Surgery in India: What Was I Thinking-The Patient's Perspective (Guest post)

The following post was written by my husband a bit after his surgery.  Please read, imagine, enjoy.

I just had surgery. In India. Before deciding to do it I spoke to several friends who had either had surgery in Pune, or had similar procedures done elsewhere. The overall consensus was – go ahead, but proceed with caution. For example, multiple people told us that I shouldn’t be in hospital alone. I needed an advocate who would argue my corner and also ensure that I was getting the correct medications. I also needed someone there so I wouldn’t be robbed blind. A lot of advice included – don’t take any valuables with you. 

So into the hospital we went, Meg and I. She did an amazing job of arranging care for our three kids for the time I was expected to be admitted.

I was scheduled for surgery on a Saturday morning, and had to call the hospital on the Friday before for instruction. I duly called and was asked what time I would be arriving that day. That day? Nope. The doctor I was talking to explained that he needed to complete a battery of pre surgery tests and that he needed me overnight. I listed off the battery of tests that I had completed the previous day – they matched his list. Great, I thought. He still insisted that I be in overnight for observation or some other BS. I declined. A brief discussion followed and he promised to call back after talking to my surgeon. I was messaging my surgeon on WhatsApp throughout our phone call. An hour or so later the hospital doctor called back and conceded that I could be admitted in the morning. 7AM. 

The next day we arrived on time and started the admission process. “Sir, what kind of room would you like? Standard, Private, Deluxe or Super Deluxe?” I had been quoted the price for a private room and explained that, but also asked what the cost differences were. No numbers were given but apparently the more luxurious your room the more expensive everything is. Yup-the surgery, the medicines, the whateverthehellelese they charge you for. “I’ll take a private room please” was my decision. I’m sorry Sir, we don’t have any available. We will upgrade you to a Super Deluxe room for no additional cost. Glad I didn’t choose one of those and get charged for it then.

After the admission counter it was off to the payment counter to surrender my passport and a deposit of 50,000 Indian rupees. Then back to the admission counter to show the receipt and be issued our paperwork and a room number. Room 614.

We walked to the elevator bank. 2 side by side elevators, nothing unusual. Except that the buttons that are usually arranged ^v were arranged < >. We laughed and pushed the one to go right wondering if an Indian great glass elevator was on its way. Meg later found out that the buttons were arranged that way because the elevators to the left went to floors x through y and the ones on the right went to floors a through b. No signage explained this. We just got lucky.

We exited the elevator on floor 6 and were met with a sky bridge. I don’t love heights much. This bridge was pretty wide, about 8 to 10 feet but had the lowest, most open railings I’ve ever seen at that height. I must have looked like an idiot walking carefully down the middle of the bridge, arms spread for balance. I was not comfortable. We made it across and found the room. Our Super Deluxe Suite.

It looked like a decent, but not fancy American hospital room. There was a hospital bed, a sofa/guest bed. A TV, satellite box, fridge, a couple of metal chairs and a small bedside table. There were also some built in cabinets that included a small safe. The room was ensuite and the bathroom wasn’t too dirty. The bathroom fluorescent light flickered in that awful menacing way reminiscent of a hallway in the DOOM PC game from back in the day though.

So here we were. We got somewhat settled and then a doctor came in. He said I needed to complete a battery of pre surgery tests. I told him I had already done them and showed him the paperwork. He left. We were then visited by a nurse with some clothes for me to wear. I held up the pants. Now I’m not a small man, I have about a 36” waist. The pants said “Large” on them. The waist on them must have been 60 inches. Oh how we laughed. I put my clown pants on and we hung out.

Another doctor then came in. He said I needed to complete a battery of pre surgery tests. I told him I had already done them and showed him the paperwork. I asked him if anyone ever communicated with each other. He left.

The next visitors were a couple of nurses. They wanted to put my IV in. I’m lucky, I have “good veins” and rarely has anyone struggled to access my blood. At first they wanted, as all nurses seem to want, to put the IV in the back of my hand. I declined since this is often painful and restrictive. I showed them my arm. They poked me and missed, moved around a little. Gave up on my left arm. So after dropping the needle onto the bed they moved to my right arm looking for a vein. Once they located one they picked up the needle – both Meg and I yelled “Get a New One”. This confused them. “But Auntie” one of them said, smiling to Meg – “it’s only been in him”. Meg insisted on a new one and off the nurse went. 3 minutes later I had a clean, new IV hooked up in my right forearm. Phew.

I think it was at about this point that everyone decided that Meg was the only one that needed to know what was going on. I didn’t get a say. It’s quite disconcerting to be in the room, conscious and as capable as ever and not have anyone tell you what is going on. You can listen to the conversation, but no one except Meg wanted to include me in it.

The nurse that had put the IV in then told Meg she needed a blood sample and produced a syringe with needle. Use the IV we both said. This confused the nurse so we repeated it several times. “Oh no auntie that is only for putting in things, not for taking out.” She explained, again with a smile that seemed to say you people are idiots.

She then stuck me and drew some blood. From my left arm. The one where she had previously been unable to find a vein. First time. No trouble. Sigh. Next was some antibiotic that needed to be put under my skin to see if I died or something. This was completed without issue but burned like welding spatter.

A doctor came in. He said I needed to complete a battery of pre surgery tests. I told him I had already done them and showed him the paperwork. He then asked whether I had shaved. I felt my face and must admit I was confused. I always shave for the office but not on the……oh, yeah. Down there. For surgery. Nope, I hadn’t. Damn it. He said not to worry he would have the barber come take care of it.

A little while later an older Indian man arrived with a small leather bag that said “barbar” on it. He spoke no English. He grunted at Meg and motioned to the door. We assumed that he wanted her out. I said no, she can stay. We repeated this pantomime a few times and he gave up. He was now grumpy. He trudged off into our bathroom and then locked the door to the room.

When he returned he gestured for me to remove my pants down to my ankles and take my shirt off. Gulp. He then lathered me up with a shave brush from nipples to knees. Taking his straight edge razor he then proceeded to reverse 30 years of manhood and rendered me bald as a bald thing. There’s a certain peace that settles over you when a grumpy old Indian man that you share no common language with has your penis in one hand, an open razor in the other and is deftly removing hair. Wait, that wasn’t peace. Panic. That’s it, panic and an overwhelming need to not move at all. To improve matters, Meg’s sister facetimed her in the middle of the shaving. Of course she answered.

Once the hair removal was complete the barbar returned to our bathroom, threw water all over it, packed his bag and left. I inspected the job he’d done – everything important was still there. However he had left 2.5 hairs right at my belly button. I decided not to complain.

Shortly after the shave of a lifetime a doctor arrived to paint me with iodine. He insisted that Meg leave the room so that she wouldn’t contaminate me. Since I didn’t know if he was involved in the surgery I agreed. I didn’t want a man with hurt feelings working on my insides.

I was thoroughly painted several times and told to let it dry. Then put my shirt back over it. The same one that I’d been wearing up to now. Meg returned and several doctors in street clothes arrived. They all leaned over me and looked and poked and prodded. So much for staying sterile then.

After a while a man with a wheelchair arrived. It was time for surgery. I got on board and off we went. Meg following. Down the hallway through the ward to the elevator. Down to the main lobby of the hospital. Across the main lobby. Into a second huge lobby full of meandering people. Out through a door and down an outside walkway. Into a building, through some hallways and into that building’s lobby. Where we waited in a crowd of about 30 people for an elevator. This wasn’t like the US or UK at all. Eventually we boarded an elevator and up we went. I said goodbye to Meg and was wheeled into the OR recovery/waiting room. Some of the doctors and nursing staff had crocks on their feet, some were barefoot. Hmm.

After confirming my name on my paperwork I was put back in a wheelchair and taken to the OR. Thankfully it looked about the same as every OR I’ve ever been in. Phew. I was helped onto the table by people pointing at it saying get on.

The room was full of people but none of them were paying any attention to me. Finally someone came over and asked where I was from, what I was doing in India etc.. He explained that he had lived and worked in Surrey, England for a while and talked about that. Then he mentioned that he was the anesthesiologist and that he would take care of me. 

I asked him to confirm what the surgery was going to be – since no one else seemed to need confirmation. Hmm, hang on he said. He shouted at several people, no answers, finally the surgeon confirmed hernia repair and diastys recti repair. I was then about to ask whether they would re-sterilize my abdomen following the tour of the hospital (I’d promised Meg I would do this) when Mr. Surrey plonked the black mask on my face. Out.

Pain. Pain. PAIN. Ow. Ouch OW. Fuck. Where am I. I couldn’t open my eyes. I couldn’t hear. There was just pain. More than I ever knew was possible. Something had torn me apart. OK. Ok pain means I’m alive. That’s good. I’m alive, better than dead.

Finally got my eyes open, kind of. Blurry. Out of focus. Recovery room. Who’s screaming. Who’s making all that noise? Oh it’s me. Out. Back PAINPAINPAIN. A doctor. Out. Back. PAIN Meg’s voice “I thought he’d died” out. Back. PAIN. Why did Meg think I was dead? WTF did they do to me? PAINPAIN out.

Apparently this went on for a couple of hours. I regained consciousness many times, sometimes I saw doctors or nurses chatting close by. I tried to get their attention and failed. No one explained what was going on. We later learned that they had attempted to put a block in place so I would wake up pain free. It didn’t work. I had nothing in my system, no painkillers at all and woke up from abdominal surgery. They finally got it under enough control that they took me back to the room.

Movement hurt. Elevators crowded with people hurt. Being transferred from the gurney to my bed hurt like nothing else. But I was back with Meg. That helped a lot.  We chatted, we talked. I realized wait – I’m far too lucid, too clear minded to have any serious pain control going on. Meg asked. I was on paracetamol and ibuprofen basically. How could I have been in surgery a few hours ago and only be on over the counter painkillers. Is that why EVERYTHING hurt so bad?

Meg asked again. “Oh that is all he can have auntie” was the response. As evening turned to night the pain ramped up. Every breath hurt. I would breathe to the edge of serious pain and then stop. That edge slowly worked its way closer and closer to the start of each breath. Time passed and I was barely breathing. Meg was arguing valiantly with the doctors and nurses. Who finally admitted that I was on all they could prescribe. To get better drugs we needed an anesthesiologist. Well get one then!

Apparently the one they were thinking of was busy. In a surgery. Finally, at I believe about 1 AM an anesthesiologist arrived and gave me a shot of Fentanyl. I have never experienced such profound relief. I slept. Wonderful restorative sleep right up until I woke to Meg telling a crew of nurses that “I did NOT need a bed bath at 5:30AM I needed sleep – GO AWAY.”

The lack of pain control lasted into the morning. I decided I was done. I could control the pain better, myself, at home. We asked what I needed to do to be discharged that day “Oh but it is Sunday – no doctors are available” was the response. Arguing with the nurses quickly proved pointless. I started WhatsApping the surgeon. His response was that if I could walk and pass flatus the only reason I needed to stay was for pain control.  Which I wasn't getting.

I rang for a nurse and expressed my desire to take a walk. I explained that they needed to take my catheter out and unhook my IV. Surprisingly this was done without too much fuss, or pain. Walking hurt. I was slow. Meg supported me. But I did it. Walked the length of the floor and back. I walked every hour slowly increasing the distance and speed. At lunchtime I messaged the surgeon that I was walking fine and passing gas. The last part was a lie, but I figured with my history it shouldn’t be a problem to get there before discharge.

The discussion/argument about discharge started in earnest at about noon. We left at about 8PM. I still think it was a win.

In summary – if you are in India and need surgery, make sure you actually need it. If you do then it seems that you will likely survive. You won’t enjoy it. It will suck.

Surgery in India? What Were We Thinking?

Chris was prepped for surgery in the room.  They asked me to leave the room while they covered his belly with betadine, in case I spread germs to him while they did it.  And while they did it, various nurses and doctors wandered in and out in their dirty jeans (seems to be dress code for doctors here) and t-shirts, no masks or gloves in sight.  Then he was allowed to rebutton the hospital shirt over his newly sterilized belly, rendering it no longer sterile, and we were brought to the operating suites.  To get to the suites, we had to take a crowded elevator, walk (Chris pushed in a wheelchair) across a very crowded lobby, through a crowded hospital, down dark corridors, outside and into another crowded lobby and onto another crowded elevator.  At this point I was begging Chris to be sure, before they started anesthesia, to confirm with them who he was, what surgery he was having, and if they would again sterilize his belly.  I said goodbye to him at the door to the operating suites, where he was walked into the OR by a barefoot nurse.  Yes, a barefoot nurse, in the OR.  They told me the surgery would last 1.5 to 2 hours and that I should wait in his hospital room and they would call me when he was finished.

Sanitation was not their strong point.  Blood? No problem.  Bodily fluids?  No worries.

Chris and I had agreed that I would pop out once he was in the OR to buy food and water that we realized I would need in the hospital for our stay.  I reluctantly left and was gone for 40 minutes, because you can't get anywhere quickly here.  When I returned, the nurses on the floor stopped me, clearly distressed, saying the surgeon had been trying to reach me.  They couldn't find his next of kin.  I stood there shaking with my suitcase and shopping while she made phone calls and spoke to a few people in Hindi.  She said I needed to go to the OR because his surgery was over, but no one would tell me if he was OK.  In a panic, I dumped my bags in the room and rushed to the OR.  I had to run down 8 flights of stairs because the elevator was too slow, fight my way through the crowded lobby and hospital, the dark corridors, outside and in again, and wait FOREVER for the second elevator.  10 minutes later, in a state of near panic, sure my husband was dead, I arrived outside the operating suites.  They took one look at me and instantly called me inside. I was told the surgeon wanted to talk to me, please wait outside.  "Is he OK?!" I gasped.  He answered, "I don't know, I'm not the surgeon."  Shit.  He's dead.  We decided to do this and now he's dead.  Another nurse came and I begged, "can't you tell me if he's OK?!"  She said, "yeah yeah, he's fine. Don't worry" and told me to again wait outside-in the elevator lobby.  I paced and then sat, frantically messaging my best friend, scared to death.  What was I going to do?!  Something must have gone wrong for the surgery to end so soon.  He's riddled with cancer.  He had a heart attack.  He reacted to the anesthesia.  They found (fill in the blank with an overactive imagination) when they opened him up.  After what felt like forever, but was probably 10 minutes, a doctor came out (I later learned he was the anesthesiologist).  "I just wanted to meet you because Chris said you were worried.  I lived in Manchester for a while."  WTF!?  I asked,
"the surgery is over?  What happened?  Is he OK?  It was supposed to take 1.5 to 2 hours?"  "No, it's not over.  He still has about 45 minutes to go.  He is doing very well, we just took some extra precautions since he's allergic to morphine."  Oh my God.  The relief was overwhelming.  I was sobbing. He couldn't understand why I was sobbing, even as I explained that the nurses told me the surgeon had been trying and trying to reach his "next of kin" and no one would tell me if he was OK or even alive and I was told the surgery was over far too early..."  I think he just wanted to meet me, the American wife of the English patient.  He clearly missed the issue, but told me I'd better wait for Chris there, in the elevator hallway, in the heat of the building with no air conditioning, on a 103 degree day.  So there I sat.

A lot of smelly bodies

My view for the next 4 hours

Desperately trying to catch people's eyes through those windows for the next 4 hours.

OK, so let's rewind a bit now to the beginning of this story.

Here we go.

Chris had a hernia, and a bad case of diastisis recti (the separation of the stomach muscles that support your core).  Most people think that diastisis recti is an issue that only women have after pregnancy.  And because it is a common problem after pregnancy, in the West it is also considered cosmetic only and insurance will not cover the repair.  Diastisis recti causes hernias, back pain and leaves your organs being fully supported by connective tissues instead of the muscle that is supposed to protect them, leaving weaknesses where the organs shift around and the intestines can burst through the abdominal wall.  It is not just cosmetic.  Not even close.  But because it is thought of as a result of pregnancy, insurance won't cover the repair.  (After all, before the much maligned "ObamaCare," pregnancy was a preexisting condition that could mean you didn't get medical insurance coverage.)  Well, Chris was having a LOT of issues, both from the small hernia, and certainly from the diastisis recti.  In men it tends to be genetic.  Chris' Dad has it, as does his uncle and brother.  His dad has been told his was too far gone for repair-and he has a lot of troubles because of this.  So, Chris needed to have his repaired.

We discussed doing it over summer break in Seattle.  But because our insurance most likely wouldn't cover it, it was going to cost us somewhere between $70,000 and $150,000, out of pocket.  We don't have that out of pocket.  In India, including all of the preoperative tests (they did a LOT), it will cost us about $3,300, and that is paying the "foreigner rate" which is a lot higher than the Indian rate. Chris doesn't have much time he can take from work for this surgery and recovery.  His job demands a lot, including a lot of travel, so we realized he had to do it NOW, or in October.  But with his problems increasing so steadily, it seemed foolish to wait.  After researching, asking a ton of questions, and talking about it a lot, we decided we would do it now.  My good friend had a hernia repair by this same surgeon several months ago.  She had it at the same hospital.  I have 7 other expat acquaintances that either delivered babies surgically or had surgeries there.  They are all OK, and they gave us a lot of advice.  That helped the decision.  Also, this hospital has a fair amount of "medical tourism," where people come to have procedures done that are too expensive where they live (largely in the USA).  So, we decided we could do it, and scheduled the surgery for 5 days later!

Some of the advice we were given was that you are required to have an advocate stay with you in hospital and that that person should be sure to find out what medications you were supposed to receive and make sure that the correct medications were received, because it's quite common that they are not.  So that became my job.  I reached out to the "Mommies in Pune" WhatsApp group, a group of mostly expat or repat moms, to ask for help finding childcare so I could be gone 2-3 nights.  The response was really amazing.  I got advice and many offers of help-women saying, "I know we don't know each other well, but I can take your kids"  or, "I know we've never met, but I have four kids under 4 and a household full of help, so I can take your kids" or "Just let me know what you need and I can help." Amazing.  So, for the first day and night I got Grace and Alex's wonderful preschool teacher from their former school to come.  Then she brought them to an American friend's house for an Easter party (yes, we were missing Easter Sunday with our kids), where they would enjoy a wonderful Easter party with 20 other kids, then spend the day and the night.  The family has two kids, a good friend to George and a good friend to Grace.  I also had friends willing to take them if we needed another night, so OK, we were all set.

Check-in Time

The surgery was scheduled for Saturday.  We were told we would receive a call on Friday to give us the check-in and surgery time.  And, indeed, on Friday a doctor called to ask when we were coming in that day to check in.  Wait, what?  Why do we have to check in today?  Well sir, so we can do all the pre-op checks and studies?  Oh, OK, the ones I had done on Wednesday and the surgeon has the results to?  Oh, why yes, those.  Well, we still want you to come in today to check in.

We finally convinced them that there was no need (and no way) we were checking in that day.  We were told to arrive at 7 am on Saturday.  We made the drive and walked up to check in.  Everyone looked pretty surprised to see us, so I'm guessing the medical tourism is not a daily event.  One of the first things we were asked was, "Do you want a private room, a deluxe room, a super deluxe room, or a super deluxe suite?" (We later learned the super deluxe suite has wood paneled walls outside, a wooden door with golden handle-who knows what it looked like inside.  It was probably carpeted!  Ew.)  After asking what the difference was and being told that everything costs more with each higher level of room, even the surgery, we opted for just a private room, and lucked out that they were all full so we got a super deluxe room for no extra cost.  I'm a bit worried about how I would have felt about it all in a normal private room.  Super deluxe at least seemed OK.

Super Deluxe room

My "bed"-really, not bad.

So we waited close to forever for the elevator, walked to our room crossing a rather large, very high, very open sky bridge which even made me dizzy.  We found our room, met a nice nurse and the questioning began.  Every few minutes a different nurse, or different doctor, would walk into the room requesting we start all the tests we'd already had done.  After explaining multiple times to multiple people, that the tests had been done 3 days prior and that the doctor had soft copies and we had hard copies with us, they left us in peace.  30 minutes later, a nurse came in asking if Chris was ready for his pre-op tests.  Um, OK.  Clearly you people don't talk to each other.

Do we go left or right for the 6th floor? 

You really can't tell how scary this sky bridge felt, even when you're not afraid of heights (Chris is!)

Finally they brought Chris his hospital pajamas to change into.  Luckily, this brought us heaps of laughter and some much needed comic relief.

Note the not easily laundered wool blanket on the bed.

Eventually, after I sorted out the testing issue, Chris was able to lay back on the bed to relax a bit, only to discover that his 5 foot 11 inch body was about 3 inches too long for the bed.  Luckily I figured out a way to extend the footboard away from the bed so at least his feet could hang over the end freely.

Then the nurses came in to start Chris's IV.  I had to ask 3 times to get them to use sanitizer on their hands, and they did not use gloves.  Like usual, they wanted to go into the back of his hand, the place where it always hurts the most.  We finally convinced them to try his forearm.  They poked and prodded, and missed the vein.  So they pulled the needle out and set it on the bed.  Then they moved to his other arm, searching for a better vein.  When they found it, she picked up the used needle that had been lying on his bed and was about to put it into his arm.  "Stop!" I said,  "Are you really going to use the same needle?"  She replied, "Only used in him, mam."  Oh my God!  I made her go get a new, sterile needle.  She only argued a minute, then grumpily sent the other nurse to get a new needle, and finally got the IV in.  Phew.  Another nurse came in, hooked up the saline, then told us they had to do a blood draw.  They didn't seem to understand at all why they could have taken the blood when they put the IV in before they hooked up the saline 30 seconds before.  Another needle poke for Chris.  Luckily they got this vein on the first try.

We were then informed that we should just lie back and wait, surgery was scheduled for 11 am.  OK, we thought it was for 8, but fine.  Chris went to use the bathroom and when he came back we realized he had bled quite a lot into his IV tube.  So I called the nurses, who scolded him terribly for getting up without calling them to unhook him (though they never suggested we would need to do that before).  But they then unhooked the IV, literally just squeezed the tube to dump the blood into a plastic bag they'd just pulled a syringe out of, in the stainless steel tray they bring medications in in, then tried to hook his IV back up using the same connectors.  I told them he needed new connections, not the ones that had just been handled (with bare hands) and touched a plastic bag and a dirty tray.  So the nurse took hand sanitizer and started washing them with that.  She was quite shocked when I insisted she get new leads before she hooked anything back up to go into his body, but when I wouldn't back down, she finally did.  No, I wasn't getting more and more nervous at all, really.

Meanwhile, there was now a bloody tray on the bedside table, a small pool of blood actually on the bedside table, and splats of blood all across the floor.  I asked them to send someone to clean it up.  10 minutes later, a Didi (I believe this means "big sister" but is used for helper) came in with a dry mop duster, dusted over all the blood, absorbing some, spreading the rest around with a nice dirt streak.  She then took that same duster to dust other peoples' rooms and the hallway, spreading Chris' blood and germs all over the ward.  A little while later another Didi came in with a filthy mop and mopped the bloody floor, leaving behind the lovely smell of dirty mop.  But at least she was wearing a mask, right?  I was seriously beginning to worry.  I asked if she could clean up the pool of blood on the bedside table and she came back with a piece of gauze and just wiped it up.  She didn't wash it.  She didn't sterilize it.  She just wiped it off.  Blood, off the table, just wiped off...  OK.  Please just be more sterile in the operating room.  It must be, right?

Well, sort of.  

Chris being wheeled into the operating suite.

The barefoot OR nurse closing the door.  Hey, but at least her hair was covered, right?

Now you know from the beginning of this post that Chris didn't die.  I waited in the elevator hallway for 2 hours after talking to the anesthesiologist before they called me back to see Chris.  They had him on a gurney in the walkway outside the OR.  He was having a lot of pain, but they thought he needed to see me to help him calm down.  They had no idea how much I needed to see him!  He was in terrible pain, so they gave me about a minute with him, then took him back to get him some more relief.  I was told to wait another half hour, then I could go with him to the room.  After 2 more hours, they finally got his pain managed and I asked if I could wait in the room because I was so thirsty having sat in the heat for 4 hours with no water.  

I got to the room, drank my much needed water, put the food in the small refrigerator, and lay down to rest.  They brought Chris in about 10 minutes later.  You can only imagine my relief to see him and touch him, and to have him with me where I could look out for him.  Such profound relief.  He was here.  He wasn't dead.  

We got him settled in the too small bed and he dozed in and out but was remarkably coherent for someone who should have been on pretty heavy narcotics.  Because he wasn't.  They'd finally given him some short acting fentanyl after his hours of crying in pain, but now he was just on paracetamol.  

Within two hours, the pain had escalated.  I begged for more relief for him so they gave his a NSAID (basically, ibuprofen).  This didn't touch his pain.  I begged for more, they called the doctor and about an hour later gave him Tramadol.  This too didn't touch his pain.  He'd been unable to take a deep breath now for 3 hours and no one would help.  I finally went into the hallway and made a small scene, begging, "Why won't someone help him!?"  After 30 more minutes arguing with nurses who insisted he was maxed out on pain meds, and begging to see another doctor, the doctor came back and informed me he had just called the anesthesiologist because he was the only one who could administer narcotic pain relief, and once he was out of surgery, he'd come check on Chris, then order some stronger pain meds, then a while later come back to administer them.  I finally cried out, "Is he the only anesthesiologist in the whole hospital?!"  (Can you tell I was pretty stressed out as my husband whimpered in pain taking too small, shallow breaths?)

By 1 o'clock in the morning, the anesthesiologist came and got Chris' pain under control with an injection of fentanyl to last 2-3 hours, followed by a patch of a lower level med that would cover him from 4 hours later to 8 hours so he could sleep.  By 1:30 he was snoring comfortably, and by 2 am I was able to collapse into a fitful sleep.  Just three hours later, at 5:30 in the morning, I unceremoniously kicked the 3 nurses out who had come to give him a sponge bath.  I insisted that sleep was more important than a 5:30 bath that I could do for him later.  We were able to sleep until 6:30 when rounds began and the constant interruption of nurses doing their good work began.  The nurses even, eventually, started sanitizing their hands before they touched him without much more than a look from me.

Needless to say, Chris was sore and we were both exhausted, and I was emotionally shattered.  By late morning Chris felt that he had to use the toilet, so I helped him out of bed.  An hour later he decided he could walk.  Then we started doing laps in earnest so he could be discharged.  With Chris fairly comfortable, I took an hour to head to the closest escape I could find, the Conrad hotel just 5 minutes away.  I sat and had a coffee and a sandwich and listened to a book on audible while families came in to celebrate Easter Brunch together.  It was good, and peaceful.  I needed it.  An hour away, a bit of rest, then back to the hospital where real vigilance was required.

We kept asking for discharge.  The surgeon said the only reason he was in hospital was for pain management, so it seemed that since they could not manage his pain reliably, we'd be better off at home.  We'd certainly be more comfortable.  After being told by the nurses several times that we couldn't leave because it was Sunday and there were no doctors on Sunday, I finally said, "we're leaving at 7 pm whether we're discharged or not."  (yes, expat Meg can be a real pain in the backside born of never ending frustration)

In the end, the nurse's jaw dropping to the floor when she realized we simply picked up the phone and called the surgeon, who agreed we could go, 8.5 hours later we were discharged.  It is SO GOOD to be home!

And in case of fire in one lobby, they were very prepared.  Fire anywhere else in the building?  I'm not so sure.

I Had a Dream

I had a dream.  I wonder if Dr. Martin Luther King would be appalled, or say it meant I was trying to do right?  Would he call me a privileged onlooker, or praise my honesty and encourage my desire to do the right thing?

I should have gotten up right then to write it down when it was fresh, but I so wanted to sleep that I didn’t, even when further sleep alluded me.

I was sitting in a café, probably in the US, but really it could have been anywhere in the world.  It was a basic mid-sized café with 10 or so tables.  Suddenly a man starts to verbally attack a family, or perhaps just one person.  It is clearly racially motivated and he is screaming at them, and yelling, and he seems so violent that I’m so afraid.  I sat and watched.  Everyone in the café just sat and watched.  Nobody helped.  Nobody intervened.  I was frozen with fear.  I couldn’t move.  I sat there thinking, why aren’t I standing up?  Why aren’t I intervening?  Why am I just sitting here with my children letting this happen?  But I was so scared.  I felt immobilized by terror.  He started to hit and kick.  This faceless man was hurting people, and I didn’t move.  Suddenly, he just left.  He ran away.  I remember only then thinking, why didn’t I at least call 911?  Why couldn’t I at least do that much? 

You see, this is something that’s haunted me most of my life.  I started studying the holocaust when I was very young, probably 5^th grade.  I was profoundly affected by The Diary of Anne Frank, and started to read everything I could find on this atrocity.  I was deeply fascinated by it because 1). I couldn’t imagine how it could happen, 2). I didn’t understand how people could hate so strongly, 3). because I was introspective enough to wonder if I would have had the courage to risk my life and the lives of my family to protect another person.  I always prayed I would be strong enough and brave enough, but I was never sure.  I wanted to believe, but I was never sure.

When I was taking Jewish studies or Holocaust courses at University, I regularly got in arguments with people who were so sure that they would always stand up and help.  They were always so sure that they wouldn’t even think twice before they protected these people.  I wanted that belief, but I found it so naïve.  They could never agree with me that without the benefit of hindsight, they really didn’t know if they would.  They hadn’t stood up to every school bully they’d witnessed hurting another child.  They didn’t stand up to all the mean girls taunting other girls.  Some of them had been the mean girls.  I had stood up to the bullys, sometimes.  I had stood up to the mean girls, sometimes.  And that sometimes says a lot.

I always wanted, to the depths of my being, to believe I would be the one who would risk everything to protect someone else from a terrible wrong, stranger or friend.  But I was never sure.  And today, I can’t imagine intentionally putting my children at direct risk, for anything.  Actually, I can imagine it.  I imagine it every day.  I think about how I could tuck them behind me before I stood up and spoke calmly at the attacker.  Or how I could send them to a corner before I stood up and pulled a person off an innocent.  But then I imagine the attacker seeing my vulnerability and hurting my children.  Or simply hurting me in front of my children.  I worry at the scars it would leave.  I also worry at the scars it will leave for my children to watch me just sit and watch, or pull them away to safety without intervening.  It seems such a catch 22.  If I stand up and don’t get hurt too badly, or killed, and my children are safe, it will always be worth it.  But I don’t know before if that will be true.  If I stand up and my children have to see me get hurt or killed, or they are hurt or killed, would the victim even want that?  Would it help them?  Or would they be grateful and feel tremendous guilt for all their life?  Yet I believe so strongly that the right thing to do is to stand up, to speak up, to help.

I think about these things, all the time.  Do you?