider cancer chatter. Each was given the title...

~~~   A D V I C E   F O R   T H E   D A Y   ~~~

August 20

When the raisins in your cereal taste really bitter, consider that the milk you poured on it might have been sour. Do not ignore the bad taste while eating 3/4 of the bowlful before pouring milk in your coffee to see it curdle.

September 2

When softening butter in the microwave, do not set it for two minutes on High, and don't put a quarter pound in one of those tiny little souvenir plates. Coming soon... how to clean a quarter-pound of liquid butter out of your microwave!

September 8

After removing the screen from the kitchen window, do not leave said window open wide enough for a Stellar's jay to fly through after you have, like an idiot, placed peanuts on the windowsill. Note to self: buy more Fantastik Orange Action just in case you have another morning of cleaning up birdshit in the kitchen.

to a friend i haven't met yet

A couple of days ago, a friend told me that her sister was just diagnosed with lung cancer, and that she's going in for a lobectomy the end of August, the same surgery I had about a month ago.

I don't know this woman. I know nothing about her except that we both have the same type of cancer, us and tens of thousands of other people. Still, I feel a connection with her because of our shared... um, let's call it a challenge because anything else sounds fatalistic and self-pitying.

Maybe it's like the connection made by men (okay, women too) who go to war. I know a few Viet Nam vets and they are brothers because of shared experience. They speak the same language. They know things about each other because of where they have been and what they have been through. Their experience changed them, and no one else gets it, unless they've been in Nam.

Cancer is like that, like finding yourself in the middle of a war that you never signed up to fight (hell, you never even got a chance to dodge the draft). There is this bond among cancer survivors. We know stuff that no one else knows unless they've faced cancer. So, this woman is where I was six months ago, newly diagnosed and facing surgery, and in my head I'm talking to her like she's someone I've known all my life. Carrie isn't her name, but let's say it is.

Carrie, you lucked out getting Dr. Ken Evans as a surgeon. He's a wizard with the scalpel and you'll be so pleased when you discover that your incision doesn't have any staples, or even stitches, just a taped-on dressing that may be abandoned after just a couple of days because it heals so quickly. It heals smoothly, without the bumps and puckers that are typical of stitched and stapled incisions.

Carrie, I'd like to tell you about mistakes I made so you can avoid them. You'll probably make a few of your own, but at least I can give you a heads-up on a few that you don't need to subject yourself to:

1. Do not log on to YouTube and watch the videos of lobectomies. They are graphic, gory and absolutely terrifying. They are meant for medical students, not sensitive human beings like you and I. No one needs to see, in full colour, what the inside of their lung looks like.

2. Do not try to be a hero by scrimping on your pain medication. Narcotics are your friend, and there is no danger of addiction when you're taking them for legitimate pain. Further, by not taking them, you risk slowing down your recovery.

3. On the subject of narcotics, be sure to ask for medication to counteract the constipation they will cause. Don't wait until it's a problem because, if you do, then... well, it's a problem. Drink lots of water and don't eat the cheddar cheese you'll find on your lunch tray every day.

4. You'll wake up to find a little clip on your finger (it measures the oxygen saturation in your blood). Do not remove it. If you do, your computer monitor will immediately begin sounding all kinds of alarms and this will just annoy your neighbour patients and the nurse who must rush over to see if you've died.

5. Your visitors may try to make you feel better by telling you a funny story or a joke. They mean well, of course, but this is a mean thing to do to you. Laughing hurts. Tell them to talk only about serious topics, maybe the price of gas or forest fires in the Interior.

6. Your visitors may get bored so, to help them pass the time in a more interesting way, send them out to get coffee for you at Starbucks and one of those delicious sandwiches at the little shop across the street. There's also a Subway at the corner if you're really hungry. They'll appreciate the Vancouver scenery and you'll get a break from hospital food.

7. Be sure to bring your own pyjamas and slippers. You just can't say enough about how bad hospital gowns are for one's morale.

Carrie, that's the really important stuff you need to know to get through this as comfortably as possible. They say a lobectomy is a major surgery, right up there with open-heart, but in fact you'll not find it that hard. Why? Because you'll be so stoned you won't know and won't care what you've been through.

You'll go home with prescriptions for pain medication, and at least for the first week, you'll want to take them regularly. This is fine, but you'll forget what you came into the kitchen for, you'll forget the first chapter of the book you're reading by the time you get to the second chapter, and you'll forget just about everything that anyone's said to you. Make sure you explain to your friends and family that you're not really suddenly stupid, you're just under the influence of some high-powered drugs.

After you stop taking the pain medication, you'll forget that you're recovering from surgery, and you'll absent-mindedly reach for something you dropped on the floor or stretch to get something from a top shelf in a cupboard... and then you'll scream in pain. After a few times of doing this to yourself, you'll pay more attention.

Plan to sleep either in a recliner chair or propped up with lots of pillows in bed. At first, lying flat in bed is not only painful but it's damned near impossible to get back up. Under no circumstances should you get in the bath tub; you risk being stuck there for a couple of weeks at least.

You will likely develop an annoying little cough. They never mentioned this in the hospital, but I've since learned that it's quite normal and it does go away. This little cough isn't painful, but sneezing certainly is, much like it would be if you had broken ribs. It's an excellent excuse to avoid all dusting and vacuuming.
 
For me, the hardest part is the slowness of the recovery. Three weeks would have been a piece of cake, but supposedly it will be three months until I'm back to some semblance of normal. The best part is looking back and realizing that, every day, I'm getting better. And you will too.

the lobectomy papers: part 4

Ghost in the Machine

In spite of the high technology and professional staff, things do not always run smoothly in Stepdown.

Let's look at the computer monitoring system for patients. Each patient's computer can sound an alarm to warn nursing staff of any abnormal readings.

This is an excellent tool to provide a timely heads-up if a patient happens to be having a cardiac event or if they've, um, died, causing the signals to stop altogether.

An excellent tool, providing it functions as it should. But, we all know computers are prone to little glitches, ghosts in the machine so to speak. The one connected to the patient on my immediate left is not an exception.

The patient's heart rate, pulse or whatever reading jumps from 117 to 124, then dives back to 117, setting off the alarm because of the rapid change.

Nurses rush over, determine that the patient (who somehow sleeps through the whole performance) is not having a cardiac event, and reset the machine to shut off the incessant, high-pitched beep-beep-beeping alarm.

Within minutes, the alarm sounds again. Same drill. This goes on all day, all night, the next day and night and the day and night after that. Various nurses coming and going on their particular shift try to fix the problem. They all fail.

The obvious solution is to turn the damned thing off altogether, but that would defeat its purpose and certainly cause some embarrassment if the patient died and nobody noticed his heart stopped beating because the alarm didn't sound.

With the malfunctioning computer just inches from the head of my bed, I'm all for turning it off. By the time I reach 48 hours without more than a few minutes' sleep at a time, I fantasize about strangling the patient in the bed beside me.

I know it's not his fault. I know his computer monitor is to blame. Yet I so badly crave uninterrupted sleep that I cannot think of a good reason to spare this person's life, especially because he sleeps like a baby through the whole thing. Lucky for him, I couldn't get out of bed to save my life.

Nurses work a 12-hour shift for three days, then get four days off, so today there's a new face in Stepdown, Dan, a male nurse who responds, like all the others have, when the alarm sounds next to me for the millionth time.

"Good luck," I grumble, with no attempt to conceal my sarcasm.

"It's fixed," he replies after playing around for a bit in the menu level of the system.

"Yeah, right," I say.

I wait for the alarm to sound. It should happen in a few minutes. All is silent. Can it be? Could this guy have figured out so effortlessly what no one else could manage? I think, Nurse Dan is da man! I think, maybe there is a God. I begin to relax. I feel myself drifting, falling into the arms of Morpheus.

BEEP-BEEP-BEEP-BEEP-BEEP ...

Jesus H. tap-dancing Christ, here we go again. I'm so thoroughly exhausted and angry that I am near tears. 

... BEEP-BEEP-BEEP-BEEP-BEEP ...

I'm going to ask to be moved. No, demand that I be moved, away from this instrument of torture. I'll ask to see a supervisor. I'll threaten to go to the media. I'll call my Member of Parliament, my Member of the Legislative Assembly, I'll write to the Hospital Authority, I'll e-mail the freakin' Premier of the Province, I'll throw my food on the floor.

... BEEP-BEEP-BEEP-BEEP-BEEP ...

And here comes Dan, the smartass who thought he fixed the problem. Oh yeah, he's gonna get a piece of my mind.

"Here we are," he says cheerfully, picking up a little clippy-thingy he sees beside me, on my bed. It's an infrared device to monitor my oxygen saturation, it has a cord leading into my computer, and it's supposed to be clipped to my finger.

Dan replaces it on my finger, resets the computer and all is silent.

"Um, I guess it musta fell off," I say in a small voice. A very small voice. Inwardly, I cringe.

If you don't yet know what trance music is, or even if you do, listen to Ghost in the Machine by Xerox & Illumination, Moshe Keinan and Amir Dvir from Israel. It's the real deal.

the lobectomy papers: part 3

Highs and Lows

This recovery is ever so much more enjoyable than the one in February because my pain is considerably less. Between the epidural-delivered narcotics and Dilaudid pills, I live in a relatively happy, if not befuddled, place. But sadly, as they say, all good things must come to an end.

My blood pressure drops to 78. I explain that I normally have low blood pressure but that doesn't impress anyone. My beloved epidural is blamed for the crash, and the best way to get my blood pressure back to a living, breathing human level is to turn off the narcotic feed for a half hour, then cautiously creep it back up to 3. It was 7 when I was pain-free; talk about separation anxiety.

It doesn't take long for the epidural magic to wear off, and I am not at all appreciating this latest torment, a charlie-horse-like pain, a horrible, seizure-like cramp, that drives like a freight train right through my chest, freezing me in position with a hand pressed to my upper rib cage to hold together what's left of my lungs.

It hits just about every time I try to move, and a few times when I don't. My beloved Dilaudids, 4 mg every three hours, don't even come close to dealing with it. There are groans, there are screams, there are gasps, there are curses. I frighten the visitors.

The most amazing part of this experience is the admission by a doctor that a lobectomy is, "... an extremely painful type of surgery." Wow. I've never heard a doctor say "pain" before. They might mention slight pressure, some discomfort, a bit of irritation and other innocuous sensations, but never the P word. Fine. It's painful. I get that, now please do something about it!

But no, we must run blood tests and a cardiogram because the pain I try to describe sounds to someone like a cardiac event, otherwise known as a heart attack. A cardiac event? That's like calling excrutiating pain "slight discomfort." Oh, wait, they already do that. Perhaps the kinder, gentler term for heart attack was crafted to calm the patient's family, or to reassure his employer that he really can handle that promotion. But, "serious as a cardiac event" just doesn't have the same impact.

I've never had a heart attack, but I know this isn't one. I know that heart attacks don't occur over and over, that they aren't caused by some insignificant movement. I know that, if I was indeed having heart attacks, I would have been stone cold dead hours ago. To add to my frustration, no one is familiar with the term charlie-horse. And no one is going to turn my epidural back on until they've thoroughly checked out my heart.

The Pain Doctor is consulted, and he finally comes up with a drug he thinks is worthy of a try: Gabapentim. It's an interesting drug, used to treat epilectic seizures, bipolar disorder and pain from migrane headaches to degenerative disc disease of the back. It's also interesting that, like love or the economy, no one really understands how it works. We start with 200 mg every three hours.

A perk of living in Stepdown is that everything is brought to you, even the X-ray Dept.

A pleasant technician quietly rolls in a darling, mini, wheeled x-ray machine, lays a lead blanket over the parts of me she's not interested in, steps back behind the machine, calls out, "X-ray!" like you'd call out "Four!" on the golf course, and pushes the button to take a picture.

I'm sure it costs more than my home, my truck, all my computer equipment and all my camera gear but, here it is, another service included in a $165-a-night room. Today I'm finding it difficult to be critical of the Canadian healthcare system.

My cardiogram and blood test results are returned with the verdict that I've not had a heart attack, I mean cardiac event. Gee... ya think?

With the dosage upped to 300 mg every three hours, the Gabapentim is working. The chest charlie-horses lessen until they're gone and my epidural is gradually turned back up to a conservative but civilized 3. Along with 2 mg of Dilaudid every four hours, I'm back to a tolerable level of pain.

My blood pressure never did reach normal range but then, as far as I know, it's never been normal. I doubt that it ever will be, and that's just fine by me. Life wouldn't be nearly as interesting if everything was Normal.

As much as I love Dilaudid, because it's a narcotic, it has certain disadvantages. Narcotics cause constipation. Serious constipation and, unless you've suffered serious constipation, you have no idea of how painful it can be. Now I'm certain why junkies are so skinny. I used to think it was their unhealthy lifestyle, but now I'm convinced it's simply because they don't eat. They're scared to. Scared shitless, you might say, and that's no laughing matter.

Someone in the kitchen has a sense of humour though. Every day, on my dinner tray, appears a small, factory-wrapped package of Black Diamond cheddar cheese. Black Diamond produces a lovely cheddar (I sometimes buy it at home) but, unfortunately, cheddar causes constipation.

It takes every iota of my willpower to stash the package in my drawer rather than rip it open to enjoy right now. That's how bad narcotic-induced constipation is.

"And the doctor said, 'Give him jug band music, it seems to make him feel just fine.'" John Sebastian (Lovin' Spoonful).

the lobectomy papers: part 2

July 22 - Stepdown Unit

The deed is done, the lobe is gone, the sutures tied and the tubes in place. Seemingly only seconds after the general anasthetic knocks me out, I wake up in the Stepdown Unit. The internet said I'd wake up in the Intensive Care Unit (ICU), but there doesn't seem to be one here on the 12th floor Lung Dept. Turns out that a Stepdown Unit is like an ICU, but not quite so intensively caring. This is a good thing. If I don't need intensive care, then I can't be in intensively bad shape.

The Stepdown Unit is a ward of up to ten patients with their own stable of on-site nurses and a variety of frequently visiting doctors and other medical professionals dealing with their particular case.

Today I have six roomies in Stepdown, and they've all undergone some type of major lung surgery. In bed, they're wheeled in, groggy and barely conscious, after their surgery and, when they're improved enough to join the general population, they're wheeled back out the door, bed and all.

Each Stepdown Unit patient is connected to a computer via an assortment of equipment to monitor pulse, blood pressure, heart rate and oxygen saturation. The blood pressure cuff is a permanent fixture, strapped to one's bicep to inflate every hour on the hour for yet another reading. So much for the healing properties of uninterrupted sleep.

At 10:30 a.m. on my second day at the Stepdown Unit, I am bestowed a visit by the Pain Service Doctor. Really, a Pain Service Doctor. Is he going to evaluate my worthiness to be in Stepdown, my worthiness to be served more of that kickass pain medication? Or is he going to order up some new kind of pain for me?

Next, the Social Worker makes her rounds. I think it's interesting that she spends most of her time with patients who already have a solid support network of friends and family, and those of a "spiritual" bent. I suppose this makes it easier for her to apply the basic counselling technique of paraphrasing the patient's words in a positive slant, getting the patient to agree to the new way of looking at their situation.

Social Worker: "Do you have someone to help you with routine household tasks when you go home?"
Patient: "Um, maybe I could ask the neighbour to bring my garbage out to the curb on Thursdays, and my other neighbour might be able to go shopping for me sometimes."
Social Worker: "So I'm hearing you say that you have a reliable and competent support system in place when you go home?"
Patient, visibly perplexed: "Um, well... I guess, if you say so..."
Social Worker, happily checking off a box on her clipboard form: "Great! Now, would you like to talk to a sister from the church?"

Sometime during the flurry of visits from doctors, nurses and others in the helping professions, I find time to take inventory of my condition.

Last time I was here, I was horrified to discover a drainage tube coming from my lung and leading to some unknown recepticle below my field of vision at the edge of my bed. Well, it's baaa-aaack, and it's every bit as Stephen King as the first time. The transparent, half-inch diameter tube regularly gushes bright red blood and gore from somewhere inside my chest. This is something I do not want my visitors to see, and I appreciate that none of them mention it.

Even more disgusting than the drainage tube is the urine catheter tube. Yup, there goes my last shred of dignity, zoom, right out the window, and I didn't even know I had any left. This transparent tube leads to a collection bag that sits at the bottom of my five-footed "Christmas tree," which also holds a collection jar for the other drainage tube and, at top, whatever drugs happen to be dripping into my i.v. at any given time. The urine catheter tube is a frightening half inch in diameter but, on closer inspection and with great relief, I see that the size is greatly reduced before it's taped to my leg and headed into my bladder. Again, thanks to my visitors for not mentioning this.

The third tube is a happy tube. I have a vague idea that an epidural is a procedure specifically for pregnant women, maybe an injection of some kind. I'm in the ballpark but pretty far out in the field.

The epidural is a small catether tube leading into the layer of fatty tissue surrounding the spinal cord. It feeds a regular, pre-measured dose of high-octane narcotic directly into the sweet spot of the nervous system, effectively numbing a large area. Ahhhhhhhh. If I handed out Nobel prizes, the inventor of the epidural would be at the top of my list.

I soon come to realize the containers of red stuff from my lung and yellow stuff from my bladder must be periodically emptied. And measured; the volume of liquid leaving my body apparently indicates something important.

The red stuff is disposed of discreetly, but not so the urine. It's poured into a clear, graduated container for measuring, then carried boldly down to the far end of the ward, to the bathroom. I don't know why the nurses hold this beer-glass sized contained up so high (picture the Statue of Liberty with her torch), but they look for all the world like staff in a busy pub, carrying a glass of Canadian draft to a thirsty patron.

There are certain benefits involved with the nasty catheter. For example, one can drink limitless amounts of fluid without the inconvienience of having to get up to stumble to the bathroom for a pee at 2 a.m. This afternoon I drank several large glasses of ice water, a cup of tea and a container of apple juice with lunch, and finally, later in the afternoon, a large cup of Starbucks coffee. One-point-seven litres of urine is produced while I have not the slightest sensation of a full bladder.

Yesterday, before sending me into Lala Land at the OR, Dr. Evans asked if there was anyone I'd like him to call to report on the surgery. I gave him Gerald's phone number in Port Coquitalm, and I had already instructed Gerald to, at their request, call Jane, Judy, Pat, Billy and Steve.

Today, Dr. Evans tells me that he repeatedly tried the number but was unable to get through. No answer, no answering machine. This is concerning. Gerald does not have an answering machine, but he certainly would have waited for word on my surgery before heading our anywhere. In fact, I remember that he was going to take the day off work to wait for a call.

A nurse was kind enough to try the number for me, again and again, on the Stepdown cell phone, but to no avail. By  3 p.m. I arranged to have a phone by my bed. By 4 p.m. I was wondering who I might call to find out if something has gone wrong. Gerald, if nothing else, is reliable. If he says he'll wait for a call, he'll damn well wait for the call. Understandably, I'm worried.

Then, Gerald strolls into the ward and up to my bed with a cheerful hello, to which I replied, "Where the hell were you!'

"I just got off work."
"Where were you yesterday, when Dr. Evans was calling to let you know how my surgery went?"
In a patient voice, not quite with his eyes rolled up to the ceiling, but close, Gerald says, "You called me yesterday. You told me the surgery went fine. Remember?"

Times like this, I want someplace to hide, someplace dark, quiet and completely out of sight, until everyone forgets my latest faux pas. At least there was a reason for this one: the epidural.

the lobectomy papers: part 1

June 21: Vancouver General Hospital

I'm running late, completing last-minute preparations for a couple of weeks away from home and not expecting to be able to do much when I return home... automatic fish feeder installed in the tank (thanks, Shelley), plants watered, laundry done, recliner chair installed in the bedroom, bills paid (well, mostly), toiletries packed, pyjamas packed, notebook (oldschool type; not the laptop) packed, books and magazines packed.

Twenty minutes behind schedule, we head out the door with Gerald predicting we'll miss the ferry. Not critical, but it would result in a two-hour sit in the Langdale parking lot. Fortune shines upon me though, because the ferry is even later than we are, so we board with no wait. Damn. Although I remembered to wash the laundry, I forgot to throw it in the dryer.

At the VHG Admissions desk, I'm processed and dispatched to my room on the 12th floor of the Jimmy Pattison Pavillion, where all the serious lung cases are kept. I'm an old hand at this, having been here just in February, for wedge resection surgery.

I'm the kid who already has a season of summer camp under her belt, the old con returning for another bit in jail; cocky and comfortable, already looking to claim the best bunk and the best view, looking for a game of cards to pass the time.

My room, shared with Ingrid, is spacious for hospital accommodations by any standards, with a spectacular view of downtown Vancouver with its picturesque, bustling harbour and a backdrop of the moody North Shore mountains. Overhead cranes zig and zag above construction sites, lines of vehicles stop and start at traffic lights, tiny ferries travel back and forth through the waterways.

It looks like a child's playset of miniature cars, busses, buildings, boats and Mechano toy cranes. A tiny helicopter appears over the North Shore, heading south, getting bigger as it gets closer. Now it's a full-sized, for-real chopper thwap-thwap-thwaps its way almost right up to my window. It hovers a moment, then descends to make a perfect landing on a white cross-marked landing pad below. Cool.

My room is in a clean and modern tower in the heart of what's argueably the most beautiful city in the world. It has extraordinary room service and in-house amenitites. How many hotels do you know of that have an operating theatre? The food isn't great, but it's delivered three times a day, while juice, water and snacks are available on demand.

The view? Well, I've told you about the view. This semi-private room is billed, regardless if the patient or their health insurance carrier is paying, at $165 a night. A private room is $195. The Sutton Place is one of the nicest Vancouver Hotels I've stayed in, but I doubt you can get a room under $200 a night. Granted, they have parking, but you have to pay for your own meals. And surgery.

If I'm still here July 1, I'll have a million-dollar view of the city's Canada Day fireworks display over Burrard Inlet.

Vancouver is best known for its Celebration of Light international fireworks show, changed it from Symphony of Fire, presumably to spin attention from the polluting aspect of the days-long pyrotechnical orgy, not to mention the fire hazard in the hottest, driest time of year.

But, we love our fireworks. Even a smug, vegan, tree-hugging and hybrid-driving citizen of the planet and champion of Mother Earth looks the other way at the expense, the noise and chemical fallout of their beloved fireworks.

Admiring the view is interrupted by a visit from my first cousins, Russell and Brian Doyle, and Brian's wife, Pam. It's okay, paramedics have already transported the patient from the helicopter into the bowels of Vancouver General and the chopper has thwap-thwapped up, up and away, over the harbour and North Shore mountains, looking like it's headed to the Sunshine Coast, maybe even my home of Pender Harbour. I fantasize about being onboard, not facing surgery in the morning.

I'd never met Russell before; in fact, I didn't even know he existed. Such is the nature of my family. We don't waste a lot of time keeping in touch, so visits like this are really appreciated. Rusell contacted me a few weeks ago because an uncle died without a wife, family or will, and so all the family members had to be notified for Kimble's estate to be distributed amongst the children of his siblings, according to Canadian estate law. Kimble and his siblings numbered 12, not unusual for a Roman Catholic family in northern New Brunswick not long after the turn of the 20th century, so I doubt I'll get enough to pay off my Master Card.

Russell is in Vancouver on a brief layover, heading to the Land of the Midnight Sun to take part in the Whitehorse 24 Hours of Light mountain bike festival. He also runs, so I know he's not a smoker. Genetics is interesting. Most of the Doyles drink alcohol in that good old Irish tradition, but not all of them in my generation are stupid enough to still be smoking. Russell and Brian are my cousins though, there's a peculiar sense of familiarity when I talk to them, like looking into my mother's dark brown eyes.

Russel leaves, off to catch his plane to the Yukon, Brian and Pam leave, and Gerald leaves. I'm left with my books and thoughts, trying not to recall those lobectomy images and descriptions I found on the internet.

stress mess

"Stress is nothing more than a socially acceptable form of mental illness."

Richard Carlson

I had an appointment to see Dr. Ingrey today, to get results of my CT Scan last Friday, but I cancelled. Today is not a good day. I've got the killer headache and fatigue that's been with me for over a month now, I'm queasy, lightheaded, dizzy and my ears are ringing. Perhaps not wise to head out to hurtle down the highway at 80 kph, wondering if I'm going to pass out before reaching my destination and maybe driving a bit faster so I don't before I do.

Dr. Ingrey phoned to say that no brain tumours showed up on the scan (dizzy or not, I did a little happy dance in my head over this news). He explained that the headache is likely caused by stress from having cancer and anticipation of my next surgery. My headache is all in my head.

This is good news, but puzzling. I've had my share of stressful jobs, relationships and situations, but I thrive on stress and always have. I embrace it and glory in it, love the challenge and excitement of it. In fact, I can remember times when I probably went looking for it.

As publisher and editor of the Harbour Spiel for 15 years, I was regularly faced with deadlines and responsibility for material that might get me sued, or at least result in half the people in town pissed at me. I get a thrill out of taking risks. I've never had headaches, unless self-inflicted by lack of sleep along with excessive sauvignon blanc, cigarettes and joints the night before.

There is no reason for headaches today. Several years ago I sold the Spiel and toned down my consumption of unhealthy substances to the occasional glass of fine wine with dinner. I'm not stressed by work because I have almost none, just making minor updates to information and uploading the occasional banner ad for Pender Harbour Online.

I've had a comfortable, stable relationship with the same man for nearly 20 years, and he will stay with me after surgery until I tell him to go back to his apartment in Port Coquitlam, back to work at the shipyard. No stress there.

Fraser, my old cat, disappeared last month and I think he became a meal for a litter of coyote cubs, as has been the fate of so many cats in the area. I worried how he would make out while I was in hospital for a couple of weeks with only a friend stopping by once a day to fill his dishes on the kitchen floor. I miss him terribly, but now I don't worry about him. Even less stress in my life.

Maybe I'm stressed out because I don't have any stress? Oh, wait. The cancer. Almost forgot about that. And the upper left lung lobectomy on Tuesday morning. Hmmmm. Being sick and tired of being sick and tired for well over a year now. Still not having a clear diagnosis of the cancer in my bone marrow, spleen and lymph nodes. Still not knowing the stage of my lung cancer. Well, maybe.

Okay, I'm stressed out.

I'm stressed out because I have cancer and my expectations of the Cancer Agency have crashed. I don't know if this surgery on Tuesday is the right decision, and I never will. So, let's look at it rationally. What's the worst thing that could happen? I'll die. And why is that a bad thing?

It will be sad for the people who care for me, but it won't be a bad thing for me. It will likely be a good thing, because that will be the end of any "discomfort" as the doctors like to say, and diminished quality of life.

Oh, and the stress will certainly be relieved. I'll be dead, so I won't need anything, want anything, miss anything, regret anything or ever again get annoyed at a telephone solicitor. Happily I'm an atheist, so I won't be faced with eternity burning in hell for my sins. It's all good.

But, I'm still stressed. I suppose I'm a tad anxious about the "discomfort" of having my ribs pulled apart to rip out most of the rest of my lung, that ghastly drainage tube and a lifetime of lessened breathing capacity and physical activity. But, I'm psyched to have it done.

After all, I thrive on stress.

giving thanks

        
St. Mary's Hospital has a CAT Scanner. Big deal, you say. It is, I say back. The hospital serves a population of only 2,500 people spread across the Sunshine Coast, and the scanner was bought largely by donations from local residents and businesses. We done good.

Back in the day of the Back the CAT campaign, it was impossible not to throw money at it. It seemed like a portion of every dollar you spent on the Sunshine Coast went to the campaign.

Plus there were profits from fundraising raffles, concerts, garage sales and pancake breakfasts, and then there were those collection tins. They were everywhere, and the glares of the nearby public demanded that you drop in a few loonies and twonies. (If you're reading from outside Canada, that's what we call our money. Really. No, we don't call our banks "loonie bins.")

I wondered if a CAT Scanner was the best use for all that money raised, if it might not be better spent upgrading the operating room, or making the parking lot spaces a bit wider for those of us who don't drive a Smart car.

In those days, people were sent to Vancouver for their CAT Scans. This involved several hours' driving and a ferry trip, blowing the whole day for a ten-minute procedure. I've had at least half a dozen CAT Scans at St. Mary's Hospital, and I'm thankful that I didn't have to make that trip to Vancouver for each of them. I'm also thankful that I never once needed a CAT Scan before the machine was installed at St. Mary's.

One of these scans turned up cancer, even though Dr. Cairns thought the "wee spot" was scar tissue from the bronchitis, pneumonia or t.b. that I couldn't recall having. I'm thankful that I moved on to Dr. Ingrey, who refused to dismiss the wee spot, and I'm thankful for that CAT Scan at St. Mary's Hospital.

It's a cool machine that wouldn't look out of place aboard the starship Enterprise. The "Computerized Axial Tomography" procedure is typically fast and painless. This morning I enjoyed breakfast and coffee, verboten in so many of the tests I've been subjected to, and there was no inconvenient prep such as three days of fasting or a high-octane laxitive the day before.

All I had to do was drink water, more water, and more water after that. St. Mary's Hospital is half an hour's drive away, on a road that needs an election to get rid of its bumps, wows and potholes. Once there, I sprinted to the automatic doors of the hospital, squirmed while they opened enough for me to squeeze through, then bolted down the hall and around the corner, nearly coliding with a patient being pushed in a wheelchair. I was thankful, very thankful, that the single washroom in that wing of the hospital was not occupied.

The water is required to flush one's kidneys of the somewhat toxic contrast medium used for the scan, and it's best to drink too much than not enough. So, $3.50 for two more bottles of water, sign in, sit and wait. Must keep drinking water. A good half-hour later, I'm summoned to the room housing the CAT Scanner and directed to lie down on a sheet-covered slab. My knees are raised on a triangular piece of foam and my head is strapped down.

I don't know why these rooms are kept so freakin' cold; it feels like about 60 degrees Fahrenheit (15-16 Celsius), but the technician kindly drapes a soft, pre-warmed blanket over me, on top of the lead blanket covering the areas they don't want to see. I feel like a dish of lasagna, prepared in layers.

Now I'm lined into an i.v. drip of salt water, and I'm so wishing I hadn't drank all that water. I'm told not to move an inch, and the technician leaves the room, unaware of the heroic effort I'm making not to jump up and dash to the washroom.

The CAT Scanner fires up, sounding like an SR-71 Blackbird's jet engine warming up for takeoff, only not that loud. With a series of clicks, the slab creeps horizonatlly into the maw of the machine, carrying me into a white tunnel. I realize that life must be hell for claustrophobics. There is a pause, then I'm slid back out of the tunnel. Part One is complete.

Part Two involves waiting, unmoving, for several hours. Okay, it's only five minutes, but I'm dying to go to the toilet and ever second drags on forever.

Finally, the technician ditches the salt water i.v. solution and replaces it with contrast medium, which is really radioactive dye but "contrast medium" sounds so much healthier for something thats going straight into your vein. I've had so many CAT Scans, PET Scans, MRIs and X-rays in the past year that I do not understand why I don't glow in the dark.

As the technician begins the dye feed, she says in a perky voice, "You'll feel like you peed yourself but you haven't!" It's been over half a century since I've peed myself and I can't remember what it feels like. It feels very warm in the area of my crotch. I think with horror, maybe I really have peed myself, all that water and all that waiting has my poor bladder screaming for relief.

Now I'm surprised by a sharp, strong, metallic taste in the back of my throat, which wasn't mentioned. Gah! Apparently only some people get this. Lucky me. The bad taste and the crotch warmth subside quickly and I'm thankful to learn that I've not peed myself after all.

Now the turbines fire up again, the clicking starts, and I'm moving into the snug white tunnel for a second time. I wonder if a Freudian psychologist with a sense of humour might call the CAT Scan a "Pussy Scan," given their fondness for back-to-the-womb symbolism. I wonder how they perform a CAT Scan on a really big person. They certainly wouldn't fit into the tunnel. Maybe they have super-size CAT Scanners. Then, the slab kicks into reverse and I'm back in the room, unhooked from the i.v., unwrapped and sent on my way.

I am most thankful to finally get out of that teeth-chatteringly cold room and back to the bathroom, not a second too soon!
  

latex, leather and chains

                  
Today I had blood taken, nothing unusual for a cancer patient.

I've had it done a hundred times before, at least. Sometimes it's a disaster, sometimes I don't even notice. Today it was way up there on the scale of Simple Procedure Done Well. A little jab, hardly pain, and that was it. The way it should be.

Why, I've wondered, do some medical professionals butcher such a simple procedure? I've had them repeatedly try to hit the vein, and miss (I have good veins). I've been left with bruises up and down my arm like a downtown eastside junkie. I've had shockingly painful experiences when the needle was inserted. It's not rocket science, why aren't all of them competent?

At one memorable St. Mary's Hospital fiasco where a nervous nurse repeatedly and painfully injected a large needle under the skin on the back of my hand, but couldn't manage to hit the vein, I suggested she go out on the street and bring back a junkie to do the job right.

Okay, I know that wasn't very nice, but I wasn't feeling well and that sometimes deteriorates my usually patient and kind disposition. She left, not to find a junkie, but to send back another nurse who slid the needle into the vein, first time, no pain.

Maybe nurses who can do the deed well should have a little badge on their uniform pocket. Like a Boy Scout badge, maybe with a brightly embroidered drop of blood or a syringe. I think they deserve recognition for their skill. Plus, it would warn unsuspecting patients, when they encountered a badgeless blood-taker or injection-giver, to grit their teeth because it's gonna not be nice.

One nurse told me that she was never trained to give an injection. What the fuck? How can you not be trained in this frequently performed procedure? Anyway, that was her excuse. She blamed the current Liberal government for their "heartless" cutbacks in medical funding.

I wished that the union would back off on their Poor Underpaid Nurses rhetoric. Nurses have no choice about belonging to the union, and paying the substantial union dues, so it's not like they're in danger of losing members.

Sorry, I digress. Back to the blood sample.

Today, I noticed that the nurse did not wear the ubiquitous latex gloves, and I asked her why. She explained that she was trained decades ago, when frequent handwashing was as automatic as breathing, and that she relied on a sense of feel that was compromised by the latex. Certainly, I barely felt the needle going in and she nailed the vein, so maybe that was a factor.

Nurses, like all front-line medical workers, are at a higher risk than an accountant for needle-stick injuries, which could result in infection with AIDS or hepatitis. We talked about how ridiculous it was to wear latex gloves as a safety precaution. Think about it: is a thin layer of latex going to prevent a needle-stick injury? Not.

I religiously wear latex gloves when making wine because even one rogue yeast particle can ruin an entire batch. Making wine, your hands are moving over a large, open primary fermenter, and a tiny particle that might have been hiding under a fingernail might find its way into the mix. It's the only time I wear them, and I don't like it. They decrease my sensory input, and make it difficult to do manual tasks such as ripping open a tiny yeast package. I certainly wouldn't want to put a needle into a vein while wearing them.

But are the gloves really necessary? Do they do any good at all?

The latex-glove craze started in the 1980s when AIDS was new and no one was certain how it was transmitted. Hepatitis C was yet to be identified as a disease transmitted exclusively by blood-to-blood contact. Someone came up with the latex gloves idea and I wonder if it was to protect medical professionals or to give a (false) sense of security to patients?

I remember a nurse coming into my hospital room with that wheeled cart holding numerous vials of blood samples, and she was heading for my arm to get my sample. She was wearing latex gloves.

She took my blood and moved to the next bed to take that patient's blood. Still wearing the same latex gloves that she wore when she came into the room.

So, it seems the gloves are to protect the medical professional rather than the patient. But, think about it. We already established that the flimsy gloves aren't going to stop a needle-stick injury, so that leaves open wounds on the medical professional's hands. Wouldn't they put a freakin' Band-Aid on it? Problem solved.

But, everyone working in a clinic or hospital or ambulance or first-aid shack, touching a patient, wears the latex gloves. Environmental awareness aside (how long does it take for a pair of latex gloves to decompose in a landfill?), just what is the point of wearing these gloves?

They decrease one's manual dexterity, don't offer much protection, and very well may instill a false sense of security that results in sloppy hygiene. I would much rather have the nurse or other medical professional be obsessive about handwashing with antibacterial soap.

Sorry, I don't really want to talk about leather and chains. Maybe another day.
     .

rebooked and unquit

My original surgery date was May 3, but I cancelled that in a state of uncertainy and occasional bouts of panic. We're talking about cutting out most of my left lung, so it's not a casual decision, not like whether to have salad or fries with that sandwich.

I still don't know whether it's the right decision but, on May 12, I agreed to sign up again, and this time I'm determined to go through with it. After all, if I died becaue I didn't have it, I'd feel pretty silly, now wouldn't I? Dr. Ingrey sent the request to my surgeon, Dr. Evans, and the first word on the page was URGENT!

Ever since, the sound of the telephone leaves me cold. Is it my summons to a Vancouver General Hospital operating room? Is it the beginning of a lot of pain and downright inconvenience for the rest of the summer, at least? Total strangers, even telemarketers must wonder why I seem so happy to hear from them. My phone rings about a dozen times a day, so it's lots of little rollercoaster rides.

This morning I decided it best to follow up on the referral. Just in case. You never know, sometimes these things get misplaced. Plus, there was the fury of Dr. Evans' secretary when I cancelled last month. I didn't really expect that she was mad at me enough to lose the referral, thinking it best that I die as quickly as possible but, still, every day without a phone call made me wonder.

"Dr. Evans' office."
"Hi, this is Myrtle Winchester. I'd like to follow up on a surgery request from Dr. Ingrey in Pender Harbour a couple of weeks ago."
"You want your surgery date." No, this was not a question.
"Um, yes!"
"June twenty-second. Admit on the twenty-first between one-thirty and three-thirty."

After a pregnant pause long enough to make it clear that she had nothing more to say to me, I asked, as politely as I could manage, "When was the surgery scheduled?"
"A few weeks ago."
"Why wasn't I notified?"
"Because I was on holidays."
"When did you get back?"

This wasn't a pregnant pause but an angry one. Then...
"I got back Tuesday morning."
"Okay..."
"Good. Bye." Click.

Right. Not making any new friends today, are we Myrtle? Oh well, June 21, so I have a bit of breathing room. No pun intended, but it works. June 21, the first day of summer, the Summer Solstice. I'm sure this will be one to remember.

Did I mention that I unquit smoking?

The day I un-cancelled the surgery, I decided that a few weeks of cigarettes wouldn't make a big difference in my lifespan, and a few weeks of smoking again would certainly improve the quality. I like smoking and, although I quit nearly four months ago, it wasn't going well. Not going well at all.

There were times when I almost could have chewed off my arm for a cigarette. You know how they say it's so much easier after three days, three weeks, three months? They lie. The gum took the edge off but I couldn't quit the gum. I guess methadone addicts feel like this when they trade heroin for a more socially acceptable but equally addictive drug.

The first drag of that first cigarette tasted... well, strange, but not unpleasantly so. You know how they say it will taste so bad you'll feel like puking? They lie. By the end of that first smoke, I was enjoying the flavour as much as a fat slice of Billy's strawberry cheesecake. Home made with real whipped cream and fresh strawberries.

You know how they say the first one puts you right back to smoking as much or more than you ever did? They lie. Well, maybe not an outright lie, but an exaggeration for sure. The first couple of weeks I was smoking no more than half a dozen a day, and not really wanting more. A cigarette killed the craving like the gum never did, so after a smoke I forgot about smoking for hours. The gum didn't work quite like that.

And, yes, you're right. I'm rationalizing. I'm an addict and a spineless one at that. I'm also the reason lung cancer doesn't fare so well in the cancer family of national fundraising events, even though it's the cancer which kills more people than any other. Fundraising is all about marketing, so it's not hard to figure out why lung cancer isn't so popular a cause.

First and foremost, it's the cancer associated with smokers. Dirty, nasty, evil smokers. They deserve to get sick and die, they are 100% responsible for their cancer and they deserve what they get. Of course this is wrong, many non-smokers die of lung cancer, but who cares when you're deciding which disease to give your money to.

Next, lung cancer rarely occurs in children. Children are the best prop in any fundraising campaign. Where do you think the term "poster child" came from? Almost everyone loves babies and puppies, so huge dollars go to children's cancer research. And the SPCA.

Finally, there's breast cancer, which is the most common type of cancer but far from the deadliest. But, more people support breast cancer research than any other. Hmmm. Could it be the breast thing? Breasts are motherhood, breasts are sexy, breasts provide nourishment and fill out clothing nicely. And men love breasts. Breasts can make an otherwise rational man throw away his money, and we've all seen it happen. I'm not saying it isn't a good cause, but we can see why it's so successful.

But, lung cancer, well it's just not got a good hook. I also feel badly for the rectal cancer fundraising teams, because they've got their marketing work cut out for them too.

Some years ago, when I ran a store in downtown Madeira Park, I was accosted by fundraisers on an almost daily basis. The Cancer Society, Stroke Foundation, SPCA, Volunteer Firemen, Girl Guides, Music Society, Coast Guard Auxiliary, Seniors Housing Association, Legion, Lions, Rotary, community clubs, various environmental groups, school classes wanting to go on field trips and on and on and on. I simply couldn't give money to everyone, so I had to identify criteria for who got my donations.

Say you have $100 to give away. Who deserves it most? Where will it do the most good? Is it better to give 100 groups a dollar each or give it all to one? Is it more important to support people trying to cure a fatal disease or those providing shelter for unwanted pets? Underprivelidged children going to summer camp or volunteer firefighters saving lives? A new piano for free music lessons or affordable housing for seniors on a fixed income?

Well, of course they're all deserving and all the causes are good ones. So you can't decide, you can't give more to one and less to another and you can't afford to support them all. Ultimately it gets down to the person in your face with their hand out for a handout. If it's someone you know, it's a lot harder to refuse. And that's how irresponsible we are in deciding whether to help find a cure for a fatal disease or help buy a gleaming new baby grand.
 

undead like me

"Rumours of my death have been greatly exaggerated."  

Mark Twain.

I used to publish the local paper. In fact, I started the Harbour Spiel and ran it for 15 years before selling it to my friend Brian Lee in 2006.

The Spiel was, and remains, pretty much a one-man show, which is about the only way a small-town publication can survive.

The publisher is also the editor, reporter, photographer, ad designer, layout artist, bookkeeper, salesperson, janitor and bill collector. You can see how the line blurs between the person and the paper.

Brian and I agree that the Spiel is a big part of Pender Harbour, and for a long while now he's wanted to do a story on its early history. Last month we got together in my living room for The Interview, conducted with the tape recorder rolling while we ate pizza and drank wine. It was fun, as a visit with Brian always is.

He titled the story, "The Myrtle Years," and made it the main feature of this month's issue. I have to admit I'm pleased with the story. Like the photographer who never has their picture taken, I've never had anything written about me before. Well, there was that item in the Police Report a few years ago, but we don't need to bring that up.

Brian concluded the article with a mercifully unsentimental mention that I have cancer an am documenting the experience in (this) blog.

Today I met a woman I'd not seen in some months, and the first thing she said was how great I looked. I thanked her.
"But you look so good, you look so healthy!"
I thanked her again.
"I thought you were dead," she said, somewhat accusingly.

That would most surely explain why I looked healthy to her. Few corpses have any colour in their face (okay, I was wearing makeup), never mind drinking coffee and bopping around Madeira Park in the sunshine. We all know The Vampire Diaries is fiction.

"I read the article about you in the Harbour Spiel," she said.
I expected her to say that's how she knew I had cancer, and maybe someone had mistakenly thought they heard, and repeated, that I'd died. You know how small-town gossip goes, like the Chinese whisper game.

But, no, she wasn't going to let herself off that easily.
"I thought it was your obituary. It said 'The Myrtle Years'."

Right. Well, the whole exchange really was quite comical, and I know how it is with writing. No matter how hard you try to second-guess how someone might misinterpret something, there will always be one reader who will entirely miss the point or come to a seriously incorrect conclusion. No big deal, and it's a funny story to tell at the pub.

Which I did, later this evening, sitting with a few people I know. Everyone laughed. Everyone except for one woman (I'd known her for years) who looked me straight in the eye, directly across the table, unsmiling.

"I read the title and put it down. I couldn't read the rest. I thought you were dead."
Her chilly tone made it clear that I had quite some nerve to be sitting there in front of her, breathing and talking, eating nachos and drinking wine and, well... being alive, after my obituary was published in the Harbour Spiel.

I won't be telling the funny story, any more, of how someone assumed the early history of the Harbour Spiel was my obituary. At least not to anyone who reads the Harbour Spiel.

If you're wondering about that article, you can download the .pdf file to read the May edition of the Harbour Spiel. "The Myrtle Years" starts on Page 14. And, no, I'm not dead.