Snarl

         During my latest hospital stay, I had fever dreams the likes of which I’ve never experienced. The dream consisted of a tangled mass of thoughts in my head. They weren’t clear, like lines of gibberish in an ever-shifting knot, though I could tell they were stressful, anxious, paranoid. I kept trying to pull the lines away from the mass, as if they were strings or wires, but they kept becoming tangled together. I should emphasize that I couldn’t actually see them, they were just thoughts, though they seemed like they had a physical form. I knew I would not get well unless I could extricate them all, one by one. I needed desperately to do so, it felt horrible not to be able to. The dream seemed to go on for hours. I felt like I was in hell. 

        This morning I had another dream that again consisted only of thoughts, though these were much clearer and not stressful. In this dream I was thinking about my art, and how I am not a disciplined nor terribly skilled draughtsperson. I thought about the fact that after all this time I don’t really know how to do anything, and yet sometimes everything works out and I make something that looks pretty good. And I thought to myself, the key to my moving forward as artist hinges on two questions, which I jotted down the moment I awoke: 

Are your triumphs accidental?

Are your accidents repeatable?

        Of course, if you’re trying to repeat something, it’s not really an accident, is it? But you can make an accident more likely by setting up conditions that are unstable and could have unpredictable results. None of it’s really all that profound, but I was grateful  to my subconscious for giving me something to think about other than my goddamn foot. Surgery is still not scheduled. My doctors are not returning my calls. My disability claim is still under consideration. I haven’t worked or gotten paid in a month and a half. The knot gets pulled tighter and tighter. I fear I’ll never be able to undo it. 

General Hospital

     Dr. B has no idea why my foot is not healing up. She suggests I contact a vascular specialist, in case it’s a case of a circulation blockage. “The infection may have damaged your capillaries,” she says. She pauses. “Let me see if Dr. G. has a moment.” 

    Dr. G. is her colleague who performed my surgery in the hospital. He takes one look at the toe and says, “Looks like the bone is infected. The toe will probably have to come off.” I start to breathe heavily and cross my arms to keep from sobbing. 

    “I don’t think so,” Dr. B. says, an edge to her voice. “Look closer, the bone’s not exposed at all. I think it's okay.” Dr. G. puts on gloves and starts kneading the toe, feeling the wound. 

    “You’re right,” he says. “Sorry man, I may have jumped the gun.” He grins and claps me on the shoulder and turns to Dr. B. “What do the x-rays look like?” She looks away. “You did x-rays, right?”

    Ten minutes later the assistant leads me to the x-ray room. Dr. B returns with an iPad. She shows me the images of my foot and explains that it looks like Dr. G was right after all. The bone looks infected and the best course of action is to have the toe removed. 

    “Antibiotics are only effective on soft tissue,” she says. “The longer we wait, the greater the risk of this spreading, and you will almost certainly lose your entire foot.” She stares at me, not saying anything for a minute. She has big, beautiful brown eyes. I feel like she expects me to say something. “You don’t have to decide right now,” she says, “But you shouldn’t wait too long.” 

    A friend encourages me to try calling my old doctor for a second opinion. I hadn’t seen her in years and the only reason I've been going to the other clinic is because it’s the only place my primary doctor had been able to get me in. 

    When I call, the office assistant says she can’t get me an appointment until I pay my bill from eight years ago. “I’m amazed it didn’t go to collections,” she says. “I’d say 'Praise the Lord' if I actually believed in such things.” It’s an odd thing to say for someone who works at a Catholic hospital, but four minutes later I’m four hundred and forty dollars poorer and have and have an appointment four days from now. I should buy a lottery ticket. My friend insists on giving me the money. I’m grateful but feel incredibly guilty. I’m already asking so much from everyone. I know they care about me and want to help but I hate it. I hate being the needy one, the one who's always sick, always in crisis. The one who just can't get his act together. Nothing feels quite as pathetic as being pitied. 

    But this is one of the only doctors I’ve ever liked. She actually listens, and you can practically see her thoughts turning while she does. I figure she’ll probably tell me the same thing Dr. B. did, but if she can do the surgery, I’d feel a little easier about the whole thing. 

    She takes new x-rays and comes in and does indeed confirm that the bone is infected and the toe will have to be lopped off. I briefly explain some of the issues I’ve been having with the clinic. "They either hate each other or are sleeping together," I say. "Maybe both. I feel like I'm stuck in a soap opera." I ask if she or someone in her office can do the surgery. She says she’s sorry but everyone there is booked for months in advance. 

    “Things are nuts around here, my dear,`” she says, with that slight lisp I haven't heard in so long. It's been eight years. The skin at the edges of her mouth is crinkled now. “We can’t get caught up. I know you don’t love your doctor but if they can do this soon, you should let them. Don’t wait.” She presses her delicate hand against my shoulder, right where Dr. G. clapped me with his meaty paw. Then she’s gone. 

Whitney

  Three days after they attached the wound vac, a nurse came to my apartment to change it. She struggled with the contraption for two hours before finally getting it to work. My cat was very interested in the operation but the nurse said she was deathly allergic. 

    Monday I went to the podiatrist and she took off the vacuum and reattached it differently. The following day it started losing pressure and finally stopped running. I called her and she said to take it off. The next day a different nurse showed up to try to reattach it. The cat instantly jumped up on his shoulders. He just laughed and put her down and she sat in the chair glaring at him for the rest of the visit. The nurse took one look at the wound vac and started making phone calls. He called his supervisor, the wound care specialists, and the head of their social work department. He left without reattaching the wound vac. 

    That afternoon the podiatry office called to ask if I could come in the next day, which worried me. I was already scheduled to go in Monday, why the extra visit? 

    I brought the wound vac, expecting her to reattach it, but she did not. All she did was clean the wound and rewrap it, and tell me that she wanted me to see if a vascular specialist to see if there was a circulation problem, despite my having just undergone testing in the hospital for just that. She said there was a possibility the infection had damaged a capillary in the toe. If so, I would have to undergo further surgery and possibly amputation. She gave me the number for the vascular specialist, told me it was up to me to contact them. “You need to advocate for yourself,” she said. “I’m so tired,” I said. “I know,” she said. She called in a prescription for a thirty-five dollar ointment she said may or may not help. A mournful cover of “I Wanna Dance With Somebody” played as I left the office.

    A friend drove me home and bought me lunch, and another couple of friends had dinner with me. It was good to have some distractions but afterwards I felt more alone than ever. I was so tired of being the only one who was always in crisis, tired of being the only one anyone knew with seemingly endless health issues. I was tired of having to rely on people, tired of them worrying about me. Chronic illness isolates you, puts up a barrier separating you from the healthy. Everyone has something to deal with, but I didn’t know anyone who had to deal with something like this. “Find a support group,” people recommended, but the last thing I wanted to do was talk about this shit to other people like me. 

    I was especially fed up with being the only one of my friends who was always alone. Despite feeling like I was a good person who had plenty to offer, I had gone through my entire forties without dating anyone for more than 90 days. I felt awash in self-pity and resentment. I envied  my friends their health, their owning houses, their having loved ones to come home to. They had made good choices in their lives, whereas I had ignored all the Dead End signs and sure enough the street had come to an abrupt halt at the curb. A part of me had never expected anything else, yet I still found myself surprised to be here, standing at the guardrail, staring out over the abyss.

    The next day, none of the people the nurse had said would call did so. No nurses showed up, though they were supposed to. The temperature was dropping. Snow was expected that night. I had plenty of food and my apartment was warm and I had books and music and projects to work on. The cat was sleeping peacefully on the couch. I knew I should be grateful for all of this. All I wanted to do was scream.  

Landslide

  I’ve been out of the hospital  a week and change but the foot is just not healing up. It keeps vacillating between looking slightly better and much worse. Both the podiatrist and surgeon decide I need to be hooked up to a wound vac, which is just what it sounds like. Everyone says they’re amazing devices but the thought of having this contraption attached to me 24 hours a day is the proverbial last straw for my somewhat fragile state of mind. My mood plummets immediately and nothing seems to be able to raise it.

   At the podiatrists’ office, they pump in a music station which exclusively plays covers of 70s soft rock hits slowed down even further and warbled by sweet-voiced nymphs. I’ve been here enough times to hear the songs repeat. Have You Ever Seen the Rain is always followed by Here Comes the Sun, and then I'm On Fire, somehow even creepier than the original. 

    Dr. B comes in and asks how I'm doing. I tell her I've about reached the end of my rope and am tired of living. She smiles through her mask and says she understands but notes that the foot is looking much better. I don’t think it looks any different but say nothing. A woman’s voice coos a syrupy rendition of Landslide, a song which has always turned my stomach. 

    The doctor brings her assistant in to attach the wound vac, but ends up doing the whole thing herself. She asks if I have anyone to help me at home. I tell her no, I had to fire my butler. "Oh, that's too bad," she says. I tell her I'm joking. She looks at me, puzzled, and says, "Well home care will be constacting you. In the meantime we have some supplies for you to take with you." The assistant lugs in a box the size of a big screen TV. 

"You're fucking kidding me," I say. The assistant assures me that she is not. She says my medical leave paperwork is waiting for me at the front counter. I go out and make my appointment and the woman at the counter says there's a charge for them having filled out the paperwork. "You're fucking kidding me," I say, but apparently no one around here kids about anything, so I hand her my card.

    As I sit waiting for my ride to return, I see a familiar face beaming up at me from the coffee table. Henry Fucking Winkler is on the cover of AARP, beneath headlines promising How to Stay Safe Driving at Night and Love Lost and Found after 47 Years. A man comes in to repair the automatic door opener, and for the next hour I am treated to blasts of cold air accompanied by a high-pitched drilling. I try to make myself some coffee but the coffee machine serves me a cup of hot water covered with a film of coffee grounds.  I give in and read the AARP rag. “Don’t think about what you don’t have,” Henry extolls us at the end of his interview. “Embrace and enjoy what’s in front of you.” The machine on my shoulder gurgles. I want to throw both it and the magazine at the wall. 

    At home I eat lunch and immediately black out. When I reluctantly come to, it’s dark outside. I warm up some leftover black-eyed peas and sit and watch the dark thoughts circle ever closer. 

    All the while the machine in the shoulder bag ticks like a drunken clock, occasionally emitting a deep gurgle like a burst of flatulence. It’s not large –about the size of an old portable cassette recorder- but it’s heavy. Crimson beads dart along the clear tube that leads from my bandaged foot to the vacuum itself. It’s not as off-putting as a colostomy bag but it’s still disturbing. Every once in a while it shuts itself off for no apparent reason and emits a high pitched shriek to alert me. As the night progresses the ticking sounds wetter, like someone taking slurps of bubble tea through a straw. 

    My first home visit nurse arrives the next morning to interview me. She’s very young and very kind, her hands covered in rainbow tattoos that look like they were drawn on in crayon. Olivia is obsessed with her but she says that while she loves cats, she’s deathly allergic. We talk a while and I somehow manage to convince her I’m no threat to myself, something I’m not all that sure of at the moment, and she leaves and says I’ll be seeing three more nurses this week; the nurses of Christmas past, present and future, I assume. I don’t look forward to the stream of strangers into my filthy, cluttered little burrow. 

    I try to sleep the afternoon away again but my body doesn’t cooperate. I manage to read an entire issue of the New Yorker but it’s so depressing I feel nauseous afterwards. I just want to close my eyes and at this point I don’t really care if I ever open them again.