Got in past the vast ice rink covering the walkway to the hospital – me with just enough balance to get my wonky foot and the bags through. Jesus, what were we going to do after the operation – in this evil weather, and with Brooklyn sure to be its usual wild west show of chaos, garbage, and mounds of filthy ice?
We got into the elevator and a woman getting out asked us where we were going. I told her 4F, the ambulatory check-in. And she grilled us some more about what we were doing. Since I assumed it was none of her business, I said, “We’re going to 4F,” and I was kind of snippy about it. I was already cheesed off from the cab ride and the Walkway of Death for the Disabled. I didn’t want to have to explain our every move to everyone. The woman got back into the elevator with us. It turned out that she was the person who’d have to check me in. I felt bad that I was snippy. “See you’re early, we don’t open ‘til 7:30,” she said. She actually said it twice by the time we got up to the fourth floor. It was literally 7:25.
We followed her down two long stretches of hallway to the waiting room. (Dear God, is there no respite for the lame?) She got to her desk, removed her coat and in her chatty secretary Latina way, “Yeah, I wasn’t ready for you, you see. Because we don’t open ‘til 7:30.” This was at least the fourth time she said this since the elevator ride. It made me feel as though we were completely ruining her day, when I was the one about to have his foot sliced open. “Yes, you’re not open yet, we understand.”
After which I added, “Sorry I’m a little stressed.” But it was okay. She didn’t seem to be affected by anything I said. She carried on in a cheery way, and proceeded to hand me my paperwork. She must deal with all kinds of people, and all kinds of people must deal with her. It reminded me of what my mom and dad had to go through when my father was sick. That was the first time I’d witnessed how hard it was to be a patient – because most of the people you deal with will just want to tell you about their problems and not help you deal with yours. It also reminded me that I can be a super-snippy asshole, and that’s kind of what got me into this mess in the first place. Breathe, brother.
I filled in the paperwork. Then the nurse came out and asked me to come back into the prep room. Bring your clothes but leave your bag, she said, which was confusing, because I had clothes in the bag. I had the sweat pants they'd told me to bring; shirts, underwear and contact lens stuff. I asked her to clarify and she repeated herself, and so I brought back everything. Once I sat down she asked, “How are you doing?” I said, “Anxious.” She replied, “Yes, I can see that – because I asked you to bring back your clothes back and not your bag. We don’t have room for it!” Really? Seriously? You’re going to quibble with me over bags at a time like this? This is the moment in every stressful scenario when I become Larry David. I cannot let questionable behavior just go by. If it defies my logic, I have to argue. I have to make my feelings known. Again, this might have something to do with the fact that I have a disrupted limb and a questionable future.
I explained that I had clothes in the bag, and we found a place for them, finally coming to an amicable discourse. The questioning began. Heart disease, lung problems, any chance you could be pregnant, ha ha?
Got seated in the prep chair, and met Doctor Carter’s fellow, whom I hadn’t met before, and who asked me more questions, including. “So, what are we doing today?” Guess it’s not his job to know. Comforting. Wonder if he asks the patient where he should make the incision too. I was explaining the state of my metatarsal-phalangeal joint when Dr. Carter came in, dressed in his scrubs, friendly and smiley as usual, shouting, “Okay, here we go! Which foot is it?” Amazing. It was not a joke. I lifted up the right, at which point he whipped off my surgical sock and made a marking with a pen on my right ankle. A couple of vertical lines and some other squiggle. I guessed that marked where the nerve block was to go. (And perhaps to remind him that it’s the right foot that needs operating on, not the left?) He then consulted with his fellow and talked about what he was going to do, and said that he would probably be doing a Moberg procedure in addition to the joint cleanout. “I’m a big Mobergist,” he said, again in his particularly avuncular way, as if talking about his favorite TV show. “That gives the best results. Unless there’s not enough dorsiflexion,” he said, and demonstrated by pulling my big toe down toward the floor, “but if there is, the Moberg helps almost every time.” And then he bent the toe in the other direction, towards me, and I grunted in pain, which he duly ignored. “And we’re looking for a cyst, right?” I said, and he said, “Yeah,” but not convincingly. Maybe he was affronted by my telling him what to do; maybe he wasn’t sure there was a cyst at all, so didn’t want to give a definitive yes.
He left for the operating room. I asked the fellow if the doctor would definitely doing the Moberg procedure, which, to my understanding, is where they reset the toe at a slightly higher angle, so that not so much weight goes on it in the future. Yes, the fellow said, reassuring me that this procedure often helps tremendously. “Okay,” said, remembering from the doctor’s info packet that the Moberg procedure would cost me about $3500 extra. Amazing how the Jewish mind works. Or is it the actor’s mind? Not sure which of my personalities is the one more concerned with money.
The anesthesiologists – both of them – looked all of about twenty-five years old. Women. And I must have had that look on my face, the one they probably see all the time. That “YOU’RE my doctor?” face. That “can I get someone older?” face. One of them was African American, the other, Persian perhaps. Dr. Al-Alawi. See had a less than awesome bedside manner – even the way she said “Hello, how are you?” was so cold and detached, I wanted to scream at her. She said it in the sing-songy tone that drives always me crazy when anyone uses it to say ‘hello, how are you?’ It’s the melody of I-don’t-care. Plus, she didn’t look at me. This was a perfect demonstration of how eye contact can really do wonders to set your fellow human beings at ease. Whether it’s on a date, or an interview, or being prepped by your anesthesiologist. The exclusion of eye contact feels like an exclusion from society. You are a number more than a name. Just a little can go such a long way.
She said, “I’m going to ask you some questions while Dr. Too Young to Be a Doctor gets your IV started.” I turned to look at the IV getting started, and Dr. Al-Alawi said, “It’s really best not to look. I’m going to distract you with some questions.”
The IV was the worst bit. A pinch and a burn, they always say right before it goes in. I’d had pinches and burns before . This was a big one. I felt my voice raise to a little girl’s pitch while trying to answer one of Al-Alawi’s questions. “Do you have any history with heart irregularities or shortness of breath.” “Nnnn oooo….!”
The IV girl said, “All done,” followed immediately by “Oop!” I looked over to see blood all over my forearm. “What, what is it?” I asked, trying to stay calm, but clearly failing. “It’s okay, you’re just a good bleeder,” she said, “It’s totally normal.” And I begged, half smiling, “Um… please don’t say ‘oop!’ if you’re trying to keep me calm.” I’m just a complete freak with blood and needles. And, as is evident, an unintentional Larry David. I really don’t know why that transformation occurs. It’s an instinct. A plea for help more than anything else.
She cleaned me up and it still looked disgusting. A small pool of blood surrounding the entry point, visible through the transparent band-aid she’d put over it. Dear God, that thing is going INTO my arm. Wait a minute – it looks like some blood is coming out into the IV tube. Is that right? That can’t be right. Excuse me, is this right?
Dr. Al-Alawi made me sign a transfusion agreement (standard procedure) and told me not to worry – I was probably in more danger getting into the cab this morning than with anything about to happen in the operating room. That was a good line. It did put me at ease, and on this day was probably pretty accurate. I wonder if it’s a standard-issue line she gives to all overly anxious patients. It’s pretty good.
The first RN came over and asked me if I wanted my mom to come in to say hi, or just to open the door and give me a wave. I said, “No, just tell her I’m ok.” Which I regarded as a pretty mature male thing to do – ‘cause inside I was feeling much less than ok. It was my first instance of feeling brave for my mom – I knew she would freak out to see me lying in a gown with an IV. I also know that part of the reason I didn’t want her coming through and waving at me was that I didn’t want to be reminded that I had only my mom to look after me at my age. It was still pretty embarrassing to me.
Word came in that they were ready for me in the operating room. I walked in with the first anesthesiologist holding my hand. I’d told her I still have trouble walking. Dr. Carter said, “There he is!” and I suddenly felt like a Bar Mitzvah boy again. Ugh – hate that feeling. On parade, and in some kind of awful ceremonial outfit like a tallis or a hospital gown. I was truly amazed when Dr. C. said, “Put your fanny right in the middle there, in that curve,” pointing to the indented spot on the operating table. Fanny? Really? I knew he was folksy and Texan but – fanny? This was a new level of folksiness that didn’t do a lot for my confidence.
I parked my fanny in the crevice, the anesthesiologist removed my glasses, and that really is the last thing I remember. I have a vague memory of futzing with a mask, but I don’t remember anyone putting a mask on me.
When I came to, the nurse asked me if I wanted coffee or juice, and my mom was there, or came over, I don’t remember which. They’d removed my glasses in the O.R., and I couldn’t see anything.
That’s when the surgeon came over.
“Well, Mr. James, we had a couple of surprises in there. We found a big ol’ pothole on the joint…” And at this point I still couldn’t see a thing, and wanting to give him and this moment my full attention, I asked, “Where are my glasses?” A nurse found them and handed them to me – at which point Dr. H. said “Are you listening?” And I said yes, I just couldn’t see. That was the first time he’d ever been impatient with me. That immediately made me worried. He said, “We’re looking at a much longer recovery time, I think. I found a big pothole at the head of the joint, and so I drilled three holes around it” (at least this is what I think he said – I was still groggy. I’m not sure if this is accurate) – “and cleared out the dead cartilage. Now we just have to wait and see. But we’re looking at about a 50/50 success rate with this.” At which point my mom let out an “oy vey” and interjected – “What about a cyst? Did you find the cyst?” “No, there wasn’t a cyst. Come back and see me on Monday and we’ll get you into the boot and see how it goes. It’s a good thing we got this taken care of.” Mom interjected again, “What about physical therapy?” “No, not for a couple of months. I don’t want anyone touching it for another 2, 3 months.”
I remained unbelievably calm considering that this was not the post-op report I was looking for. Even thinking about it now, I still get totally creeped out. He repeated, “it’s about a 50/50 shot we’re looking at.” And he looked very serious. But I just said, “ok.” It must have been the drugs. Or maybe it was my mom being there that made me want to be behave more rationally and maturely, so that she didn’t freak out. Perhaps it was the idea in my mind that ending up on the negative-50 side was not possible. There was no way this thing could go that wrong. No way – I’m a healthy young(ish) man. I’m an actor. I’m smart, creative, and nice to look at. Being crippled for life is not something that could happen to me. It just didn’t make sense.
What the hell was going on with him and his bleak outlook. What happened to folksy? What happened to the smile? Come on, doc, say something about my fanny, or my noggin, or this little piggy. Give me a god-damn lollipop, will you?
He then asked for my phone number so he could check on me, and that made it feel even more dire. I gave it to him, concentrating very hard to make sure I got the numbers right. Maybe this was purely a test – to see if I was cognizant enough to remember my number. I’m pretty sure I gave him the right one. (He never called me.)
Even through all of this, as one of the nurses helped me on with my sweatpants and guided me into the wheelchair I was thinking, “Well, I mean, this isn’t SO bad.” Meaning the process of getting operated on. But I know that’s because I couldn’t feel my leg at all. Somehow my foot being completely numb made me believe the operation was a success. For the first time in almost a year, my foot did not hurt at all. And it was wrapped up in a splint under countless layers of bandages, which somehow gave me the sensation of it being was wrapped up in lovely crocheted blankets made by someone’s grandma. This feeling continued even during the epic bumpy cab ride home, me sitting in the back seat, my back against the door and my foot up on the seat. Hmmm… nice, this feels nice. Ok, great, let’s go home. Larry David had gone. I guess this proves I must have been high.
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