Bill Totten's Weblog

Monday, November 30, 2009

Fat and scant of breath

by Paul West

Harper's Magazine Notebook (July 2009)

Only the other day, I had the ravaging exposure of five or six women in pursuit of my most numinous weapon: my penis, which they were intent on rescuing from the mishandling of a certain colleague of theirs, who had managed to make the creature live inside-out. My penis had fallen afoul of the device, known as the Foley catheter, and known to thousands as the last twist of the knife.

The trouble essentially was that I remain uncircumcised. Perhaps these barbaric women were eager to see me suffer the "cut". Or they wanted to fold my foreskin back where it belonged, parallel to my penis: enclosed, ready for duty. The beefy hand of some nameless doctor had mangled it out of shape. The whole mess was finally corrected by a Dr Sanjeev Vohra, who with a goodly dose of panting and heaving made it obey reason, or as he put it, "As God intended it should be". I shall forever be grateful for this blissful outcome. A hearty, headlong man much after my own type, he and I discussed literature in the intervals of urology. We also discussed cricket.

In my rage at having been confined yet again by Foley and his devilish works, I had gone to the John in the dark, thus leaving behind me all manner of restraints intended to bind me into place and stop me from wandering about (which I adore to do).

Into the abyssal dark of the toilet I stepped, crouched, and performed, then felt something on my right. A Foley? Yes. In a burst of reckless passion I tore it out, freeing it to catapult all over in a shower of gratified passion, leaving behind several floors' worth of blackened blood and minute ordure. The Foley destroyer had struck again.

This habit of mine, resulting in the destruction of one or two Foleys a year, stems from a hatred of being boxed in. Other minor hindrances suffer the same fate, from the delicate tracery imposed on someone who is supposed to ring for the toilet facilities to be opened up to the nameless, glutinous mess that prevents you from speaking; the savage ropes that make a prisoner of your arms, to prevent you from scratching; and the cordlike toilet pull that does not work except to bring apostles running to see what you have been up to this time.

The background to all was bewildering and potentially lethal. I had woken on Tuesday, January 27 2009, unable to breathe normally, gasping for air in fact, and once standing erect had swiftly gotten worse. My wife, Diane, ever vigilant, summoned the 911 crash-cart or ambulance, which arrived with commendable speed. Seconds later, I was into curative sleep and en route to the hospital, but on the way my blood pressure declined from V-tach, and into oblivion, which lasted until afternoon on the next day. Diane remembers my unseeing eyes and my pallor.

I'd had a close brush with death, of which I could remember nothing at all. Apparently, some seventeen doctors and clinicians decided I was not to go into the good night awaiting me, piled every appliance into me and upon me, and successfully brought me round without knowing exactly why. My lungs were full of fatal stuff anyway, but some questioned the heart as well.

It was on the next day, feeling almost chipper, that I had the Foley encounter followed by the penis caper. I was still aware of little beyond the need "to go", but I recognized in the ministrations of the nurses attending me the tender do-no-harm of their credo. Sure, they had to clean up after the night visitor, but that was to come afterward. The main thing was to see that I was all right, which they did with inexhaustible patience, especially Melissa. It was the same with my maltreated penis: gentle fingering with all the precise aplomb of a supersurgeon. I had never been so scrupulously treated in my life. And I thought, betimes, of Kirk Douglas, who in the putrid movie Cast a Giant Shadow declares, "I was circumcised without my permission". Unlucky he.

Thus a rough sketch emerged: oblivion, Foley encounter, penis rectifier. What would come next? That old swimmer's-high experience, the one I felt usually after two hours of swimming? It was a beautiful interval during which all was right with the world and I was glad to be in it. I had come through again, or so I hoped. I leaned back on my air supply and said a brief orison.

What followed this was a week in the hospital: cramped beds, cords to pull for nurses' attention, constant interruptions for replacement drugs, egg breakfasts, and milk, milk, milk. Not bad, but a kind of wolfish demeanor to some of the younger nurses, the less educated, of course. I nominate Bonny, my supernurse. How she finds time to keep up with her reading while always hastening from pillar to post, I won't ever know.

I've neglected so far to incorporate into this account the words said on this or that occasion. Some of them were significant, as when the young clergyman, whose duty was to do this favor, asked the already tearful Diane what had been my instructions for resuscitation. Try everything, she resourcefully answered, everything. When that failed, she said it again to a doctor, on whom it worked, preventing her from gazing for the last time at the sightless eyes and the green pallor peculiar to those who have been chopped off, not exactly in their prime but too soon to "go".

I afterward complimented her on saying, "Try everything", only to hear her saying, "It wasn't enough". By God, it was. Who does this kind of thing better than you?

We are not responsible, any of us, for our funeral orations. Since then, the phrase has slipped into our daily vocabulary, honorably recharged and pronounced with abstract relief: one of the phrases to savor ever afterward in lieu of something quintessentially blank.

A visiting friend, eager to do something for the nurses, brought with her one day some leftover pharmaceuticals. Look what happened when she proffered them.

SHE: Here they are.

NURSE: Thanks.

SHE: Please wipe your hands.

NURSE: Maybe I should wipe the pen I am using as well. Said with an extraordinary amount of huff, and reminding me of an old phrase: Be wary of Greeks bearing gifts. You cannot win them all over, even with gifts, this light militia of the local air.

But this was a mild one as reproofs go. More important was the authentic cry from the heart about Diane and myself, just back from the jaws of death. This nurse wrote, "She is condescending and insistent, especially about using the hand-sanitizer. Two of the most doting people of all time." Oy vey. You cannot please everybody, even your obsequies are set in stone, like this nurse's notes. There was another nurse hell-bent on delivering little self-serving formulas ("I know my job even if others don't"), but she isn't worth rebuking, not in the mainstream of buxom lasses who could not do enough to please.

Slowly, I emerged from my cocoon, resuming my baritone voice and responding to questions, as best I could, about coming back to life after being lost for two days. I felt singularly well, but I had missed all the frantic efforts to save me, apart from one photo depicting me in extremis, a cloud of prosthetic paraphernalia amid which I hung like last year's laundry.

"I was that bad?" I asked Diane.

"And then some. You were out."

"How come I feel so well then?"

"Inspired propaedeutics".

"The best". I took my offered benison to heart, and promised not to do it again. Vain promise, though. We have little enough control of our bodies at the best of times.

I next was wheeled down long, funereal corridors to the CAT-scan machine, heartened by being swathed in voluptuous wrap, which I was allowed to keep for the journey back. I knew this machine well, its creaks and juggles. The keeper of the CAT was an old familiar, and he recognized me as well, from months ago. Did he remember everyone, or was this part of his bonhomie chatter?

Back from the CAT, I soon was destined for another machine - an elaborate contraption menacingly called a chemical stress test, which an assistant prepped me for by listing the various things that could go wrong. Like vomiting up one's lunch, like feeling scalded or scorched, like tremors, passing out, or the bone-ache, but not forgetting the overall stink of rotten fish. He was an expert, rolling out his pattern of horrors like a pro, skipping nothing, backed up by his repetitious litany of "If you ever feel it's too much ..." Who on earth, confronted with such miserable bounty, could feel so much. Get on with the vomit part, and get ready for the next abomination.

"Some, however", he pointed out, "feel nothing untoward". I thanked him for the delicacy of his phrasing (how many of them still used "untoward"?), which introduced an aroma both antique and festal into this doomed arena of blood flow and mishap. "Maybe you'll be one of those". He could already sense my revulsion at his hideous machine, tricked-out space vehicle that it seemed. Could they not have designed a Versed that put people out beforehand and awakened them asking when the test would start? As it happened, I felt nothing at all, neither scent nor ripple, neither pain nor excremental overflow. I was one of the chosen, he hummed at me, glad of a freak to bandy words with.

I left memorializing those who had suffered, the unlucky survivors of his chemical stress test who had gone on to negotiate greater horrors while this white-faced ghoul with his advanced vocabulary of hurts cringed in the foreground, waiting for the shrieking to stop.

Whatever we subject ourselves to, in the interest of something called health, we are destined to come a cropper sooner or later. Some nightmarish oaf, in his pursuit of a more efficient nostrum, is already designing it, full of radioactive strontium or of tiger sparkle. You'll never get away from it, says the stress machine in the corner, the loitering instrument of pain hunts us all down, and only the strong survive.

My experience of yet another stress test was to be absolutely different. I had passed the previous one, extorting from the machine's owner a tribute to my one blemish, an old scar from way back, not worth recording and maybe an artifact. No more. This one, dobutamine, required the same warning and codes of recognition as before, but, delivered by an MD, the sermon from the mount as distinguished from the simoom from the half-wit. Nothing "untoward" happened. Nothing to record. The machine ground to a halt. Interrupted in mid-flight.

They had canceled the test, for all time, at least until they discovered how to make it behave. They could not deploy the second half, in spite of valiant efforts by Claire Teeter, the lady who knew all things (yet could not make the test 100 percent). So, to the nasal bark of Dr Brand, announcing that he would not give me the dramatic, enfilading chemical after all. Half the test was perfect, with nothing to report, the other half could not be done at all. It was a matter of obtaining the correct angle, which my physiognomy refused to do.

I emerged with no test after all, whether or not something unknown was probably blocking my arteries. This left me free to explore the catheter invasion of my blood vessels, which with my history of previous strokes (two), I had been advised not to do.

Until science developed a new way of doing things, I would not risk a third stroke, but it was an open question whether or not something was occluding my vasculature. I had almost died of it, and perhaps was scheduled to do likewise at some unknown point.

Astonishingly, I felt good after my brush with the reaper. Nothing felt out of place, nothing obtruded. The specter of the route not taken haunted me as it should have, but not that much. I was already in my second week of successful breathing. No more vainly struggling to catch my breath. And we left it at that, the final decision up to me, until a new invention broke the brink of the sciences, and if I were still around to savor it. I was not the first to be in a quandary, nor the last. The only reason for my being denied a virtual angiogram is that I have a bumpy heart anyway, which ensures its own taboo. So I am denied on all fronts, like a French general in World War Two, anxious to do the right thing but barred from it by fate. Each day, several times, Diane asks how's my breathing, and each time receives the same answer: Perfect up to now.

All the same, it was a painful novelty to pass each day thinking it would be my last, and wondering how I would respond to it. Which one of my numerous ailments would catch me out, heart or blood pressure, second stroke or first test? For a few days, I felt like one of the damned, but that soon passed (nothing had happened), giving way to an elation I had not felt since I last swam. It was a feeling of heady delight. I was alive, nobody knew for how long, but I didn't really care about that.

I took an advanced interest in my high spirits. Was it only the relief from swimming each day, a combination of athleticism and joy, or was it something superior? I settled for the latter, being aware of its spiritual dimension. I was happy, which meant a feeling more like celebration took over from the mild-to-moderate sensation I usually had when renewing my contact with the water. This lasted an hour or so, then ebbed away, only to be renewed the next day.

Was it anything to do with swimming at all? I had grown accustomed to thinking that way, but it felt more grand than merely that. Something in these blithe sessions took me beyond water sports: high energy, an almost exciting buoyancy of spirit, the feeling that everything was going well (even if it wasn't). So I had this exhilaration upon me, much the same as reputed among those about to die. Had I been fooling myself all along with profound misconstruction of an actual morose sensation?

The problem, if that, would bear thinking about. Quite naturally an optimist, had I been thinking in the usual way when, at the time, I should have been preoccupied with doldrums? I found it hard to believe, and soon switched to a more optimistic attitude, not far from the original one of triumph.

And this applied to my sudden uplift of spirit. With, say, a more decent dose of potassium, I should be even better. The amplified oxygen was doing well by me and so was the Lasix, which helped me pee. All was right with the world, though it behaved like a conundrum, easily misconstrued and deadly to get wrong.

In the last analysis (the one you're bound to get wrong), you can force-feed your optimism into a simulacrum of common sense until you believe in it. As I do, daily, not willing to justify such recklessness.

I'm unwilling to bargain for a third stroke, not until one presents itself, ugly head and all. A brain doctor, surveying the detritus left in my skull after the second stroke, expressed amazement when he heard that I continued writing, as before. From such an amount of damage, and to two separate areas, he expected a gibbering idiot to come out the other end.

I am left with an old saw, sounding hollow and vainglorious: Happy days are here again. Or the watch that ends the night, either way.


Paul West is the author of more than fifty books of fiction, memoir, criticism, and verse. His memoir "Cadets" appeared in the January 2009 issue of Harper's Magazine.

Bill Totten


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