This is not the column I started to write last week. Not the irreverent flip-off to sellers of “natural” products that contain grossly unnatural ingredients. That will have to come later, after more pressing problems are resolved.
For the past week, I have been seeing, up closer and more personal than I ever dreamt, the process by which modern medicine corrects the maladies incurred by a life of total disinterest in health, nutrition, exercise and all the ways people can improve their chances of living to see their great-grandchildren.
This was an affair of the heart, literally and figuratively, this bedside vigil at Veterans Hospital in Westwood, where my significant best friend came finally to grips with a lifelong indulgence in red meat, deep-fried everything, all dishes made of butter and whipping cream and a particular affection for Gitanes and single malt scotch, the brands with Glen-something on the label. Add to that an irrational disdain for brisk walking and one could see he was headed for this rendezvous with the VA surgical team.
And lucky he is that they are gifted and dedicated in a way seldom seen in HMOs. I would suggest that anyone who recoils at the mention of socialized medicine take a closer look at the care given free to the nation’s veterans, administrated by the federal government and absent the profit motive that afflicts most private sector medical practice.
It all began a few months ago with slight angina, for which his local VA doctor prescribed nitro glycerin, cholesterol lowering drugs and a battery of tests. A “chemical” stress test turned up negative for abnormal heart function or blocked arteries, but his doctor wasn’t satisfied. He was referred for an angiogram April 9 at the Westwood hospital, which showed more than 50 percent blockage of the main coronary artery. He was immediately admitted, and after two days of pre-surgical work up, scheduled for a bypass. The average HMO doctor, in the five minutes allotted for consultation, would probably have sent him home only to wind up in full cardiac arrest at an overcrowded ER somewhere. Bless the VA.
Thursday morning he was wheeled into the O.R. for a six-hour procedure known as a quadruple bypass. In this surgical equivalent of a chain-saw massacre, the chest is split open, a length of femoral artery is pulled out of the thigh and spliced into the offending coronary arteries.
When I walked into the surgical intensive care unit, I was sure I had the wrong room. There was a bed, and under a crisp white sheet lay a body with tubes attached to every orifice, IV lines hooked to every vein, needles in every appendage. Machines monitored every bodily function in wavy and jagged colored patterns and digital readouts, the numbers of which corresponded to nothing I understood. The sound of gurgling water came from the floor on the far side of the bed, where two vacuum pumps sucked sanguineous fluid from two hoses attached to his chest. A wonderful man in green scrubs named Ernie checked the machines, the IV lines, the catheters, every few minutes, taming the pain with morphine, careful not to give more than was consistent with the rate at which his lungs oxygenated his blood.
Somewhere under all that equipment was the man I love. His eyes fluttered once or twice, and I held the only inch of his hand that didn’t have needles in it, but it would be days before we heard the weak, rasping sound of his voice.
I admit that I am no good at this. There’s not a single Florence Nightingale gene in my body. His daughters are much better advocates, sensing when he needed ice chips, asking Ernie for more pain medication, asking questions, reading his answers through hand squeezes and eye blinks.
By the second day, they were sending me on errands. Good thinking. I badly needed to get away from those machines. While I was searching for jazz tapes and headphones, Ernie removed tubes one by one, stitching the skin after, apologizing for the pain not adequately covered by drugs.
After three days, I came down with laryngitis, some kind of weird sympathy pain, I guess. It’s the first time I’ve had so much as a cold in about six years, so it must have been some psychosomatic thing that would excuse me from hospital duty. So I went to his mountain cabin, picked up his mail, made his bank deposits, called the plumber to repair two broken faucets in his house, watered his cherry trees suddenly in full bloom, took his laundry home with me. These things I can do, need to do, to feel useful, to make up for escaping the hospital.
He can eat a little bit now, so Monday I’ll bring homemade soup, maybe poached salmon or a vegetable frittata (egg whites only). And hold the butter and whipping cream.