Emerson Essay 05.04.09

Unsung Heroes of the Medical Community

I have a new right hip. It’s made of porcelain and on an x-ray you can see a few formidable-looking screws holding it in place. It will last a lifetime and doesn’t hurt like the old bone one did. As operations go, this was a standard procedure and I was lucky to have a great surgeon with an excellent reputation. There was little to fear and it turned out to be a remarkably successful experience, taking less than two hours at Honolulu’s  Kuakini Medical Center.

Hip replacement is not a glamorous surgery. There will be no Hallmark Hall of Fame Sunday night movie about my (or anyone else’s) heroic recovery from a hip replacement. This type of surgery is so common that on a recent episode of “30 Rock,” Jack’s octogenarian mother, who was carrying on an affair with a younger married man, had ordered a book on-line called “Sex After Hip Surgery.” 

Several friends suggested that my surgical experience would give me lots of material on which to base an essay, and they were right. But it’s not the surgery itself that merits attention. Instead, it’s the unsung heroes of the medical community I encountered during my hospital and rehab stay. I’m not talking about my brilliant surgeon or the astute rheumatologist who diagnosed my arthritis.  Instead I want to tell you about the nurses and a special physical therapist who brought me great comfort and were instrumental in expediting my recovery.

My first close encounter of the nursely kind actually happened two days prior to my operation. I had to report for an orientation on what to expect on the day of the surgery. My wife and I were greeted and educated by my “admittance nurse,” a charming 30-something local woman I’ll call “Doreen.” (I remember few real names of the nurses I met, so henceforth the names will be changed to cover for my poor memory that was further degraded by medication.)

Doreen was attractive, cheerful, and laughed at all my jokes. We hit it off immediately. Living on an island the size of Oahu, one experiences the phenomenon of “three degrees of separation.” It seems everyone I meet knows someone who knows someone who plays in the Royal Hawaiian Band (my “day job”). Doreen was no exception and we ended up talking about mutual friends and other island connections.

Doreen told us what to expect the day of the surgery. She walked us through the paperwork and showed us a video about Kuakini Medical Center. I felt safe and secure with her. I asked if I would see her the day of the surgery and how long would she stay with me. I selfishly wanted Doreen by my bedside the entire four days I was to be there. She told me if I showed up at 5 AM on the day of the operation she would be with me up until the time I was wheeled up to the pre-op area at 7 AM. I had to settle for two hours with Doreen, which would be a great way to start my Kuakini Medical Center experience.

This first encounter with nurse Doreen occurred on Tuesday afternoon. On Thursday morning at 5AM, my wife, Barb, and I found ourselves in the waiting room huddled around a small TV set, watching CNN and waiting to be called.

“William Willie?” said a voice.

“That’s WILEY and that’s me,” I said. Not only did she mispronounce my last name, she was not Doreen! Nevertheless, we were led into the very cubicle in which Doreen had interviewed us less than 48 hours before. This was a good sign. Surely Doreen would show up soon.

They took my vital signs, drew blood, and gave me more paperwork. I signed a lot of release forms. I guess the medical community has to cover its ass in case I ended up in a ten-year coma. I politely did what I was told by this non-Doreen nurse. Not wanting to seem rude and unappreciative, I did have to enquire about my favorite admitting nurse.

“So? Is Doreen expected in anytime soon?”

“No. She called in sick today.”

I smiled weakly, nodded my head and tried not to look too disappointed. In all fairness, although she lacked Doreen’s warmth, humor and good looks, non-Doreen did her job quietly and efficiently. Before I knew it, I was in bed, dressed in a embarrassingly small gown. I said goodbye to Barb, told her where all the important legal papers were hidden at home, that ten-year coma thing still nagging at me. I was wheeled into the operating room.

Here I met a model of efficiency, the O.R. nurse. Her medical knowledge and communication skills made me feel safe and secure. I was injected with something “to make me relax.” All thoughts of the ten-year coma vanished. The anesthesiologist arrived to explain what further meds I would be given. My surgeon poked his head in ever so briefly to nod and say he’d see me later…“in there.” That’s the last thing I remember until…

  ***************************

…I awoke surrounded by more nurses. They scurried around like ants building a colony, attending to my every need. Tubes were attached and inserted in places I didn’t know tubes would go. Vital signs were taken. The “no drinking liquids eight hours prior to surgery” rule was finally revoked. I was parched and it felt like I had been run over by a locomotive.

Summoning up one of the few bits of Scripture I remember, I spoke Jesus’ words: “I thirst!” Like a Roman centurion, a nurse mercifully wetted my gums with drops of water from a sponge. After a few hours, I was transferred from Intensive Care to my hospital room, where Barb was waiting. More nurses sprang into action, attaching me to countless monitors, checking the incision, and even smiling at my feeble humor when I tried a few one-liners like, “I’ve always wanted to see this room.” In addition to taking care of all my needs, the nurses went over my pain med options. I was now allowed to eat and drink, although during that first day, Jello and applesauce were about all I could tolerate.

The day after my surgery two nurses talked me into taking my first steps on my new hip. I walked about one yard and was totally exhausted. They were patient and understanding. It was always the nurses who were there. I saw very little of the doctors.

My favorite nurse at Kuakini (we’ll call her “Joy”) was a tall, thin, attractive young woman who was particularly concerned about answering my call button in a timely fashion. Joy would come running into the room and slide on her stocking feet…sideways. She would magically appear from behind the bed curtain, her palms upward at shoulder height, with a big grin, saying, “You rang?” She always went around in her socks…no shoes. But in spite of this frivolity Joy was the consummate medical professional. She was always ready with the knowledge, skill and concern to tend to the sort of medical emergencies that pervade the post-op room. When my blood pressure went plummeting and I broke out in cold sweats, Joy calmly and efficiently knew what to do, and when to call the doctor if she was concerned.

Nurses not only save lives, they are called upon to do a variety of tasks that would make the rest of us run and hide. Sponge baths and wet pants are the most benign of these tasks. Nurses do these duties willingly and without complaint or judgment.

I spent four days total at Kuakini Medical Center. During this time I came to appreciate the genuine concern exhibited by the nursing staff. The term “caregiver” is used a lot but with nurses one cannot over emphasize the care they truly give.

 ***************************

After my time at Kuakini was up, it was on to the Rehab Hospital of the Pacific. I wasn’t quite sure what to expect there. Would I be surrounded by Iraqi War veterans with multiple amputations trying to rehabilitate themselves back into society? A friend of mine from L.A. joked to me on the phone, “Rehab, eh? That term has a whole different meaning here in Hollywood.”

I was soon to learn that at a rehab center, people aren’t there to die. Everyone, even the very old and the severely injured, comes to get better. It was like the most positive hospital in the world with the most caring staff imaginable. There were several patients who had also had hip replacements. So much of recovery is determined by attitude. The nurses here had incredibly optimistic outlooks, geared toward the patient getting progressively better. They were always sure to state the goal of their treatment, perhaps so that the patient could start to envision it. “By the time you leave here, we’ll have you going up five stairs.” It seems inconceivable to me in the beginning, but they, of course, turned out to be right.

My two favorite nurses were Jodie and Myra. Jodie was a heavy set Samoan woman whose wide face always beamed with a smile. She worked the day shift so I would see her first thing in the morning, usually around at 6 AM.

“My God! Where have you been?” I would always tease her. “I’ve been waiting up all night for you!”

She would kindly chuckle, then take my vital signs. I’d always start the day with a smile on my face when Jodie was there. We become good friends and she told me all about her family, especially her kids and her husband’s softball team.

Myra was a cute, young Portuguese-Hawaiian woman, small in size but a bundle of good energy. My favorite experience with Myra was the day she told me I had to be sent to Saint Francis Hospital, about a half mile away, for an ultrasound on my leg.

“How will I get there? How will I know what to do?”

“Don’t worry,” said Myra, “I’ll be with you every step of the way.” And she was. We rode together in a handi-van. It was my very first day outside of the rehab center. Once we got to Saint Francis, Myra was great. Everyone seemed to know her. She handled all the paperwork and bureaucracy with the utmost efficiency. I felt such comfort with her. The ultrasound took a long time but I felt great knowing I’d ride back to rehab with Myra.

Not all the nurses were women. I remember one male nurse at the rehab center, in particular. He contradicted the gay male nurse stereotype. He came in at 11 PM one Saturday night, ready to work the graveyard shift. He sported a back-pack and a motorcycle helmet. He came in and introduced himself and assured me he’d be there all night if I needed anything. As it turned out I didn’t need anything that night, sleeping soundly with the knowledge that someone was always there…just in case. He came back in the morning just to say “good-bye” and asked how I slept. He told me he was just a part-timer who only worked an occasional weekend. I never saw him after that, but he struck me as the kind of guy I’d like to have a beer with.

But nurses and patients don’t stay in touch. There were no sad good-byes when I left. Nurses can’t get involved emotionally. I really wanted to say good-bye to Jodie and Myra but I left on a Sunday afternoon when neither of them was working. I thought it might be nice to send up a box of cookies or something to the rehab nurses after I returned home, but I never did.

A wonderfully kind nurse named Joanne processed me out of rehab. She went over my list of meds and all of the precautions I needed to take when I was back home, away from the immediate care of the rehab staff. Joanne went with us in the elevator on the way to the car and watched me delicately ease my healing hip and my tall self into the front passenger seat of Barb’s little Honda. I wanted to give Joanne a final hug…but I didn’t.

This homage to the unsung heroes of the medical community would not be complete if I didn’t mention someone who is not a nurse or doctor. She is my physical therapist with whom I am still working. Her name is Kelly and she is 30 years old. Don’t believe the myth of physical therapists being Nazi drill instructors. Kelly is an angel.

I have spent more time with Kelly than any other medical professional during this three-month journey. I spend hour-long sessions with her two or three times a week. She makes me lift weights with my leg, and makes my leg do things I never thought it could do. She massages my “bad leg” and puts ice on it at the end of our sessions. Her feedback is nothing but positive. She uses the word “perfect” more than anyone I’ve ever met. As I attempt to stand and lift my leg back and out to the side at a diagonal angle (30 times), I will ask her, “How am I doing?”

“Perrrrfect,” she coos, “perrrrfect.”

We have great chats during the time I spend in P.T. She had surgery on both her knees at age 16, due to her many years of playing basketball. She knows the science of rehab but also can relate to her patients needs from her own experience. She humanizes the rehab process. So we talk basketball. Kelly can name the entire 1992 USA Olympic “Dream Team.” We talk travel too. She knows the West Coast from Northern California to Washington State. She has eaten crab cakes in Baltimore’s Inner Harbor. She’s become a good friend. When it’s time to say good-bye to Kelly, I will hug her.

Doctors get the glory, reputations and big bucks. But it’s these foot soldiers who I appreciate most. Thank you Kelly. And thank you Doreen, non-Doreen, Joy, Jodie, Myra, Macho Guy, Joanne, and all the others.

You guys are…PERRRRFECT!

 

© William Emerson Wiley

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1 Comment

  1. dorothy hayden said,

    June 7, 2010 at 10:46 am

    hey bill i can hardly wait to have a new hip. sounds like you had a BLAST

    well not really but such good support happy for you see you wednesday
    what is URI ???


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