Coming back slowly

I’ve been home from hospital for a few days, and I can focus on fine print. I’ve cut my fingernails so I can type again. Bread tastes funny and I can’t tolerate coffee. I’ve been away a lot longer than we expected.

My first conscious memory after my bowel resection is one of the worst things you can confront in a hospital - an apologetic surgeon. I’d been hit by a medical emergency which was 50 years in the making.

When I was very small I had some kind of unidentified infection, which stopped one kidney from growing. Instead, the bowel had occupied the space, which meant the spleen had moved too. Reorganising my unexpected gut design, the doctors nicked my spleen, which collapsed and had to be removed, while I bled badly.

Two days later, I responded to the trauma with a small heart attack.

The next ten days became a blur of disconnected vignettes, my bed a nest, pushed from scan to scan and ward to ward.

With all that morphine I made friends with a huge bear in the corner. I lost control of my visual cortex and lay for days in a muddle of spontaneous images, some viciously ugly, most collaged from shattered pieces of coloured Perspex cut with frozen, scanned memories. In my own naturally verbal sensorium, I suppose this was the pictorial equivalent of voices in my head. I puzzled for hours over the way that could happen but still be under control, which I guess is the way visual artists function, in a parallel to the stream of words coming from my fingers to this screen.

I twisted back and forth on a mobius strip of recursive identity, trying to work out who I was if the drugs had seized my brain. The “I” that I needed being a creature which could ask questions, organise my bedclothes and work out whether to put my hearing aids in or not.

I remember a man across the ward who was 86-years-old, stone deaf, who shouted very loudly and was mentally flitting through the twilight zone. The doctors seemed to think he might have had a stroke at home; his family simply ignored his ravings, as if they had known his behaviour for a long time.

Next to him was a young man of Islander background who had been in some sort of fight. His mates came and he swanked around, making moves and swaying his hips, laughing about the violence. His big sister was on the mobile talking about someone else who had been arrested over the incident. But that night, when everyone else had gone home, I heard him sobbing in his mother’s arms.

Beyond the curtain at my side was a Czech chippie, who got away from the Russians in the 50s. Eighty-years-old, still smooth skinned and strongly built, he lives with his wife who is five years older on a piece of land somewhere in the hills. His eyes lit up when he talked of his two ponies. Lying there patiently, waiting for his heart to calm, I felt like he was an inspiration, a direction for a life well lived.

I rowed on through the hospital, my bed a dinghy, across rivers of knowledge. Bowels. Spleen. Hearts. I saw slices of my own heart beating, which were slowed down and repeated with their own sound track. “Beat” is not the right word - the thing flutters, endlessly precise, fabulously fragile, each dancing move identical for every second from the womb to the grave.

They gave me some kind of terrible muck to drink on a fragile stomach, which tasted like roadside fennel cut with decaying mulch. Then slid me - without instruction - into a torus which told me to breathe in Korean-American. Some weird dye injection bathed my whole front in heat like I had been whacked by the transparent alien ray gun over my shoulder. Maybe I had. It showed me just how fast something pumped into my bloodstream can rush across my torso. It was the only time a harassed department really failed to communicate to its astonished patients.

I was trundled around because I stayed over a long weekend. They had 70 emergency patients tucked into every corner where the machines could service them. In the cardiac observation unit, we were the low needs gang. Our night nurse was first trimester pregnant. Hammered by our Evil Mouth of Noisy Doom across the ward, our doctor confessed that she was two weeks off full term to have her baby. That’s a staff shortage.

I opened my eyes one night to the blue glare of the helicopter headlights sweeping the room, making the walls incandescent as it looked for the pad across the next building. Carrying God knows what burden of suffering.

Gradually my tubes were taken out. My colostomy bag came off early, on a day when Susie now tells me I didn’t wake when she arrived but just lay there weeping. A couple of days later, the tube came tickling out of my nose. Then my drip. Then my oxygen pipe with its nipples tucked into my nose. They left the catheter in my bladder for most of the time. My drainage tube came out by simple force, with a doctor bent over and yanking what looked for a moment like an artery. I look at this list and marvel how I could possibly be so festooned but at the time it seemed not only natural but comforting. In our cosseted times, I can’t imagine doing this without the drugs.

Once I was mobile, I was sent off to walk the corridors with stern instructions to get exercise. Since I couldn’t put my jarmies on over my wound, I wore a pair of hospital gowns mounted both ways. Fluffed up with cotton, I staggered up and down like a huge, drugged dandelion. I’d lost all sense of personal dignity, and it didn’t bother me at all.

Since each patient is covered by three shifts, each with its own intricate roster, the day carries an endless routine of small visits. A nurse for morning, for afternoon, for night. A doctor for very early, who I gradually realised had been involved in the operation. Various doctors randomly for later. Gangs to have looks at the wound. Someone with a trolley to take blood. A squad for special blood tests involving ice.

Best of all was a ghoulish, smooth faced triumvirate called The Pain Team. “Hi, we’re The Pain Team. Are you in pain? On a scale of one to ten, how would you rate it?” They reminded me of creatures from Miyazaki’s “Spirited Away”. It all seemed very stupid until I realised they could use my early use of the pain button to correlate my idea of a three or four with the amount of morphine I had pumped into my body. Smart, huh?

You learn quickly to judge the carer. On successive days, different people take the same blood, deliver the same shot, dress the same wound. They fiddle, or hesitate, or push too hard. They don’t want to hurt, or don’t care. Some of them have a magic touch.

You pick laziness as well. The surgeon wanted me sitting up and moving, so the morning shower was a big deal. I was pulled upright, swayed across the room, and trailed my drip and bags and air hoses to sit on the plastic chair and be scrubbed in a confined room. A good nurse didn’t flinch at getting wet. A great nurse soaped a flannel and washed my back. An ordinary nurse shut the door and let me get on with it.

The secret is a simple but saintly combination of self confidence and the ability to acknowledge my individual needs.

A couple of times the system worked so the nurses managed a handover in my presence. I lost their names immediately, but I valued the teccy talk, which made no sense but reassured me they understood my processes in complicated ways.

Even before I went into surgery, I was fascinated by the power and status system. I reckon a big public hospital is probably the place where the Australian culture of control and authority is most clearly displayed, since the hierarchy contains a myriad of disciplines, a huge variety of cultures, and an omnipresent accounting system.

There’s a sense of 21st century machismo about the whole thing, fed mostly by the doctors. You can see it being absorbed by the younger staff who are supposed to be An Elite, and to Live Up to the Responsibility, which creates a distinctively different sense of self compared to nurses, who may be the same age.

Here’s a vignette: nurse removes a cannula, the tube that puts nutrient and drugs in through a taped needle. There’s a bit of a thing about this because my veins are so hard to find and it takes skill to install one. Then I am shifted to another ward. It turns out I need another cannula, and the nurse in charge of the night station - an older woman - does the job with no fuss and bother, in a trice. Best one, in fact. Then a doctor arrives a few minutes later, and tries to take it off, to put in a new one. I stop her, tell her it has been done by the nurse. The doctor says: “Why did she do that? I do at least 50 of these a day ...” and stomps grumpily off.

I suspect fierce clothing competition. Despite the racial diversity, and the occasional surly but efficient male nurse, the largest group by far is women in their 20s and early 30s, with shiny, shiny wedding rings. They all wear huggy trousers, little tops, and various bits of cardigan thingys over that. A look which I bet shows off any money spent, is reasonably practical for work, and cruelly exposes excess body fat. Particularly brutal because several of them had at least one small child. The women doctors were generally a bit baggier in the fit. I think I even saw a few skirts.

I guess each sector is defined by dress. My favourite was the X-ray unit on the top floor, which is a completely inhuman zone, all empty corridors with glimpses of chairs in the distance, with the occasional cluster of patients waiting like bean bags in the Bauhaus. I floated through on my bed, early in my stay, festooned with plastic bags slopping with very, very ikky things from inside my body.

Somehow the trolley clipped a corner, and one of my waste bags fell off with an ugly splash, breaking across the floor. I just sat there, drugged to the eyeballs, while three immaculately dressed young technicians in high fash black and white flapped around, calling for help, exclaiming about the smell. Stalk-like and horrified.

The cleaners were a sad group. Silent, bent, almost all black, wiping, dusting, mopping, making no contact, they were invisible and unregarded. Each seemed to work in a private bubble of despair, proving with every step that bad things are happening at the bottom of our economy. For the first time, I really saw how big households maintained an army of servants by simply treating them as if they did not exist as human beings. To me, they were an endless reproach.

At the end, with the emergency patients cleared away, I was transferred to the Alfred’s very own Medihotel. Wards with a bit less equipment, with patients able to move around by themselves, needing less direct care.

We are so used to patients being sent home as soon as possible, this area was a sort of anti-space, with its very own ghost population of patients who simply couldn’t get away. People who had endured unspeakable things on other floors, and were in for endless mysterious “tests” and “monitoring”, sometimes for weeks on end. The man who left on my first day in this blood test gulag had been there for 22 days.

As I was wheeled into my final four-bed dock, I was confronted by the sight of a vast, hairy man, almost naked, cross legged on a bed, in hospital for his psoriasis treatment. It was the only moment when I wanted a private room. He was a sort of self-appointed den host, who spent a lot of time on a seat in the corridor, talking happily to anyone who came past. I picked him for one of St Kilda’s many street identities, who probably lived in a boarding house. He had a thing about fluoro lights, and told the staff which ones were dead or dying. I figured he knew a lot about institutions and maintenance staff.

It turns out he has four grown up kids, and is a full-time carer for his wife who had a stroke. He worked for Spotless for 35 years in the plastics division, making bathroom fittings. They supplied hospitals. “The toilet seats here, I probably made them”, he said.

In the other corner was a neat man who proudly informed me he was a veteran of the Royal Australian Navy in World War II, and had lived in Albert Park down the hill since 1976. He never married, but stayed close to his mother until she died at the age of 93. She lived two blocks down from our flat. “You know that Hyacinth Bouquet woman on the television? That was my mother. She was a good woman but she had her traits, you know.”

He was a complete hoot. Eighty-four and still entertaining, addicted to ships, ecstatic about the shape of a bow wave on a cruiser, happily telling me about ship interceptions outside Vladivostok, but discreet about his social life on the bay after the war. He went to work for the SEC in Melbourne power stations, hung around the docks looking at ships, helped in the kiosk at the end of Station Pier, was a volunteer at the National Gallery and knew old gossip back to the days when Roy Grounds designed the new building.

He was in Portsmouth, my home town, during the blitz, and watched it burn from tents on high ground outside the city. The sailors were trucked in each day to work in the docks. They were fed in the seamen’s mess, where hundreds of men queued for their plates of egg and chips and bread in a fog of steam from the urns. Down the end of the line, they stirred their tea with a single teaspoon on a chain.

The day I left, the nurse, a clipped voiced Chilean man, pulled 29 staples out of my stomach with a specially designed pair of pliers. My wound was clean and he was able to leave it open.

While I packed, men came and fixed the fluoros.

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A good friend of ours has just had her second hip replacement in Cabrini Hospital, with her own room. She knew her surgeon, had continuity of staff.

I am sure her food was better. She had wine with her meals. When she left, someone said goodbye. Her fellow patients were probably prosperous, and propertied, with reliable cars and educated relatives. Not too many of the patients I met at the Alfred have a command role in our economy.

The Alfred is a vast institution, with 3,500 staff, a staggering array of diagnostic equipment, a burns unit, a transplant unit, and community outreach programs. Tucked in among the spectacular stuff is a spleen registry, which will help to keep me up with the vaccinations I now need.

I joke about the other patients, and sometimes I was glad of my hearing aids. But the one night I spent by myself, I felt lonely and abandoned.

It has taken me three days to write this post. I’ve been on a tough journey. I think death touched my cheek and passed on with a smile. I know something more of mortality, of compassion, of friendship and love.

Tucked up now in my dressing gown, heater going on my socks, slowly, slowly finding my writer’s voice, it seems to me that The Alfred is one of those places where we can find the essence of our civilisation.