Four More Years
Dear WBW Readers:
The trifecta of surgery, daylight savings time and the election, all within the last two and a half weeks, is now in my rear-view mirror. Or maybe this should be called a hat trick?
I was discharged from Memorial Sloan Kettering Hospital on Halloween after just three days at the MSK Spa Resort. I had always thought that discharges were initiated once the nurses logged a certain level of complaints, but Ann Kenney informed me that no, they watch for the patient to have applied mascara two days in a row. I suggested to the doctor that perhaps I should stay until the gas that was in my belly dissipated to the point that I only appeared four months pregnant. I was told tartly that nobody ever died of gas. Even though I thought I was about to.
I was kicked out a full day earlier than the earliest possible day I had been told would be the earliest possible day, even if they did that thing where they opened me up, observed that radiation had turned my insides into a Salvador Dali painting – The Persistence of Memory perhaps – and just closed me up again.
I’d learned, however, in a week of pre-op encounters, that it was more likely that I would awaken with the tumor gone, but considerable collateral damage: my gall bladder removed, some kind of shunt or tube thing shoved down my bile duct, a resection of my duodenum, which was consistently pronounced completely differently in Mrs. Carlson’s 10th grade biology class, a chunk of my pancreas artfully carved out and patched, like a bike tire, my inferior vena cava resectioned or patched, drains sticking out of me and possibly a feeding tube. Yes, I actually signed a piece of paper saying all this was OK. Two pieces of paper. I’d fully educated myself via YouTube videos about this procedure, known as a “Whipple.” It may or may not have killed Steve Jobs. Don’t try it at home. And please don’t squeeze the Charmin.
In the end, this wasn’t necessary. The pesky stubborn lymph node (rechristened by the surgeons as a “tumor” – a word so carefully avoided in the two and a half years I’ve been growing it) was not embedded in my pancreas as was speculated and there was astonishment in the OR at how the anticipated damage from last year’s Chernobyl-level radiation just wasn’t there. This did make me wonder if I even got radiated at all, or was it like, fake radiation.
The surgery took under four hours with hepatopancreaticobiliary and urology reinforcements stopping by to offer their help but the gyn team shooed them away and took care of it all themselves. They even had enough time to set aside the staple gun and embroider me shut – oh yes and pull my appendix too. That was the Cracker Jack prize. No new scars – they just cut along the dotted line Dr. Einstein set me up with three and a half years ago. It measures 14” long and right now ain’t pretty. If they ever have to go in a third time, I am going to suggest installing a zipper.
I came to in Recovery, always a Fellini-esque experience, with the epidural apparatus still pumping painkillers and a guardian angel nurse watching over me. I felt around for tubes. My ex-roomie Evan slipped in for a visit and confirmed I was tubeless. I was texting within the hour. Somewhat sloppily, but that’s another story. I arrived in my room around 9:00 PM, and within 10 minutes established that I detested my roommate who was a Karen Complainer. Happily, she was gone in a day.
After gently settling me in, the transfer nurse asked if there was anything else I needed. Yes, I said, let’s walk. She escorted me on a victory lap around the circumference of the 10th Floor. This was where I’d been billeted back when this “tumor” first presented in June 2018, so I knew the territory. Fourteen laps equal a mile. I managed one circuit that night. With a friend I made on the track, Ashley, on Saturday morning I’d completed 12.
There are so many good things that came of this surgery – not the least the appendectomy. Unlike other treatment decisions I’ve made, I didn’t jump at this one and even as the anesthesiologist was sticking the needle into my spine, I was having my doubts. I truly wondered about the wisdom of having major surgery while Mercury was still in retrograde.
Going through the decision-making process, however, was a healthy exercise and in no small way involved the specter of Covid-19. Of course, it is beyond great that the surgery went so well with really minimum (OK a lot but ephemeral) pain. It is beyond greater that the pathology report, which put me on edge for a week until it was posted, confirmed that yes, the node was cancerous (if it hadn’t been I would have been mighty pissed off) but it was out and all the surrounding nodes tested clean. So, as I am just days from entering that psychologically oppressive fifth year (under 50 percent survival rate at that point; much worse for primary peritoneal) I do feel like I dodged a bullet. Not only that, I have hair, eyebrows and eyelashes this time around and didn’t have to spend my waking hours worrying about my scarf slipping off. This was a bigger relief than you might imagine.
Memorial Sloan Kettering has sealed my loyalty forever. The medical teams (onco, surgical, nursing, even PT and the lovely housekeeping and maintenance staffs) went about their business with confidence, empathy and a brisk, no-nonsense efficiency. I have long maintained that my personal treatment plan of the last four years has required just two things – management of that which I can control (my time, the mess in my apartment, my finances, relationships, the cleanliness of the turtle tank), and attitude (which includes a healthy dose of denial). After this experience I would also add as essential confidence in my medical care– from MSK, from Dr. Einstein at Hartford Hospital who I run to for a reality check on every MSK recommendation and from the MBL Advisory Committee (my inside guy Dr. Doug Koo at MSK, Dr. Ann Kenney, Drs. Lisa and Rocky Marotta, Nora Klocek, RN and Dr. Michael Selch). Also, in this particular instance, I also consulted Dr. Bob Aldoroty, my 1270 neighbor, a Mt. Sinai surgeon. His response: Just Do It. He advocated doing it at Sinai, but I was sticking with the horse I have been riding. Even Dr. Bruce Gellin weighed in this time, obliquely urging me to carve some time for myself before checking into the hospital. Forty years ago, Bruce was my “inside guy” across the street at what was then New York Presbyterian, in his third or fourth year of med school which meant he and his crazy classmates were authorized to transport me around the hospital for various appointments. Memorably, one day, he pushed me into a storage room, unhooked my medical chart off the back of the wheelchair and proceeded to read it aloud. “Patient is a 26-year-old unemployed white female . . .” I yelped indignantly. I wasn’t unemployed! I was a freelance writer!
Once I secured Doug’s solemn promise to visit me every single day, the deal was sealed.
Many, many others contributed to the success of this adventure from a lay perspective, from my family (Sarah and Elise chief among them), to Mary Jane Auer and Christine Goffredo who spent the Sunday before surgery with me cruising the Upper East Side and Keith Palzer (a close relative of the Keith Salazer mentioned in a previous WBW) and Anita Kawatra who took me out for an extraordinary wine-soaked, dress-up, scrumptious outdoor Last Supper at Elio’s the Saturday before, and all my amazing neighbors at 1270.
Jamie Allen Black drove me hime and endured my groaning every time we drove over a pebble on Madison Avenue. I returned, by choice, to an empty apartment, which is what I wanted, and given the coronavirus situation seemed prudent. But I was hardly left to my own devices. Ruth Mackaman showed up as I was strategizing how to get onto the bed; for the first few days all such maneuvers had to be carefully mapped. I learned the hard way that my living room couch was NOT my friend. . I couldn’t reach up or bend over; like that Vegas thing, what fell on the floor stayed on the floor. Ruth was bearing a bunch of flowers and a Fairway spit-roasted chicken. Vinny McGee kept me hydrated with Whole Foods Tropical Blend Italian Soda and Perrier and many others hung treats on my doorknob, rang the bell and ran away. The1270 desk attendant (she’s not a doorman and not a security guard, somewhere in between) texts me to make sure I’m OK if she hasn’t seen me by midday. I readily recruited a 1270 escort team to patiently supervise my shuffling around the Meer that first week, since then I’ve been able to manage this on my own.
The first week at home was rough; the hospital bed, the hot-and-cold running nurses, the grip bars on the bathroom door were all missed. But every day it got a little better, I was off the oxy in 72 hours (I’m reserving the balance for future use), I am back on the Lovenox bandwagon for the month, sticking myself in the belly just like the bad old days. As an alternative to following the election news, I slept. I had a lot of sleep to make up for. Like four years’ worth. Not to mention the previous four weeks.
I don’t recall sleeping at all the Wednesday night of the surgery, I was itchy and barfy from the pain meds, though not, technically speaking, in pain. The Zoloft and Benadryl didn’t help much, making fun of the dreadful roommate with my nurse did. I was able to coach one of the aides how to plug in the Amazon Fire Stick I’d packed and by 10 PM I had all the comforts of home which is to say Law & Order on the huge flatscreen opposite my bed. The next two days flew by punctuated by mundane Chicago Med-like dramas (a drop in blood pressure that necessitated puling the epidural; I brought it back up by salting my soup and reading the Times), a transfusion that I welcomed as it perked me right up and put some color in my cheeks; the challenge of exchanging the hospital johnny for street clothes. I was initially told ditching the johnny was verboten due to the risk of Covid hiding in the seams of my t-shirts and sweats. By Thursday I was in “regular” PJ’s and Friday got fully dressed and put on makeup. When the team came by for afternoon rounds, it was led by a doctor who hadn’t been involved in the surgery. I was standing at the window trying to get a clear photo of the 59th Street Bridge, cursing that the window was so dirty, when they came in the room. “Where’s the patient?” she asked me. The others burst out laughing.
Also keeping me giong was a friendly competition with my b-school buddy Brent Smith, who checked in regularly from his bedside in California; he’d had a hip replacement two days before my procedure. We compared surgeries, pain killers and estimated hospital bills. I won.
I started work this last week. I have an assignment – a big one – from Institutional Investor and hope there will be more down the pike.
Perhaps the single best thing I did on arriving home was institute a news blackout, silencing NPR, steering clear of CNN, resisting the temptation to click on the NYTimes app on my phone and eliminating with extreme prejudice any election angst invading apartment 3R. (Just ask Liz Baxter, I took her head off for broaching the subject.) I finally tuned in about 11 PM on election night, then shut it off again, anticipating correctly there wouldn’t be any real news for a couple of days. Yes, I watched lots of TV: The Queen’s Gambit, Season 1 of Fargo and Song Exploder with intermittent Schitt’s Creek chasers. And Borat #2 and Chicago 7, did you have to ask? The six issues of unread New Yorkers I dragged to the hospital remain unread.
So as of this issue of the WBW, I am officially considering myself uncancered, at least for a while. Of course, it could (and chances are, will) pop up somewhere else, anywhere, any time, but, like the election, I just can’t stress over something I can’t control. My new personal credo is “Four More Years.”
I send my best and my gratitude to all my readers, whether you’ve been lurkers or in my face – this makes no difference to me. OK, I should single out the ones who had the insight to send chocolate-covered strawberries and organic underpants and Starbucks cards. You know who you are. But, really, you’ve all been there for me and I know it.
One of the best things I packed for my hospital stay (along with eye makeup and the Fire Stick) was a set of over-the ear closed-back headphones. On my second night I clapped them on, tuned into the SXM app on my phone and clicked on E Street Radio, adjusting the volume so it was hanging in the balance of letting me sleep or listen. The next night, at 11:00 PM, I swapped Bruce for Billy, and picked up on 88 Key Cuts, where he introduces 88 songs with all the personal commentary and accompanying riffs on the piano I could ever hope for. That took me all the way through to 7:00 AM Saturday morning. I couldn’t have asked for better companionship. Want to know the #1 song? Just ask.
Yesterday morning, for no particular reason, I remembered that while I was in somewhat of a fugue state streaming Springsteen, there had been something in the programming that I’d made a mental note to look up, a song played with the Sessions Band.
I want to pause here to remind you that my obsessions with these old-time rock-and-rollers developed late in life for me, sometime after May 2018 when I tuned into their stations on the Sirius XM installed (six months free) in the Forester I leased that month. My attitude toward both these men prior to then that was “meh.” Springsteen mumbled and Joel was a whiner. You can document this readily – if you bother to read through any WBW prior to mid-2018 you will find no mention of either.
With some effort I managed to locate the song, which seems as fitting a way to sign off today as any.