One of the perks of working for the Federal Government is the amount of time you get off. For starters, you get all of the holidays. When was the last time you got Columbus Day off?
And, you get five weeks of paid vacation a year.
In April of 1995, I did something I had never done since I had started working at the MVAMC. I took two consecutive weeks off, but I did it for a good reason. My father-in-law had called, and said he needed help cleaning out his house after his wife had died.
Wanda had died the previous October after traveling all the way from the bottom of Texas to Minnesota to see her baby girl before her fourth abdominal surgery in three years. Wanda had had an heart attack after arriving in Minnesota, and needed another coronary bypass surgery before she could safely travel back to the bottom of Texas. She would die on the table in the OR, leaving a tidal wave of shock and grief in her wake.
My lovely supermodel wife called her sister, and plans were made. The three of us would drive down to the bottom of Texas and clean out Dave’s house. We would rent a truck, load that sucker up, then drive back home. I would drive the truck. Leslie would drive our car. Lea would ride with me or Leslie. Done deal.
Early Saturday morning on April 8th, Lea and I drove from our house in Minneapolis to just outside of Ettrick, WI where Bill and Leslie lived on their hobby farm, Pfaff’s Happy Acres.
I loved their farm. Bill had planted a bunch of apple trees, and collected himself an herd of miniature goats. He named all his goats after Biblical prophets. Amos. Isaiah. I think he even named one Elijah. And he had a girl goat named Ruth, of course.
Leslie had a kind of a miniature horse named Andy. Miniature horses are supposed to be, you know, small. But in the Spring of 1995, Andy went through a growth spurt, and had turned into a mutant, semi-large horse.
I was much taller than Andy the first time I met him. Andy was a few inches taller than me the second time we met. And he had developed a bad attitude.
As I was packing Leslie’s luggage in the trunk of our car, Andy grabbed one of the goats by the scruff of the neck and started shaking it around like a ragdoll. I raced into the house to tell Bill.
Bill was working as a consultant back then, and he traveled a lots. Bill had just returned from a trip to Philadelphia, where he had contracted a particularly virulent, though short-lived stomach virus, and he still looked a little green around the gills.
Despite his weakened state, Bill and I ran out to the barn to do try to save one of the prophetic goats from the psychotic horse. We were able to get the goat away from Andy, but we were too late to save it. Then Bill moved Andy into a different pen before he decided to kill any more goats, but Andy wasn’t exactly cooperative with the move, and Bill was shaking with anger and exhaustion by the time he was finished.
“I have a really bad feeling about this…” I whispered to Lea, as the goat we tried to save took one last gasping breath, and died. We said our good-byes to Bill, and climbed into the car, and headed off to San Benito, TX.
* * * *
It’s a little over 1500 miles from Ettrick to San Benito, and none of us felt like spending twenty-two consecutive hours in the car. Dusk was approaching when we reached Oklahoma City. We found an hotel in Purcell, OK, and checked in. We would resume our journey in the morning.
Lea and I were ready to roll early Sunday morning, but Leslie was not. She was pale and clammy looking. She just needed a few more minutes to compose herself. Before we hit the road, we stopped at a nearby Burger King for breakfast. Leslie took one bite of her breakfast sandwich, and turned a stunning color of green. She ran to the Ladies Room, and she stayed there.
“Maybe you should go check on your sister, and make sure she’s still alive.” I suggested to my wife.
“She’s laying on the floor.” Lea announced when she returned, and sat down to finish her coffee.
“What does that mean? Should we call 911?”
“No. She’s just being dramatic. She’ll be okay.”
This was my first exposure to the odd dynamics of my wife’s family. There would be more.
There was an Urgent Care office next door to the Burger King. I thought about dragging Leslie across the parking lot to be evaluated. She’s a much larger woman than her sister, but when Leslie finally emerged from the Ladies Room, she declined all offers of medical treatment, and crawled into the backseat of the car.
“Drive!” she ordered. I drove.
The next 700 miles were perhaps the longest miles of all our lives. Leslie was utterly miserable. She moaned and groaned and prayed for death.
“If she doesn’t shut up, I’ll fucking kill her myself!” Lea told me during one of our stops for gas.
As night started to fall, we pulled into Dave’s driveway. The first stage of our rescue mission was over. We had arrived safely, and more or less alive.
* * * *
Leslie looked a whole lots better on Monday morning. The Philadelphia flu had wreaked its’ havoc upon her, and then it was gone.
Lea and I slept in the guest room. Dave moved into his motorhome, so Leslie could sleep in the master suite. We usually went out to eat while we down in the bottom of Texas, except when Leslie or Lea felt like cooking. But I think those occasions were rare. The reason for our visit took an emotional toll on everyone.
Dave’s daughters surveyed the house like generals planning an invasion. They started sorting stuff into three piles: Leslie’s Stuff. Lea’s Stuff. Stuff No One Wants. The stuff no one wanted, like all of Wanda’s clothes, would be sold at a local consignment shop, or given away.
Leslie and Lea shed a lots of tears in the process. They understood the necessity of what they were doing, but it was tough duty.
Dave and I tried to stay out of their way as much as possible. He showed me his medals from the Army, two Purple Hearts and a Bronze Star, and casually told me how he got them. Dave had received a battlefield commission to captain during the Battle of the Chosin Reservoir in Korea after all the officers in his unit had been killed to death. He had only been almost killed, and as the highest ranking surviving NCO, he instantly became the commanding officer of what remained of his unit.
Dave had to have been the luckiest unlucky bastard I ever met. He was at Anzio in WW II, which was one of the worst places you could be at that time. And he was at the Chosin Reservoir, which was one of the worst places to be, ever. For all time. He was lucky because he wasn’t killed or captured, but he was wounded twice. And he was an emotional basketcase for the rest of his life.
He showed me his pistol, a .45 automatic, and offered to let me handle it because I had been in the Army, and I could appreciate it. But I had seen one too many handguns up close and personal, the last one during my vacation in Dallas with my buddy, Shorty.
Leslie and Lea would occasionally question Dave about what to do with a particular item. He almost always opted to get rid of it. The sorting continued daily, the three piles of stuff grew progressively larger. No one else started exhibiting the symptoms of the Philadelphia flu, and I thought the rest of us were going to dodge a bullet.
Leslie felt like cooking on Wednesday. She made beef stroganoff, and she made a lots of it. We had a meal that couldn’t be beat, then retired to the living room to relax. After watching TV for awhile, we all headed for bed. And I started feeling not so good.
I can’t remember how many times I vomited, but by the time I finished, I knew one thing for sure. I would never eat beef stroganoff again.
Being sick is one thing, but being puking sick is the worst. Ever. I’ve rarely been puking sick in my life, even when I drank to excess, and I did that a lots. If I had been prone to vomiting, I might have been inspired to quit drinking sooner because I fucking hate puking.
I eventually crawled into bed, and started praying for death, much like Leslie had a few days earlier. I tried not to moan or whine too much because I knew what my wife had endured when she had been trying to survive her battles with Crohn’s disease.
But I was miserable. I eventually said this to my wife, “Honey, I hope you don’t think I’m a sissy or anything, but I’m sicker than a dog, and… I… want… my…mom!”
* * * *
By the next morning, I was pretty sure I was going to live, though I was feeling very shaky. And then Dave came into the house from his motorhome. We took one look at each other, and knew we had both fought the same battle.
Dave thought we all needed a break, so we got into his car and drove the short distance to the Mexican border to do some shopping and stuff.
Leslie and Lea walked around some of the streets of Reynosa while Dave and I parked ourselves in a little cantina and tried to drink a beer. It was perhaps the least amount of fun I’ve ever had with a beer in my hand.
We ate dinner at a Mexican restaurant in Reynosa, and I actually started feeling better. I was ready to back to the cantina, but everyone else wanted to go home. Lea said she wasn’t feeling too good. By the time we got back to Dave’s house, the Philadelphia flu was beginning its first assault on my wife’s already compromised body.
Lea’s health, or the lack thereof, had been the intense focus of our lives for the three previous years. She’d had four major abdominal surgeries, and had almost died at least three times. She had had about one third of her intestines removed, and had ended up with an ileostomy and an external pouch.
I wasn’t a medical nurse, but I knew enough about my wife and her medical issues to know she wouldn’t be able to survive the ravages of the Philadelphia flu without professional help. At the very least, she’d need IV fluids and electrolyte replacement therapy, or the consequences could be dire.
Lea ran into the house and down the hallway to the bathroom as soon as we got back to Dave’s house, and as the rest of us walked into the house, the phone rang. Bill was calling, from wherever he was in the world on business, and he needed to talk to Leslie. It was an emergency!
I had an emergency of my own to take care of. I tossed the phone to Leslie, got directions to the nearest hospital from Dave–fortunately, there was a little forty bed facility just a few miles from Dave’s–and helped Lea into the car, hoping she could get the medical attention she needed before she started having seizures. She said her muscles were starting to spasm, and I didn’t think a full blown grand mal seizure was far behind.
The local hospital had an emergency room. I got Lea checked in, and started explaining her complicated medical history to the admissions clerk while the staff started taking care of Lea. The ER staff all knew Dave and Wanda, and they assured me they wouldn’t let anything happen to Wanda’s baby girl.
But I knew this was going to be kind of an ordeal, no matter what anyone said. When I told the clerk at the desk my wife had an ileostomy, this was her response.
Illy-what? Can y’all spell that for me?
Like most ER’s, this one was busy. I gave the clerk a list of all the medications Lea was taking and the dosages of all of them. It was a very long list. I made her make a bunch of copies, and I would hand a copy to anyone that had anything to do with Lea’s care while we were in the ER. I stopped every staff person I saw, and told them I was a nurse, and what my wife needed. STAT!
The nurses in the ER were actually very helpful, and Lea had an IV running with a potassium piggyback running in no time. She didn’t have the same issue with vomiting that I had had, but her external pouch needed to be emptied constantly.
Lea’s nurse was a tall Texas blonde. Besides my wife, she was busy taking care of at least three other people, one of whom was a big hairy guy that had been brought in by a couple of Texas Department of Corrections Officers.
I don’t know what this guy had done, but I’m guessing jail isn’t anywhere near as much fun as they make it look on TV. This guy presented with chest pain, but didn’t appear to be in any apparent distress as he strolled into the ER. He had a big smile on his face, and he waved at everyone, making sure they saw the handcuffs on his wrists.
Per hospital policy, the big hairy guy was restrained to a litter because he came in under police escort. He totally cooperated with that, but he had stopped smiling. Once he was restrained, the tall Texas blonde nurse explained what was going to happen in no uncertain terms.
A nasal cannula was placed in his nose holes, and he was started on O2. An IV was started, and labs were drawn, using the biggest needle the nurse could find. And she made sure she missed his vein with her first attempt. Then she informed the big hairy guy she needed an urine sample.
“I can pee in a cup. I do it all the time for my PO.”
“Nope, y’all can just lay back and relax. I’m going to cath you.” And she did, using a catheter about the diameter of a small garden hose.
The big hairy convict guy probably wasn’t in any pain in any part of his body when he walked into the ER, but after roughly thirty minutes of tender loving care from the ER staff, he was hurting in at least two places.
“Hey! Take me back to jail! I’m good! Get me the fuck outta here!!” And once his lab results came back normal, back to jail he went.
* * * *
Just between you and me, that was the most beautiful intervention I’d ever seen on a malingering patient, ever.
A malingering patient endorses a plethora of symptoms to lengthen their stay in the hospital. We saw this all the time in Psychiatry. Some of our patients wanted to stay in the hospital as long as they could, for a multitude of reasons.
Some of them were homeless, and if you’ve never tried living on the streets, it totally sucks. Some of them were trying to avoid going to jail, and I’m going to guess that probably sucks, too.
It might have been legal to restrain a guy and stab him in the arm with a really big needle a couple of times, then shove a garden hose down his dick in Texas, but it wasn’t in Minnesota. If we had been allowed to use those interventions, we could have easily cut our recidivism rate in half, if not more. We couldn’t even carry tasers, which I thought every psych nurse should be issued, no matter which state they worked in.
Seeing how Lea’s nurse was busy taking care of a guy that didn’t need any care, I decided to take care of my wife because she did, and I was a nurse, too. I grabbed a box of gloves and a basin, and I informed her nurse each time I emptied Lea’s pouch, or she vomited, and the volume of fluids she expelled each time. Her nurse was grateful for the help, and offered me a job.
One of the other ER nurses heard I worked in Psych. She came over to quiz me about her ten year old son, who had recently been diagnosed as Bipolar. I can’t remember her name, but she was probably a couple of years younger than I was. She was kind of attractive, and clearly overwhelmed by the situation with her son, and practically started crying on my shoulder.
That seemed like a weird diagnosis for a ten year old to me, and to her, for that matter. I suggested she get a second opinion from a real doctor next time, and spent close to half an hour listening to her. I wished her luck, then we both went back to work.
Bipolar Disorder is a terrible disease.
Lea’s condition had stabilized somewhat. Her nausea had passed. She was no longer vomiting. In fact, I thought she looked good enough to go home, and even Lea thought she was going to be okay.
But given the fact she’d had multiple surgeries and she had an ileostomy, and then there was her family history of heart disease… The ER doctor didn’t feel comfortable discharging my lovely supermodel wife, no matter what we said. He wanted to keep her overnight for observation, just in cases.
And that’s where the ordeal started. Given Lea’s cardiac history, the ER doctor wanted her to be admitted to a monitored bed. The only problem was there weren’t any open monitored beds in the hospital.
Now, you might be thinking, it’s an hospital! Aren’t all of the beds monitored? A monitored bed is hooked up via EKG leads and highly sophisticated circuitry to an alarm system behind the nursing station. If something goes awry in a monitored bed, alarms go off and every nurse on the floor goes running to that room with crash carts and oxygen and a shitload of medications to save a life.
I used to work in Cardiac Care, and I understood the rationale behind the ER doctor’s decision. So we waited for a bed. And we waited. And we waited.
The first symptoms of the Philadelphia flu hit Lea about 6:00 PM. I had called Dave’s house a couple of times with updates. My last call was probably around 10:00 PM. Lea was doing better, but the doctor wanted to keep her overnight. Dave said he and Leslie were going to bed, but they’d leave the door unlocked so I could get in the house when I got home. They’d see me in the morning.
When midnight arrived, Lea was still waiting for a bed. She was getting a little upset with the wait. I was way past that.
I’m an incredibly patient man. You can ask around if you like. But this situation was beyond ridiculous. I asked to see the Administrator on Duty, every hospital has one, and I wanted some answers. I was informed she was busy, of course, but she’d be down to see me in a few minutes
When 1:00 AM rolled around, I demanded to see the AOD. Now.
She actually came running into the ER. She was a very sweet woman who apologized profusely in her darling Texas accent. She offered her condolences to us. Wanda had been a friend of hers, then explained the difficulties she was facing.
There were a limited number of monitored beds in her hospital, and they were all currently occupied. She had called in the maintenance team, and they were moving heaven and earth to hook up a monitoring system in one of the rooms to the nursing station so Lea could be admitted.
In the meantime, was there anything she could do for us?
Well, yeah, there was. It was incredibly noisy in the ER. It was filled with a lots of unhappy people. Was there any place to put my lovely supermodel wife that wasn’t as loud and busy while we waited for the monitored bed was being set up?
Yes! Lea could be moved into a room in the ER, and a real bed could be put inside the room. Lea would be more comfortable, and the room would be much quieter…
Lea said that would be fine. And the very sweet woman left to see that this was taken care of immediately. And it was. As to how long it would take for Lea’s monitored bed to be ready, well, that was a mystery.
When 2:00 AM rolled around, I was falling asleep standing up. I told Lea I was going to go back to Dave’s house. I hoped her bed would be ready soon, but she was at least in a quieter place, and maybe she could even get some sleep, but I had run out of gas. I had to go.
I think I finally got back to Dave’s around 3:00 AM. I would find out later that Lea would wait in that room for at least another three hours before she was admitted to her hastily assembled monitored bed.
* * * *
I woke up the next morning around 9:30 AM because Dave knocked on the door and told me Lea was on the phone. My head was foggy, and full of cobwebs.
“Come and get me!” Lea’s voice said. She sounded terrible.
“Are you being discharged?” I asked. I was a nurse. I kind of understood how hospitals worked.
“No! The fucking doctor here doesn’t think I have Crohn’s disease! He wants to run a bunch of stupid tests on me! I told him to go to hell!”
“How did he take that?” I decided to ask.
“He’s not very happy with me right now.”
“How’s everything else going? Are you getting your meds?”
I knew getting her meds right would be complicated. That’s why I handed out a list of them to everyone, hoping the floor nurses would get a copy and get them ordered.
“No! I haven’t gotten anything! Not even morphine!”
“I’ll be there in ten minutes.”
I was so pissed I was shaking. I almost asked Dave for his gun.
* * * *
Lea wasn’t in the best of shape when I had taken her to the ER, but she looked even worse when I arrived at the hospital the next day. She was drenched with sweat, and writhing on her bed. I was a nurse, and I was a very good nurse. I knew what what was happening to her the moment I laid eyes on her. My wife, was going through serious opiate withdrawal.
I went to the nursing station, then tracked down her nurse in the hallway, and I tried to be polite, at first.
“Excuse me. I know you’re incredibly busy, but my wife is in that room down there at the end of the hallway, and you need to come see her now, please.”
Lea’s nurse was a young-ish slob wearing light blue scrub bottoms and a multicolored top about the size of a pup tent. She kind of shuffled when she walked, and her hair looked like it hadn’t been combed since March.
“Yeah, I’ll be down there just as soon as I can. I’m doing something right now.”
“I’m sure you are, but have you seen my wife lately? She hasn’t gotten any of her meds yet, not even her pain meds, and she’s going through withdrawal.”
“I haven’t had time to go over her meds yet. Like I said, I’m doing something right now.” she replied, not even bothering to look at me when she talked. And that was the last straw for me.
“You listen to me, and you better hear every word I say.” I said softly, but loud enough for her to hear me clearly. “I’m a nurse, too. So when I tell you you need to come to my wife’s room now, I mean right fucking now. And if you don’t do as I ask, I’ll have your ass in front of the Board of Nursing before your shift ends. Now, move!”
I appeared to have gotten her attention. She stopped doing whatever it was she’d been doing and turned to look at me for the first time. I nodded in the direction of Lea’s room, barely controlling the urge to push her down the hallway.
“Oh my word!” she said when she entered Lea’s room and saw my wife.”She didn’t look like this the last time I was here! Let me go check her meds. I’ll be right back, I promise!”
“That’s bullshit.” Lea said, as her slob of a nurse shuffled out of her room. “I’ve been like this for at least an hour!”
“Well, let’s give her a minute to fix this. Then I’ll kill her.” I said. I was only partially joking. It’s probably a good thing I didn’t ask Dave for his gun. Unlike Hillary, I probably would’ve used it.
In a very short amount of time, Lea’s nurse returned with a syringe filled with Demerol. She injected the drug into a port in Lea’s IV tubing, and by the time she shuffled out the door, Lea looked a whole lots better. My wife exhaled a huge sigh of relief, and smiled.
“That’s better!” she said.
“Can you walk?” I asked. I was making an assessment. Lea was wearing a hospital gown and a pair of panties. The only clothes she had with her were a pair of denim cutoffs, which I pulled out of the closet and handed to her. She didn’t even have a pair of shoes. I had taken her purse and the rest of her clothes home with me when I left the ER.
“Yes. I’m fine now. Why? What are you thinking?”
“I’m thinking if I don’t get you out of here, you’re going to die.”
“Then get me out of here!” she said, and pulled on her shorts.
I disconnected Lea’s IV, and covered her IV site with gauze and tape. Then I started disconnecting the leads of the monitor. This was the tricky part. Lea was in a monitored bed, and the moment I started messing with her leads, all kinds of alarms would go off. A veritable army of nurses would descend upon us, and even her slob of a nurse would eventually shuffle back to her room to check on her.
But a funny thing happened when I disconnected the first lead.
No alarms went off. No one came running. And I got even more pissed off, if that were possible. When Lea was disconnected from all her equipment, we walked out of her room, down the hallway past her slob of a nurse, who was so busy doing something she didn’t notice us walk by her, and got on the elevator.
We walked out the front door of the hospital, my barefoot, hospital gown wearing lovely supermodel wife and I, across the parking lot, and I drove us back to Dave’s house. I think we laughed the entire way.
* * * *
Dave was waiting for us at the front door when we pulled into the driveway. He had a puzzled look on his face.
“Mark! The hospital is on the phone!” he said. His expression was also one of concern. “They said you took Lea out of the hospital without permission! They want you to bring her back, right away!” Lea was his daughter. And he had just lost his wife a few months earlier. I don’t know if he ever understood how many times his daughter had almost died in the last few years, but he clearly thought I had done something to endanger her life now.
“This is Mark.” I said into the receiver. Lea was explaining what had happened while she was in the hospital to her her father and her sister, and that way her family would know I wasn’t trying to kill her to death.
“Mr Rowen, this is the hospital administrator.” a male voice said into my ear. “I understand you and your wife have had a bit of a bumpy ride while you were here, but we would certainly like the opportunity to fix that. You’re a nurse, right? You have to know your wife is very sick!”
“Yes, I know.” I replied. “And I’d like to keep her that way if you don’t mind.”
“I…I don’t understand, Mr Rowen.”
“Yes. My wife was very sick, but your hospital did a great job and she’s doing much better now.”
“But your wife is still very sick.”
“And, she’s still alive, and I’d really like to keep her that way. However, if she had much more care at your facility, I don’t think she would be.”
“Now, Mr Rowen, that’s–”
“I agree. That’s more than quite enough.” I interrupted, and hung up the phone.
We had driven from the top of the country to the bottom of the country to help Dave do something he didn’t have the heart to do himself. And it was a task that nearly broke the hearts of my wife and her sister. They were clearing their father’s home of most of the items that reminded him of his dead wife, and collecting the items that reminded them the most of their mother.
We had all come down with the Philadelphia flu, and we had all survived. Even Lea. There had been one casualty, an innocent goat had been murdered by a homicidal horse, but that had been way back in Wisconsin, before we had actually set off for the bottom of Texas.
Thank you, God, I thought. And I also thought at least nothing else could go wrong on this trip, and that the worst was over.
But life is a funny thing sometimes. And while there might be times when things can’t get any better, things can always get worse.
Sometimes, they can get a lots worse.