|1. CHARITY HOSPITAL part I
It sounded as if someone were saying “Keep on Truckin” and kept saying it over and over. “Keep on Truckin”.
I couldn’t see anyone or tell where the sound was coming from. Like most of my dreams there was kind of a semi-dark, smoky atmosphere all around and the scene was sort of shifting back and forth. “Keep on Truckin”. I began to sense my emotions rise in exasperation at not being able to make out where the phrase kept coming from and tried to turn my head all the way around. I became utterly frustrated until finally I woke myself up. “Thweeee Tucka” sounded the ventilator an arm’s length away. On the ascending rise of the corrugated bellows, encased in its silver and glass cylinder, a loud, clear “Thweeee” sound would emanate. It would hover there for a slight moment before collapsing back down with an emphatic “Tucka” sound. Over and over.
I had been instructed to not try to breathe on my own, to let the machine do it for me. An impossible task I knew from the start, like trying to make your heart stop or something but I soon learned. If I tried to inhale on my own or went against the proscribed function of the unit a loud alarm would go off. That meant I was in distress and the Intensive Care Unit (ICU) staff (such as it was) would be alerted to the situation and do what they could to get me back into a rhythm with the apparatus.
Although metal tongs had been screwed into both sides of my skull and attached to weights that immobilized my head, I could still glance sideways. A long, plastic, ridged tube was connected to the ventilator and snaked across the bed railing, my green-sheeted chest and hooked up to the latex trachea port that had been incised into the front of my neck.
Thweeee Tucka. I had no idea what time it was. The lights in the ICU never went out. The nurse or an orderly would come by and drape a sheet over the frame of the circle-bed I was in to shield me from the fluorescent lighting overhead. The bed was an ingenious contraption, designed to prevent pressure sores (or decubitus ulcers in hospital parlance); it featured large, circular rings on either side of the cot I was laying on. After enough time had passed on my back, another cot would be fashioned with cushions, towels and straps for my forehead and chin. After attaching it securely in place, I would be rotated head over heels and then lay face down for several hours.
I couldn’t understand why I hadn’t heard from my family. My injury had happened three days ago and I was continuing to deteriorate. My room-mate, Marino, had come by to tell me that he had called Seattle and told one of my brothers what had happened but so far there had been no word from my parents. Thweeee Tucka, Thweeee Tucka.
There looked to be about a dozen beds in the ICU. Mine was across and down a couple from the nurse’s station and I felt a little better when I could see her at her desk. Whenever she went to attend to someone I started panicking because there appeared to be no one else around.
By making a sputtering sound with my lips I could signal her. Since my tracheotomy surgery required that my vocal cords be separated I had stopped talking. Lip reading and telepathy were my only means of communication.
The neck fusion surgery was done within nine hours of arriving at Charity Hospital. Pieces of bone fragments were extracted from my hip and had been inserted between my fifth and sixth cervical vertebrae. I had signed the release form by inserting a pen in my mouth to make an X. Ever since the anesthesiologist had put me under I had lost all track of time.
A gurgling sound developed somewhere along my new respiratory system. Condensation was building up in the tube and it threatened to back up into my throat. Sometimes it was a relatively simple procedure to unhook the tube, attach a manual hand pump over the trachea and inflate it by hand while a technician or assistant nurse would drain the accumulated fluid. Once it was re-attached my mechanical lungs would continue to keep me alive.
I sputtered my lips to attract the nurse. There was plenty of noise in the room; families helping attend their loved ones, other respirators wheezing, drip machines humming, motors whirring and the clanking and rolling of beds, gurneys and wheelchairs. I sputtered twice in a row as loud as I could and tried to make eye contact with the nurse across the room. Thweeee Tucka, gurgle, gurgle, gurgle.
A higher pitch and a more rapid series of sputters finally got her attention and she came over. Her nametag read Glenda Dunmore and the whiteness of her starched uniform made her look even blacker than she was. She had short, nappy hair tucked under her hat with Tulane University embroidered across the front. She wasn’t very tall with a flat, broad nose, tiny ears and eyes so dark brown that they looked almost as if they were only pupils. I noticed there was a dark, red smudge of blood on the cuff of her sleeve as she grabbed the upper railing of my bed. “Lord, child, how you’re carrying on” she said. “Take it easy now, don’t get yourself riled up”. I widened my eyes and looked over to the ventilator. “Yes, I see”, she straightened up and looked around to see if there was anyone else in more desperate need and if someone was available to give her an assist.
“We might as well make sure that your breathing’s cleared out,” said Glenda. “Hey, Morris, HEY! Morris, Where you at?” “Yeah?” replied Morris, his head popping up between two beds further down the room. “Be there in a second”. Glenda started getting the necessary supplies together; gauze pads, a long wrapped catheter, a few extra towels, a purple-colored kidney-shaped basin and some white latex gloves.
I dreaded being suctioned. They had only done it a few times since my tracheotomy. At least it was an improvement over the first couple of times I needed suctioning. Without any stomach muscles to speak of, I was unable to form a cough with enough force to clear my respiratory system. The only way the staff could clear my airways was to goober the end of a catheter with a glob of KY Jelly and insert it all the way into and beyond my nostril. It was impossible not to gag during this part of the procedure and I convulsed a couple of times and hoped like hell I wouldn’t vomit. I swallowed against the hard plastic and nearly wretched. Once the catheter was in place, the nurse would turn on the vacuum and a sickening slurping sound would issue from deep within me.
“All Right” said Morris, as he wiped his hands on the towel he was carrying. I could tell he was an orderly by his blue scrubs. A thin and wiry black man who I felt wouldn’t be offended at being called colored or a Negro, he seemed to have endless energy. His bald head was beaded with perspiration and his eyes were almost as dark as Glenda’s. “Where’s he at?” “We’re going to suction him,” said Glenda, in a tone of resigned familiarity as she started laying the medical supplies on my chest.
First, she peeled back sterile pads and laid them under the ventilator tube and around the tracheotomy hole. She positioned the basin within easy reach in case I puked. Next, she attached one end of the catheter to the suctioning unit and turned it on. It shuddered awake and gave a whine like an antique vacuum machine. “I’m going to set the ventilator to give you a deep sigh and then we’ll clear your passages”, she said to me, making sure that I understood by reading my eyes. “Morris, stand by with the hand resuscitator if we need it and get ready to remove the respirator cap”.
Glenda peeled the covering from her sterile gloves and the 28-inch long small gauge catheter and stood over me on one side while Morris followed her every movement with deliberate attention. “All ready?” she said to both of us at once. “Here we go!” The respirator seemed to take a bigger breath suddenly and injected my lungs with precious air. In a flash, Glenda signaled to Morris to unhook my trachea tube and she inserted the catheter directly into and down my esophagus. The nasty slurping sound was music to my ears as I knew that my breathing would be easier once the procedure was completed. She twisted the catheter, probed around as best she could and slowly retracted it so that she could remove as much phlegm as possible. With eager eyes, Morris followed her actions and the moment Glenda had the catheter clear he snapped the cap back over the trachea and instantly I was re-inflated and felt my lungs full, clear and a bit more responsive.
I could hear Glenda give a big sigh of relief as she gathered the spent supplies and pitched them into a nearby trash bin and I wondered if my condition was worse than I already knew it to be. Either it was her impeccable professionalism or she simply didn’t want to burden me with the truth but when she said, “Okay, you should be fine now” I didn’t really believe her.
Morris laid his hand on my shoulder and gave me a wink. “Hang in there bro. It’ll get better”. I didn’t believe him either and let my eyes wander to the stained patches on the ceiling as they left me to attend to the other patients. “How the hell did I get myself into this mess” is all I could think of. I’d been in New Orleans for barely six months.