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Home: The Toast

Not much bad health-wise had ever happened to me until my appendix burst at the end of 2011. For two and a half weeks my internist had misdiagnosed my stomach pain. She was a mild-mannered thirty-something woman who took careful notes but never really looked me in the eye. Impaction? An x-ray had ruled out blockage. Diverticulitis? Ovarian cysts? There was a weird ridge on my right side that she pressed, mystified. Over those seventeen days she prescribed: Fleet enemas, laxatives, white foods, no nuts or seeds, liquids only, and a torrent of antibiotics — aimless warriors, shadow boxers — which slowed the infection but tore up my stomach. I couldn’t keep any food down. I’d lost 15 pounds. When my lab work showed a white blood cell surge, she finally ordered a CT scan. It confirmed what had never been ruled out. She phoned and said, “Get yourself driven to the hospital.”

My husband Malcolm hurried home from the office to take me to the hospital that before Katrina was called Baptist Memorial. In the ER, the admitting doctor was young, energetic, and on the ball. “It’s like your appendix exploded,” he said, looking at the scan. “You should be curled up on the floor.” But the pain hadn’t been that bad. It was an old habit to not want to be a bother or make a fuss for fear that your family might suffer over you. A kind and burly male nurse gave me a shot of morphine, anyway, and I got admitted and prepped. That night Dr. Wren was the surgeon on call. “He’s a good one,” the nurse said.

First, Dr. Wren tried taking my appendix out laparoscopically. He punctured my stomach in three places but found too much infection. He needed more room to work, so he sliced me open navel to C-section to break up the abscess with his hands. My appendix had adhered to my colon, trying to seal itself off in a battle against time. My body tried, but it alone could not have saved me, and the muted pain that kept me calm was not on my side. I spent two days in the ICU and four more in the hospital, waking to find Malcolm beside me in a turquoise chair reading the newly dead Steve Jobs’ biography. You trust your spouse would do anything for you but how so? Malcolm handled the worried phone calls, the traffic of visitors, ran back and forth to feed and walk the dog, disconnected from the office, kept his own fears at bay. Our marriage shifted into a gentler mode. Sickness rearranges us, places us at each other’s mercy. I loved Malcolm not more, but harder. I missed him when he went home at night to sleep and I brightened up when he came back in the morning.

On my bed rail a morphine pump had been mainlined into my arm. “Don’t forget to use this while you can,” the nurses said, and, sure, I liked the dreamless Michael- Jackson-knocked-out effect that in the news had sounded both desperate and peaceful. But I also wanted to be alert to the lengthening space between the surges of pain.

Dr. Wren made his rounds in the early afternoon to check the wound. He’d left it open to lessen the chance of infection and it was packed with surgical gauze.

“Sepsis could have occurred,” he said. “You’re lucky.”

“And thankful to you,” I said.

I looked forward to his visits, wanted to ask him, wife-like, about his day, the surgeries he’d performed that were more dire than mine, but he was all business. On Day Four he pulled out the gauze packing and closed me up with Steri-strips.

“Do I really need that blood thinner shot twice a day in my stomach?” I asked. It hurt.

“You’re sedentary and you don’t want a blood clot,” he said.

Some nurses jabbed harder than others. If you stay in the hospital long enough you see the difference between the Florence Nightingales and the journeymen. My gratitude for the profession was wearing off. There would be a kind nurse with a gentle touch, and then her shift would end and I’d never see her again. Getting Dr. Wren’s okay to shower on Day Four felt like a small triumph. Clean hair! Now I wanted to sleep through the night, wear my own pajamas, put back on my wedding ring, some lipstick. Besides the section that gave me a beautiful son, I’d never been in the hospital.

On Day Six I was ready to matriculate, unhook from the IVs and get out of there. Dr. Wren was late with his rounds and didn’t discharge me until 8 p.m. Malcolm helped me dress. I couldn’t zip my jeans because of the edema. My body was bloated, a freak. He drove me home in the dark, helped me up the stairs, and for the first few days he worked from the house. On the weekend, our son Andrew came from college to sit with me, offering his easy company.

Our neighbor, a trial attorney, wanted to file suit against my internist, but I am not a person who ever feels 100% certain. I’m too quick to see the other side, to share the blame for letting things go too far. When I was in my twenties I’d been pawed by my ob-gyn, a physician who’d delivered babies all over New Orleans. A woman who worked in my office went to him. He’d delivered her. He told her she had a bowling-ball ass like her mother’s. I guess her mother had been okay with hearing that too? During the internal exam he told me a story about how a patient’s boyfriend had tasted her yeast infection, knew she had one before she did; he’d searched my breasts for lumps and stopped to admire my tan lines; he’d put his finger up my ass for a rectal exam that was off-script for my age group. I didn’t know when to tell him to stop, how to cover up. His nurse never left the room. She heard and saw him. This didn’t seem to bother her. Maybe I was a prude. I remember, though, when he left and she told me to get dressed, averting her eyes, that she seemed sad, tired, and maybe sorry for the both of us.

I’d gone back to him the next year, tried again to not be uncomfortable. When he did similar things, I jumped ship on male gynecologists. A female physician delivered my son. When I needed an internist, I chose a woman. And when she couldn’t figure out what was wrong with my stomach I didn’t go around her to get another opinion, because I trusted her, I trusted a woman, to figure it out, deductively. How many things could and couldn’t my symptoms be?

In the ICU, I had lain still, shocked at the solemnity of this care, and at how just the day before I’d been at home, and three weeks earlier I’d been bopping around running errands, cooking dinner, drinking wine. I floated above my body, willing it to heal. I woke to find my sister, Gianna, standing at the foot of the bed, concerned. “Come hold my hand,” I said. A lawsuit would re-examine, imagine and embellish. Recuperating was a ritual I didn’t want overshadowed or disturbed by anger and what-ifs.

On the Italian side of my family, medical issues were high drama, public events, and everyone’s problem. Death was always looming, ready to ambush you before you were done, yet these relatives died when they were old.

On the Polish side of my family, people were private, stoic and steeled themselves against crappy diseases that came their way and did kill them. My mother had two sisters and a brother who died young. When I was five my mother got tuberculosis and had to be quarantined. She’d just come home from being on tour with my father. They’d left my baby sister Nina and me for three years with our Italian grandmother. And then my mother was, gone again, but sick this time. I waited at my grandmother’s house for her to heal and come back to me. During the four months that she recuperated, my mother made crafts from kits my father bought her at the hobby store: a tree with thick branches patch-worked out of scraps from worn out dresses, curtains, my father’s shirts, the patches edged in thick black yarn; a white plaster casting of a queen’s face with a yellow crown, curly eyelashes and bright red lips. For years it sat on the sideboard in the dining room and goggled us while we ate. She knitted Nina and me scarves and matching hats popcorn-stitched out of soft wool that didn’t scratch.

She turned being sick into a special occasion.

Not so my ninety-year-old grandmother, my father’s mother, who after a colostomy ripped out her IVs and had to be tied down in white canvas restraints. At home she fought her disgust over the bag by not eating, then dying. She called us to her bedside in New Jersey to be with her while she did.

I am the child of them both: frightened, deferential, enraged, poised. My internist’s office was across the street from the hospital but she never came over to look in on me. For that I’d like to sue her, but is there a malpractice of not stopping by? She didn’t want to admit her mistake. She’s a coward, and it’s enough, at least today, that I’m a writer, riled in the text.

 

In the spring of 2013 I decided to go ahead with surgery for a hernia that bulged out under my ribcage like a ruptured bicycle tire. I’d carried it around for twelve years because it had never been enough of a bother to fix, but now I knew a doctor I trusted: Dr. Wren. I wanted to commission him back into action because I missed his rescue, the close call, how he shoved death back when he removed the dumb appendix pouch evolution forgot, no bigger than a finger joint, withered and leaking waste into my intestinal wall.

The hernia poked out, Incredible-Hulkishly, and it was time to push it back in with netting or some stitches. This would be a surgery, but outpatient. Dr. Wren and I shared a history. There’d been transference, yes, like Stockholm syndrome without the captivity. And it had been luxurious after the appendix emergency to see my friends and sisters, my husband and son, rally around me, because it’s rare to be at the very center of concern.

My mother had shown me this, how to be graceful and appreciative when you are sick. Her tuberculosis gave her high fevers and she sweated through flannel nightgowns. For the first month she slept most of the day, but when she was well enough to sit up, she switched to pink linen bedclothes from her trousseau, and delicately embroidered silk bed jackets with ¾-length sleeves. She saved these jackets, and when Nina and I got sick she’d let us borrow them. We’d wear them over our PJs, becoming little versions of her. She brought in extra pillows. “Prop yourself up,” she’d say, and place a white wicker breakfast tray over our laps. On it would be ginger ale in a champagne flute, saltine crackers on a china plate, a new coloring book with a fresh pack of crayons, a rose in a bud vase. Better than room service at the Plaza.

I didn’t tell my mother about either of these surgeries until they were long over, because she doesn’t rise like she used to above what is going wrong; instead she obsesses over worst-case scenarios, calls too often, not believing what you tell her, unable anymore to calm herself down. But I keep my younger mother with me. From her I learned how to be a patient, how you give in but only because you will soon be through this, and you don’t want the people around you to suffer more than is necessary.

The morning of the hernia surgery, Malcolm drove me at dawn down Napoleon Avenue to the same hospital, and again I undressed and put on the open-sided gown. The anesthesiologist connected me to the magic that would black out this piece of time, and masked nurses with pretty eyes materialized, assured and lifted me with warm hands from a comfy bed onto a tight, narrow surgical cot. The operating room was chilly and bright, swimming with medical help, out of view but I could hear them. “All for me?” I said, the guest of honor, dumb on Valium. On the radio Robin Thicke was singing the catchy, wrong song about how women know they want it.

When Dr. Wren stepped in I was already under. He zeroed, chastely, on that one square of skin, stitched the hernia back, and I saw him on the other side, in Recovery, where he said everything went well. Again, I thought. Tell me how. I wanted to be a patient worth remembering. But he spoke in results, in science, not story. On any given day there were people who needed him more.

He passed me into the hands of a discharge nurse and she wheel-chaired me into the hands of my husband, waiting with the morning paper, now old news. He helped me into our Yukon, which he’d left idling in the circle drive. We stopped at Walgreens to fill the prescription and made our way home, avoiding potholes.

At the house I took my place again in the reclining chair and the encore of healing began: the jet-trail of anesthesia, the novelty and delirium of pain meds, clear soup, cool water, and Ritz crackers that tasted as good as cake. I thought about my mother alone in her house, watching TV, safer in not knowing. The white wicker bed tray is still somewhere because she doesn’t throw anything out. During the night Malcolm checked on me, kept his warm hand on my arm, and again there was no rush, just his quiet, alert company and all the time it took to heal what was opened.

Our skin is seamless, a cloth, like silk, that covers us and reveals the smallest tear. Scars are made when the body replaces missing skin. Mine are all on my stomach and they map a birth, a repair, and an emergency. The incision from my C-section was closed using plastic surgery stitches and it’s razor-thin, near invisible, an elegance of new life and a blessing. After the hernia surgery there is a one-inch burgundy scar under my ribcage. These stitches rubbed off like adhesive and the bump is gone. The appendix scar is more drastic, six inches long and a keloid. Dr. Wren said he could revise it, but I’m letting it be what it is, an overworking of tissue, me knitting myself back together. Unless I – God forbid – need surgery again, I won’t be seeing him anymore, and there’s some loss in that.

But Malcolm is here to help me remember. When I ask him he patiently goes over the details of the time I could have died, because this is a claim not everyone can make, and maybe I’m borrowing from my grandmother’s playbook, which rages at how cruel and fickle sickness can be, and insists on knowing what might have happened.

He tells me again about those six days: I was in the same hospital where so many critically ill patients had died during Katrina, and even seven years later the only wards open were the ER, the surgical ward, and the ICU. The other floors were empty and dark. In the ICU there was one other patient, a terribly sick man whose frightened family took turns with him. Malcolm can still see them hovering, shrouding their loved one with care, entreating him to come around. He tells me that up on the fourth floor in the surgical wing, there were only a few rooms with patients. To get to me, he had to walk through the ghostly halls. “Did you think I’d be okay?” I ask. He says, “Once I talked to Dr. Wren I did.”

The windowsill in my bland room had been lined with flowers: dark red poinsettias because it was December; Skittles-colored Gerber daisies from my sisters; white tulips from Malcolm and Andrew. Outside my window and across the street there was a cheerful trompe l’oeil mural of a streetcar gliding past the live oaks and mansions of St. Charles. If you couldn’t get to the city, the city would come to you.

Weeks later when I was cleared by Dr. Wren to drive, I drove the hospital’s perimeter and found the mural across from the grid of windows where my room had been. Was mine the one with the blinds half-drawn? I wondered who was in there now and what was wrong. I wished for them a husband reading a book beside their bed. I wished for them a voice louder than mine.

Pia Z. Ehrhardt is the author of Famous Fathers & Other Stories (MacAdam/Cage). Her stories and essays have appeared in McSweeney’s Quarterly Concern, Oxford American, TheRumpus.net, New World Writing, and Narrative Magazine, and have been widely anthologized. Her work has been featured on NPR’s Selected Shorts and at WordTheater in Los Angeles. She is the recipient of a Bread Loaf Fellowship and the Narrative Prize. She lives in New Orleans, where she’s a visiting artist at NOCCA.

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