At The ER… Again

Hello, friends.  Here, for your amusement, is my latest adventure at the ER, which seems to be my favorite place these days. I had a bandage on my neck the past few days. It was covering a painful swelling. It was not a boil, but an infected sebaceous cyst. I was soaking it and using antibiotic cream, hoping it would get better on its own. Not to be.

So a few days ago we were off to the emergency room at HeywoodHospital in Gardner, Massachusetts. Though not an actual emergency, they don’t have walk-in clinics that can handle day surgery out here. Rosemary and I were there from 1:30 PM till 8:00 PM.  The first hour was an efficient intake process. I saw four people at four locations, answered forty questions, and presented three forms of ID: Picture ID, Medicare Card, Secondary Payer Card. Since I just turned sixty-five, my retiree medical plan via Proctor & Gamble now takes a back seat to Medicare.

Finally alone in the exam room, the intake nurse asks where my problem is (neck).  “OK,” she said, “Just checking whether you have to get naked.” And that is the last laugh for a good while.

After an hour or so, Rosemary joins me. We wait together. Misery does indeed enjoy company.

Then the fun begins. They inserted an IV, drew lots of blood, took multiple pulse and pressure, and queried about my level of pain (one through ten).  “Five or six,” I said.  Whereupon I was offered Vicodin.  I hate taking opiates. So I passed on the pill. Fool that I was.

After an initial exam, I was sent to the CAT scan room where I was given an iodine injection (via my permanent I.V.). I told them I was allergic to shrimp. They told me one of the side effects of iodine, for those allergic to shrimp, is:  DEATH!  However rare. But we went ahead, with emergency teams standing by. Such drama. All was well and it was back to the exam room to await administration of pain.

Finally, the efficient, but humorless, nurse practitioner entered with a tray full of bandages, swabs, needles, and various other torture implements. I make jokes under pressure. But not good enough for this serious lady.  Rosemary, however, laughed at the good ones:

Preparing a needle of anesthetic (useless, by the way), the nurse asks,

“Do you have any other allergies, Mr. Rapson?”

“I am highly allergic to pain,” I said.

Unamused, she proceeds with the usual deceptions during torture.  My favorite:

“You’ll feel a pinch,” she says.

I have been pinched a few times, Gentle Reader. And I have done some pinching myself. I am well acquainted with the giving and receiving of pinches. I can confidently tell you that what I felt next was well outside the set of sensations categorized as “a pinch.”  More accurately, she might have said, “You’ll feel a white hot poker knifing into your flesh.”

After repeated stabs, comes another deception, “One more, ” she says. And delivers three or four. She did occasionally apologize for the torture. Something even real torturers might do.

After several minutes of me pretending to be brave, and cracking jokes to avoid whining like a girly man, it was over. At least the administration of the pain was over. Pain lingers, however. And linger it did. So when drug pusher nurse walked in—Chelsea was her name and she was lovely—I begged for those drugs earlier refused.

“And your pain is now what…?” she asked. Keeping up the tough guy front, “Oh, eight or nine, I guess.”  It felt like eleven or twelve.  A small white pill was produced. Fifteen minutes later I was heavy lidded, smiling a silly smile, and nearly painless.  So this is what all the fuss is about!

After being instructed what to do if things don’t get better (they have), we filled prescriptions, bought pizza, watched The Voice.  And so to bed.

And that is my latest ER adventure. Coming so soon after three months of bliss in Florida, I have a new appreciation for the difference between pleasure and pain. They may be different sides of the same coin, but it must be a darn fat coin.

 

At The Walk-In Clinic by Steve Rapson

It’s March 5th. We, Rosemary and Steve, have returned from our road trip with Steve suffering an ailment. Seeing that whatever it is will not go away on its own, I take my brother’s advice and call the dermatologist/allergist office:

 “Dermatologist’s office…”

 “Hello, may I make an appointment for a skin problem?”

“We are booking for the end of April.”

“But, I am really suffering now.”

“I don’t know what to tell you.”

 “I guess I’ll call my primary.”

 “Do that.”

 *click*

 Meanies… though not blue.

 (dial, dial, dial… or push, push, push, actually)

 “Primary care…”

 “Hello, I have a bad rash and I think I need to see my doctor.”

 “Who is your doctor?”

 “Dr. Beckett.”

 “We’re making appointments for mid-April.”

 “I really need to see someone sooner.”

 “Go to the walk-in clinic, if they can’t help you they’ll send you to the ER.”

 “The ER…?  I thought that’s where you went when you had no insurance or were bleeding.”

 “Walk-in will help you.”

 “OK, thanks.”

 Rosemary and I go to the walk-in clinic at Mount Auburn Hospital. We stop at the information desk and are told to go to registration first. At registration we give my name, a brief problem description, sit and wait about fifteen minutes before we are called: 

 “Uh…G…?”

 “G. Stephen…  Steve is good.”

 “Hi, Steve, please come with me.  How are you today?”

 “Fine… wait, no… I am not well. Thus my visit here today.”

 “Ha, ha.”

 I go into a little office with the nice lady, sit, answer questions. 

 “Your date of birth…?” 

 “March 24, 1948.  Don’t I look good?”

 “Ha, ha… Yes, actually, you do.”

 After more Q&A, and making the nice lady laugh, and blessing of the Holy Insurance Card, enter Nurse Evelyn. 

 “Hi Steve, please come with me.”

 “OK.” 

 There is gay banter with Nurse Evelyn on the way to a little exam room. We like Nurse Evelyn. More Q&A as blood pressure, temperature, and pulse are taken. Nurse Evelyn scowls, pleasantly, at my vitals.

 “So what’s the problem?” she asks. 

 Remove shirt. Show problem. Cover ears as Nurse Evelyn runs screaming from room (just kidding).

 “Ohh, that does look uncomfortable,” she says. “Have you had heart problems?”

 “I… what…?  I mean… no, not really… How is that rash-related?

 “Your heart rate is forty-eight beats per minute. Are you feeling alright? Light headed? Chest pain?”

 “No. I’m good.”

 “You should be checked out in the ER, your heart rate is a bit low.”

 “Well, I used to do a lot of aerobic exercise: swimming, biking and such.”

 “Yes…?  And how long since you last did that?”

 “Ohhh, maybe twenty years or so.”

 “Mmm, I see. Let’s take you to the ER for an EKG.”

 “But… my rash…?”

 “Don’t worry; we’ll make sure the ER doctor checks that out, too.”

 So, having come to the walk-in clinic for problem A, we are off to the ER for new problem B. Problem A deemed less important. This is one reason you should never go to the hospital. It’s always something else. I want to ask if I could die from this. But I recall that those were Andy Gibb’s last words upon his visit to the ER, and history has a penchant for repetition.

 Nurse Evelyn asks if I want to ride in a wheel chair. Really…?  I have to ask, she says. So off we go: Rosemary, Steve, and the affable Nurse E., all of us ambulatory. It’s a long walk around corners, into elevators, down corridors, all the while we share a few laughs and I think that Nurse Evelyn is really good at her job.

 We arrive at the ER where several people wait to be seen. Cold air rushes in through the double doors as EMT’s push a gurney back out to an ambulance, lights still flashing. Real emergencies here.

 The ER.  E for Emergency. Is this an emergency? The dermatologists were booked solid. My own doctor was not available. I wasn’t really suffering, just itching, bumpy, and red. Maybe hospitals need another room called the Overflow Room. The OR!  Not that. How about the EBR:  Everyone’s Busy Room. Not an emergency? Try the EBR.  But, then again, there is Problem B.

 Nurse Evelyn hands us off, and, after a brief wait, we check in. More laughs with the intake lady and her cohorts. I love making people laugh, and this is an easy crowd. I get a wrist band, and I joke that this is just like being admitted. They tell that I am indeed being admitted… to the ER.

 Another brief wait and Andy, an adolescent, calls me in to the EKG room. I did not know that middle schools had work study programs. Andy stickers me up while I ask him how many of these he does a day. Thirty-five to forty, he says. A serious production line. These guys should be paid piece work. Andy says to relax every muscle in my body. I do, and it’s over in a couple of minutes.

 Back out to the waiting room. Rosemary and I are called, along with a woman wearing an oxygen mask and a johnny, to follow a diminutive, efficient Asian nurse. The four of us parade single file to a single exam room. The johnny-clad woman goes left; we go to the right bed. A flimsy blue curtain separates us. This has the potential to be most awkward. I ruminate on the situation. It is more usual that patients brought here are unconscious, shot, run over, or otherwise unconcerned about who is on the other side of the flimsy curtain.

 At first Rosemary and I maintain a polite silence. But the poor girl next to us is really having a hard time breathing and we find it better to chat and create a little noise pollution so our neighbor can suffer in a semblance of privacy. This is why restaurants pipe in music. But why Year of the Cat at my sushi bar? Angular banjos sound good to me.

 I sit on the bed. Rosemary, now my health proxy sits in a chair. We wait.

 We were prepared for many hours of waiting. I brought materials to write letters. Rosemary brought her book. But, until now, there has been little waiting. I barely got one and a half letters written. Now it appears we will have a bit more time. I sit on the doctor’s stool and resume letter writing.

 Rosemary doesn’t need her book. We are in a busy ER. She loves listening to the goings on.  And she is good at it. In fact, Rosemary can filter out a single conversation five tables away in a noisy, music filled restaurant:

 “That couple is having a fight over there.”

 “No way! You cannot possibly…”

 “Shhh! I’m listening…”

 “You know I don’t like to be shushed.”

 “Sorry, please be quiet for a minute… Ohh, they’re breaking up!”

 “Oh, please…”

 All around us people are being examined and interviewed. Many of them are old and hard of hearing. The ER is child’s play for Ms. All Ears.

Thus occupied with letters and listening and chatting it up. We wait. The following sequence of health care providers enter and exit.  Each with their own, “How can I help”, and, “What brings you to the ER.”   Like this:

Wait.

Enter:  Efficient Asian Nurse: Remove shirt, apply monitoring stickers. I was entertained by watching my vital signs on the screen, wishing my now ever so normal heart rate would skip a few beats, thus justifying my taking up all these health care resources.

“Now, put on this johnny,” she says. 

“Do I have to?”

“Yes, all the better to examine you.” I thought not, and took it off as soon as she left.

Wait.

Enter:  Physician’s Assistant.  A handsome young man, but definitely over the age of consent, with his own Q&A: What? A rash. Where? Everywhere. Show me (here I must pull the curtain) When? Eight days ago, on the New Jersey turnpike, at 7:35 PM.  So precise?  Rosemary does all the driving. After 12 hours in the car I had little to occupy me. What about your heart? Any pain? Discomfort? You mean this normal beating heart right here?  Yes. No. All good. 

Wait. (full disclosure here… I do take atenolol for P.A.C. (look it up) a common heart issue afflicting millions of people, non-lethal. I had stopped taking it four days before.

Enter:  Physician’s Assistant again. MOS (more of same)

Wait.

Enter:  A doctor from New Jersey. MOS. Though he was amused about the New Jersey Turnpike. 

“I’m from New Jersey, that road has a lot of fumes. How’s your heart, previous problems?”

“I’m good. Though I do take atenolol for PAC. 

“I am looking at your EKG here,” he says. “It shows PVC.”

PVC. Also not a big deal, usually. “So, about that rash.”  Ahh, finally.

  “It looks like contact dermatitis to me. You’ll probably never know what caused it. It’s easily controlled with an anti-histamine and Prednisone.”

Great!   The pills were soon produced and administered. Prescriptions were written.

A few more visits from the PA and Efficient Nurse—also young, cute and charming (is that wrong?)—and, with appropriate waiting between each visit, we are free to go.

After paying our $100 co-pay, I took Rosemary to The Greek Corner in Cambridge. A restaurant featured on Drive-Ins, Diners, and Dives.  Rosemary got the address by going out to the ER admitting desk and asking if they could help her find it. Computer consoles were manned, Internet searches were done and voila! This was, of course, between emergency admittances. But, could you ask for more from your ER?

The food was great. Rosemary was happy. Life is good.

So that was my visit to the walk-in clinic at Mount Auburn Hospital. All in all a positive experience. You will never hear me complain about medical care in the Boston area. Maybe a bit of overkill. However, the PA had scheduled a blood work-up that the doctor cancelled, saying he thought we might want to get out of there, and he didn’t feel it really necessary. So someone is watching the store.

I am feeling better, too. Not sure if that is good. I went on the internet and checked out the side effects of Prednisone. There are about fifty of them, none pleasant. Two stood out: A Rash, and Itching. Ahhhm… Hello?

But here’s the best one:  Inappropriate Happiness.  I feel good. Na na na na na na na.

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Steve Rapson is the author of The Art of the SoloPerformer: A Field Guide to Stage & Podium. He is a concert guitarist and composer with several CDs in release.  Find all at soloperformer.com and even more of Steve at reverbnation.com/steverapson  Email : steve@sologuitar.com

Pain, Irony, & Humility by Steve Rapson

I fell off a roof last month. I didn’t want to fall off the roof. I tried hard not to. I clutched the roof with all my might as I slid from peak to eaves. I clutched so hard the ends of three fingers were torn off. And, in spite of all the clutching, I fell anyway.

I was painting the ridge board, backing along the peak and stood up as I neared the far edge so as not to fall off. I stood, turned, and stepped, saw my paint rag under my descending foot and thought, Don’t step on that rag, you’ll slip.

After I stepped on the rag and slipped, the fall happened quickly, but time slowed. This allowed for a thoughtful descent.

First thought, Damn, the paint spilled.
Second thought, Whoops, better hold on, I don’t want fall off this roof.
Third thought, Shit, I can’t believe I’m going to fall off this roof.

Then, the void…

I have fallen out of trees, off galloping horses, into sand pits, off ladders and fences, out of second story windows, and from other roofs I have known.

I have fallen out of moving cars and off speeding motorcycles. While drunk in the former, sober in the latter. One of my favorite ways to fall is to have a car door flung open in front of my bicycle. In martial arts class the sensei used me as demonstration throwing dummy.

One could say that I have earned a PhD in falling.

After thought three, (Shit, I can’t believe I am going to fall off this roof) I went into fall mode, which, at its core is, Oh, well, relax and go with it.

I hit the ground falling backwards. I tucked my chin to my chest and rolled, doing a complete somersault. Momentum carried me back to my feet, facing the building. I came to a halt with my arms in the air, like a gymnast landing a vault. Two inches to my right was a stack of concrete blocks. Had I fallen on them, this story might be delayed for weeks, or longer. I wiggled around, amazed that all parts were in place and operational. In my right hand I still gripped the paintbrush. Don’t know why I didn’t let go of it. But it saved the right hand fingers.

On the other hand…

Blood, lots of blood, obscured what was the matter. I shook the hand to see the damage. This was a mistake. First because up till then there was no pain, second, I totally saturated my pant legs with sheets of spattered blood. I looked like a scene from CSI. I became light headed, and dropped to one knee.

I am not usually squeamish; the sight of blood doesn’t bother me. I now understand that what doesn’t bother me is the sight of someone else’s blood.

Ditto with pain.

Speaking of pain, let’s. First, the happy news: significant trauma is not initially painful. Later, it is. Still, it is hard for me to remember just how much it hurt, even during the initial washing, and the repositioning of the torn off tips–though still hanging by the most tenuous of threads–or the wadding of a paper towel, which I held in a bloody, oozing fist. I vaguely remember driving myself to the hospital eight miles away.

I fell about 12 feet. Not that big a deal. But the emergency room personnel ignored my bleeding all over the place and took me in for X-rays. It seems that if you fall twice your height, the odds are good for back or neck injury. This was their concern and not my painful fingers. I kept pointing them out, they kept ignoring them.

They did ask about my pain, “On a scale of 1 to 10, Mr. Rapson, with one being no pain and ten being the most pain, how much pain are you having right now?”

“My pain goes to eleven,” They were all young and didn’t get the Spinal Tap gag.

The doctor said I was lucky to retain the fingertips as they usually are torn away or need to be snipped off, making for a lengthy healing process. She said she’d try to save them by stitching them back on.

It’s hard for me to remember what it felt like when the doctor injected anesthetic right into the open wound of each finger prior to stitching. Rather than scream, I laughed out loud and told the doctor that this was the most pain I had ever felt.

“I know,” she said, “the finger tips have so many nerve endings. One more to go; do you want to take a break?”

“Please get it over with,” I whimpered bravely, enduring another needle of doom and then 27 stitches.

So it is only the memory of what happened during the pain that I can report. The actual feeling of the pain I cannot quite recall or adequately describe. This is why women can have more than one child. If they remembered childbirth pain, all they’d be saying is, “Get away from me with that thing.”

The poetic irony of my injury is that I had been preparing for six months to compete in The Walnut Valley International Fingerpicking Contest. I had practiced the same four songs* for two hours a day right up to the day before I left, which was when I injured myself. Everything was paid for, and Rosemary said I could go if I demonstrated that I could change my bandages by myself. Which I did.

Walnut Valley Guitar Showcase in Winfield Kansas

So I flew to Winfield, Kansas and camped for ten days with 15,000 other guitarists, mandolinists, banjoists, fiddlers, dulcimerists, and dobroists. Perhaps God knocked me off that roof so I would just listen to all those marvelous players. I found it truly beneficial and a personal growth experience. For the future, dear Lord, a burning bush will do.

I pray for humility every night. In Winfield my prayers were answered with great players showing me what I don’t know.

Further humbling me was Garry, a fellow camper, who helped me change my bandages every day. He didn’t ask if I wanted help, he just sat down and said, “Let me help you with that.”

It is hard to accept help, but doing so allowed me to plumb the depths of humility. I was so humble there wasn’t any left for my fellow campers. My quest for true humility is cursed, however. Because, should I ever think I had attained perfect humility, I would surely be proud of my achievement.

And finally, to show you the power of positive thinking, when I saw the damage to my fingers, my first thought was, I could always play the Dobro.

Post Script: I went back to Winfield the next year and competed in the finger picking contest. I applied all the techniques I know to play my best, and thus did. I didn’t win, but it felt like I did.
My next blog will be about the Walnut Valley Festival, the various contests, and the scene.
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Steve Rapson lives in Boston, Massachusetts. He is the author of The Art of the SoloPerformer: A Field Guide to Stage and Podium. A guitarist and recording artist he has seven CD’s in release. His web site is http://sologuitar.com