It was Sunday, 8am. The car was loaded - CD’s, snacks, maps, and my own big-font back-road directions. I was headed to Lake Dreher in South Carolina to camp a night with my high school friend Emily, and then to Chapel Hill for four nights with Luli. Freedom! Giggles! Long intimate talks! What could be better? I had just buckled my seat belt when my cellphone rang.
It was Luli, but not lively Luli. It was her dead voice. She was speaking from the abyss. “Lizzy, don’t come. I can’t have houseguests. I can’t see anyone.” I had never heard it so bad, though I’m careful not to miss our daily phone call when she’s depressed. Of course, when she’s at the bottom, she doesn’t answer the phone.
I called Luli’s psychiatrist, who told me to come right away. I called Margaret, Luli's good friend and neighbor, who promised to keep an eye on her. I called Emily and told her my sister was sick and I was going straight to Chapel Hill. Ten hours later I was driving in the dark, lost as usual in the surreal meanderings of 15-501. I called the motel Joe had booked for me. It was only two blocks away, and in a few minutes I had collapsed on the bed. Luli refused to see me, but agreed I could call her in the morning.
In the morning, she said Margaret and I could come over after breakfast, and the first thing she said when we arrived was, “My sense of humor is returning.” Luli’s depressions can go on for more than a year; this had been only twenty-four hours. She wasn’t all the way out of the pit; she lacked energy and had that frailty of someone who has just emerged from a nightmare. Still, Luli was back. Despite a sharp pain in her gut, which she attributed to a new iron prescription, she was ready to visit. We settled her on the couch with a heating pad.
By mid-afternoon she told me to cancel the hotel and stay with her. Nausea had joined the pain, but she remained pretty cheerful. I ate a delicious supper of salad and Luli’s frozen clam chowder. She ate a few bites of yoghurt and threw up. She persisted in blaming it on the iron pills.
It was 2:30 in the morning when she woke me up and said we had to go to the emergency room. I found the directions on Mapquest; at that hour there was no traffic, and it was a straight shot and short drive. Or it would have been had I turned left intstead of right on Columbia - I blame Mapquest but it certainly could have been me. When I knew I was lost I pulled over, turned on my flashers, and called 911.
As I had hoped, a police car pulled up. Officer McDonald said we could wait for the ambulance or he could lead us to the ER, a mile away. I chose that. Luli was in no condition to choose anything - she was doubled over in pain, which now stretched from her belly to her breast.
The parking lot was full. Officer McDonald, his name now inscribed in the Book of Good Deeds, told us to inform the receptionist we’d left our car in the driveway. The waiting room was even fuller than the parking lot. I muttered to Luli, “Tell them you have chest pain.” In classic Eder-family fashion she began by minimizing it, so I interrupted and said, “She has chest pain and vomiting.” We were in triage in less than a minute, with a kind, plump doctor who sent us back immediately to the “cardiac room” a big room with one bed, one plastic chair, and many monitors and machines, right across from the nurse’s station.
Mary Scott, a lovely 14-year old nurse, spoke soothingly as she took Luli’s vital signs, set up monitors, started the IV and - Hallelujah - began the morphine. I sat on the chair, covered with coats and purses, and watched Luli’s lips slowly curve upwards.
Luli is not a whole lot sillier on morphine than she is in real life. She was back, and she proceeded to charm everyone who came in the room, flirting and joking and making it clear that there was a real person underneath all the tubes and monitors. While she enchanted the staff, I wrote down everyone’s name and what they told us.
At 7 o'clock the shifts changed, and brought a new nurse, Peter. Like Luli, he was a New Yorker, and they talked about neighborhoods and theater and everything New York while he learned all about her condition and did a thousand medical things. If he hadn’t been living with his fiancé, I think he would have asked Luli ro marry him. I asked him if we could turn off the lights so we could get some sleep. He had only been at UNC a few weeks, and though he looked all over the room he couldn’t find the switch. He went out in the hall, crossed his fingers, and flipped a switch. “I hope this doesn’t turn off anything important.” The lights went out, an aide found a recliner for me, and we slept a bit.
Nurses work REALLY hard. image:mlive.com
I was too tired to be tired; Luli was drugged. Coffee for me, X ray, CAT scan, blood tests for her. A resident came in with the results - there’s a hernia and an intestinal blockage, we’re going to consult the cardiac team (Luli has a bad heart valve) - and he was gone. Luli was still on morphine, she didn’t care. But I knew “intestinal blockage” was serious. And I didn’t know what they were going to do about it, or when, or ANYTHING.
I went looking for Peter, who was watching two monitors, writing in a patient chart, and eating a bagel. He didn’t know who the doctor was, and I couldn’t remember his name. But shortly afterwards a tall blonde woman came in followed by two young women and a man. They were the surgical team, led by Dr Dreisen. She introduced herself to both of us and carefully explained what they were going to do, down to the different types of mesh they would use depending on what they found inside Luli. If the piece of intestine trapped in the hernia were healthy, things would be pretty simple; if it were infected or dead, they would do a bowel resection.
Luli was still stoned, and still charming, but she was calm and lucid. She asked about the possibility of a colostomy. She told about the nightmare of her week-long UNC hospital stay seventeen years ago after a pulmonary embolism, when ineptitude, neglect and cruelty reigned. Dr. Dreisen apologized for what used to be, and assured her they would take good care of her this time. As soon as they had consulted with cardiology they would get her into surgery.
In less than an hour I was following Luli’s gurney all over the hospital and in to a pre-op cubicle in the surgery suite. Another team of three came in, led by the anesthesiologist who specialized in cardiac cases. She was as clear, thorough, and kind as Dr. Dreisen, and even taller. She questioned Luli at length, and responded to each answer with “Awesome.” She explained that they were going to lower a camera down Luli’s esophagus so they could keep an eye on her heart during the surgery. After the long interview, which included medical and personal details, and Luli’s somewhat strained wit, she concluded that we were both awesome. My concern at having a twenty-year-old responsible for my only sister’s heart was allayed by her awesome knowledge of all things cardiological and anesthesiologocial, and the clarity of her explanations.
I sat in the surgery waiting room with all the other people whose loved ones were being cut open. I was exhausted. I was scared. I had a raging case of cystitis and was desperate for pyridium, the pain-killer. I asked the very kind volunteer where the nearest pharmacy was, and she told me there was one in the cancer hospital. I walked and walked to the far end of the complex, to discover that this was the pharmacy where outpatients got their prescriptions. I walked back to the other end, and almost cried when the volunteer in the little sundries shop said yes they had pyridium. I swallowed two on the spot.
It's really four hospitals, and VERY large
I returned to the waiting room, and then Luli’s friend Kathy showed up to keep me company. We talked about everything. Though she was dealing with her father’s severe medical emergencies, her mother’s distress, and the imminent death of an old friend, she was going to spend the night with Luli in the ICU.
At about five Dr Dreisen came out, gleeful. All had gone well, they’d shoved the healthy intestine back where it belonged, and patched up the hernia. From that moment, things just got better and better. Luli is a 71-year-old woman who works out vigorously five days a week. They kept her in the ICU because of her heart valve, but she recovered ridiculously fast. We had gone to the ER at three in the morning Tuesday, and left the hospital at noon on Friday. I stayed with her till Monday. Four weeks later Dr. Dreisen told her she could return to the gym and resume her regular workout, with the exception of the rower and Pilates.
Hospital World makes the outside world disappear. There’s nothing but long corridors and elevators, bustling people in scrubs and white coats. I must have encountered two hundred people at that hospital: desk clerks, doctors, orderlies, nurses, cafeteria workers, aides, housekeepers, medical students. I met them at length as they cared for Luli, or briefly as they served me a meal. In elevators they greeted me with “How are you doing?” At the information desk they helped me find Margaret - I was waiting for her in the Corner Café; she was waiting for me at Starbucks. Fourteen hours after we’d arrived at the ER, when Luli was out of surgery and settled into the ICU, I went down to see about my illegally parked car. The parking lot attendant: “We were trying to find you, we didn’t want to have it towed, we paged you, aren’t you Gonzalez?” And there was my car where I had left it.
Clearly management has set the tone for this hospital. I suspect the head honcho is a nurse, because the focus is on the patient, and families are welcome, even in the ICU, where the patients are in private rooms instead of multiple beds around the nursing station. The predominant note is kindness - I think they pump it through the ductwork - followed immediately by knowledge, technical skill, and clear communication. We only encountered a couple of staff who need some coaching: the resident who delivered bad news with no explanation and then disappeared, and a housekeeper and transport orderly who talked non-stop, wearing us both out.
I have read that hospitals are making themselves over, with fine cuisine and chic decor. I don’t care about that. What matters is people who remain humane as they deal with crisis and killing workloads, who know that what is routine and ordinary to them is unique and frightening to patients and families.
I don't want lobster (Lenox Hill Hospital image:NYPost.com)
Even with the best of staff, no one should be alone in the hospital. And no one should be alone waiting to hear the news after surgery. Kathy distracted me in the waiting room with videos of her grandbaby; Margaret organized Luli’s friends and shared night duty with me and Kathy, while other friends spelled me during the day. Staff were impressed by the support, and the anesthesiologist said, “I don’t think my sister would do that for me.” In our case it’s payback. Years ago I arrived at Luli’s house with the flu. She spent a week taking care of me with garlic soup and single malt. After each of my knee replacements she came to Gainesville for a week. She cooked delicious dinners every night, and left us with a freezer full of stews, soups, and chicken pot pie.
It was an unusual vacation, not at all what I had hoped for. But this dramatic and terrifying emergency, which in the end was merely a hernia repair, brought several unexpected benefits. My sister and I are closer - I wouldn't have thought that possible. I got to know Margaret, who is my kind of people. And Luli, whose brief depression had been brought on by the prospect of cardiac surgery at the place that had ill-treated her so long ago, saw that UNC Memorial had been transformed. She met and admired the cardiac team, and learned all about the proposed valve replacement. I can't say she's excited about the prospect - she'd probably prefer a week in Paris - but she's not dreading it anymore. She'll probably get it done sometime this summer. And I bet that by Labor Day she'll be back at the gym.