Cared For, Intensively

You’re not supposed to remember, I think. Something about the drugs saving you from the formation of memory, your brain soaked in morphine, a flooded library. I do remember, but the memories are a bit lumpy, as if scrawled on soggy paper, with no hard edges.

I remember waking up, on my side, jolted out of the blank of anaesthetic, consciousness returning like a modem reset. Blinking and flickering, my systems came back online and at a certain point my throat recognised that it was stuffed with a tube, deduced that this was not ideal, and began to choke me violently. The sensation woke me like an angry parent but I suspect it was the sound, a splutter that bubbled into straight-ahead panic, which prompted my nurse to attend to that unwelcome penetration.

The minutes that followed, full of blear and fog, who am I, where am I, bed righting, pillow wrangling and desperate thirst, come into my mind trailing the same scent as my memories of long-haul flights, with their own minutes of waking and adjusting under watchful eyes, as window blinds are slid open and the plane prepared for landing. I suppose the similarities are genuine: being doted upon, and being high as a kite.

Some crucial differences, naturally: I had just been cooled down, blood diverted, sliced into, sawn through, prised apart, heart valve excised and updated, then wired, stretched and sewn back together. It seems quite dramatic, written out like that, like an ordeal or a tragedy. It was neither, and writing about it now, five years later, is challenging not for any trauma of reliving the experience but because it’s difficult to sound convincingly nonchalant. It may test your credulity, but aside from some anxiety and mild discomfort, it was a positive experience.

Now minus the choker and having been lifted onto my back by long-lost orderlies, I made a quick inventory of new limbs and counted five tubes still coming out of me: one each in the neck and the arm, two under the ribs for ‘drainage’, and most pitifully, a catheter extending from a forlorn and fearful manhood, the removal of which loomed ominously in my future for the next three days.

Near to my right hand lay a plastic device with a large green button, a wondrous thing to cradle in your hands and whisper sweet sonnety nothings to. O love, pharmaceutical! Here was the warmest chemical embrace, soothing, devoted, and when it began to wane, I could simply press a button and be enveloped anew. Morphine. Initially I had a misguided intention to use it as little as possible, until the nurse told me that this was daft. ‘Are you in pain?’ she asked.

‘No.’

‘Exactly. Stay on top of it.’ My abstinence was characteristically fickle, and I ceded my intention, giddy with permission.

For the next 24 hours, I rode that green button like it was Pegasus, holding me aloft as chaos and catastrophe streamed ordinarily into the Intensive Care Unit. It was oddly enjoyable, in a surreal way. I dozed, stared out, drifted. Somehow, despite the accidents and the heart attacks that were called out in colour codes, euphemistic catalysts of rush and scramble, I was serene. Maybe this was the result of all the devil juice I was pumping into my arm every ten minutes, or perhaps I was just high on a more natural intoxicant: relief. I was awake, and ignoring the various frailties of my situation, I was myself.

Of all the risks of heart surgery, I was most afraid of having a stroke, of coming back altered or incompetent, inducing familial obligation or unhealing dependence. Standing in the bathroom, pre-op, watching a grey ghost in the mirror holding an electric razor, I felt an acute sense of irreversibility, a mid-fall longing to defy gravity and go back to before the jump, scrambling pointlessly against the events that were so horribly imminent. I wanted to be able to ask someone ‘do I have to do this?’, for the answer to be ‘no’, for them to put a halt to it all and let me go home. It’s a bit undignified, this supplication, like a dizzy drunk promising to never drink again if only the world would stop spinning, but considering I had to walk out of the bathroom in a hospital gown, an item of clothing that is almost entirely hypothetical, my dignity seemed to have been shed with my body hair.

After the obligatory observation period, I was moved from Intensive Care to the cardiac ward, wheeled through the corridors like luggage on a trolley. Helplessness is infantilising, and it’s surprising how quickly even the prideful accept this state of being. Then again, how much resistance can you muster when your bladder is emptying itself autonomously, completely unnoticed, into a bucket under the foot of your bed? But then again again, if your most inconvenient functions have been delegated into someone else’s hands…well, why resist?

The next two days are undefined, faded like the scar on my chest, but I can still recognise that not much actually happened. I should have been sleeping, drowsy from the drugs and the physical toll, but a mundane side effect was holding me from sleep’s door: the hiccups. For three days they interjected, regular, incessant, maddening; an unreachable dripping tap. The doctors and nurses were rendered powerless amid their own rising annoyance – as with a relentless sneeze or cough, compassion for the noisy soon turns to resentment – their medications rebuffed by what was revealed to be my body’s objection to being stuck in the chest by a prong of tubes. A fair but futile protest. I was so exhausted from the lack of sleep that I became temporarily narcoleptic, falling asleep mid-sentence (my own) during a visit by my sister, waking at the next spasm to her laughing at me. It turns out that morphine is no match for embarrassment.

The hiccups gave up their vigil soon after the drains were removed, part of an eventful interaction with a double team of nurses. On either side they stood, gloved and purposeful, professional in their concern and with a matter-of-fact ability to distribute care; whoever coined the term ‘tough love’ was surely acquainted with the charms of a nurse. They exhorted me to hold my breath and not allow any air into the nostrils they were about to create at the base of my ribcage. Perhaps it was classic misdirection, busying my focus on an action that cleverly involved keeping my mouth shut, but given I’m prone to wobble in sight of my own blood and/or internal organs, I took the bait, looked at the ceiling and held on. Two horizontal scars remain, about 1 cm across, a faded white, marking the spot in surgery Braille.

With the drains now plugged, my nurses turned their tube-removing attention to the catheter I had been taking for granted ever since waking up three days before. Other feelings not covered by morphine: worry and self-consciousness. Both were warranted. The worry soon gave way to actual pain, and the self-consciousness to actual shame. I felt like a watched dog taking an uncomfortable shit, furtively avoiding eye contact and annoyed by how long the process seemed to be taking. This was the physical low point of the whole enterprise.

It was also a turning point, of sorts. Unplumbed and forcibly separated from my green button of tenderness, everything became a little more real. Nature’s call now required a graceless lean-and-fall out of bed, like tipping a cow, arms braced across my sternum to prevent them bearing weight, followed by a very slow shuffle to the bathroom. Without the morphine to stroke my brow, discomfort gained a new and ragged edge, adding a sharpness to the daily belly injections and the deep coughing I was required to simulate, painful hacks to shovel air into the depths of my lungs to stave off pneumonia. I was soon moved to another room for the last few days of my stay, began to sleep and walk around twice a day, and gradually confronted the two months of convalescence that lay ahead of me.

One final memory from the hazy phase remains, a strange and uncommon experience that were it not witnessed, I would think it a hallucination. I can’t say with certainty when it occurred, but I think it was day one on the ward, at the height of sleep deprivation and morphine reliance. My sister was in the room, standing to the right of my bed, probably on the same visit as my dalliance with narcolepsy. Her phone rang: it was my mum, calling from the other side of the world. I listened to the one side of the conversation I could hear, standard answers which filled the silence with obvious questions:

‘Yes he’s fine, it all went well.

 

No I wouldn’t say that, he looks pretty awful actually.

 

Well he just fell asleep mid-sentence, but he’s awake now, I’ll put him on.’

 

My sister walked to the bed and held the phone to my ear, I said ‘hi Mum’, and then burst into tears.

 

It was strange for a number of reasons. Firstly, without any false machismo, I’m not a crier. Various moments of sentimentality can turn me misty-eyed, like the death of animals in films, or stubbing my toe, or having a particularly good hair day ruined by the wind, but when major emotions need expression, I don’t cry. At times I’ve wished I could, but it’s usually impossible and I turn to food. Feelings can be delicious, but not in hospital.

Secondly, I didn’t feel upset. I didn’t feel anything, I was too busy paddling serenely on a green morphine sea. I tried to talk, to explain that I was fine, but it was impossible with a flood of tears pouring out of me, my ability to communicate dissolved like a sugar cube in the rain. Eventually my sister took the phone from my ear, agreed to call back later and then stood there, embarrassed and eyeing me askance, wondering at what point it would be acceptable to leave. I said, ‘immediately’.

I probably didn’t say that. Truthfully I don’t remember any words of the conversation, but the broader details are true, and it’s fascinating that in amongst the soggy pages of memory from those first few days after surgery, there are two with solid ink: the removal of the catheter and my spontaneous disintegration at the sound of my mother’s voice, crumpling like a cheap car between the forces of bottled anxiety and maternal concern. Evidently the sharpest experiences etch the deepest, and I guess that’s what Ted Hughes meant when he wrote ‘the things that are worst to undergo are best to remember’.

Is he right though? I often think about the tyranny of memory, its ability to haunt, to stop time on a person, to imprison, and I want to argue with him. But if I think of these particular memories, these two lowlights, I am glad I can remember, glad that my treasured opiate didn’t rinse them away. They’re both symbolic, if I look hard enough: of good fortune and risks dodged, of ‘not that bad’ and ‘I can do that again’, of survivable discomfort and the importance of family, whether laughing at you or feeling embarrassed on your behalf.

Then again, who knows how much I’m inventing. Even sober memories are unreliable, so perhaps I shouldn’t look for sentiment in drug-addled corners of the library, and perhaps I should’ve picked stories which paint me in more dignity, not less. Oh well. It grew back in the end, and that is best to remember.

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