Trapped in an Emergency Room

Wednesday

I wasn’t able to post last night because I accompanied my friend Rachel Kranz to a hospital emergency room in the Bronx after fluid build-up from her ovarian cancer suddenly incapacitated her. After spending hours watching a frequently dysfunctional system at work, I crawled into a hotel room at 12:30 last night, only to crawl back out of bed at 5 a.m. this morning because Rachel needed me.

I was struck by how, once you’re in the system, a different logic can take over from which it seems impossible to escape. It reminded me of Vladimir Nabokov’s short story “Cloud, Castle, Lake.”

Rachel went into the emergency room knowing what she needed: the fluid needed to be drained so that it would stop pressing on her heart, lungs, and abdomen, causing breathing difficulties and swelling her feet. The process is known as paracentesis.

A week before, doctors as a different hospital had drained 16 pounds of fluid and she needed to have it happen again. This hospital, however, had other plans and detected other problems. Suddenly, what was supposed to be a short visit extended over at least one night and we’re hoping not to spend a second night here. While Rachel’s doctors are convinced that all of symptoms trace back to the cancer, others were suddenly talking about possibilities of heart attack, brain tumor, lung embolism, and blood clots in the legs. As a result, Rachel was suddenly subjected to a series of tests which may well be totally unnecessary. (I’ll update you.) Many of the tests required multiple drawing of blood, a particularly excruciating process as Rachel has tiny veins.

Combine with being deafened by the incessant beeping of monitors, sleeping all night under bright lights, and being awakened at multiple intervals, Rachel felt like Lizzy assaulted by the goblin men in Christina Rossetti’s Goblin Market:

…the goblins cuff’d and caught her,
Coax’d and fought her,
Bullied and besought her,
Scratch’d her, pinch’d her black as ink,
Kick’d and knock’d her,

Maul’d and mock’d her

Unlike Lizzy, however, Rachel doesn’t accept such treatment passively, demanding explanations and expressing her displeasure. There were multiple battles.

It was as though we thought we were entering a house of healing and instead found ourselves as members of Vasili Ivanovich’s travel tour in the Nabokov short story.

Vasili has won a lottery ticket for the tour and, although he doesn’t really want to go, discovers that there is too much paperwork involved to pull out. He goes and finds himself forced into unwanted comradery with his fellow travelers. Unpleasant though this is, the trip seems worth it when he finds a perfect spot with a castle, a lake, and a beautiful sky. He decides he will drop out of the tour and spend the rest of his life there.

Unfortunately, this proves not be be an option:

‘If necessary we shall carry you,’ said the leader grimly, ‘but that is not likely to be pleasant for you. I am responsible for each of you, and shall bring back each of you, alive or dead.’

Swept along a forest road as in a hideous fairy tale, squeezed, twisted, Vasili Ivanovich could not even turn around, and only felt how the radiance behind his back receded, fractured by trees, and then it was no longer there, and all around the dark firs fretted but could not interfere. As soon as everyone had got into the car and the train had pulled off, they began to beat him—they beat him a long time, and with a good deal of inventiveness. It occurred to them, among other things, to use a corkscrew on his palms; then on his feet. The post-office clerk, who had been to Russia, fashioned a knout out of a stick and a belt, and began to use it with devilish dexterity. Atta boy! The other men relied more on their iron heels, whereas the women were satisfied to pinch and to slap. All had a wonderful time.

Rachel’s doctors, nurses, and orderlies were not necessarily having a wonderful time, but she felt like Vasili. We’ll discover in a few hours whether she can leave the tour.

Update: It turns out that both Rachel and the hospital were right. Rachel was right that the parencentesis should have been performed first (it wasn’t) because everything got much better the instant they performed it, with her strength returning. The hospital was right because Rachel had blood and lung clots as well fluid build-up. These can be treated, however, and it looks as though she will be released tomorrow (Thursday).

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