Fade to White

I have known for years that a stapedectomy was indicated for my conductive bone hearing loss, yet I had shied away from even discussing this with doctors, other than one time with Doctor Downey perhaps 10 years ago.  You might think that I was afraid of the downside, which is total loss of hearing in the affected ear if the surgery fails completely.  Or that I am afraid of pain, or hospitals, or doctors, which many do indeed fear.

Nope.  I am pathologically afraid of anaesthesia.  When we were kids, my cousin used to tell everyone that he was “allergic” to spinach, conjuring visions of him writhing on the floor in anaphylactic shock if he came in contact with the leaf (and inspiring in me periodic thoughts of rubbing spinach on his back when he was not looking, just to see what would happen).  All grown up, I have borrowed this strategy when talking to doctors, telling them that I am “allergic” to anaesthesia.  I find that those simple words act like a magical talisman, making sure that they don’t suggest surgery to me unless absolutely necessary.

My fear is well grounded.  Back when I was seven, I had “lazy eye” syndrome where the ocular muscles of my eyes were not working properly.  My left eye would dive down and in towards my nose, while my right eye would roll up and towards the top of my right ear.  It made for a lot of fun for kids in my schools.  I endured many hours of torturous eye exercises–following the tip of a pencil as I moved it towards and then away from my nose, rolling my eyes in circles, focusing on objects at different distances.  But the only real solution was surgery, which at that time was pretty radical.  My eye doctor, Doctor Roth, brought me and my parents to a meeting of eye surgeons for a series of opinions.  One after another they shined lights in my eyes and made me follow their fingers wagging in the air, and I listened sedately as they made comments like, “I wouldn’t touch that one,” and “He will be blind in the left eye before he is a teenager.”  My parents, listening in the back of the room, were not happy to be hearing all of this, but I was too young to really understand what it all meant.

Still, Doctor Roth persisted, and after consultation with his mentor in New York City, my parents decided to let him do what was then pretty radical surgery–cutting the ocular muscle and then letting it knit back together, presumably stronger and tauter than before.  Or I could wind up blind in that eye if it failed.  We rolled the dice and put our faith in Doctor Roth.

I woke up in the recovery room of Hartford Hospital and felt the inside of my head spinning within my skull.  Total vertigo.  I had no sense of up or down.  And then I threw up.  Huge, heaving projectile vomiting all over myself, the floor, the bed.  They gave me an anti-nausea shot and I threw up right through it.  As they wheeled me down the hall to my room the fluorescent lights flashing above started spinning and warping and I heaved again, dry and painful.  Somewhere in my mind I was afraid I would rip that surgically-attached muscle with all the strain.  But I could not stop vomiting.

The little boy in the bed next to me was named Brian, and he lived in the subsidized housing complex a few blocks away from me in Hartford–squat, two story brick buildings with no adornment sitting forlornly on Granby Street across from an elementary school and hard against an industrial park.  Brian had a massive brain tumor and he spent most of his time moaning and passing in and out of consciousness.  But when he was coherent we talked, and I tried to play with him.  I felt a connection with him, wanted to perhaps play with him when we got home, but my mom found out later that he passed away soon after I left the hospital.  I still feel a sense of loss when I drive by that old housing project on Granby Street.

And I kept on vomiting like crazy.  The world would just not stop spinning and gyrating and heaving and bucking, and my stomach followed suit. Finally, my mother looked at me and said it was time to go home.  I was petrified–how would I make it in her car?  But mom, as always, had a firm answer for that one.  She told me if I threw up in her car she would rub my nose in it.  Not very subtle, but it worked.  I clamped my mouth down hard and used my mind to override the nausea that was rising in my throat the whole way home.  Eventually the anaesthesia wore off and my stomach returned to normal.

Years later, when I was in my late 30's, I had sinus surgery in New Jersey, courtesy of Doctor Robert Fieldman (Dr Downey’s associate).  Dr. Fieldman is one of the great ENT doctors in this area, renowned not only for his surgical touch, but also for his friendly and straightforward manner.  I loved cracking him up with funny stories and sardonic comments about my sinus infections.  He is one of those guys who you just love to watch laughing.

In this surgery he ran small cutting tools up through a flap of skin inside my nose then into my skull, opening up scar tissue along my maxillary sinuses.  Pretty routine stuff these days.  I told the anaesthesiologist that I was very sensitive to any drugs, and had bad reactions in the past.  Please use a low dose, I said, and he said he would also use drugs to curb nausea.  I was reassured, especially when Dr. Fieldman reviewed the dosage and said it looked right.

Later, I felt someone shaking my shoulder and calling my name.  “Mark, Mark, you have to wake up.  Mark, we can’t send you out of recovery until you wake up.”  I opened my eyes and saw a halo of light, with a masked Dr. Fieldman in the middle of it looking down at me.  He was still wearing his surgical cap and his glasses, but I knew it was him.  Suddenly, his eyes got wide, and he backed off saying, “Holy shit!”.  I was wondering if a large snake had crawled out of my sinuses–his reaction was that fast.  Then I noticed I was projectile vomiting all over the place–blood and bile and whatever else was in there.  Dr. Fieldman beat a hasty retreat, and what was supposed to be outpatient surgery turned into a three day hospital stay until the anaesthesia wore off and I could walk again.

Even when I had a colonoscopy years later, and they put me in “twilight sleep”, I suffered a severe bout of amnesia.  To this day when I think back on that time, there are episodic memories interspersed with patches of white light, as if someone had reached into my brain and rubbed out my memories with a huge eraser.  The few memories I retain are like film clips that suddenly open on a scene and then close, followed by another one that is not connected to the prior one.    Fade to white, as opposed to black.

I remember the nurse in the recovery room asking me if I wanted cranberry or orange juice, and then I remember nothing more until I am in my friend Greg’s car heading back to Maplewood.  I have no clue of getting dressed, walking out of the screening center, or even seeing Greg in the waiting room.  Nothing but white for that stuff.  I recall saying to him that I wanted to eat as I had not eaten for a day, and to drop me at the Mapleleaf Diner.  Are you sure, he asked?  Yes, I insisted.  Next thing I remember is the waitress plopping a large plate of pancakes and eggs and toast and bacon in front of me.  I have no memory of eating or even paying for it, and even now I wonder if I simply walked out and they were too polite to say anything.  Next memory is standing in my kitchen.  I must have walked the mile or so home, crossing several busy streets, but I have no picture of that at all.  The next day my secretary told me I had called her on my cell phone while I was walking home, and I was totally coherent, giving her all sorts of direction on various issues.  And I have not a clue that I did that.

So the thought of having more surgery for a stapedectomy scared the life out of me.  I kept avoiding the issue for years, although I always knew it was in my future.  That day when Craig Barth mentioned it to me, I knew the time had come.

Doctor Downey is a confident, warm, no-nonsense woman with mirth dancing in her eyes.  She was immediately certain that a stapedectomy would work for me, although it would not affect my hearing loss due to nerve damage.  Then I told her I was allergic to anaesthesia.  And I have sleep apnea.  The mirth died out, replaced by concern and calculation.  What do you mean, allergic, she asked?  I told her about the vomiting, how Dr. Fieldman ran in the recovery room, and the amnesia.  Oh, she said, you are not allergic (as in anaphylactic shock)–we will tell the anaesthesiologist and he will give you anti-nausea drugs.  Won’t work, I puke right through them, I said.  Well, we’ll see.  But her normal swagger was now clothed with concern.  Still, we scheduled me for outpatient surgery in mid-March.

How scared was I about getting vertigo and losing my memory again?  In early March my mother called me while I was on the train going to work.  It was 8 AM, and I knew something was terribly wrong for her to be calling me at that hour.  My dad had a ruptured aortic aneurism.  He had perhaps a few hours to live.  I was standing in the vestibule watching the Meadowlands run by in their spring finery, snowy egrets and white swans floating in tidal pools and marsh grasses gently waving in the sun.  I broke down in sobs, tears flowing down my face in rivers, and I cried out “No, No, it can’t be”.  I feel sorry for the other people who were in that vestibule near me that morning; it could not have been fun to see or hear.  And yet, even with this, somewhere in the back of my mind I was as happy as a kid with an excuse to miss a math test.  I had to get to Florida right away–I had to cancel my surgery!  My mind always pursues multiple simultaneous paths, and this time it locked onto the one bright light in a sea of impending misery and despair.

Perhaps sometime I will write about my dad’s passing, which was in turns magical and inspiring, devastating and humbling.  It was a good death, if there can be such a thing.  But for now, for this blog, it is enough to say that I ran to work and buttoned up my own affairs so I could fly to Florida, and one of the first calls I made was to Dr. Downey’s office to postpone that surgery–perhaps forever, as far as I was concerned.