Gaps in the fence

The other day I was driving home when our neighbor’s wife called to say her husband had died. We didn’t know them well. I’d only ever spoken to the wife over the telephone, though I knew him to say hello or wave. He and the Hubbit were friendly; they’d call on each other for help as needed – to borrow tools or equipment, or work together on some or other repair. For a while we took care of their pasture in return for grazing our cattle there. More than once he zipped over in his golf cart to help us chase down a runaway steer.

Somehow I never got around to inviting them over to barbecue, and we had no idea that he’d been diagnosed with throat cancer in February.  When I got home I told the Hubbit the news and he was dismayed. “Well, dang!” he said. “I’ve been thinking I should go over and visit, but…”

A few weeks ago I learned that my Aunt Marietjie had died. She was in her nineties and I knew she’d become frail, but the last time I saw her – just a few years ago at Marmeee’s memorial service – she was as I’d always known her: calm, unfalteringly kind, resolute. We weren’t close; I didn’t see her that often and in the 23 years since I moved to the US we’ve never corresponded … but when I named this blog it was with her in mind, because she was someone I kinda wanted to be like – strong, unflappable, salt-of-the-earth, a woman of strong faith and stronger Scrabble skills, a quiet source of wisdom and comfort food.

My father, the Olde Buzzard, used to refer to her as a soustannie, and it was only after I named this blog that I learned that the word didn’t mean an intelligent, powerful woman with excellent culinary skills. It’s not a compliment. It means someone who is female, fat and bossy. Well, some might say that makes it a fine name for my blog …. Oh well. [Insert shrug emoji here.]

Moment of truth: the Olde Buzzard was intimidated by strong women, and that made him mean. He had uncomplimentary nicknames for me too. He died a few years ago, and … well, all I want to say is, I’m grateful that in the end I was able to do my duty, to treat him with love and kindness, and that everything needing to be said and done between us was indeed said and done.

Getting back to Marietjie … I thought of changing the name of this blog, but decided instead to stay with the image I’d originally had in mind – an image largely inspired by this aunt, whom I am not at all like, yet who was extraordinarily kind to me at random intervals throughout my life. She was the one person I could trust to love my Girl Child when she needed it and wouldn’t accept it from me. I always meant to write to her care of my cousin, but…

Some years ago I wrote a post that won a response from a different cousin, from the other side of the family. I replied, but he never commented again. But from then on, every time I wrote about dogs, a small part of me wrote for him, because I grew up hearing stories about his extraordinary ability to connect with animals.

I grew up loving him.

I have many cousins and I’ve had crushes on several of them, but Michael was special. He was so handsome, tan and blue-eyed and blonde, with ruggedly regular features and a smile that reached out and pulled you in. When he invited me up onto his lap and taught me how to tell the time on his big wristwatch, he made my four-year-old heart flutter. I was convinced I would marry him, and I was devastated when he married someone else.

The Old Buzzard had adored my cousin – they were close in age – and he disliked the wife, and now I realize that she’s probably strong and intelligent as well as being “a damn liberal who thinks we aren’t good enough”. Back then, viewing her through the distorted lens of his resentment, I couldn’t warm to her. But I spent a month with them, while I was a university student with a vacation job in their city, and I remember she was kind, and their home was beautiful, and they seemed happy. (Who wouldn’t be happy with Michael?) I remember that she collected silver, so at the end of the visit I spent almost everything I’d earned on some too large and probably tacky addition to her collection because I needed to prove that I’d been raised right. I remember I fell and sprained my ankle getting off the bus, and Michael – who was a successful vet by then – bound it up. When I complained that he hurt me, he laughed at me for making more fuss than a dog with far worse injuries. But I forgave him because he still made my teenage heart flutter.

After I got that message from him on my long-ago blog post, whenever I wrote about dogs and hoped for another message I thought about making contact. I imagined going to see him on my next trip to South Africa. And then a couple months ago I heard that he’d died. Hoping for more detail I looked at his sister Midge’s Facebook page – and that’s when I learned that her daughter had just died – a beautiful, bright, happy woman that I’d never met, barely knew existed, just gone. There are wedding photos on Midge’s Facebook page, and she shines. I wept over them for several days – I don’t know why the loss felt so agonizing; I didn’t know her! And then I tried to write to Midge, but…

Then I got a message on my last post, from Michael’s wife, reaching out, and that’s when I learned that he’d actually died long before I heard about it – last January, of covid – such a horrible, horrible way to go! And I wanted to write to her, but what to say? Where to send it? We’re not even connected through Facebook – which I rarely visit anyway. It’s not that I can’t figure this out – and I will – but…

But I want a do-over. I want a neighborhood barbecue, and after that maybe conversations and coffee with a few new friends.

I want to talk to Michael and his wife, and see her with my own clear eyes. I don’t know what we’d talk about … dogs, probably, but what else? I want to know!

I want another game of Scrabble with Marietjie, with a plate of koeksisters and big mugs of rooibos tea. And I want to walk on the beach and then loll about comfortably and talk about cats with my cousin, her daughter, who is still this side of the dirt but on the far side of the planet.

I want to hug Midge, and meet her daughter, and maybe be invited to the wedding, or at least send a gift. And I want to meet her niece, my goddaughter, whose parents thought it would be cute to make 12-year-old me a godmother, since they didn’t take such things seriously, only I wish I had. And actually I’d like to see her parents again too.

And then there’s the other cousin who used to look so hot in his SA Airforce uniform, and his brother who was in a quite popular band and then became a DJ. They used to tease me, and one time I played in their mother’s cactus garden and ended up sprawled over my mother’s lap, butt exposed to the sunshine and their gleeful mockery, while I shrieked my outrage and she picked out tiny needles with a pair of tweezers. Those cousins are still alive, as far as I know, round the other side of the planet, and one day it’ll be too late for a do-over, but right now I have no idea what to do about that. We had a friendship – the DJ cousin and I did, anyway – and then it fizzled and we drifted and … truth be told, there’s probably no way back. None on my map, anyway.

I have cousins scattered all over the world, and others – nieces and a nephew, second cousins – so many people that I love or have loved or wish I’d loved. And although I know I don’t have the capacity to reconnect deeply with all of them – or even with more than a very few – being strangers just feels wrong.

And then there are friends. Like Deej. I want to sit with Deej and lay out all my questions about God and ask him how he, one of the finest and fiercest champions of Christ I ever knew, could possibly think well of Donald Trump. I actually tried to ask him that, via WhatsApp, but he didn’t answer, and over time he ghosted me. That stung, because he was my pastor more than anyone else ever was or will be, and I want to look him in the eye and ask why he wounded me. But I can’t, because he’s gone, and there are no do-overs. He died last December, a week shy of his eightieth birthday, leaving me still burdened with so many questions and no one else I’d entrust them to.

I ache every day to go on a road trip with Twiglet, the sister my heart gave me. Talking on WhatsApp doesn’t cut it, especially as her connection is so bad that usually I just listen to her voice; it’s impossible really to follow what she’s saying. I want a cream tea with Luscious. I want to talk about God and poetry with Fair Bianca. I am homesick for the friends of my young womanhood!

I want to kick back and laugh with the Kat, and talk deep talks with the Egg and Homeboy, and argue face-to-face with the Girl Child instead of getting mad and frustrated over WhatsApp. I want to laugh and talk and eat with my foster kids, and watch the granddaughters they gave me grow up, and be there to love them through it when their mothers make them angry, and go to their weddings and cuddle their babies – or not, if they choose a different road. But they’re all, all on the wrong side of the planet.

I want to find a way back to the Stranger, but I don’t think there is one, and the meeting place where I’d hope to find him might not even exist.

I remember my blessings. Here I have friends, a few anyway, some quite elderly, and a Hubbit ditto, that I love as best I can – although never enough. I have neighbors that I may invite to barbecue next summer.

I’ve been thinking that the people we touch are like fenceposts. They enclose the fields where we grow our lives.

I look at my fence, and there are gaps in it. It’s been standing a while and has reached that stage in the life of a fence that gaps form more and more frequently. Some of the timbers are broken, others are weathered and warped and working loose, and many are out of my reach. Beyond the fence I see the wilderness pressing in.

I’m not afraid of the wilderness. Often I’m drawn to it … I stand next to the fence and imagine what it would be like to push through and see what’s out there. Then I remember that I have work still to do on this side and I turn back.

But it troubles me sometimes to think that one day the gate in the fence may open, and it won’t matter because the fence itself will be down. I’ll walk through, as one must, but I wonder who will know.

Photos by Denise Karis and Foto Maak on Unsplash

Breathless

I bitched so much that they hung this on my door, and after that people tiptoed in and apologized for turning on lights even at midday. And, yes, keratoconus does mean sudden bright light hurts my eyes … but actually the spirit of my bitching was more along the lines of Proverbs 27:14 – “He that blesseth his friend with a loud voice, rising early in the morning, it shall be counted a curse to him.”

Today didn’t start well.

There was a thump at the door, the rattle of a trolley full of sharp implements, a hurting blaze of lights. I yelped and clamped a pillow over my face. With a trill of merry laughter my tormentor took my hand, stuck a needle into it, and plundered my blood, then made her galumphing departure.

I wanted to go back to sleep, but – of course – I needed to pee. I disentangled my legs from clutching sheets, hit the call button, disconnected the wires attached to my chest, and tottered all the way to the bathroom without tripping over my IV drip. I assumed the position. Released the flow into a little plastic stetson-shaped thingummy positioned at the top of the bowl, because they measure my bladderly essence. And woke abruptly to the wet and horrible realization that it hadn’t been emptied after my last visit.

The toilet hat – can you see it? When you’re being pumped full of fluids, they have to make sure what’s going in is finding its way out. But if you have a capacious bladder, you don’t want to use it twice in a row without someone emptying it out first.

By the time I’d swabbed myself down and had been tucked back into a freshly made bed by a sympathetic nurse who managed to control her laughter until after she’d left my room, I was wide awake. And I was irritable and feeling sorry for myself – in short, completely over the sense of euphoria I had been feeling for the previous few days.

I should probably tell you about those days.

They started last Tuesday, when I visited Wonder Woman and caused both of us some perturbation by almost collapsing when I reached the top of the flight of stairs leading from her garden to her living room. “Dang I’m unfit!” I wheezed, mopping my sweaty face. “I have got to quit talking about getting more exercise, and start walking! Just as soon as I buy a Fitbit!” Well, it turned out she had a Fitbit that she’d bought for herself before she realized that setting it up would take at least half an hour of technological tinkering. Wonder Woman is nearly 90; she figured she didn’t want to spend one of her last remaining half hours that way, so she gave it to me. And although that’s somewhat peripheral to this story, if I were writing actual Literature it would count as Dramatic Irony, which proves that sometimes life does indeed imitate art.

Anyway. To get back to my point.

Wednesday I was draggy. I spent it trudging through the bare minimum of chores, yawning over my news feed, and wishing the black dog would just damn well let go and let me breathe. I didn’t feel especially depressed – just so, so tired, and when I thought of all the things I wanted to do -happy things, like gardening and writing and giving the horses a bath and taking Argos to the river for some training time and baking bread and even shining my little house – I felt overwhelmed and weary. I’d felt that way for a while … but on Wednesday just breathing felt hard. And late in the afternoon, when I went outside to feed my chickens, I had to lean quite heavily on my cane, and when I came back inside I was staggering and I had to sit down and just quietly pant for a while.

While I was sitting I consulted Dr. Google about Reasons To Be Short Of Breath. His insights were disturbing.

I told myself to quit being stupid. When you’re lazy and obese, of course you’re gonna be short of breath, I said to me. This isn’t rocket science! No further research is required! I got myself up on my hind legs and moved laundry around and was going to swab down the kitchen counters, but … first I needed to take another little rest. I chatted a bit more with Dr. Google. I decided that if I didn’t feel better by Thursday morning, I should probably call my doctor.

This isn’t something I do lightly. This is America, the Land of Hell-no-it-ain’t-free, and I don’t have health insurance, because the Hubbit and I inhabit that awkward gap between people who qualify for subsidized (and therefore affordable) insurance, and those who can sniff judgmentally at the Affordable Care Act. That is, the Hubbit has Medicare and supplemental insurance, which is just as well given his penchant for dancing with heavy machinery, but I pretty much just keep chugging along and trusting God to keep me going as long as he wants me around. It’s worked for me.

I’d been looking forward to Wednesday night, because we’d been promised a spectacular show by the Perseids – no moon, clearish sky. In 20 years of trying I’ve never actually seen the Perseid shower, and it’s become a bit of an obsession – so this year was definitely going to be The One. I planned to go out into the backyard with a blanket at around 11.00PM and just lie and watch them.

Only, between an increasingly insistent Dr. Google and sheer lack of oxygen to the brain, by 11.00PM it was dawning on me that maybe this shit was real. So I texted the Hubbit from the bedroom (he was in his study) to tell him I was worried … and waited for him to come busting through, brimming over with husbandly concern (and maybe a hug or two), to insist that it was only money and drag me off to the hospital. Only he didn’t, so I sent a couple more texts phrased to make him feel like a heel, and then I went to get dressed so I could drive my own damn self to the hospital, and found his phone lying on the floor of the closet.

He does this. He scatters his phone in his wake like one-at-a-time confetti. It drives me completely insane.

Turns out you can’t stomp and shout very effectively without breathing, but I did my best, and after delivering his phone to him I went and got dressed, stopping as needed to inhale. Then the Hubbit wandered into the bedroom and said that of course he would take me to the hospital because that was his responsibility as my husband. So I came a bit unglued and broke my phone, because it doesn’t take that much breath to thump things.

On the way to the hospital we stopped so I could hang my head out of the car window and look for meteors, but I didn’t see any.

I don’t remember much about the ensuing 20-or-so hours, which is a pity, because the whole time I was blogging about it in my head, and it was hilarious. But I couldn’t write it down because I had to keep my arms straight on account of the IV drips inside my elbows, plus the persistent interruptions by people with machines that needed to interact with me, and other people who kept sticking me with needles and taking more and still more of my sluggish, unwilling blood. I remember snapshots…

Did you know that getting an MRI is almost exactly like going through a wormhole in space? You lie down and someone injects you with a magical substance that uncoils a delicious heat in unmentionable places, and the world moves and you’re inside a giant halo, and lights flicker and the voice of God tells you “Stop breathing” and then, just at the moment you absolutely have to, “You can breathe”.

I asked for water and they told me I was “nothing by mouth” while the doctors decided whether or not to do a procedure to blast the blood clots out of my lung, and I thought that was strange because I’d thought my heart was failing, but it turned out my heart was fine but one of my lungs (I’m not sure which one) was all clotted up and icky, and this was sort of a good thing, relatively speaking, because if caught in time it will heal, whereas a failing heart can only be helped, not healed. And then after a while someone brought me a menu and told me to order lunch, and that’s how I found out that they’d decided the procedure wasn’t necessary, which was also good news, especially as I was hungry enough to eat a doctor by then.

They asked me questions about my family medical history and I did sums in my head and realized that my father was about the age I am now when he had the heart attack that turned his life around, so I decided I could turn my life around too.

The tech who did the echocardiogram helped me look at the screen so I could see inside my own heart, and it was working so, so hard! It didn’t flop helplessly like the sad, sick heart of the transplant patient I told you about, and nor did it rat-a-tat like the young, new heart that patient received. My heart is like the little engine that could, and the sight of it working with such steady determination to take a too-heavy load up a too-steep hill made me weep with gratitude and shame.

Eventually – it was Thursday evening by then – they brought me up to the room where I’m writing this. It’s a spacious private room, and even has a small sitting area with a recliner and a view of the hills. They tucked me into a real bed and fussed around asking what they could do to make me comfortable, and all I could think to ask for was hospital socks.

Hospital socks – conceivably the greatest achievement of medical technology.

At some point during the ensuing days I learned the name of what had happened to me. I had a pulmonary embolism, and it probably happened because I spend too much time sitting and feeling sad instead of getting up on my hind legs and living my life. I let the black dog harry me into the Valley … but I skirted the Shadow, and I’m coming back out into the light, and as God is my witness that dog is going to learn to walk to heel.

I haven’t had much experience of hospitals. Prior to this adventure, the only times I’ve stayed overnight in a hospital were after I was born, and when I was 10 years old and had my tonsils out, and when the Girl Child was born. But I’ve heard enough about hospitals from other people to have learned that they’re dehumanizing places, where one becomes a patient rather than a person, where the food is awful, where a good night’s rest is less important than the staff routines. So my own experience has been surprising.

The fact is, I have felt cherished. Protected. Provided with a refuge where I had one job and one job only: to heal – first my body, but it’s also given me a quiet place to begin healing my soul. Little by little my breath has come easier. On Saturday I had an actual shower. Yesterday – Sunday – they said I could go home, and disconnected the IV and taught me how to inject myself.

Now I’m just waiting for my final visit with the doctor, and then I can peel off the sticky pads that keep me connected to the heart monitor, and they’ll remove my last IV port, and I can take off the hospital gown and put on my real clothes. They’ll wheel me down to the main entrance and the Hubbit will come, and we’ll go buy me a phone and swing by Yokes for a supply of fresh vegetables – because mealtimes in the Took household are getting a radical makeover. And then we’ll pick up Argos from boarding and we’ll go home.

*****

A little over a week has passed since I wrote this post. It took a while to get my computer hooked up again and download the pictures, and I’ve once again been spending way too much time just sitting. I think about getting up and moving … I think about how I’ll die if I don’t – not right away, because I’m on drugs that keep my blood safe and runny, but I’ll come off them in a two or three months, and then if I haven’t changed my habits … Well, I have to change my habits. That is all. I’m putting it in writing. And I have a Fitbit. Surely that will make a difference!

Chasing rainbows

I’ve been mulling over a couple posts I want to write during the past wickedly hot week, but I don’t like to type when I’m sweating. It makes my keyboard icky. And meanwhile I’ve had this epiphany that I want to share – so those posts are going to have to wait.

Here’s the epiphany, brought to you courtesy of my phone news feed: sad people and introverts are more likely to suffer from dementia than chirpy little extroverts.

Now when you google “introverts risk of dementia”, it becomes clear that many of the perpetrators of the articles on this subject are … well … annoyingly jolly types. One that I found equates “introvert” and “neurotic”; another said it wasn’t introversion per se that sent your marbles rolling somewhere over the rainbow so much as a tendency to focus more on rain clouds than rainbows, only (the article added) an attitude of gloom was more common among introverts anyway so …

Clash Royale Shrug GIF by Clasharama

So here is a public service announcement:

Bounce No GIF

Look, I can’t help that I’m an introvert. More than that, I don’t WANT to help it! I don’t want to go to parties and yodel “Ho Ho Ho” and clap people on the shoulder!

But …

I’m pretty sure I can be more intentional about holding the Black Dog at bay.

I googled “How to be happy” – and no, that’s absolutely not a weird thing to do! If it were, I wouldn’t have found answers – and I did – I found many long lists, drawn up by people who take the question quite seriously, of things one can do to become and be happy.

And I noticed an interesting thing. Right near the top of almost every list was one word: Gratitude.

Oh calm down. This is not going to become one of those 100-days-of-gratitude blogs. But maybe a single post on the subject wouldn’t come amiss. After all, today is Independence Day, and although I’m actively opposed to both fireworks and flag-waving, I’m grateful that we don’t have a flotilla of giant spaceships hovering over earth’s major cities, waiting to suck us all up, or blow us to oblivion, or whatever it was they did in the movie … it’s been awhile since I watched it and I may be confusing the story with V … dang, can you believe Independence Day is 25 years old already? Anyway, my point is, I’m grateful to know the Gubmint wasn’t just softening us all up for the Big Scary Reveal when they confessed to lying to us.

And here are some other things I’m grateful for:

Boudicca lives. Last week the Hubbit detected a Smell in the workshop and we thought she had died, but it turned out merely to be some of Angelo’s garbage. I was worried because I hadn’t seen her for a while – she goes a little feral in the summer – but she visited the Cool Dude the other day and she’s just fine.
Apricots. The first apricots of the summer were ready to be picked yesterday, in time for me to take a couple to Wonder Woman, who is about to have surgery, and who was cheered because she loves them.
Hummingbirds. Some of our regular visitors made it through the California fires last year, and came back for another summer.
People who adopt rescue dogs. I didn’t think I’d ever find a home for Bear, and yet I did, and they send me pictures that tell me, over and over again, that no matter what he does he is loved.
The Hubbit. Not gonna lie, he can be a curmudgeonly old poop. But I’m grateful to have him around.

Five is enough to start with. And you know what? It works! Poking through my messy picture archives in search of illustrations for this little gratitude list made me smile all the way down to my bones. So … feel free to make your own list, and share it if you like. I’ll be around, watching for rainbows and available to smile along with you.

GIFs from Giphy.com

Between one beat and the next

Photo by Patricia Tser on Unsplash

My friend Bridie and I used to ride our bikes to school together. Every morning I rode the half mile or so to the corner near her house, and then we rode the remaining two or three miles side by side, giggling, ignoring her bossy older sister Jan who pedaled and puffed behind us. One morning Bridie wasn’t there so I rode to her house, leaned my bike against the wall, started to walk through the back door.

Someone – her mother? – grabbed my arms and stopped me. Told me Bridie wouldn’t be coming to school that day because her father had died. He and her mom had gone to bed the night before, but only her mom had woken up. His heart just stopped beating.

Some time later I stormed into her house, raging over the latest fight I’d had with my father. “You should be grateful you still have him,” Jan told me – so pompous! I snarled at her, “You have no idea how lucky you are!” and her face went white as her heart missed a beat. After that we didn’t speak for a long time.

By the time my father had his first heart attack, I think in 1997, which was the year before I married the Hubbit and moved to the US, he and I had achieved a truce of sorts. I was on my way to an interview when someone – my mother? – called me on my cell phone and I changed direction and sped to the hospital. The Egg and her husband were already there, huddled together on one of the long benches in the large, empty waiting area. They directed me to another waiting area next door, where I found Marmeee standing beside him, clutching his hand and looking scared. He was on one of those narrow, wheeled metal hospital beds, gasping for breath, his face the dull yellow of old fat that’s been exposed to air.

Not far from them was a counter, and behind it an empty reception area, and beyond that a room full of nurses engaged in loud conversation while they drank their tea. There was a bell, which I rang furiously with one hand while slapping the wood of the counter with my other hand. A nurse emerged and looked me up and down. “Yes?” she asked.

“My father needs attention!” I demanded.

She glanced dismissively at him. “We are waiting for his file,” she said.

“Where is his file?”

She flipped a languid finger back toward the room where the Egg and her husband were waiting. “The messenger will get it. But now he is on his break,” she said. I stormed through the door, rang a different bell, slapped a different counter. Demanded the file, which I carried back and slammed down in front of the nurse. She rolled her eyes, flicked the file open, froze. Called more nurses. Moments later they wheeled him away, Marmeee scurrying alongside as he clung to her hand.

There was nothing left for me to do, except … I could call for favors. I called Cass, a cardiologist I’d interviewed a few weeks previously. He was a hot shot, associated with a private hospital. My father, who didn’t have medical insurance, was in a state hospital. Cass had liked the story I wrote about him, and had asked me to write another story about organ transplants and the need for donors. I’d told him I would, but that it would be a better story if I could actually witness and write about a heart transplant. So at that point – the point I was at, sitting in the waiting room while my father clung to my mother’s hand in a different room full of machines beeping and nurses scurrying and doctors barking instructions – at that point, we were waiting for one of Cass’s patients to be matched with a donor heart.

Well, if your father has a heart attack and you happen to know the top cardiologist in town, maybe happen to have impressed him enough that he wants a favor, obviously you call him. And even if he can’t personally get involved in the case, he makes a few calls, lets it be known that he has an interest, and the awed cardiac team responsible for your father’s care snaps to attention and gets the job done. The Olde Buzzard had surgery and it went well and he got medical insurance and started seeing Cass regularly, and his heart kept up a steady thump for nearly twenty more years, until Marmeee’s stopped and his no longer had a reason to keep on beating.

It was late Friday afternoon, a hot day at the end of a too-long week. The voice on the phone was warm. Sexy. “Hey there – would you like to spend the night with me?”

My pulse quickened … but … I was in Johannesburg, and the only man at that time likely to make me such an offer was on the other side of the planet. “Who is this?” I squeaked.

He chuckled. “It’s Cass,” he said. We had a heart!

I met him at the hospital a couple hours later, and he took me to meet the patient’s wife. I had forgotten the wife until I read my notes today. At the time she was merely background, barely relevant to the story. It’s interesting how life has a way of teaching one empathy.

I had my laptop with me, and I made my notes in the form of a letter to the Hubbit. He wasn’t my Hubbit yet, of course; we were still at the internet romance stage of our relationship, he in the US and I in South Africa. We didn’t yet expect to meet, but we’d got into the habit of sharing the events of our lives.

Hiya, honeybun!

I’m sitting on the floor of a large passage in the hospital. Nothing much is happening … I need to write down what I’m experiencing, and – hope you don’t mind – it’ll be a lot easier just to tell it all to you. I guess it’s one way to spend the night with you … <smial>

Oh yeah – we got pretty steamy back then. Even with the full bulk of the planet between us he could make my heart flutter!

I told him about the family – Hindu, a large crowd, the women all dressed in saris. The mother, who sat lotus-legged and praying on a plastic chair, one eye covered by an eye patch held in place by masking tape – she’d had cataract surgery a few days previously. Three sons, the youngest 13. A brother who was a cardiologist, who later showed up in the operating theater.

The patient is only 47. He has had heart disease for about six years and they had been keeping it under control with medication, but early this year he went into heart arrest and Cass said it was time to plan for a transplant. He’s been incredibly lucky – he’s had to wait only five weeks. Some people wait years.

An orderly brought him his pre-med while I was there – a tiny plastic tot glass of water and a handful of pills. The orderly told him not to drink more of the water than he absolutely had to, but he must have been thirsty – he downed the whole lot almost compulsively. Then they had to give him an injection; wanted to give it into his shoulder, but he’s so thin there’s not enough flesh there. They had to inject him in the buttock.

Suddenly it was time to take him away. Orderlies pushed his hospital bed speedily toward the operating theater, and his family streamed behind, keeping pace with his bed until a nurse stopped them, gently told them to say goodbye, that they’d see him the next day. They stood in a small cluster, waving and smiling with determination, and kept waving even after he was out of sight, their fear surrounding them like a fog.

Then a nurse brought me a hideous green overall to wear. Needless to say the one-size-fits-all trousers didn’t, but she found me some bigger ones. I had the MOST frustrating time trying to persuade my hair to stay tucked inside a silly little cap. I’m wearing nothing but thin plastic overshoes on my feet, because I didn’t think to change into sneakers and the overshoes won’t work with the heels I was wearing. My feet are freezing! Now I’m sitting in a little room outside the theater, drinking tea and waiting for something to happen. In TV hospital programs hospital life looks like one adrenaline rush after another. Not so. This evening has been mainly waiting.

And now I’m in the theater! I rushed in and was promptly chased out – I’d forgotten my face mask! Put it on – how do doctors wear these things? After less than a minute I felt as though I was suffocating.

The operating theater was a small room crammed with equipment and crowded with people – several nurses, an anesthetist, two cardiologists, all chatting and joking as though they were at a party. The perfusionist – the person responsible for the heart-lung machine – sat next to the patient reading a Playboy magazine. The two cardiac surgeons had their own extra-high-sterility area, separated from everyone else by a low divider covered with hanging towels.

At the center of it all is the patient. He is very still, and is almost completely covered by green sheets; even his face is covered, except for a little slit where a tube goes in. On the cardiac monitor his heartbeat is erratic, frantic… They’ve started cutting and his heart is going crazy… They’ve sawed open his sternum. It looks like meat, but the smell is strange, nasty.

Okay … I went to stand above the patient’s head, and watched the surgeon cut open the pericardium. I saw inside his body. I saw his heart, laboring sluggishly to keep going. And now … we wait. The new heart is on its way. They are ready.

Time is of the essence in a heart transplant. The donor heart must be in and beating within four hours or tissues start to break down. In this case, the donor heart was flown up to Johannesburg from a town on the coast. To save time they opened up the patient and were ready to go, but they didn’t disconnect his old heart until the new one had actually arrived.

The heart is packed in ice, inside a plastic bag, the whole kaboodle inside the kind of polystyrene cooler box one uses for picnics. They’ve put it next to an identical box that’s full of ice and soft drinks. The packaged heart looks like someone’s groceries.

They have taken out the old heart. It fibrillated for about 15 minutes while they were connecting the heart-lung machine, before they removed it and the monitor finally fell silent. Now it’s lying off to one side in a kidney dish, still trying its best to beat. Cass says it wouldn’t have lasted longer than a few more weeks. It makes me sad to think of it being thrown away now, though, when it’s tried so hard.

The new heart looks more solid, meatier, than the old one. The surgeons agree that it’s a nice heart. It used to belong to a 43-year-old woman who lived in a small coastal town. Today she had a cerebral aneurysm – she had a massive bleed and died – just like that. Well, technically, she didn’t die until they took her heart out about two-and-a-half hours ago. I wonder what she’d planned to do today.

And right now, technically, this patient is also dead. A machine is doing his breathing and moving his blood, and his temperature’s right down at 28 Celsius. Every now and then a nurse takes some ice out of the picnic box and puts it into his heart cavity to keep it cold. I touched his head. It felt … horrible. Icy. Not alive.

The surgery I watched was something of a milestone. I’d forgotten that too, until reading my notes. It was the first time of using surgical superglue in a heart transplant in South Africa. They spent an hour stitching the heart and supplemented the stitches with glue. I’m sure by now surgeons use glue alone to connect the blood vessels to the heart tissue. According to my notes that was the goal, anyway.

They’re trying to start the heart by pumping blood into it, massaging it gently by hand, and shocking it. It doesn’t want to start. They massage, shock, look at the monitor. It fibrillates, then stops. They try again and again. They look like Sunday afternoon mechanics huddled around a car engine, coaxing it to life.

Ten minutes in the beat is strong and steady. There are a few little leaks, which the surgeons are stitching and gluing. There’s gore everywhere, and the surgeons are spattered with blood.

Everyone is tired, coming down off a high. The final stage of the process is mechanical. They disconnect the heart-lung machine and the perfusionist packs it and his magazines away. Release the clamps that have been holding his rib cage open, remove the swabs, finish cauterizing the wound – that disgusting smell again. Insert drains and sew him up.

I thanked the hot cardiologist for giving me one of the best nights of my life. “I learned a lot!” I told him, and went home.

The Hubbit’s new cardiologist isn’t especially hot. He’s a large, blustery man, a kind man, I believe a good doctor, but as hard to pin down as a picnic blanket on a windy day. I’m learning from him that the language of the heart is imprecise. Love … fear … loss … failure … What do these words actually mean? I tried to ask him: in the context of this husband, in this consulting room, at this moment, what exactly is heart failure?

I asked him question after question, and his words were like bits of dry grass swept up by a dust devil. They had no shape or pattern. He tried to answer. He opened a folder and showed me printouts – the results of many tests over the past few weeks. He used words like “ventricle”, “left”, “right”, “congestion”. I think he may have showed me a diagram. At last he gave up, ordered another test. It’s scheduled for the day after tomorrow.

Perhaps it’s not his answers that are imprecise, but my questions. I will rephrase them.

Will his heart keep going, or will it just stop between one beat and the next?

Will I wake up one night, hear the soft snores of the dogs snuggled between us, raise my head and strain my failing ears, hear silence from his side of the bed, reach out and touch him and find him cold as ice?

Can you fix it?

In the context of right here, right now, how best should I cherish him?

Usually I end with questions for you, dear reader. An invitation to engage. This time, my questions are all directed elsewhere … but please engage anyway.

Channeling my inner little old lady

So you know how sometimes you have to dial an 800 number, and from the first syllable emitted by the robot voice you can tell by the roiling in your gut and the pricking of your thumbs that this isn’t going to go well, but you persevere because you screwed up and now you’re in a panic?

And the reason you’re in a panic is that you’ve just woken up to the fact that your husband’s insurance has been blithely denying all the claims relating to his tractor accident? Okay, in all honesty I don’t know they were necessarily blithe about it. They may have been in ho hum mode, thinking about the past weekend or looking forward to the next one. No reason for me to presume there were any shrill cackles of banshee glee. Either way, to get back to my point…

What this means, in ordinary everyday terms, is that the giant wodge of papers covered with numbers and headed, reassuringly, “Explanation of benefits” and “This is not a bill”, which you’ve been ignoring because, seriously, who reads those things … but then you do, and HOLY CRAP!!

Paper pile (2).jpg
The actual wodge, artistically draped over a pile of fresh bills.

Oh – and I should mention that the reason you’re reading the wodge is that suddenly you’re getting actual bills – $1,814 for the emergency physician, who is the guy who essentially saved the Hubbit’s life, so it was totally worth it (most of the time, although maybe not so much when he refuses to wear his hearing aids) but, you know, on the other hand, you could do a lot with $1,814, if you had it. For example, that’s pretty much the cost of a pregnant cow around these parts.

But I digress. I was telling you about bills you might happen to receive following a major medical event.

Like $961 for the emergency hospital. You go “Ouch” because, after all, he was there for only a couple hours before they shipped him off to a hospital that was actually capable of keeping him alive – and then you look again and you realize the $961 is what’s left over after insurance kicked in $25,765 – and I mean, seriously, that’s more than $10,000 per hour! The Hubbit’s a smart guy who was highly qualified and certified up the wazoo back in his pre-retirement days, but no one ever thought he was worth that much back then! If they had, we’d probably be in ho hum mode at the sight of these numbers. Or maybe not, because … there’s more. So much more.

A whole sheaf of bills for the ambulance services that got him from home to the local emergency hospital, and from there to the bigger hospital in Spokane … and bills for the rehab facility, and the orthopedic clinic, and the imaging company, and the physical therapist. But that pile of bills is still smaller than the “explanation of benefits” wodge, so you start flicking through it, and you come across one for $25,765, which is the amount due for the local emergency hospital, and you realize that when the hospital sent you a bill for $981 they were (blithely?) assuming that the insurance company was going to pay – only this particular benefit explanation says, in a word, “Nope”. And you keep going and you find one for $99,285.97, which is just for that first day at the hospital in Spokane – less than a day – he arrived there after 6.00PM, for crying out loud. But that’s what it cost to make it so that he didn’t die right away.

Bill
You see that number? Someone tells me that’s my “total responsibility” – except that it isn’t, because this is only one of 55 pages of ridiculous numbers that came in a single envelope; other envelopes have come bearing additional pages – and all I can do is laugh. Shrug my shoulders. Vote for Bernie. Because this is absurd – not because magical medical technology isn’t worth what it costs, but because no individual human can or should shoulder such a responsibility.

And you look at it and you think, “Well, he’s alive. So there’s that.” But at the same time you realize your heart is going “Ofuckit Ofuckit Ofuckit” like The Little Engine That Could, after it made it to the top of the hill and headed down the other side and then gravity took over just as it noticed there was a wide, churning river at the bottom … and no bridge.

You know how that feels?

I really hope not, because if you’re taking the time to read this blog I like you, and I value you as an important source of warm fuzzies and endorphins, and I don’t want you either to plunge headfirst into a river or succumb to a heart attack.

Anyway, at that point, feelings aren’t really the issue. The issue is, what are you going to do? What I did was clutch the wodge in sweaty hands and take it to the Hubbit, and pick a fight with him about politics – his being conservative, and therefore opposed to state-funded universal healthcare. That urgent business having been satisfactorily concluded (it’s hard to concentrate on defending a philosophical point of view when your doting wife has just delivered a quarter million dollar-or-so whack upon your shiny pate), we agreed that there was no point in worrying about it, since payment was impossible. I promised to call the insurer on the next business day for a WT actual F conversation, organized the wodge into a neat stack (ordered by date and page number), put it on my desk, and promptly forgot about it.

I have an excuse. The Girl Child has been visiting and I’ve had coffee to drink and arguments to have and … oh, just generally more interesting things to do. Every few days a fresh bill would arrive, sometimes with a plaintive note scrawled across it from a medically-oriented bookkeeping person dismayed by the failure of the insurance to pay, and I would snicker at their naivete and rush out to suck down another coffee with the Girl Child. A couple included a form and a request that we complete it with the details of the “motor vehicle accident”, and I’d roll my eyes, because a tractor is not a motor vehicle, it’s farm equipment, and the reason I know this is that it’s not insured as a motor vehicle, so obviously it can’t be one! I’d add each bill to the growing pile on my desk and promise myself (and, occasionally, the Hubbit) to deal with the matter “tomorrow” – which, as we all know, is always a day away. Hooray for tomorrow!

Well, a couple days ago I was poking around on my desk and I came across a letter from the insurer dated April 12. It was addressed to “Dear Sir or Madam”, and expressed regret at our injury/accident and a wish for “good luck with your recovery”. There was also some reference to the need for a prompt reply.

Ofuckit Ofuckit Ofuckit.

They provided a post office box address, and a phone number.

I pondered my strategy while remembering how to breathe.

It was clear that a snail mail letter wouldn’t work. For one thing, my hands were trembling too much to type. Also, my grammatical synapses felt out of whack. And this wasn’t all bad. While tremor and grammatical uncertainty are a problem when one is wording a professional-sounding business letter, they can be helpful in presenting the persona of a slightly dotty and forgetful old lady.

I picked up my phone and dialed 1-800-ETC-ETRA – as provided at the end of the insurance company’s letter for the Other Party Liability office. A chirpy young woman answered, and introduced herself as Jessica. She asked for my name, and I gave it. With cheerful enthusiasm she expressed her eager willingness to help me. “But first,” she said, “I’d like to tell you about a great opportunity we can offer you.” Then she asked whether anyone in our household was over fifty years of age. I didn’t feel like listening to a sales pitch, but on the other hand she sounded so hopeful and eager that I decided to humor her. “Yes,” I said warily, “we’re both over fifty.” She launched into a description of a medical alert system the company was offering. She was clearly new to selling – she said “um” a lot, and a couple times she forgot to tell me something and had to backtrack, and although she was very sweet after a while I ran out of humor and cut her off.

That is, I tried to cut her off. “You know, I don’t want to waste your time. I really just want to deal with my query. Can you put me through to someone?” She ignored me. Just kept right on talking, rolling over me. “Hey!” I said. “Jessica, stop! I’m not interested!”

There was a pause, then she asked, “Would you like to talk to one of our representatives?”

“NO!” I shouted. “Just put me through to customer service!”

kate mckinnon omg GIF by Saturday Night Live

“Oh! Okay!” she chirped, perky as ever. I ground my teeth and breathed deeply, and a new voice came on. This sounded like a more mature, experienced woman. She also expressed a desire to help me – but first, she said, she’d like to offer me a great opportunity. Did I have a cellphone? I exploded – I was totally and irredeemably out of humor by then – and blow me down, she also just rolled straight into her pitch.

It finally dawned on me that she wasn’t human, and nor was Jessica. Nor was the woman who invited me to sign up for a roadside assistance program, or the friendly young man who wanted to know whether we had a TV. They were all, every one of them, bots. Not even real artificial intelligence.

The fact that Jessica had fooled me was profoundly embarrassing!

So, anyway, by the time the fourth robot voice came on I gave up on the number provided in the letter. If you’re wondering why I didn’t hang up sooner, it was because I kept hoping for a human! There comes a point in any venture where you’ve invested so much time and emotional energy that you can’t stand to quit, in case you’re just one cuss word away from Nirvana.  Come to think of it, that’s probably also why I keep buying Lotto tickets.

Anyway, eventually I called the number on the back of the Hubbit’s medical insurance card. That got me through to someone who could find no record that I had authority to speak with them on his behalf, so we got to have one of those super-fun threesomes that so enrich the lives of partners of the hearing impaired. You know how those go: you turn on the speaker phone so you can both hear, and he leans over the phone, breathing heavily into your ear, and then the person on the other end says something and he says, “Huh? Whut?” So you repeat it, and he loudly and clearly enunciates his response, and … rinse and repeat, for however long it takes. In this case it took a while, and the grand finale was when she read back a contract, and every time he started to say “Huh? Whut?” I’d frantically flap my hands in his face, because we did NOT need to be interrupting an electronic recording of a legal document. Eventually he got to say the required legally binding words, and he was given leave to kiss the telephone, and they were married. Or something like that.

We all heaved a sigh of relief and the Hubbit trundled off to play with his tractor, leaving me to explain the difference between a tractor (wheeled farm equipment) and a vehicle. “Oh,” she said, “No problem. You just need to speak with the Other Party Liability department. I’ll give you the number.”

“Oh no you don’t!” I exclaimed. “If the number you’re planning to give me is ETC-ETRA, forget it. That’s the number I called before this one and it connects directly to the fifth circle of Hell!”

There was a slightly stunned silence. “Are you sure you dialed the right number?” she asked. I said I was, and launched into a tirade about companies that infest the ether with robo-voices and inflict sales pitches on helpless little old ladies (at this point I remembered to insert a slight tremor into my voice) who are exhausted by caring for their injured and aging spouses, and also potentially facing homelessness because of denied claims and unpayable medical bills in a world that keeps voting for Damn Capitalists who refuse to support Medicare For All and just want us all to die in penury..

She offered to connect me directly to someone in the Other Party Liability department, and I said that would be acceptable provided she could vouch that they were human.

So that’s what she did, and this time I remembered right from the start of the conversation to quaver and dodder and make reference to how slowly old men heal after running over themselves with heavy equipment (which is not the same thing as a vehicle), and how stressful that was, and how difficult it was to remember everything, especially when we’d dealt with all sorts of paperwork at the hospital and I’d no idea there was more. I should mention that by this time I was tired, which meant I had to pause and say um occasionally while I thought about what to say, and I tended to forget details, which made it necessary to keep backtracking and repeating elements of my story, and all I’ll say about this particular young woman is that she sounded perky enough but she didn’t exhibit much empathy or compassion. She abruptly cut me off. “Was he at work when the accident happened?” I explained that he was loading up the tractor to get feed to the animals, right here at our little farm, and that he’s been retired for more than fifteen years now. She interrupted me again. “Okay,” she said.

“Um,” I said. “So what happens now?”

“I’ll adjust the record and pass it along to the appropriate department,” she said.

“But what do I have to do?” I quavered

“Nothing,” she said.

And that was it. What had been building up to be a fabulous blog post on the fundamental awfulness of the American medical insurance system fizzled with a soft pop. Which doesn’t mean I won’t still write it … but maybe not today.

Instead I thought I should write a blog post on the fundamental awfulness of insurance companies that use robots to try to sell services to people who want to deal with serious business, so I decided to call back 1-800-ETC-ETRA and find out just how many exciting new opportunities they’d offer me before connecting me to a human. I looked up the number on the insurance company letter.

That’s when I realized that the number they’d provided was in fact 1-866-ETC-ETRA. The 1-800 version of the number connects to a company that sells panic buttons, roadside assistance, and similar products.

So what the heck am I supposed to blog about now?

Please talk to me! What do you think about the cost of healthcare, and how it should be funded? Do you talk to robots on the phone, and do you find it reassuring or terrifying when they sound human? How do you decide what to blog about?