Update

We’re in Omaha, and arrived here without incident. Our dinner, at a local Mexican restaurant was just ok – I thought it was pretty good, actually, with a mediocre margarita, but Kay didn’t like it much, and didn’t eat it. Strangely, she doesn’t eat if she doesn’t like the food, even if she’s hungry. I always try to get her to eat more. Tomorrow we go to a few appointments, and the next day is Kay’s surgery.

Attention Microsoft Programmers, or Influential Competitors

I would like to create a document, stored on my hard drive, containing links to other documents stored on my hard drive. I don’t want to upload those other linked documents to an internet document file, because I don’t always want to have to hook up online to get access to those documents. I simply want to be able to turn on my computer, open one file, see an internal hyperlink (perhaps colored green instead of blue), click on the link, and have the second document open after having been accessed from its location on my hard drive. Is that possible to do now? If not, is it possible to make it happen? It would make my life as a teacher easier: I could create a syllabus with links to all the relevant documents, or perhaps with links to the relevant folders containing the relevant documents. For instance, if I have “Syllabus” saved on the desktop, I want to open it and click on the internal hyperlink “Elizabethan Literature,” which would then open my Elizabethan lit. file. Or, if I have “Hamlet reading schedule” listed, I would like to click on it and suddenly have the Word file “Hamlet reading schedule” pop up. It would be even better, of course, if, once the original document was published online, it could automatically make the linked docs accessible online, via actual hyperlinks, whenever one’s computer was online, but perhaps that would be too great a hassle – certainly the accessibility of such docs would be highly variable.

So, please, People Who Know More About Computers Than I, if such a capability already exists, please let me know. Consider this a bleg. And please, Microsoft Programmers Or Their Influential Competitors, if such a thing does not exist, please make it do so, quickly, so everyone else has to make it do so too, and then I’ll get it in my next computer when I buy it in a few years – but remember, you’ll have to let me know that it’s been put in, so don’t forget. Thank’ee much.

Sincerely,

J.

A Wide Gulf

Went tonight to see WALL-E with a couple that are friends of ours. The boyfriend and I get along, but at a bit of a distance (my wife and the girlfriend are the original couple). We don’t seem to understand each other when we discuss serious issues. When I asked him about Neil Gaiman, the review of whose American Gods I still have not finished, he was unfamiliar with the guy, which was unremarkable, though his long-time girlfriend, a fan of graphic novels, knew all about Sandman. We discussed the book only briefly, since he hadn’t heard of it, but I said the odd thing about it is that it has some huge holes, including the Greek gods, but even more startlingly, including Jesus. I remarked in passing that perhaps it was better that way, that I would probably have been offended by an inferior or wrong-headed depiction of Christ. The boyfriend, who has an infectious laugh, thought that was great. He was positively merry about it, about getting offended over someone’s portrayal of Jesus. It’s strange. I don’t ask that he be a Christian, or even have any sympathy for Christianity, but for him to be so humorously struck by the quaint notion … I’m not even sure he would describe it as quaint, for that would imply it has ever existed, that it at one time seemed reasonable to someone, if only of a benighted age. He seemed incredulous at the very concept, not just its wizened obsolescence. For him to be so struck merely underlined just how deeply different he and I are. To think! Being offended on behalf of Jesus!

A Strange Season

This has been an odd summer. As Kay and I walked in the cool of the summer night around ten o’clock, the breeze just ruffling the leaves so that their silver undersides glimmered dimly in the street lights, we marveled at just how little heat there has been this summer. We’ve been blessed, though, for the heat would have added to the discomfort she has felt recovering from her surgery. In the cool, she is progressing apace, and looks to be healing fully. The hole from the JP drain is closed and is almost healed, and her scar looks great. There are still a few issues that seem to be left over, however, from the stress her body has been through. She’s still complaining of an odd taste in the mouth, but I think that will go away once the effect of the antibiotics wears off and her system is allowed to return to normal. Because of her temperature being lower than normal for the past few days, we are not really worried about a resurgent infection, but the doctors have suggested that she may have a bit of anemia, so they have scheduled a blood test for tomorrow. And she has had some problems with digestion. We have introduced new foods to her system gradually, a few fruits here, a couple of seeds or nuts there, but after a particularly rich delayed anniversary dinner (we hit five years in early July), including escargots, Alaskan king crab, and rice pudding accompanied by the ever-perilous raspberry, she awoke at 2:00 AM with stomach pains. Sitting up helped to ease them and allowed her to sleep eventually, and nothing more occurred. Tonight she is a bit uncomfortable, too. I hope that some Tums antacid will help her to sleep.

Meanwhile, I have become beleaguered as well. Yesterday, lying on the bed in the hotel room we ended up scoring for free on the night of our anniversary celebration, I felt the room begin to spin. Only once or twice did it go round, and then it was over, but it was alarming. Rising, I realized that I didn’t feel quite right in the head, and I haven’t since. My head spins seem to be related to the motion of getting up or lying down, and it’s more common when I am lying down. Luckily, my mother is office manager for a neurologist. When I called him after hours yesterday, having mentioned these odd symptoms to my mother late in the day and getting her imprimatur to call her boss, he dashed away my apologies, saying something like, “No, you are not allowed to apologize – you are a member of an honorable family that are good friends of mine. You are welcome to call.” When I explained my symptoms and answered his diagnostic questions, he said I was likely suffering from something in my inner ear, not my brain, but that I should get an MRI anyway, just to be safe. So off I go tomorrow, to relieve my wife’s (and my own) lingering fears that I might have a brain tumor or a stroke, that she will not be left alone at the end of this strange cool summer that we have spent fearing for her, not for me.

The String Has Been Cut

For some reason, I have found myself unable to finish off a review of Neil Gaimon’s American Gods and so have done nothing else in the way of publishing in my concentration on, or wholesale ignoring of, that so far abortive project. I’ve not talked about Lovecraft, whom I’ve also been reading (he’s kind of silly, overall), and I’ve not updated Kay’s condition, despite knowing that there may be some who are interested in the latest. Those who are interested, by the by, are welcome to prod for more information, either through the comments (all three of which I checked before allowing two of them to be published, the first being abusive), or through personal e-mails to jrrhawking@gmail.com.

Kay’s condition is pretty good. A few days ago her spirits received an uplift when we were called by Dr. Hilgers’ office to let us know that the second bacteria in her abscess had been identified, and that the Flagyl she was already taking orally would kill it. Up to this point, knowing only that the E. Coli was being taken care of, we were uncertain that the second, as-yet-unidentified, bacteria was going to be destroyed. They had told us that the Flagyl was likely to do it, but not knowing the identity of the bacteria, they couldn’t be sure until they received a positive identification. As the days stretched on, we were both worried and mollified, worried, because we weren’t sure whether the delay was caused by the slow growth of the bacteria (which we assumed could only be good) or their inability to find something that would kill it (which we assumed could only be bad); mollified, because the output of the drain both lessened and became less yellowish-brown, more clear, with a pink substance we were told was new tissue, white blood cells, and other signs of a return to normality. Clearly we are not really sure how bacteria cultures are accomplished. But however it’s done, it’s been done, and the infection is at bay, if not positively defeated.

So effective has Drs. Hilgers and Fitzgibbons’ effort been, in fact, that the drain’s outflow has dropped beneath the magical number of ten cc’s per day (cc’s are apparently equivalent to milliliters). Once beneath that number, said Dr. Fitzgibbons, the drain could come out. It attained that level on Thursday, at which point Kay called him, and he contacted a local surgeon to remove it. That local surgeon was leaving for vacation, but asked a colleague to do it. This colleague, whose odd name I will not repeat, because I am about to make fun of it, but the oddity of which can be hyperbolically approximated by the pseudonym “Dr. String Barracuda,” was available today, Monday, and, after having been needlessly warned by Kay, as she had been told to warn the person taking it out, to “cut the string,” thus releasing the coil that held it in place, removed the thing out without incident. The extra time with it in did cost Kay another few days of mild discomfort, and some lost sleep as she does not sleep naturally on her back, but it also afforded us the added satisfaction of knowing that the level of drainage did not go up. It has, in fact, not gone above around seven per diem since then, implying that the infection is properly finished. She will, however, watch the leftover wound – small enough to be only bandaged – closely, to make sure there is no excessive drainage, and plans to continue taking her temperature well after this entire project is over, as fever seems to be a good indication that the body is up to something that is causing it exertion, whether or not it is obvious on the outside.

Dr. Barracuda and Kay chatted about how she had gotten to this point, and he did worry her some by his surprise that Dr. Hilgers was using GoreTex to reduce scarring. Just now, in fact, I went into our bedroom, where I found her sitting in front of the TV with worry stitched into her face. I reminded her, as I reminded her earlier, that Barracuda is not a fertility doctor and has no previous experience doing or exact knowledge of what Hilgers has been doing, with some success, for many years. Presumably, had GoreTex not, in the past, precluded adhesions from forming post-surgically, Hilgers would not be wasting his time with the stuff. I also reminded her that Dr. Fitzgibbons, the chief of surgery at Creighton, is aware of and accepting of what Hilgers does, and has said that he uses internal GoreTex bandages all the time. Back when we were in Omaha, Dr. Fitzgibbons said, specifically, that he would have no trouble removing the bandages when we came back. These reassurances had their good effect, but more will undoubtedly be needed, for worry with Kay is like a persistent army that lays siege to her piece of mind, fortified howsoever it may be, and will not be dislodged without a determined assault on his supply train, or an end, altogether, to the war.

We are due to arrive again in Omaha on the 30th of July, with the 31st reserved, we assume, for a pre-op visit, and the surgery scheduled for the 1st of August. Assuming all goes well, and assuming the surgery is able to be conducted laparoscopically (there is some potential that it will become a laparotomy, mini- or otherwise), we will head for home on the 3rd or so, with just under two weeks to prepare for the beginning of the school year. Whether Kay will start on time or not, or as a full-time teacher or not (we are lucky in that, childless and with some help from our families, we can afford to do either), depends on the outcome of the surgery (which will be reported here), as well as on a conversation she will have with her school principal, a woman sympathetic to her because of similar fertility ordeals she underwent herself, some years ago. One way or another, we hope for things to continue looking up, so please place or keep us in your prayers.

We're Home

Kay and I are at home now, having gotten back to our apartment around 7:00 last night. Her parents came over last night with dinner, and my mother will be bringing dinner over tonight. My dear sisters brought over flowers and basic groceries for us, leaving them with a sign that said, “Welcome Home!” By the time we got home, the cold I'd been nursing along the last few days was in full force, so I've been feeling poorly to the point that I could barely rouse myself at 10:00 this morning. I only got out of bed because the nurse was coming over to administer Kay's IV. Having the family care has therefore been a great boon.

The nurse, who came from Coram Specialty Infusion Services, was very friendly and professional. She was entirely unfazed by the abscess – beyond feeling bad for Kay that it had happened – saying that these things happen and are easy to solve. When we said we didn’t know what the second bacteria causing the abscess was (the first is e. coli – very common and nothing to worry about once identified, she said), she speculated that it might be a type of staph infection from the skin. No matter how much they do to clean the surface of the cutting area, she told us, sometimes things survive. Kay lamented that she forgot to wash with Dial antibacterial soap before the surgery, but I figure that if the iodine and things they use in the OR didn’t do it, store-bought bar soap is unlikely to. Still, would have been better to be safe than sorry, I suppose.

We are likely to return to Omaha in about three weeks, when Dr. Hilgers and Dr. Fitzgibbons (the chief of surgery at Creighton) will remove the Gore-Tex bandages. By that point, the course of anti-biotics will be over (the one being given via IV will end on Tuesday), and, we hope, the drain will have been removed. Kay is doing pretty well overall, though she is suffering some minor discomfort from the drain – when the nurses ask her to list her pain on a scale from one to ten, she usually says one or two. Her taste buds are also a bit discombobulated, we think as a result of the antibiotics. All told, we will be glad when the bandages are out and this part of the process is over. We can only hope that the inflammation from the abscess has not undone the progress of the surgery, but we won’t know until we go back in August.

Some Reading

Finished Volume I of Shelby Foote’s The Civil War the other day, then blasted through Robert Louis Stevenson’s The Master of Ballantrae. Great novel, though perhaps a bit unpolished – part of its conceit, but causes it to end abruptly and perhaps never commit to a mode: is it supposed to be a tale of Scottish adventure and family drama, like Kidnapped and David Balfour, or an exploration of evil like Dr. Jekyll and Mr. Hyde, or a dark journey through unavoidable passions in stormy landscapes, ala Wuthering Heights? Still quite entertaining. Will try to write more on it later. Just picked up John Gardner’s bio of Chaucer, but being more in the mood for fiction just now put it down almost immediately for American Gods, by Neil Gaiman. Enjoyable and vulgar. Can see it as a comic book – Shadow’s early internal monologues and the wry humor more generally seem typical of the genre. Couldn’t help but compare the love-goddess-as-anthropophagous-whore scene early on to Lewis’s Aphrodite in Till We Have Faces. The former is horror-film gross, the latter deeply frightening in its darkness. Only about thirty pages in, though, so these are first impressions.

Some Minor Relief

Something I forgot to mention in the last post. Before she went to bed (a good couple hours before I posted “The Waiting Game”), Kay asked me a question: “What if they can’t kill it?” Not quite understanding, I asked for clarification. She then gave me to realize that her conception of the bacteria-identification process was this: the doctors take the culture and then try to kill it with various antibiotics. When they succeed, they know what bacteria they are fighting, and they know how to kill it. Kay’s culture was taken on Sunday evening, and still has not been identified. The longer the wait, the more worried she was getting: they still haven’t been able to kill it!

I responded to this novel concept by reassuring her: no, they identify the bacteria by letting it grow until it identifies itself. But there was a small stab of horror within me as I said this, because I frankly didn’t really know how they do it. I know there’s a disk of sheep’s blood and that the stuff grows on the blood, and that’s about all I knew. I wondered, could Kay be right that this is how they do it? After all, shouldn’t a microscope do the trick? – what needs all these days of growing? Finally, when the nurses came in to hook Kay’s PICC line up to the antibiotic bag, I decided we had to ask. Turns out, I was right. The stress melted out of Kay when we heard this, and I pray that she will sleep better tonight as a result.

The Waiting Game

We know now what we knew the last time I reported anything: Kay has a pelvic abscess. It seems to be under control. She has a little plastic drain coming out of her right abdomen, just a tube and a bubble pump that, when squeezed, wants to expand to its natural rotundity and so suctions out what is inside – a translucent brown liquid that is, if I’ve been listening closely enough, a combination of mucus, germs, and a foreign saline pumped in to liquefy the others. The hand grenade, which is what we call the pump for its resemblance to that weapon, hangs pinned to her clothing, transparent to allow for an easy measuring of the poisons extracted. The plan is that the amount will decrease regularly, implying a decrease in the amount available to be pumped, and that the lab will then figure out what the bugs in the brown fluid are and what antibiotics will destroy them.

Our doctors have been very good to us. Dr. Hilgers comes by every day to keep us up to date, even though there has not been much to tell in the past few days. He is always upbeat and always willing to answer the questions he can. There is none of the condescension in him that one sees so often with doctors, though he is always confident, in an understated way. Kay likes him quite a bit, as do I, and all the nurses speak quite highly of him. (This abscess, incidentally, is apparently the third time he’s seen one in twenty-five years of doing this surgery.) The GI surgeon with whom he has been consulting, and who has been very reassuring that they will fix what ails Kay, comes by every two to three days, and a Hungarian doctor from the radiology department (they put in the pump) has come by on a number of occasions to make sure the hand grenade is working well.

The wait comes from Dr. Hilgers and the GI surgeon needing more information to decide whether they want to take the internal bandages out sooner or later. On their own, Gore-Tex bandages are not a problem – they are used because they are non-allergenic, and their use is fairly common, from what we’ve heard. But as an artificial mesh, they are attractive to germs, and once the germs are in the same region, there is a chance they can colonize the Gore-Tex. Once they do that, they will be protected from antibiotics, which can only reach the abscess through the blood stream. The removal of the Gore-Tex is thus desirable, but the surgery to take them out could stir up the infection dangerously. Therefore we play the waiting game: suction and then reduce or destroy the infection with antibiotics, then go in safely to remove the Gore-Tex at a later date. What that later date will be depends, probably, on what the culture turns up and how long the appropriate antibiotics take to destroy it. It will not be more than three to four weeks, we’ve been told.

The problem now is to wait without getting too down. Kay is has been down for the better part of two days, and doesn’t know whether she wants to leave more or be well more – well, she knows she wants to be well. But she doesn’t want to be here for another week or two while it happens. We are able to go outside, but Kay is confined by doctor’s orders to the hospital grounds. There is some talk of her going home with the grenade – either to the hotel or really back home – then coming back for the Gore-Tex-removal surgery, but until they know what kind of bug or bugs she is fighting, they don’t want to let her go. Ultimately, we just want her to get better, and we’ll do whatever they want us to do to make sure that happens.

An Annoyance

Why is Blogger's block quote function so useless? The much-maligned Microsoft Word somehow manages to figure out that a block quote means a new left margin now exists, with words on the right wrapping into place along the new margin and not carrying with them their enter commands on the right-hand side. In visual terms, what this means is that I have to manually re-configure each block paragraph I create, so that instead of this:

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bbbbbbb
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bbbbbbb

I get this:

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Which obviously makes more sense.

If Blogger has in fact fixed this problem with some work-around, I make no mea-culpas for not doing my research, as their block quote button has not incorporated it, and a block quote button that doesn’t block quote seems fairly useless to me.

If the fault lies with html code, and not Blogger, then I guess I’m sorry. But if somebody’s invented the i-Phone, not to mention this tablet I’m using, couldn’t someone figure this out, considering just how many are blogging today?

Update: This is not to mention that in the “Compose” window of the Create Post function, a space between the main text and the first line of a block quote is meaningless until it is actually placed manually in the “Edit Html” window. Why? And the same space below the block quote is always smaller than the space above it. Why? None of this seems rational, though no doubt code writers – and I am ignorant of their craft – know the reasons.

Update: Of course, now that I’ve pasted this into Blogger (which can’t do curly quotes or apostrophes, so I compose in Word), I’ve got to reformat the block quotes again. Sigh. I know, it’s the least of my worries, and the system’s free. Shut up and blog.

Faith and Its Fluctuations

From the beginning of this whole process, Kay and I have been ready to rejoice, only to find our hopes disappointed. The first month we tried to get pregnant, Kay was late with her period. She was never late, she’s rarely been late since, but she was not pregnant. For well over a year we tried, but nothing happened. Finally, they went in to take out her ovarian cysts, not having anything else to try (various fertility drugs, such as Clomid, had failed) only to find that she had endometriosis. At first, that seemed like a good thing: we knew what was wrong and had heard it could be cured with hormone treatment (I think I’m remembering this correctly), not to mention the scraping they had done already. It turned out that it would not be so easy – endometriosis is infinitely more complicated, and as we found out later, the scraping did possibly more bad than good, as it left behind adhesions as effective as endometrial tissue at physically isolating and damaging, through inflammation, the reproductive organs.

We finally began the process with Dr. Hilgers and the Pope Paul VI Institute, well over a year ago (perhaps a year-and-a-half ago), and things seemed to go well in the operation, though we knew it would be a difficult one, and by no means guaranteed success. But these last two weeks have been full of nothing but setbacks, it has seemed: a good first day followed by the somnolence of atalectesis; her revival and subsequent eating followed by vomiting and diarrhea; a bowel revived from ileus followed by fever and renewed coughing; plaintive hopes for pneumonia followed by revelation of the pelvic abscess. Now the less harsh procedure of the catheter and a dose of antibiotics is our hope, against which is juxtaposed the six-month colostomy. (This is not to mention the damage this kind of inflammation can do to ovaries, tubes, and uterus, which, along with the coughing, is for now a secondary worry.) I hope our beleaguered troops hold the line here.

The military metaphor arises because I have been reading the first volume of Shelby Foote’s The Civil War. I am not alone in having Lincoln as my favorite president because of his thoughts, expressed in his profound and serious words. I was too poor a philosophy student to say whether Lincoln’s thoughts were particularly original, but the humility and cadence of their expression is moving in the extreme. There are two writings that Foote quotes, in each of which Lincoln addresses situations of much greater extremity than that in which Kay and I are embroiled. In speaking to a Quaker woman who called on Lincoln to show her support for his having issued the Emancipation Proclamation, he said,

We are indeed going through a great trial – a fiery trial. In
the very responsible position in which I happen to be
placed, being a humble instrument in the hands of our
Heavenly Father, as I am, and as we all are, to work out
his great purposes, I have desired that all my works and
acts may be according to his will; and that it might be so,
I have sought his aid. But if, after endeavoring to do my
best in the light which he affords me, I find my efforts
fail, I must believe that for some purpose unknown to
me, he wills it otherwise. If I had had my way, this war
would never have been commenced. If I had been
allowed my way, this war would have been ended before
this. But we find it still continues, and we must believe
that he permits it for some wise purpose of his own,
mysterious and unknown to us; and though with our
limited understandings we may not be able to
comprehend it, yet we cannot but believe that he who
made the world still governs it.

Kay and I are not so much instruments here, not so much operating as being operated upon (quite literally, in her case), but still her subjection to treatment and my support for her can be said to be our “efforts,” and certainly our “war” would have ended before this had we been allowed our way. And our little case is as worrying to us in its threat to the world for which we are responsible – our parents, our marriage, each other – as the horrendous losses of Antietam were in their threat to the vast arena for which Lincoln was so tragically and movingly responsible.

Lincoln also wrote a private piece, left on his desk but apparently not intended for publication. It was rescued by his secretary John Hay, being published later. In it, Lincoln attempts in effect to reconcile the existence of men such as Bishop-General Pope, and his prayers, with the equally fervent Northern clergymen, and their many prayers:

The will of God prevails. In great contests each party
claims to act in accordance with the will of God. Both may
be, and one must be, wrong. God cannot be for and
against the same thing at the same time. In the present
civil war it is quite possible that God’s purpose is
something different from the purpose of either party;
and yet the human instrumentalities, working just as
they do, are of the best adaptation to effect his purpose.
I am almost ready to say this is probably true; that God
wills this contest, and wills that it shall not end yet. By
his mere quiet power on the minds of the now
contestants, he could have either saved or destroyed
the Union without a human contest. Yet the contest
began. And having begun he could give the final victory
to either side any day. Yet the contest proceeds.

This passage is perhaps less applicable to Kay’s and my situation: there is no one, after all, praying against us. But the enemy that (or who) has entered the field has not been prevented from bringing his soldiers against us. The contest proceeds. We can merely fight by our best lights and pray that, supposing it is His will on earth and in heaven, we receive our daily bread, and that our trespasses will be forgiven us. Father, if Thou wilt, remove this chalice from us: but yet not our will, but Thine be done.
___________________________________________________________________
Thanks, by the way, to The Abraham Lincoln Association, as well as to that perfidious academic institution holding the electronic version of their The Collected Works of Abraham Lincoln. As their version contained some confusing punctuation – perhaps in the manuscript sources? – I have made some changes to match Foote’s version, on pp. 709-10 of Volume I of his work.

Worst Day 1.2

Well, now we know. The fever and the white blood cell count are due to a pelvic abscess. Who knows whence the cough, though that is not our worry now. What is an abscess? It’s not like an ulcer, apparently. I always figured it was a spot in the surface of the organ (skin or internal) where the germs were multiplying and eating away at the flesh. Instead, an abscess, or at least a pelvic abscess, seems to be a collection of germs surrounded by a membrane created by the body in an attempt to ward it off from the rest of the body – it sounds as if its appearance is not dissimilar to a bubble, though this one apparently multiplies and spreads itself wherever it can, without concern for a globular appearance. Worst case scenario, and fairly likely it sounds like, is a temporary colostomy, which would apparently give the body and doctors a chance to fight off the infection in Kay’s interior. The less-bad case, and the one they will try first, is a temporary catheter inserted through her side. This will drain and collapse the abscess, allowing antibiotics to more easily reach the whole of the infected area, which is cut off currently from blood supply. If this is successful, it may preclude the need for a colostomy, which would save Kay six months of that indignity and inconvenience. But better six months of indignity and inconvenience than various worse alternatives.

Worst Day 1.1

Update on yesterday: The problems of this first of the worst days have not gone away. I forgot all about the white cell blood count. White blood cells, of course, attack infections in the body. When they increase, that is a sign that there is an infection. Kay’s white blood count had gone up following the surgery, so in addition to being told to walk and use the incentive spirometer, she was also given antibiotics. Her CT scan showed, in the end, no leakage or abscesses anywhere in her gut, so they supposed the white blood count and the clearing of the throat she had been doing might indicate the onset of pneumonia or atalectesis (the “external compression of her lungs by fluids used during the operation” that I referenced in the last post). A night of the diuretic, with the dissipation of the fever the next day indicated it had been the atalectesis after all.

This issue has come back up, however, and the diagnosis seems to have been wrong, or at least incomplete. Kay’s throat clearing has continued, turning into a cough, deep and regular, but productive of no phlegm. Her temperature, having fluctuated all week, has gone up to 101.6, which is quite high, and her white blood cell count is high again, I believe for the third time since the surgery. There are two possibilities, one being that she has come down with pneumonia, which at this point would be a good thing. The worse alternative is that she has some kind of abdominal abscess or infection or inflammation (not sure how mutually in- or exclusive these things are), for which reason the follow-up procedure is going to go on as planned, if not sooner. They’ve ordered another chest x-ray and a CT scan to explore both possibilities, and if something abdominal is indicated, they’ll go in today, instead of tomorrow as planned. (In this case, the coughing proceeds from something else entirely, and is a secondary worry.)

The Two Worst Days, Part I

The bad days these past two weeks have been many, but there are two that stand out. The first worst day was Friday, the 27th of June, the third day following surgery, when Kay spent a second day in a stupor more pervasive than the preceding one, in and out of a fever, unable to get past 1500 on her incentive spirometer. She was awake, but not endowed with anything resembling her true personality, just grimly trudging through life and sleeping a sleep that may have been a “prisoners release” but was not “the certaine knot of peace, / The baiting-place of wit, the balme of woe,” for when she awoke she only trudged the more. In the late afternoon and the late evening, she was given a diuretic, the diagnosis being that her somnolence and fever were due to the external compression of her lungs by fluids used during the operation. This diuretic had no impact until late, perhaps twelve midnight, at which point she got up to go to the bathroom. This continued all the night, every half hour exactly, until it tapered off near morning. As she was still somewhat disabled from bending and yanking, I was point man for unplugging the IV – conveniently between her bed and my couch – and we both spent a vergessenworthy but unforgettable night. Miraculously, the next morning, she was better. The fever was down, the lethargy gone despite the long night, and she was allowed to take her first liquid tray since she had gone under, her first food, in fact, since noon of the day before the surgery. All seemed well.

Diversions

How, then, is Kay fighting off the boredom? For entertainment we have watched a few movies and some television, played some Scrabble, perused the Internet, and read part of Carmilla, by Sheridan Le Fanu, one of Kay’s favorite authors. Yankee Doodle Dandy and Gentlemen Prefer Blondes were our two movie choices. The first was our apt selection for the Fourth, and thoroughly entertaining, though it lacks much in the way of dramatic arc to carry it through its length. This is understandable, though. Made in the early days of World War II, and screened for its subject George M. Cohan in the weeks before his death, it plays more like a revue, or perhaps like a feature-length tribute for a life-time achievement Oscar, or, I suppose, Tony. It is certainly a piece of propaganda, though I don’t mean that slightingly, because the things it elides – Cohan’s first marriage and divorce, the deaths of his mother and sister, his objections to a Broadway labor agreement – do not counter its essential argument that America is a great place and worthy of praise even by those who struggle to rise to the top. The last elision probably does counter that argument, in the eyes of some, and probably makes him a villain, and perhaps it objectively does so – I’ve not investigated the details – but as an actor and a producer, Cohan knew both sides of the argument and seems to have lost a lot for his stand, including much of his acting career. In any event, whether my ambivalence about unions is correct in this case, the movie contains some great dance numbers, some stirring patriotic songs, and Cagney’s charisma. It’s worth seeing.

Gentlemen Prefer Blondes was exactly what we needed the day we watched it, I believe Wednesday. We needed silly escapism, and that’s what we got, though daft and mercenary never reach so near the sublime as they do in Marilyn Monroe’s Lorelei Lee. The IMDB quote list for the movie doesn’t seem to have the ones I laughed at the most, though of course now I’d have to re-watch the movie to remember them. These, though, will do:

Daft (said of a diamond tiara):
“You DO wear it on your head. I just LOVE finding new places to wear diamonds.”

Mercenary (in conversation with the father of her fiancé):
Esmond Sr.: Have you got the nerve to tell me you don't want to marry my son for his money?
Lorelei Lee: It's true.
Esmond Sr.: Then what do you want to marry him for?
Lorelei Lee: I want to marry him for YOUR money.

What I also found interesting about the film was the dirty sensibilities that were there for those who wanted to find them, censors be damned, such as the sly one-liner uttered by an Olympic athlete when asked which girl – Monroe or Jane Russell – he’d save from a sinking ship: “those girls couldn’t drown,” reminding me of my father’s advice to lay hold of Dolly Parton should I ever find myself on a leaky vessel with her. These sneaky one-liners seem to have been all over certain films of that time, along with an absolute fascination with adultery: cf. The Seven Year Itch (1955), The Apartment (1960), and A Guide for the Married Man (1967). While adultery is almost always rejected in these films, they seem like a foreboding, a straining against the reins, that makes the advent of the Seventies and Eighties unsurprising. The one-liners I enjoy – I was raised on dirty jokes and can find nothing wrong with them, within some limits; the clear interest in adultery I regard with less comfort and no sympathy.

The only other observation I have on the film is this: Marilyn Monroe is a clearly superior screen bimbo to poor Jayne Mansfield, depressingly similar as were the eventual denouements of their lives.

Our Current State – Pretty Good, Overall

The last week-and-a-half has been eventful. Kay has suffered a horde of complications, some of them scary, some of them undignified, some of them simply annoying, none of them, in the end, terribly dangerous. We never did find out what a temporary colostomy would do to revive the small bowel, mostly because we’d lost interest in the question by the time we had the chance to ask it. Kay tried the liquid tray (I called it the “wet tray” earlier) yesterday morning and kept it down, meaning that whatever organs had been asleep or blocked, they’d now awakened or opened up. She’s since then had four liquid trays and one full liquid tray – the appended adjective meaning that the liquids now include milk: milk instead of juice, cream soup instead of broth. The cream soup may even have had potatoes in it!

Thus we are healing and improving. Kay’s enemies now are a relatively slow and sometimes painful digestion process, despair, and boredom. None of the doctors seem worried by the first, and it is my opinion that her digestion will improve as her GI tract realizes it’s back on the clock. The second is mild, as despair goes, and is due to missing home, wondering when she’ll ever feel normal, and fear that the follow-up procedure will restart the ileus. There’s no real way for me to alleviate this, other than to stay positive, iterate her successes so far, and remind her of the doctor’s assurance that laparoscopic surgeries never result in ilei. I thought that Kay might also benefit from getting out of the hospital, and so suggested a jaunt through the city for half an hour in our car, but our nurse said it wouldn’t be allowed, and one of the doctors disclaimed responsibility, saying only the doctor who had admitted her could ok that. That would be Dr. Hilgers, but we usually only see him in the morning, and it doesn’t seem right to ask our nurse – who said the doctor would not say yes – to ask him for us. We’ll wait until tomorrow, when we’re still likely to be here.

Pseudonymicon

Been thinking that speaking of “my wife” constantly sounds rather impersonal. I could do what someone like John Derbyshire does, and speak of her as “Mrs. Common Things at Last,” but since I actually have a pseudonym, rather than a nickname, if that’s what you call “The Straggler,” it makes sense to give her a pseudonym too. Clearly she is Mrs. Hawking, but her first name must needs be provided. I have other reasons for the name I have selected, Kay, but I also like the WASP-ish quality; it goes well with Hawking, I think. There are no doubt Hawkings in various leafy Connecticut suburbs. Perhaps one contemplates adultery in a Cheever story, though that is emphatically not my implication. Nor is Kay is what one would call WASPy, but what good a pseudonym that doesn’t deceive?

A Quick Note on Dr. Hilgers

My wife has been advised to be as active as possible, sitting up rather than lying down, walking rather than sitting, so we are currently outside on the rather nice patio of Creighton University Medical Center (unfortunately overlooking the highway), where we are engaging in one of our favorite, but recently neglected, joint pastimes – Scrabble. So I don’t have time for a full update, but I wanted to mention something we appreciate about Dr. Hilgers, now more than ever: his kindness and patience. He has enlisted the advice of a gastro-intestinal surgeon and a general practitioner, both to give him advice on my wife’s probable ileus and to prescribe various fluids for her IV. A young and rather jaunty doctor, who seems to be working under the GP, blew into our room yesterday when we were feeling pretty optimistic and announced to my wife, “Well, you look great, but your x-ray doesn’t!” He made a jokey comment about how he was happy to see her distended small intestine, because surgeons love when things are difficult, rather than easy. After reassuring us by saying that he treats the patient, not the x-ray – in other words, that in the absence of corroborating symptoms such as nausea and vomiting there is not enough reason to assume a blockage of the bowel and therefore no reason to operate – he blew out of the room again, residents and fellow doctors following in his wake, leaving us mouth agape and my wife jittery and nerve-wracked.

Dr. Hilgers, who has been in every morning, came in today when I was not here, having left very early to pick up my dad at his hotel for Mass and then a trip to the airport. Dr. Hilgers and my wife had a good conversation. She mentioned this doctor and his extremely poor bedside manner and how it had jarred her, how she’s now imagining all her worst fears. He asked her to tell him what she was afraid of. Other than death, she’s afraid of a permanent nutritional IV – never being able to eat again. I think doctors have to strike a balance between needlessly informing patients of worst-case scenarios, thus stimulating their fears, and limiting their fears by setting the boundaries with a worst-case scenario. In this case, Hilgers rightly chose the latter, telling my wife the worst-case scenario would be a temporary colostomy – six months is the figure he put on it – because the small intestine always wakes up. It just does. He also let her know what the next step will be: tomorrow, if the passage of gas continues and the vomiting doesn’t come back, we’ll try the wet tray again. If she keeps it down, we’ll go to the dry tray. His attention to us, his apparent knowledge, his willingness to explain and answer questions, are all qualities we value highly in him. They’ve made an unexpectedly-difficult recovery that much more endurable for us.

Update: My wife and I have been reading this over before I post it (we’re no longer on the patio playing Scrabble – I’m winning by the way – as these postings always take longer than I think they will to write), and we’ve just realized that we’re not quite sure, now that we think about it, how a colostomy would allow her to go on while waiting for the small intestine to wake up. A colostomy replaces the large intestine, if we understand this correctly, because the large is concerned almost exclusively with disposal, which a colostomy bag can do, while the small is concerned with distribution of nutrients to the body, which a colostomy bag can’t do. Clearly we’ve missed out on some details somewhere along the line, but Dr. Hilgers will no doubt answer them for us when we see him tomorrow.

Surgery Update

I should have posted something by now, but it's been a long, rather eventful week. My wife came out of the surgery ok, but there have been bunches of minor complications keeping her in the hospital, the most significant of which has been something called “ileus,” which has been described to us as a “sleepy bowel.” None of this seems to be life-threatening, and Hilgers has been very attentive to us with daily visits and sometimes multi-daily visits, but it’s been frustrating for my wife and me, and sometimes exhausting, as various issues, such as a diuretic and a nutriment-filled IV have kept her (and therefore me) up half the night with regular urination – as often as every half hour. Anyway, my dad has come into town to spend some time with me, so my wife has released me to go to a steak house for a martini and a t-bone in an hour or so, and I need to take a shower. I will update the blog tomorrow with much more in the way of detail, as my wife and I have recorded many of the events.