Hospital Stories

1536529212423784287722The woman in bed one rejected her liver on Monday. Her best friend since high school, they were in the same sorority in college, sits sideways on the edge of her seat, elbow pressed on the arm of the chair. The lady in bed one’s son, lies back in another chair, one hand across his eyes. Both hold their phones.

The man in bed two, a “big boy” my dad says as his eyes follow him, hobbles across the floor with a walker and two physical therapists holding him upright with a harness. His wife with a mountain of strawberry blond hair sits in the waiting room checking her phone.

Your mom chats with a tough little lady from Seguin with short white hair and an expertise in computers. Her sister awaits a new liver. She has to get back to work. This is not her first time at the rodeo. They confer about the gout in your mom’s fingers. Her brother-in-law — her sister’s husband — arrives with his two teenaged granddaughters. “If God calls me home, I’ll give her mine,” says the redheaded older girl, offering up her own organs.

Across the room, a Navy vet fresh from his own hernia surgery has just arrived from Korea where he and his wife teach special needs children of military personnel. She has moved a step closer to death’s door, the search for her liver upgraded from regional to national.

A grey-haired man shows up just before visiting hours each day with a book. “Here we go,” he says as we all get up and head for the Unit. He has the jovial world -weariness of a man who has been here a while. He will stay as long as he must.

The lady in bed one gets a liver. The doctors tell her friend that the operation will go all night. She might as well go home. The next day, she returns to her vigil. “I got no sleep,” she said. “I kept dreaming the phone was ringing.” The son returns. She can’t believe how old he’s become. They talk of older things, people who have not taken this seriously, who aren’t here. They wait.

The Navy vet and the teenagers fret about hotel costs. The Sheraton and Marriott are so expensive. “My grandpa says ‘La Quinta all the way,'” the younger brunette says. She also says that she hasn’t flown on a plane since 9/11. “Were you even alive during 9/11?” you have to ask. She laughs. “No, I wasn’t born yet, but I still won’t fly.”  The Navy vet gets a great empty room deal at the Sheraton.

Outside of the ICU the man from bed two lies on a gurney. “Say good night to Paw-paw,” a young, woman who looks older than her years encourages the little girls around her. The strawberry blonde wife stands among a small crowd of people clustered around her husband. “He got his liver!” she tells your mom.

The best friend is not around for a few days. You worry. Then she comes in wearing church clothes. You are surprised at how happy you are to see her. “She’s doing fine,” she says of her friend. The doctors had left the incision open because her friend had rejected so many others, “they are going to close her up now.” She’s doing that much better.

The grandfather signals to the girls. They have to go back to school in the morning. They will return the following weekend. “We’ll be prayin’ for ya’ll,” they say. They mean it.

The Navy vet runs in. “They got her a liver!” he shouts. Two minutes to visiting hours and he counts down every second. He sprints in to tell his wife.

You want to stay. The doctors say they will expect to send him out of ICU on Monday, when you have to fly back. Classes start on Tuesday. You stay at his side as long as you can. The narcotics have made him dopey. You can think of nothing to say but “I love you I love you I love you I’m sorry for the bad things I love you so much thank you for all you have done I love you. Please know that I love you.” What do you say when you aren’t sure if this is the last time? You have asked yourself this question for years. You don’t know the answer. He puts on his machine for sleep apnea and you leave him looking a bit like a Hefalump, cute and ready for a rest. You wish him nice dreams. You will see him at Thanksgiving.

The next better is that they move him out of ICU. The next better is that they move him to an extended care facility. Better. Better. Things are getting better.

You know what the call means when you see your mother’s number.

 

 

 

“Better”

1535220962426649561295Define “better.” Here, “better” means “not as bad as yesterday” or “not as bad as when we got here” but it seldom means “all better” as in “well.” You have to know the specific points of reference to understand that the person whom you see before you is, in fact, “better.” Otherwise, you would not use that term. That term would never enter your mind for the state of the person you see in the bed.

This is what better looks like sometimes. Better is no ventilator tube down his throat, but he is deeply uncomfortable, in pain, thirsty, and cannot find the words to explain these things. He finds adjacent words and sometimes words adjacent to those words. Sometimes he finds any word at hand because it is a word. When he makes himself known, you can do nothing. You cannot give him water, only a water-soaked sponge on a stick. The nurses must limit the use of that for fear that he will drown because the ventilator tube may have damaged or confused the throat, sending water to the lungs rather than the stomach. Even the stomach might not be able to handle too much water. This is better. He does not have the ventilator in.

Better is the next day, when they have moved him from a ward room to a private room. This day he has his wits about him enough to know how much pain he is in. They cannot give him anything more than Tylenol although they have cut into his belly, removed some organs, and rearranged others. If they give him more than Tylenol, they will not be able to tell if narcotics have sent him into a fugue state or if his infection has addled him, perhaps irreversibly. He spends the day shouting out the door at anyone who passes by to please, please god please, give him some drugs, why can he not have drugs. He begs his wife, his daughter, his son, his cousin, his friend to help him die. “Do you have a gun?” he asks. “Give me a gun so I can die.” He is serious. You are afraid to give him ice chips because he might try to choke himself with them. You do, but you watch him closely. This is better. He has his wits.

Better is the next day, when he is not restrained, when one of the tubes in his nose is removed, when they have given him a tiny bit of narcotics to take the edge off the pain although he drifts about in a twilight fog.  He still has the feeding tube and they bring him jello and broth, but he has neither the will nor energy to eat. He has no will nor interest in anything. If you coax a smile from him, you feel you have won the Olympics. He is polite, as he is normally is. He says “o.k.” “O.K.” He seems to assess the situation in his head and resolve that this is what it is. Or perhaps he just says “ok” to shut everyone but the nurses up. The nurses can do things. They are not helpless in the face of his pain and despair. This is better. He is not begging to die.

Then, the next day. A plateau. The doctors keep saying “doing well” and “getting better.” You trust them. They know more about the chemistry and physiology and biology and science. They have seen more of this than you have. They are not emotionally invested, nor should they be. You get that. Their “better” carries more weight.

You wait for the next step of “better.”

 

Numb

1535137626034528180417The question, “how are you?” loses meaning as you wait. The specificity of the context, the need to reassure people, the need to assess you own honest answer, render any answer inadequate. “Numb,” is mine.

This numbness comes not from feeling too much or too little, but from holding all feelings at arm’s length simultaneously. Fear, dread, hope, guilt, grief, empathy, sympathy, the past, the future, any moment that is not this precise one right here when I can pat his hand or give him a sip of water or get my mother a ham sandwich or hug my brother like he’s still a little boy rather than the solid rock of us all or write this all out in a line so it will all go forward and not in loops. Only this moment can be borne as a bubble of limited feeling and thought. Any others are too much, too many, too like disembowelment.

Don’t mistake the numbness for whatever we in the West think is Zen. That would be a state of acceptance. This is not acceptance. Acceptance of the worst is betrayal. This is not the opposite of acceptance, either, it is not avoidance. The body is so fragile, and Frankenstein operations are both amazing and frightening. This is just a space in which to function rationally.

The Actual Waiting Room

15350506056271241132544The waiting room for the friends and families of surgery and surgical ICU patients is perhaps the most uncomfortable place in the hospital outside of actually being in surgery or the ICU.

Friends and family members sign in at a desk so that a receptionist can call you when the surgeons have finished or when you can visit. A screen, much like an arrivals and departures screen in an airport, tracks patients through the stages from checking in to recovery. A coffee station sits behind the reception area with a fairly complicated machine that causes back-ups in the line. The t.v. volume doesn’t intrude, but is tuned to Fox, this being Texas. There are only chairs, no love seats, no sofas, no recliners. Nothings invites relaxation. Nothing allows a quick nap. When the room fills, you move to a dark nook down the hall with the singular virtue of being quieter.

This set up seems to work for people awaiting surgical patients. The room fills in the morning, when most operations are scheduled, and gradually empties as the day progresses. They go to the patient’s room and wait there. Those rooms have recliners, better chairs. They expect overnight guests.

For those awaiting ICU patients, not so much. You take turns during the visiting hours, and wait during all of the others. You go to dinner or lunch. You go home at night, or to your hotel if you aren’t staying in town. You can’t sleep there, or you sleep too much. Any minute you are away, any minute you aren’t somewhere close to be contacted, to move quickly, to feel like you have some sense of control or influence or access to information, adds stress.

Worse, every one of those minutes allows you to put the crisis out of your mind for a moment, and then you feel guilty. What if something happens and here you are getting drunk on Scotch and Prosecco? What if something happens and you are having a laugh at Goode Company? What if something happens and you are yelling at Morning Joe about Trump? How can you possibly be normal, think about normal things while he is in there begging for water or can’t even find the words to beg for water? How can you do anything but sit in a waiting room and wait?

Except, you would like to put your feet up. You would like to rest your eyes for a moment. You would like to be a bit more comfortable as you worry and wait without having to wander too far. You would like a place to wash up. You are tethered to your patient, and a space to remain so while also attending to the basic mental needs of rest and would help so much more.

ICU

1535040488803325454389Intensive Care is purgatory, the waiting room for death, a never ending Judgement Day.  Five beds crammed into one room for people who show up unscheduled.  Three lined up from corner to corner along the wall across from the door, one to the right of the door beyond the hand washing station, and my father in the space just to the left. The dialysis machine and repirator take up the space between the bed and the wall. Computer carts skitter across the middle space, as nurses pilot around them.

Most of the patients await new livers, their jaundiced coloring an unreal spectrum of yellow and orange. The creamy wall might seem cheery and warm in your home, but under the flourescent lights turns the whole room sickly.  An arrhythmic pattern of alarming beeps and buzzes, white noise to the staff, keep patients and visitors alike unnerved. No windows. No day. No night.

The bodies on the beds are machines. Plugged in, monitored, recipients of the best surgical care in the country, indeed in the world. The people in the bodies, what do they feel? Trapped? Unable to escape because the very vessel of escape has malfunctioned. My father cannot access the words in his head and marshal them into a sentence. With the repirator tube, he cannot even make known those words he can reach. His eyes, swimming up to the surface of consciousness, beg for mercy. Any releif. To scratch his nose where tape holding the feeding tubes has irritated his skin. To scratch his feet, so far down and dry. To loosen the compression balloons on his legs. To take out these tubes, my god please take out these goddamn tubes. To unrestrain his hands to do these things himself.

Nothing can distract him. Nothing on his body feels pleasant so he cannot focus on anything. His existence has reduced to pain, irritation, and frustration. His agitations feeds itself. He has no external stimuli to distract him. No pleasant music, nothing of visual interest.

Visitors are there to reassure him, to talk with him, to distract him, only irritate him further because they can do nothing. They — we — ask him questions he cannot answer. We don’t understand what he is trying to say. We annoy the staff in our ignorance. He cannot relax. His blood pressure goes higher. We worry.

Around us, are others. The body is a thing that houses a person. When it fails, the person slips away. An ICU is there to bring that person back, to keep that person with us by repairing the worst damage to the body; but I can’t say I blame the person in that body if he wishes he could slip away, the other way, which might seem so much easier when that option is so close.

Don’t give up, I beg him. Don’t. Your father lived into his 90s, so you could have a good 15 to 20 years. I beg him for me, for every one who loves him. For him? That I hold at at distance. I don’t want to know his answer because I’m too weak to let him go. Not this way. Not here, not like this.

Where to Begin?

The last beginning was so long ago that I don’t really know where to begin, and I think the beginning has passed if I ever really have beginnings that I notice as such.

So, the beginning. The real one that I remember was in the 1970s with the commercials for the pilot. I remember the wagon crossing the river and Caroline declaring “my home is where you are, Charles.” My brother and I mocked that endlessly as only children can. How old was I? Six, maybe? Yes, probably in first grade, awaiting the birth of our other little brother, five years younger than the brother who mocked Caroline with me.

Maybe I remember the fording-the-river scene from the pilot’s airing. I came in from playing, or my grandparents’ house, or something. I seem to remember darkness outside, so before Easter and the time change. The television blared its usual background noise and I think my grandparents, who lived not a mile away, hovered somewhere about. What I remember was all of this activity, movement, noise, bustle, but a quiet bubble arose around me as I sat close to the television, suddenly drawn into this story that had drawn my disdain only a few days, perhaps hours, earlier, beginning with the scene when they crossed the river. My memory may not represent anything accurate beyond our living room with the multicolored yellow shag rug, the television, and me sitting close enough to the television that my eyes would surely be damaged. Still, that was my entry.

I probably did not see the first episode of the series. Indeed, I have no memory of how the series sucked me in. By Christmas, however, I desperately wanted the book, once I had learned that a book existed to want. My aunt, who always gave books, gave me Little House on the Prairie. The yellow cover, the soft illustrations, the author being the same person as the protagonist, all began to create a world of escape for me; and she had written more books, before and after, this one.

Somewhere along the line, I parsed out that the t.v. series was its own thing, separate from the books, and that the real Laura who wrote the books was probably not exactly like the Laura in the books. I don’t know how. I just did. Maybe On the Way Home helped sort some of the history from the fiction to some degree; but early on I knew that I dealt with three separate, yet intersecting concepts of a historical Laura, a Laura in a novel, and a television series. I loved them all, of course, uncritically, and without anyone to help me through any criticism.

My neighbor friends and I ransacked the library for all of the copies, checked out multiple times. My mother forbid me to check them out any longer. She wanted me to expand my reading. I did expand my reading, but I also continued to check out Little Houses and hide them. We build Little Houses in the backyard. We wore bonnets. Our grandmothers sewed us Laura dresses. I begged to visit the Mansfield, Missouri, site, even after I lost interest in the books.

I did, eventually, lose interest. Blame Star Wars, blame Agatha Christie, blame growing up, blame the declining quality of the t.v. show.  Still, your childhood loves plant something.

Imagine my surprise as I grew to become a historian and discover the Homestead Act, that Pa settled in the Dakotas on the Homestead Act, that the National Archives displayed his application in an exhibit. Imagine my surprise at learning that the grasshopper shower was an actual event, the Long Winter, too. At one point, in the 1990s, I encountered a scholarly article on Wilder and was shocked that she was the subject of real academic interest. I wished I had known that. I wished that I could pursue that. I wonder now why I did not. After all, she was a burgeoning field at the time. That trip to Mansfield finally came on my own steam in 2000. Still, there were other roads to travel.

Now, well, where to begin? This time, I guess it began when Pioneer Girl came out, and now Prairie Fires. In the meantime, out of curiosity, I read swath of other studies. What it all comes back to, really, are the novels and the t.v. show.

So, that’s where to begin.

Possibly the Next Book

I have three ideas for the Next Book. One grew out of the Last Book and has its own blog space elsewhere. One would be a YA novel written with my nephew. That may or may not end up being a blog post for another time and I would act primarily as his amanuensis. The third idea? Well, that’s the one for this blog space.

Little House on the Prairie. Yes. That’s the topic. Not Laura Ingalls Wilder, not a biography of her. That’s been done recently and done well. Besides, she doesn’t interest me enough to dig as deeply into her life as I did for the Last Book. No, I’m interested in the life of the story that she told.

I see the story as having several phases. First, of course, was the raw material that Wilder lived. That’s not so much the story as the raw data. The story itself begins with the telling and the purposes and contexts of the telling. I suppose the embryos of her journals and early columns play a part, but the first full version was her memoir, Pioneer Girl, published for the first time as a scholarly edition in 2014. Unable to find a publisher, she and her daughter, Rose Wilder Lane, herself a  very successful novelist, revised the memoir, including a fictionalized account of Pa joining a posse to lynch a family of serial killers just to add spice. Then they aimed for a “juvenile” or children’s audience, and finally found success when Lane peeled off several of Pa’s stories and strung them together as little adventures amid the daily domestic workday of rural life.

The success of Little House in the Big Woods begins the second version of the story as a series of novels that progress from children to young adult. There is a lot going on in this version from the rather broad definition of “truth” used by Wilder and Lane in publicizing the books, to the two women’s anti-New Deal politics and Lane’s growing libertarianism, to the ways that they shift a western, Manifest Destiny narrative to the female point of view, granting equal importance to domesticity. In fact, I recently discovered that historian Amy Kaplan studied this concept of “Manifest Domesticity” in writing about the U.S.-Mexican War in The Anarchy of Empire in the Making of U.S. Culture (2002). (Why had I not learned of this idea before!!!) In re-reading the books, too, I’m discovering a tonal shift with By the Shores of Silver Lake that adds a grim element to counter much of the coziness that permeates the earlier books. Then, of course, the racial issues that are very much contemporary to Wilder’s childhood, and, truth be told, the time the books were written.

The third version of the story usually appears in the last few pages of the last chapter of most of the literature of Wilder and Little House. (This is also where I, as an interested little girl entered, but that shouldn’t be relevant.) Most of the scholarship coming from literary studies, you don’t see much appreciation for the television show; but, as a historian and as a child of the 1970s, I find both the genesis and Michael Landon’s interpretation fascinating. A whole chapter alone could be devoted to Pa and depictions of masculinity. (Heck, a whole chapter could be devoted to Michael Landon’s bare chest! Buff for the ’70s.) Attempting to translate nineteenth-century, rural gender roles into an era of women’s lib and a growing presence of women in the workplace became a problem, as did the depiction of race, which was often downright weird.

The show appeared in a landscape of television that included All in the Family, Charlie’s Angels, Roots, and The Waltons, in terms of historical fiction, topical series, depictions of women, nostalgia, and race. While Landon explicitly jettisoned the storylines of the novels, he returned to certain plot and historical points for material. Mary goes blind. Almanzo Wilder appears as a character at the proper point in Laura’s development. His siblings have historically accurate names. Laura has a little brother named Freddy who died as an infant, which she excised from the novels, and the Ingalls family moved away from Walnut Grove for a time to run a hotel, also excised from the novels. The storylines around these points, however, in no way resemble history or, when in the novels, those stories.  So, all in all, Landon’s interpretation becomes both its own thing, but also something inspired by Wilder’s material.

The fourth incarnation has only appeared in fun memoirs of writers who have enough of a fascination with the novels to actually visit all of the sites that they depict, plus the historical sites. I confess that I want to do the same. Indeed, that was my initial idea for the framework of this book, which was not going to be what it is going to be now, until I found out that I was not the first, second, nor even third person to have the idea. Heck, I’m probably much further down the line than that, but three memoirs describing their author’s sojourns to the Little House sites have seen print. (Two of them are riotously funny and I want to become their author’s new best friend.)

I’ve actually been to the Laura Ingalls Wilder Museum in Mansfield, Missouri — where I had wanted to go since the age of nine when I learned that it existed. That had become a pilgrimage site during the life of Wilder herself, and her friends ensured that it would become sort of a shrine after her death. There seems to be a duality to the depictions of her in relation to Mansfield, but that’s probably another post for another time. The t.v. show revitalized interest in her books and, thus, interest in visiting the sites depicted in her books. Visitors led to a business around tourism. I know very little about this at the moment, but I’m interested in the ways that public expectations, the passionate debates about the extent of Lane’s hand in writing the novels, the influence of the television show, the historical record, and changing interpretations of her work and time affect the interpretations of the sites.

In a way, this public history site section wades into territory similar to the Confederate monuments debate. How much do you allow nostalgia and love of these novels and their author’s life to color some of the more complicated questions about it’s context, such as the settlement of the American Plains? You see that passionate debate in the American Library Association’s decision to un-name the Laura Ingalls Wilder Book Prize because of the racial attitudes reflected in her series.

(I can’t say that I disagree with the ALA decisions because, if you need to footnote your award to explain context, maybe you should just say it is an award for a best book and not name it after someone.)

Then, there is the fifth version, when the fans of the book series grew up, became academics and studied them as artifacts of American literature and culture.

The sixth, and perhaps more versions I haven’t yet sorted out. One of these would be called the “expanded universe” were it the Star Wars franchise.  These include Roger Lea McBride’s novelizations of Rose Wilder Lane’s life, the mini-series novels of Wilder’s foremothers, and the more recent Caroline: Little House, revisited, and adult novel by Sarah Miller (which was very clever and quite excellent).  This also includes counter-narratives such as Louise Erdrich’s Birchbark House, in which she re-visioned the historical period from the Native American point of view.

The children’s literature specialist at my college let me know there is a whole universe of erotic fan fiction surrounding the television series, usually pairing the young male characters. Then there is the Laura doll, made by a company founded to create more affordable versions of the American Girl types of dolls. Laura has a whole covered wagon with Jack (who is not brindle), horses, and camp equipment. (My 8-year old self has put it on her Christmas list to Santa.)  Little House still figures into school curricula, and from what I understand is very popular with home schooling, because it lends itself to many subjects and activities at the elementary level.

So, what I see it that this story has resonance, and I’m curious as to the reasons for this resonance, and I’m also curious about the limits of the reinterpretations. How far can this story go? It has the verneer of domesticity that is appealing and can be cosy and privleges the women’s story; but it also advances certain ideas that sit uneasily in modern times and with modern sensibilities — at least liberal ones, but even conservative ones given some of the twists and collapses in the t.v. series. I don’t have an answer, but that’s where you start: with curiosity.

Trolls — or A Troll

A mere week after boldly stating that I am tired of apologizing for myself, who should emerge but a troll. This troll formerly numbered among my friends. Rather, this troll formerly numbered among my “friends.” There are differing levels of friendship and this one was one that was conducted primarily via the internet and focused on common research interests.

Then, earlier this year, this “friendship” took a turn. He became obsessed with attacking other scholars in ways that were not simply unprofessional but veered into defamatory, abusive, illegal, and downright demented. He lied to me about the extent of that behavior. Like most liars, thought that the contradictions in his stories would never become apparent, then became defensive and accusatory when exposed. After that, he tried to use his connection to me to abuse other scholars and I finally had to just send him on his way. When he discovered that, he responded like an abuse ex- and went on the attack.

This is his method of operation. He tries to befriend scholars, praising them to a point of embarrassment, often while defaming others in the very same breath. For instance, approaching someone in an archive to say, “Prof. X, your work is great, have you hear of Prof. Y’s work? It is amazing unlike Prof. A, B, and C’s work. They are frauds and disgraces.” I am all but quoting him here. (What do you do if you are Prof. X and can’t back away slowly because you are trying to research?) If you run afoul of him, suddenly he finds all sorts of flaws in your work, and will take to whatever public venue he has been using to praise you to now attack you.

None of this is about your work, you see. This is about him. He uses other people’s work to call attention to himself. He does not have a PhD nor an MA. He has only published a non-academic book with a very narrow focus and no grounding in academic scholarship nor historical context. The press is essentially print-on-demand and that was several years ago. Yet, he thinks this grans him the authority to command all others to follow his dictates. His claims, in fact, have become more laughable in their grandiosity.

He has behaved quite ugly to scholars, to librarians, to archivists, to public historians. He has stated that he intends to ruin the career of an Ivy League historian. Those are his words.

I’ve met terrible people like this before, had them close to me in my life. They try to destroy you in a variety of ways, but to what end? They don’t realize that, even if they should succeed in fulfilling whatever demented fantasy they have about destroying you or having your lifetime of accomplishments stripped from you, those accomplishments don’t automatically transfer to them. This guy wants to discredit my book, he wants to destroy the career of this other historian. That doesn’t confer upon him either of our doctoral degrees. That doesn’t transfer the authorships of our books to him. That doesn’t transfer our awards to him. That doesn’t give him our jobs.

He still has to be the troll that he is. That seems to be the worst curse that he could suffer.

Fifty-One

I’m fifty-one today. I spent about 49 of those 51 years apologizing for being myself; and then apologizing for the two years of not apologizing. I’m not just sick of apologizing. That happened long ago and still the apologies. I’m tired of apologizing.

Unless I actually hurt someone. That’s another category of apology. I’m talking about apologies for just being me.

I bitch, I moan, I make funny faces, I’m awkward as hell in social situations especially if I’m getting to know you better, I forget I’m not in my 30s, I will talk your ear off about what I’m researching, I’m bougie and boring and deeply uncool but not so uncool that I got back around to being cool, I put up with a lot of shit until I snap (so jump back), I’m a dilettante, I will inadvertently embarrass myself or you in public at some point in time by just being me.

I just cannot apologize for that anymore. I’m tired of it. There is too much other shit to worry about and make up for — things that are serious and require real apologies and reparations — that doesn’t have anything to do with the silliness of my personality. There is too much about me that I like (and apologize for liking) that I want to cultivate and enjoy.

Let the awesome Mavis Staples tell it for me, about herself (details are obviously quite different).

This verse especially resonates with me:

Makes no difference now y’all
How you may feel
I’ve done reached the point
Where I wanna be real
I’m tired of living living in disguise
I like the things about me
I like the things about me
I like the things about me
I like the things about me that I once despised

Nolite te bastardes carborundorum.