Dancing with Death by Susan Engel (i can read books .TXT) 📕

I could turn my attention back to the blood type issue.
I heard my husband’s voice – thank God! He was there! – answer, “I - I’m not sure what her blood type is.”
Inside I was screaming, “A+! A+!” I knew my blood type, but the words never left my lips – I just didn’t have the energy. “I know my blood type, dammit! It’s A+!” I thought.
“Two units of O-neg,” that now-familiar voice said – clearly, he was the physician who I had heard asking the questions and giving the orders.
“Crap!” I thought. “I know my blood type!” Ugh. Still, no energy to give sound to my words.
Another blurry male face was thrust into my view. “Susan, you have a lot of fluid in your abdomen. We need to take you to surgery now to find out the cause of it, okay?” My gurney began to rattle and move. “Do you agree to the surgery?”
“Huh,” I thought. Informed consent. Nice going, doc. I’m barely conscious, don’t even have the energy to talk – hell, I’m barely alive – and this guy appears alongside my moving gurney, and blurts out, “Do you agree to surgery?” I know the legalities of medicine, and why he had to ask. They already had probably already asked my husband if he would consent to surgery for me, as he was the only relative available at the time. It seemed rather comical that this doctor would ask a barely-alive person whether they wanted potentially-life-saving surgery or not, but … that’s the medical-legal system today for you. I should know – I have asked thousands of patients myself whether they would consent to their anesthesia before I provided it because of this system. I knew it was required. It just seemed rather amusing (okay, a bit ridiculous and questionably legal) to me, given the circumstances, now that the shoe was on the other foot.
“Geezus!” I thought. “Like I have a real choice in the matter? It’s the definitive and ethical course of action. Duh.” Besides, let’s not forget that ruptured ectopic pregnancies of this severity are rather uncommon these days. Plus, I was in a teaching hospital – what a fabulous educational opportunity for all those students and residents!
My husband appeared out of nowhere, alongside my gurney. I didn’t know he had been tagging along for the ride. “Everything is going to be okay,” he said in his best forcibly positive voice. “I’ll be here …” his voice trailed off as I left him at the open double-doors to the O.R. Only staff were allowed beyond the double-doors.
My stubborn ego managed to attempt one final triumphant feat. As soon as I left my husband and entered those double-doors, my pride took one desperate last stand before surrendering her weapon. What the heck was my ego guarding, anyway?
My head began to swim with worries about who was going to be on the surgical team, and most importantly, my anesthesia provider. You see, a nurse’s worst nightmare (okay, one of this nurse’s worst nightmares) is to be a patient at the hospital in which they work. I feared that my dark, dirty chemical dependency history would surface. I also worried that they would deduce how my prideful, rebellious resistance to reality (i.e., denial of the obvious) nearly cost me my life; how stupidly arrogant I was to abstain from getting much-needed help earlier.
The shame over those issues was mercifully shattered by a new self-centered fear. It was Sunday. On Sundays in the O.R. where I worked, attending or chief physicians were scarce – surgery was frequently provided by … residents! I winced.
I had been a nurse anesthetist in that hospital up until 10 months before this incident (they used nurse anesthetists as well as residents and chief physicians as providers at this facility). I had worked with many of the nurses, surgical technicians, residents, and attending doctors for 3 years. After a while, one gets to know which residents have a bit more skill than others. My biggest fear, interestingly, was not who were going to be my surgeons, but who were going to be my resident and attending anesthesiologists! The skills of the anesthesia provider were crucial in a case like mine. “Shit! It’s Sunday!” I thought again.
As voices continued to swirl about me, I struggled to stay conscious until I could ascertain who my anesthesia provider was going to be. And my pompous ego was surprised that no one seemed to recognize me. Of course, I was vertical at the time, in a gurney, covered in a white sheet, which in turn was covered with transport monitoring equipment, wires, and I.V. and oxygen tubing. I’m sure that my normally fair skin was probably becoming ashen and/or had taken on an alluring tinge of blue due to my low hemoglobin and oxygen levels. And just to make matters more confusing, the admission information apparently had my last name and birthdate incorrect – two vital pieces of identification of someone. No wonder they didn’t recognize me.
I tried to gather enough energy to ask who my anesthetist was, but the best I could do was whisper. The continued loud “fssssss!” of the oxygen, as well as that darn mask, obscured any visual or audible sounds I may have made. At that point, I had little energy to even become frustrated by the situation.
A few bleary, indistinguishable faces appeared over me, upside down. I heard the voices of a man and a woman. They briefly stated their names, but it was difficult to discern their words over the other people chattering nearby, as well as the beeping of the nearby monitors. And there was that intrusive oxygen still fiercely blasting in my face, too … “fssssss!” Ugh. I just wanted to go to sleep and be relieved of the pain. I had no struggle left in me anymore.
“We’re going to do your anesthesia,” I heard one of them say.
Eureka! I knew one of those voices! It was a resident whom I had worked with in the past. “Oh, thank God it’s him!” I cried internally. I couldn’t recall his name, but that was okay. I knew that he was a senior resident and that allowed me a small sigh of relief. Someone with a little experience. Halleluiah!
Out of the corner of my eye, I saw another face –fleetingly – of one of the staff anesthesiologists. He usually worked at the VA hospital – he must have drawn the lucky card and been the on-call attending anesthesiologist for the university hospital that day. It took a second or two for me to put a name to the face, but I finally recalled who it was. He was old, but he was experienced. Another halleluiah moment!
I finally breathed a small sigh of relief. “Oh, thank God,” was all I could think at the time. “I hope that this doc stays with these guys,” I thought, referring to the attending anesthesiologist and his resident and … whoever the woman was (a nurse anesthetist, I sincerely hoped). I wanted to make sure that he accompanied these two into the O.R. and helped manage my case. I feared being left at the discretion of this male resident and no-name woman. I was in big trouble and really didn’t want to be the teaching moment du jour (i.e., guinea pig) for some inexperienced medical folks to tinker with. I sensed Death trotting alongside my gurney as I entered the operating room suite.
I braced myself for what was next: the transfer to the operating room table. The pain would be horrific. And it was. I heard the countdown, “Ready? 1 … 2 … 3!” and as the O.R. staff yanked the sheet underneath me, I instantly felt bolts of scalding pain ripping through my abdomen and back as everything in my line of sight went black except for flashes of bright white, blue, and orange light. The intensity of the brightness of those flashes is indescribable; it was like nothing I’d witnessed before in “real life”, save perhaps staring directly at the sun.
Monitors were changed over from the transport machines to the O.R. equipment. I.V. bags and tubing were removed from the gurney poles and hung on the I.V. stands in the O.R. Then came the familiar placement of my arms on the padded armboards, with the raspy, fabric-pulling Velcro sound as the wrist restraints were applied. The oxygen mask was removed and replaced with the bulkier plastic, padded mask that the anesthesia provider uses with their machine. It was being firmly held to my face by a rubber-gloved hand.
The ““fssssss!” noise of the oxygen became louder than before. I was being “pre-oxygenated” prior to induction of anesthesia. Part of the problem of being a patient in the environment in which you work is that you know everything that is going on … and panic if a step is missed or not done to your liking. Another hypocritical moment: analyzing and critiquing the movements of those around me – especially my anesthetist – while I was hemorrgaging to death internally. Unbelievable. My tenacious ego was alive and kicking, even though the rest of me was half-dead!
The blood pressure cuff squeezed as I heard the ECG electrodes being snapped onto my chest with their familiar “click!” An oxygen monitor was quickly clipped to a finger. Suddenly, my gown was being lifted. Or was it a gown at all? Perhaps only a sheet covered me. At that point, I really didn’t care. I couldn’t care. I couldn’t move. I could barely breathe …
“We’re putting you to sleep now,” a voice said. I wasn’t even sure if it was a male or a female voice – the cacophony of noises in the operating room obscured my ability to distinguish any particular voice. I felt a gloved finger or two slightly press down on my throat, right about where the Adam’s apple would be. I resisted my critical brain’s urge to want to know what medications they were using to induce anesthesia and instead let go in anticipation of release from the pain. “Sleep … finally … thank God …” I thought. Sounds, lights, and reality quickly faded away and for a split second before a black shroud of unconsciousness enveloped me, there was no pain. No pain! Everything finally felt “okay”. Then suddenly and voraciously … the velvety darkness of unconsciousness.