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.

Start with a gasp

I’m a shower-before-bed person. I’ve never been able to understand how a person can get between the sheets all dusty and sticky from the day, and actually sleep. Even if I haven’t done much to raise a sweat and I feel cleanish and I’m tired so I don’t bother, as I lie there I can feel the gross stickiness of skin ooze and air crud. Ugh! Gotta get up, shower it off, rub dry, and then I can sleep.

Well, sometimes. Insomnia is a thing. But that’s a topic for another post.

Returning to the topic of this post, there’s this blogger that I sort of follow, by which I mean that I receive her posts in one of my many extra email accounts – the one dedicated to efforts at self-improvement. I believe in having lots of separate accounts because I wear different mindsets when I’m trying to be a better person, or farming and gardening, or dealing with our finances, or writing, or blogging. If all my emails go into a single account the result is a mess worse than the top of my desk, and I can’t find anything and nothing gets done.

On the other hand, I don’t check all those accounts every day, and as for the self-improvement one … well, I read the email topics as they come up as notifications on my phone, but usually that’s about it. Self-improvement is something I aspire to wanting to do, but most of the time it’s hard enough just to be as good as I already am.

Anyway, this blogger – she calls herself “Dr. Stephanie” and she writes mainly about keto and fasting, and she offers various courses, none of which I’ve actually done – wrote a post about how effective humans kick-start their day. It happened to land in my inbox on a day when I was lying in bed, hating myself for lacking the energy to get the hell up and do something with whatever was left of my pathetic life … and I read it.

Most of her suggestions I’ve forgotten. They were things like “feel gratitude” and “journal”, which are lovely feel-good ideas, but in the moment didn’t feel sufficiently like the kick in the butt I was craving. The cold shower, however … Now that sounded like a punishment worthy of the name! That I deserved.

cold-showerSo I dragged my bloated, sweaty (this was back when nights were hot) almost-corpse from between the sheets and into the shower. And I turned the faucet on to cold. And wailed.

It was so horrible!

Oh. My. Word. It was so horrible.

But then a strange thing happened. First, my eyes – clenched shut against the bright light of the bathroom – popped open. Then my skin stopped cringing from the rush of icy water, and I found myself intentionally exposing places like my armpits and the back of my neck and the crack of my butt – not exactly enjoying the rush of cold, but welcoming it anyway.

She recommended five minutes. I didn’t time myself but I doubt I lasted that long. I simply rinsed all over, rotating and bending to let the water get at all my less accessible spots. I didn’t use soap or a cloth, just cold water. Then I stepped out, found a fresh towel, and scrubbed myself dry.

I felt … Amazing. Invigorated. Energized.

Fun fact: this insanity is actually good for you. This morning when I went poking through Google in search of funny free images of cold showers, I found any number of articles touting cold showers as a solution to obesity, depression, low sex drive, bad skin, low energy – in short, pretty much all the ills that might beset your fleshly self.

Plus it was kinda magical, actually, how it made me feel.

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Irrelevant photo of a happy memory. That’s another kind of magic. And being able to enjoy a happy memory … That’s the magic I really want to flow through me.

So I did it again the next day. And the day after that. And again a few more times. Then came a day when I had to rush for an early appointment and didn’t have time, and I felt icky all day, so the next day I made sure to shower again. Every now and then I skip for a day or two … but I keep going back to it.

It is always horrible. The only way to do it is to drag myself out of bed and get under the shower before I do anything else, because giving myself time to think about it – for instance while I put in contact lenses or brush teeth – just makes it worse. And now, as the nights get cold and the early mornings are chilly and I’m waking up before dawn as often as not, it’s really, really hard. Frankly, given my record for doing really hard things, I’m not that optimistic that I’ll keep going when winter really sinks its teeth into us. But … I hope I will. I intend to try.

Because that moment when my eyes pop open? When suddenly and with no effort of will going back to sleep is not only impossible, but also not remotely desirable? Holy cow, it’s a rush like no other!

Hey there – talk to me! What’s your favorite way to mortify your flesh? Does it make you feel as good as a cold shower?

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!!

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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?

So this year for Christmas the Hubbit ran over himself with a tractor

Needless to say, he didn’t pick the little old Ford tractor to get run over by …

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Not this dinky early 40s model, which is the first tractor we bought when we moved out to the farmlet. (Picture taken some years back. We haven’t had any snow this year … and although I should be stressing over climate change, right now it’s working for me. I haven’t the faintest idea how to keep our driveway clear!)

… although, on consideration, that one might have been worse, because although it’s little and cute it has monster wheels designed for gripping soft stuff, like dirt, snow and the flesh of absent-minded old men. In any case, the tractor of choice for his life-altering moment of inattention was this one…

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About 3 tons of He-Power, probably more than you want rolling over your foot-leg-groin-gut-chest, although less horrifying if the tires are smoothish, like those on cars.

If I’m sounding a tad pissed off, it’s partly because this is not how this blog was supposed to go. When I started here, my goal was to entertain, with occasional detours to expound, philosophize, denounce, and share recipes. But the first seven months of this year were so fundamentally shitty that I quit writing altogether until I recognized it was my sole defense against the Black Dog, and since then it’s been one damn shitty thing after another, and now this.

Here’s what happened: The Hubbit was in the workshop getting grain into buckets to feed the cattle before he started on some tractor-related fun-on-the-farm. The tractor takes a while to warm up, so to save time he stood beside it to turn it on. It was supposed to be in neutral. He always  leaves it in neutral. Except this time.

He leaned into the tractor, pushing down the clutch pedal with one hand while he started it with the other. It roared to life, and he released the clutch. The tractor leaped forward. The big rear wheel trapped his foot, rolled up against his leg, and slammed him down onto the gravel scattered over the concrete apron at the door of the shop. It crunched over his pelvis, abdomen and shoulder, before – oh, the sweet grace of God – it rolled off him, rammed into some barrier inside the shop, and stopped.

I was in the corral, around the corner of the shop, pitching apples into a wheelbarrow to feed to the cattle. I heard him yelling. “I’m coming!” I called, starting to close the gate to the stall where the apples were so that my old horse, Vos, wouldn’t get in and eat them all and founder himself. The Hubbit kept calling.

It’s annoying, living with a deaf person. They call you, and you say “Yes?” You say, “I’m coming!” and they don’t hear. They keep calling. Sometimes it’s as though they’re not even trying to listen for an answer. Just call, call, call until you appear. Sometimes it’s so annoying that I very deliberately finish what I’m doing and take my time about going to him, refusing to be rushed.

But not this time. There was something in his voice that snatched my attention so that I left the gate swinging wide, let the apple-laden wheelbarrow tip over, ignored Vos as he shoved forward to grab what he could. I wrested the big corral gate open, hurried to the tractor – I’m too damn fat to run, but I can hurry. He was on the ground and at first I thought he’d just fallen – it happens; his knees are shot and the dogs are clumsy. But he kept calling until I was right up next to him and put my hand on him. He appeared to be bleeding from his eyes, his face was bloody and scratched. “Get an ambulance!” he wheezed.

We live 20, 30 minutes from town. While we waited I hurry-hurry-hurried inside for blankets and pillows – not much use against the cold ground – I didn’t dare move him – but better than nothing. He’d fallen below the bucket of the tractor, and I didn’t trust the hydraulics to keep it up, and even more I didn’t trust myself to raise it, so I scurried about finding random objects that I could prop under it so it wouldn’t drop and crush him. I called the Cool Dude, who called our neighbor Paranoiber, who arrived and then left immediately to chase down the ambulances and lead them down our private road. (They brought in a helicopter as well; it landed in Vos’ pasture, but he was too busy eating apples to care.)

And then the the bustle of people whose clothes glowed luminous orange and yellow, reassuring smiles, figuring-it-out frowns, staying out of the way, staying close enough to answer questions. A wail of pain as they lifted him, the juddering roar of the unwanted helicopter leaving, the wail of the ambulance on the road to the hospital. Cool Dude insisted on taking me in and then didn’t listen when I told him the way to the new hospital location. His battered, swollen face on the white hospital pillow. Internal bleeding that demanded a flight to a better hospital in Spokane. I came home when they took him away, took a shower, threw some clothes in a bag, fed the dogs. I put fresh bedding on the bed so it would be nice when he came home – which seemed to make sense at the time.

He has a fractured pelvis, broken ribs, a cracked scapula, and bruising, but no organ damage. The scans also revealed a lump in his throat – something unrelated to the accident – so before they released him they biopsied that, which gives us something extra to think about.

I spent the first interminable week in Spokane sitting, first in ICU then in the orthopedic ward. I kept insisting that I hadn’t married him for his looks so his brain better be okay until, to shut me up, they showed me scans that proved the wheel had missed his head. I cracked inappropriate jokes about every indignity, photographed under his hospital gown so he could see the astonishing size and purpleness of his swollen groin, nagged him to suck on one plastic tube and blow into another, coaxed him to eat, bitched when his blood sugar soared, applauded when it dropped, and, hour after hour, waited for the doctors to come.

He’s been in rehab now for a week, and the waiting continues. He can sit up, can get from his bed to his wheelchair, can use a portable commode if they get it to him in time, but it’ll be a while before he can walk. He’s on heavy doses of pain medication, so of course he also needs laxatives, and … well, suffice to say they’ve spent the past few days figuring out how much of those he needs and how long they take to work. I’d like to think that next time the need for laxatives arises they’ll be in less of a hurry for them to work before they wallop him with an extra dose, but since the people giving the laxatives aren’t the people cleaning up when they do what they’re meant to do, that’s by no means certain.

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The Hubbit’s little princesses, Patchee and Ntombi, are learning to make do with me. Today I took them to visit him for the first time. Ntombi was most interested in befriending the man in the other bed, whose wife had brought snacks, but Patchee trembled and lay down under the Hubbit’s wheelchair, and when it was time to leave she begged me to let her stay.

I visit him for an hour or two most afternoons. Usually I take a dog or two. Sometimes we chat; sometimes we seem to have said everything we will ever have to say to each other. They put him through an array of tests when he arrived and, for the first time in his life, he didn’t ace the cognition test. His world has shrunk; it encompasses his pain scale, his physical therapy exercises, his carb intake, his blood sugar count, his bowels. He has a pile of books that he doesn’t read. For the first time in as long as I’ve known him he watches television. I’ve bought him a Lumosity subscription for Christmas, and when he’s dull and spacey I release my inner bitch and pick fights with him over his failure to despise that asshole in the White House as comprehensively or intensely as I do. (Sometimes it takes a poke with a sharp stick – or the verbal equivalent – to send a good surge of oxygen-laden red blood cells shooting brainwards. One does one’s wifely best.)

My world is misshapen and discombobulated, and to find my way around it I’m redefining the boundaries of what matters, and excising everything else with a sharp and ruthless blade. Some days I look at the weeks or months ahead and blaze with a kind of excitement – this is a shake-up, an opportunity to change, to renew our marriage, our life, ourselves. I’m acutely conscious of God’s grace, and hungry to draw close to Him. I make lists of the things I can make better, develop strategies for personal growth and home improvements. Other days I drag myself out of bed and put one foot in front of the other until it’s bedtime again, and then sometimes I can sleep.

Let’s talk. Have you had periods in your life when every time you thought things were as bad as they could be they got worse? How did you cope?

Walking with the Black Dog

The problem with pain is figuring out what to do about it. Do you take a pill to make it stop? Do you fix what’s causing it? Or do you learn to live with it?

The problem with the Black Dog is the noise it makes when it’s tearing your heart with its teeth. It muffles nuance; the tune pain plays on your heart-bones-breath emerges as random notes, dissonant and jangling.

Black dog in the dark

I could take a pill – put the leash back on the Dog. I still have plenty – at least a month’s supply – and my doctor would willingly give more. Here’s how the argument goes (I know it well, having used it often on others): “If you had diabetes or a heart condition, wouldn’t you take whatever pills were necessary to control it?”

The problem with that argument is, it’s specious. If you have diabetes or a heart condition, the first act of a sane person is to change the way they eat, move, sleep, live. The TV commercial narratives – glowing visions of super-sized burgers and greasy pizzas followed without a pause by ads for aspirin and Tums, Lipitor, Prilosec and metformin, always with the soothing reminder to “talk with your doctor” – those are the ravings of a crazy person.

I may walk in the dark of an imaginary tunnel with an invisible black dog at my heels, but I’m not crazy. I’m on a mission to find what’s real – friend or enemy, loss or gain, joy or pain. I’ve rejected the phantasmagoria that lie in pill bottles. I want to grieve real loss, fear real terrors, fight for what’s really good. And laughter – the kind that makes the fat on your belly jiggle … It’s been a while; I need to remember how that’s done.

So here we are, the Dog and I, still walking together and now deep within the tunnel. How deep I can’t say; how much further we have to go I don’t know. Sometimes a crack in the roof lets in a beam of light, a breath of clean air. Sometimes in the darkness the Dog leaps, knocks me to the ground, sinks its teeth into my flesh – and when that happens it makes no difference whether or not I scream, because in the dark we’re alone. So far, I’ve yielded sometimes and fought back sometimes, and I’ve learned that, either way, sooner or later the Dog is sated. It comes back to heel, its breath steamy on my left thigh, my fingertips resting on its head, and we walk on, watching for light, hoping for joy.

Let’s talk. Do you live with depression, anxiety or some other mental illness? How do you deal with it? And, as you deal, how do you identify and give priority to the things that are most important to you?