Sunday, March 9, 2008

Chapter 23 ~ Orientation

Photo by
Brendon Stuart

The day before the operation Lawrence and I went to the hospital for pre-surgical orientation. First we sat on upholstered chairs in a cramped, hidden lobby, tucked behind the main lobby with the smoothly sliding glass doors, and filled out questionnaires. I wielded the clipboard and pen. Lawrence sat close beside me. My anxiety rose as I worked down the sheet and watched other patrons arrive, wait in line at the counter, receive pens and clipboards of their own. A sliver-haired woman teetered on her walker. An older man slapped his cloth hat on his thigh. A white woman in a wheelchair was pushed by a Filipino. That was always the way, wasn’t it? The white people in the wheelchairs, the brown people pushing them, the white people’s children off earning the money to pay the brown people to wheel their parents. Would Eddy ever push me around in a wheelchair? I wondered. Would Henry? Would Rose? Would I live long enough to get old? I remembered standing outside the Sunnybrae Rec Center with my sister Jane one day when a passel of tiny, white-haired ladies disgorged from the front door. “I hope I get to be one of those some day,” I told her. She laughed.

The form asked the same questions I’d already answered a half dozen times in a half dozen offices: my name and address, my social security number, my insurance provider, my employer. The questions sometimes suggested that someone was concerned about me, but I knew better. I knew what they were really meant to find out. Where is the money coming from was the question never quite trotted out into the open. Where can we hunt you down if your insurance doesn’t pay? Suddenly it was too much for me and I grew angry, suffocating an impulse to throw the clipboard on the floor. I snapped it wordlessly in the air. “Do you want me to do that?” Lawrence asked.


I handed the clipboard to him and he started checking boxes. “Are you experiencing pain in any part of your body?” he asked me, leaning closer to make an irreverent suggestion. “Let’s write ‘yes—in the ass.’”

Lawrence took my hand whenever I put it on his thigh, sat passively waiting when I withdrew. I was the leader of this expedition, I knew, but I had no desire to reach the destination. After Lawrence filled out the forms we waited, and waited, until a short woman in purple scrubs called us into a private office area to give us instructions. We were to arrive at 6 in the morning. I was Dr. Andreas’ first surgery of the day. That was good, the nurse informed us, because the doctor wouldn’t be tired. I wasn’t to eat or drink anything after midnight the night before—even water—because they didn’t want me throwing up while lying on my back during surgery. We would walk through the front of the hospital to the surgery department, she’d show us where that was in a moment. Family members could wait in a small room there. Would there be any family members?

“Yes,” I told her. I knew my sister Jane was coming, driving down from Boulder Creek. Claire was planning to be there too, and Francine, and Rose, and Henry, and my husband, of course. I glanced at Lawrence. I wasn’t yet sure about Ed.

After dropping off the family in the waiting room, I would go in the back alone. My husband could come with me at first, while I changed and they prepared me for the operation. They would give me a sedative, if I wanted one, and make a mark on the breast to be removed with a black felt pen. It was the left breast they were removing, wasn’t it? “Yes,” I answered. When they were ready to wheel me into the operating room, Lawrence would go to sit in the small waiting room with the others. The surgeon would come out when it was over and tell them all how it went.

“How it went?”

“Yes. Whether they got all the cancer. If anything unexpected happened. What the sentinal node biopsy showed. If they had to remove any additional lymph nodes. How I was recovering.”

“Anything unexpected?”

She nodded.

I laughed—a short, explosive burst of air from my nostrils, like a horse. “You mean anything unexpected, like death?”

A very thin smile.

The room was small, with a desk, a few chairs, windows which would look into the next cubicle if they weren’t covered with thick rubberized curtains. Mauve. An old color. No one decorated with mauve anymore. Now it was watermelon.

“Sorry,” I told her. “Sorry for being morbid. I don’t really want to make you uncomfortable. I know it’s just your job.”

“You’re hoping there will be no cancer in the sentinal node,” she continued, “that it hasn’t gotten into your lymph system. That’s the news you want to get after the operation.”

“Yes. That’s what we hope.”

Next the nurse held up a stiff card with round smiley faces on it, but instead of smiling, they grimaced and frowned. Under each expression was a number. “This is a pain indicator,” she said, “for you to use to communicate with the nurses when requesting medication.” Lawrence grinned at me and squeezed my hand. The face with a 1 underneath it frowned a little. The face with a 2 grimaced and squinted his eyes. You could tell he was male because he had no eyelashes. At level six he screamed and sweated. Or were those droplets springing off his flat pancake face tears?

Did I understand the chart?

I nodded.

“Don’t ever say you’re on level six, or they’ll think you’re lying and won’t give you the good stuff,” Lawrence advised knowledgably, as if he’d had a mastectomy a dozen times. “Always say five.”

She brought out more papers. “Your scheduled to have a radical mastectomy of the left breast and possible lymphnodeectomy, is that correct?”


“Be sure to bring your referral form with you in the morning,” she told me. I had to smile at that one. Be sure to bring the form? Were they afraid someone would slip by them without a prior authorization from her insurance company, some reckless woman hoping to get her breast cut off for free?

We signed a form indicating our consent for the surgery, another one releasing the hospital from liability in case something unexpected happened—like cutting off the wrong tit, or doing an appendectomy instead of a mastectomy, or accidentally causing paralysis, coma, death. “Death happens,” I muttered to myself sardonically, rephrasing a popular bumper sticker I’d seen. I remembered my high school friend who had died during a routine diagnostic procedure while being treated for cancer at UC Davis. Something unexpected had happened, her mother told me. Something they didn’t foresee. I remembered meeting Death in my mother’s hospital room that night 30 years previous. Did He still remember me? Had He been insulted by the way I’d run out rudely? I hoped not. I hoped He didn’t remember my name.

Next it was time for the tour. She walked us through a maze of halls, pointing out the signs that would guide our way to the surgery center the next morning, saying hello to her fellow workers as we passed. When we reached the back corner of the hospital, she pointed out the small, dark waiting room for the family. Then we walked through swinging double doors into a bright, white light. This was the recovery room. Patients in various states of consciousness and undress lay on gurneys in cubicles formed by hanging curtains. Two cheery nurses sat behind a counter at their station, manipulating files and entering data on computers. The tour nurse introduced us, showed us around, gesturing with her hand upheld at the comatose patients laying with one flaccid arm or hairy leg flung free of the covers, as if they were sites of historic interest, or exciting new products we were considering purchasing. “This is where you’ll be taken after surgery,” she said enthusiastically.

“Will my husband be able to come in here with me?”

“No. He’ll meet you in your room. You wouldn’t know if he was here, anyway. You’ll be out.”

We passed through the recovery room and down a wide hall that led to several operating arenas. “You’ll be having your surgery in one of these rooms,” she said casually. “Room A, I think. Or maybe Room B.” One door swung open and I got a brief glimpse: a table under a big, white circular light. Big equipment on wheels. Old, yellowed linoleum. Three doctors walked by us in their silly-looking costumes, blue scrubs with white shower caps on their heads and shoes. They were carefree, confident, laughing. “Do you have any questions?” the nurse asked. Lawrence and I looked at each other blankly. My mind had emptied five minutes before and was filled with nothing but white fluorescent light. “Good luck tomorrow,” she said brightly before ushering us out the door at the end of the hall, meaning, I suppose, that she hoped they would cut my tit off cleanly. That nothing unexpected would happen. That it wouldn’t be like the biopsy—too much blood.

Come back next Sunday to read the next chapter, or buy a paperback copy of the whole novel HERE.

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