A personal reminiscence of a hospital episode, with all the names changed to protect the anonymity of real people.
The night was awful. Nightmarish. I didn’t attempt to sleep until close to midnight. The sounds around me of old men in pain or discomfort were psychologically disturbing while I was weal, vulnerable, and susceptible.
Some of that frailty was exposed by my experience earlier in the afternoon, when I insisted on taking a shower. The anaesthetic had completely worn off by this stage, leaving me feel brittle and worn.
Taking the shower meant being assisted into the bathroom, with nurse Breena holding my piss bag and tubes, while I wheeled the drip stand, holding two big three litre fluid bags that were constantly flushing my bladder.
There’s a strange kind of intimacy between a shattered middle aged man and any woman standing in for mother, helping him to peel off a blood-soaked hospital gown, paying no attention to his penis, sprouting the obscene catheter tube branching out into three lines—the input, the output, and the capped channel used to inflate and deflate the saline-filled balloon in the bladder that keeps the whole thing in place.
And there’s a strange kind of pride in being able to manage, on my own, to peel away the pieces of absorbent underlay material I had been lying on that was now glued to my buttocks by the iodine and blood it was designed to absorb. To shower with a plastic bag over my right hand, protecting the cannula painfully inserted into one of my metacarpal veins. To juggle the tubes hanging freely under my penis, suspended solely by the water-filled balloon inside my bladder, exerting an unnatural kind of pressure. Letting me know my fragile state with every movement, no matter how careful.
But that pride is just a mask for the total helplessness I felt in my state. Getting back into a hospital gown, with my arse hanging out naked at the back, and onto a freshly made bed, with the large square of quilted absorbent material on the sheet, presaging that I would bleed more. Leak more. Be in this helpless state more.
I’m no stranger to hospital exploits, and this procedure was explained to me as routine, requiring only a couple of nights stay for observation. For 8 months I’d been plagued by one or more stones in my bladder, which were causing me to bleed internally as they scratched away at the inside of my bladder with every movement. This had worsened progressively, until even a moderate walk would mean I’d need to urinate blood. It was not a procedure I could avoid or delay. Chances are the stone had developed over a period of years, but had gone undetected until it gave me overt trouble.
Routine or not, I confess that the procedure scared me. In a completely irrational way. I’ve had far worse and riskier treatments. But this one seemed to catch me after months of feeling progressively more vulnerable and old. Weak, tired, and afraid. Not a feeling with any redeeming features.
After my shower I tried to busy myself with scribbling notes, and not thinking about the hospital food. It was inescapable that I was no longer young and resilient, the way I remember previous hospital sojourns. But I tried very deliberately not to feel too sorry for myself. My lover rang, and so did a friend, offering me comfort that I might have dismissed in earlier years, but that made me feel better despite the corniness of it all.
Night fell. I tried to avoid it with Jules Dassin’s 1955 noir classic Rififi, some of Jacques Deray’s 1974 stylish thriller Borsalino & Co, and one of Ross Macdonald’s Lew Archer novels, Sleeping Beauty, all accessed on the laptop I had brought along for exactly that purpose. A small saving grace. I did drift off to sleep at some stage. I remember dreaming of being chased by a Nazi zombie, and trying to work out how to decapitate him. But I never quite got there. I was condemned to just be chased.
I woke badly at around two, when the night nurse tried to take my readings (blood pressure and temperature). I must have pulled on the tubes awkwardly while turning in bed. I was in sharp and ongoing pain for quite a while, and I bled alarmingly onto the absorbent underlay, which acted like a big sanitary pad, whose sticky discomfort would be with me until at least dawn. The night nurse gave me analgesics whose name I can’t remember. The drugs zoned me out and let me sleep until she came the next time at 04:30.
By that time I refused pain killers. The last lot had dried out my mouth and made me feel hung over. Instead I asked whether there was a place where patients could make tea or coffee. She offered very kindly to get one for me. Coffee. White. No sugar, please. I had it in minutes. Cheap and nasty instant that tasted like heaven.
The rest of the ward was finally in silent routine. Until way after six. When the night shift was rotating out. I decided on another shower, and managed it mostly on my own this time, returning to another freshly made bed, with the inevitable new underlay to remind me I wasn’t done yet.
In one of those execrable pieces of timing you find in large bureaucracies, the doctors in the hospital make their rounds at the same time as breakfast is being served. Not that they interrupted my meal. Two individually cellophaned, limpid slices of multigrain bread, with two single-serve patties of margarine, and two single serve tubs of Vegemite. Plus some alleged tea–someone’s used socks recycled optimistically as ‘King of Ceylon’ teabags. They always give you an extra teabag, knowing the first alone will barely colour the hot water.
The doctors came as a gaggle. So young and earnest. At least mine weren’t those arrogant white boys in their RM Williams boots and chequered shirts, affecting country-boy, private school, rugby team, boofhead credentials. What kind of doctor wants you to think of him as a country boy rugby player? What sort of confidence could any sane person have in such a doctor?
My ‘consultant’ was an Asian surgeon, Dr Esler. I greeted him with: ‘Please tell me this thing’s coming out’, pointing at the tubes snaking out obscenely from under my hospital gown.
Esler pursed his lips and nodded curtly like a Prussian military officer. His glasses and abrupt way of talking made him seem almost like a cartoon character lampooning a Japanese monster film scientist.
He told me how he had pulverized the ‘massive’ stone with a laser. How he had incised the neck of my bladder. He stated succinctly that the frontal lobe of the prostate needed to be shaved back to prevent it from pushing up the bladder, leaving a lagoon in which stale urine would pool and eventually solidify into another stone. How absurd. These things aren’t really stones. They are crystals formed by the minerals left behind when the bladder is not fully emptied every time, as mine hadn’t been for years, because my prostate was pushing on the bladder to create a small sink below the line of the urethra.
Dr Esler didn’t explain exactly what he’d done to my prostate–that little gland that secretes the seminal fluid which transports sperm. But he did say he had to shave it away. How clinical. I still don’t know whether that means he removed the entire lobe facing forward, or just part of it. My GP will have the clinical notes, and will explain. I suppose I will find out soon enough what his little procedure cost my future amorous intentions. One of the risks he so carefully explained to me in the pre-op consultation a couple of weeks earlier is of ‘retrograde ejaculations’. Nothing coming out. All being sucked back into the bladder. I suppose i will find out soon enough.
I managed to extract from him the promise that if my catheter fluids remained largely bloodless for the next few hours, I could leave that day!
Time passed. More McDonald on the laptop. Eventually, the ward nurses came to do their own rounds.
They did something quite mysterious, bloody, and prolonged behind the curtains of bed 12, opposite me, occupied by Ray Gorman. A vacant-eyed, slack-jawed, open-mouthed, wizened old man who talked in his sleep and used his bed adjuster all night like a little kid: Dzeeee, dz, dz, dzz, dzeeeeeeee, dzz, dz, dz, dz, dzeee. At least five minutes every hour. He received bad news that day about a prostate operation he will have that night. The news led to the making of powers of attorney, a lengthy discussion later about the conditions under which he would not want to be revived, and a series of phone calls in which he was saying goodbye to the people in his life.
The contrast made me feel guilty about being annoyed by his night-time antics, but also impatient about having my catheter removed so I could run away from the hospital as fast as I was able.
The nurses moved on to bed number 13, diagonally opposite. Antony Overton, the whiteboard above his bed said. Only slightly younger than Ray, he was headed for temporary accommodation until his next procedure. I don’t know what that procedure would be, but he was talking about three days’ travel to get to the hospital in the first place: he seems to live in the most remote outback. I knew him only for spending all night getting the nurses to arrange and re-arrange his pillows to pamper some horrid injury to his back that was secondary to his urological problem. I cursed him, last night, for discussing his discomfort without any attempt to quiet his voice. He bade me farewell later in the day by saying ‘keep your end up’. An overtly juvenile quip from one so old.
Then they moved on to ‘the lumberjack’ in bed 14 next to me, whose name I never saw. A massively fat barrel of a man from New Zealand or the Pacific islands, who spent the entire previous night either snoring so loud I thought my bed was vibrating, or rustling cellophane snack packets to get at the contents so inexpertly that the rustling took far longer than anyone had ever taken to consume any packet of chips in the 13 billion year history of the known universe.
It seems he was going to another department to get more treatment for a separate back injury. There was a lot of talk about his blood pressure. At his size, I imagined it was sky high.
Finally, they came to me. I had some rapport with nurse Breena and her student nurse offside Dawn. They treated me well the previous afternoon and evening, and I gave them no shit in return, thanking them each time they did things for me, showing polite interest in their trials and tribulations. In return they showed interest in what I was doing: typing my hospital journal on my laptop, the films I was watching on it, and my Calibre eBook reader.
Good news! My catheter bag was mostly clear. Dawn removed my cannula. I was supposed to hold down the cotton wool bud, but let go too soon; blood everywhere. But I didn’t care. That was never the main game.
Breena prepared for removing the catheter by capping the flow of fluid into my bladder. Next she used a huge and menacing syringe, thankfully untipped, to withdraw the saline that inflated the catheter balloon inside me. And finally, she said: ‘This will be a little uncomfortable’ as she pulled out the tube from my urethra.
I can remember few moments quite as painful. Clenching my teeth. Feeling one or two tears stream down my cheeks. Trying to control my breathing in the refined agony of the plastic tube coming away by tearing the gelatinous mass of congealed blood and lubricant.
But I also remember few moments as liberating as the shower afterwards, free of the tubes, and finished off with dressing in my own clothes rather than a hospital gown. I didn’t even stop to ponder the age old question: why do hospital gowns tie up in back, where patients can’t reach? What the hell, I thought, I’ve better things to think about, as I wandered adventurously off the ward, down to the food court, where I ate a decidedly ‘bad’ sandwich that offended against all my new dietary rules but made me feel human again.
What I could tell immediately was that the tell-tale weight and irritation of the stone had gone! No more fear of not being close to a toilet to bleed into. No more irritation every time I moved.
That’s not quite true. I’m still bleeding as I post this story. But only slightly, as an expected part of the recovery. Not as a permanent feature of my life, as it has been for months now.
Back to the ward one final time to demonstrate one more time that I could empty my bladder completely, and to check out formally, with the registrar’s blessing.
In the cab home I couldn’t help but think that all the aimless idiot drivers on the road. and all the people in the street going about their day, were beautiful people whose idiocies or carefree ignorance of people like Ray should be forgiven, if only because I was once again one of them.
One of the carefree people who would not think about others, like Ray, who might have said goodbye to it that night. I will never know.