Tuesday, June 4th, 2019

4:15am

We’re up early.  I’m flipping through mom’s surgery paperwork in her dimly lit condo, looking for the Cleveland Clinic campus map.  “How’d you sleep?” I ask.  “Good,” she says, preoccupied, stuffing garments into her overnight bag.  Half a beat later, she laughs nervously, “But I didn’t sleep so good.”

I can’t find parking deck P on Waze, but then remember I can never get the audio to activate anyway.  At least the rain is holding off.  I drive mom’s white Jeep Compass in the black predawn to get Rose.  At a red light, the engine idles off.  “God I hate that,” mom says, pushing an override button behind the gear shift.  “That will fix that.”  From the driveway, we see Rose wave out the dining room window where the dog usually stands.  Walks out with a mug, opens the car door, says, “Wait.  I forgot the doggie barrier.  Would it be wrong if I asked you to hold this?”  I wished for a mug of my own.  Rose returns, “You aren’t going to write about this are you?”

I exit MLK to E.105th.  A right on Euclid is my mistake.  Should’ve waited for Carnegie.  There’s no left onto E. 90th from Euclid, so I cruise a few blocks before a u-turn in the wake of a wailing ambulance and two of Cleveland’s finest.  Through a maze of Clinic buildings, with Rose’s encouragement, we arrive at parking deck P next to the Clinic Surgery Sign which looks a lot bigger in the pamphlet image.  After surgery, in the neuro step-down unit, I overhear Rose on the phone say to her husband, “I knew mom was nervous when she never once commanded Eric turn this way or that.  She’s always navigating when I drive.”

5:30am

Mom is checked in at desk P by one of three clerks.  The middle clerk asks, “Who’s going to wear the pager?”  I watch her mouth as she recites her rote instructions, all I hear is “Minus button, press the minus button, to read the entire message, keep pressing minus.”  Building P waiting area sprawls over two floors.  Reading crannies, small flat-screen tv nooks, chairs and dual seats and benches all with the same, aging cracked vinyl installed in the 70s.  The chairs are more comfortable than they look.  The waiting area slowly fills, people with inscrutable faces.

5:45am

Over the PA, Mom is called back to desk P. She signs insurance forms then returns to the waiting area.

6:15am

Mom is called to desk M in building M just around the corner, down a connector ramp from desk P.  Rose accompanies mom.  I stay behind.  I am directed to the free coffee machine hidden near the elevator.  I select darkest beans, maximum roast.  Ten ounces, but it’s really good.  I return again and again.

6:45am

Rose texts from the pre-op room, do you want to come back and see her before she goes in?  I’ll come and get you.  Mom lies in a hair net, hair still intact, on a roller table with an IV in the back of her hand.  A nurse says, “The surgery is expected to last 253 minutes.”  The precision seems ludicrous but reminds me of airlines and how they manage to make up time, not by flying faster, but by changing flight paths.  Once brain surgery takes off, it’s hard to imagine how surgeons make up time.  Much later, in the neuro step-down unit, mom will complain of nausea from wheeling between rooms after surgery.  The nurse will say some of the transporters are more aggressive than others and suggests she keep her eyes closed next trip. Turns out, Mom will need transporting post-surgery for an unplanned cat scan.

6:56am

Everyone in the waiting area wears a blue pager around their neck.  It’s always beeping loudly somewhere.  The first time I hear mine, I think it’s another:  The patient has entered – I press the minus button – surgery.  A flat screen on the wall near desk P scrolls patient codenames (Ho..a, S) for privacy and displays her surgery start time, 6:56am.

7:15am

Downstairs the cafeteria is open.  Rose and I order eggs.  I get hash browns and Rose fills a bowl of fruit for the two of us.  We sit at a table in the small dining area.  The eggs are tasteless but edible and the hash browns are, inconceivably, rubbery.  After chewing awhile, I reluctantly decide I cannot eat them when an aproned worker from behind the serving station brings me a bowl of hash browns, “These are fresher,” she says.  Rose and I sit in the cafeteria and talk for two hours.

9:15am

Beep beep beep: Come to desk P for locker key and storage information.  Rose stores mom’s overnight bag in a pay locker that’s free.

Upstairs we find two chairs in a corner with a table.  I show Rose Facebook photos of relatives on mom’s side, my Yellowstone vacation photos.  I have her read my essay about Mom’s surgery and can’t help notice she laughs more than my wife does.   She has questions:  Who’s the English teacher?  Who is P?  Who says your blogs are too long?  Did you really faint? Would you like to hear my sty story?

10:20am

Beep beep beep: Surgery in progress.  Patient is stable.  There is a family sitting nearby with a young boy who paces the floor in bare feet, a phone in each hand at arms length, watching cartoons.  His head swivels from one phone to the other. His father corrals him when he wanders into our space. He is not a small boy. This happens more than once.

11:15am

Beep beep beep: Surgery is complete.  Patient is stable but not ready for visitors yet.

Rose and I exhale and tell the clerk at desk P we’re leaving the area.  Rose buys a coffee drink at the Clinic Starbucks. We buy pre-made wraps in plastic containers and decide to wait before eating. I fit them in my backpack and we wait.

2:15pm

Beep beep beep: Please report to desk P.  Remove patient belongings from locker.  At desk P the desk clerk tells us the doctor will be ready to talk to us within a half hour.

3:00pm

Dr. Machado is embroidered over the pocket of his white coat.  He has thin hair, glasses.  He comports with the air of a serious, preoccupied nerd which is comforting.  “We evaluate two electrode positions and ten combinations of physical tests.  She’ll remember the tests: holding a cup of water; touching her nose; speaking exercises.  We increase the voltage until she feels a tingling down her arm.  It sets the voltage limit for our future programming.”

No change in demeanor, Dr. Machado continues, “The cat scan revealed a spot of blood.  All I have is one point in time.  She’s scheduled for another scan at 5:00pm.  Some brain swelling is normal, but we need to check this out.”

3:15pm

Outside under a light gray sky, we sit on a bench in a large grassy area and eat our wraps.

4:15pm

Beep beep beep: Patient is ready for visitors.

Rose and I go to the 6th floor of the H building.  Mom is in the neuro step-down unit rather than the general floor.

Mom cries when we first walk in to room H63.  Rose kisses her.  Mom keeps her head turned to Rose. Mom’s voice is pitched high and weak and she flails her arms, dragging along the IV and other tubes.  Head shaved, a bad military cut, a swab of orange anti-septic streaks across her forehead.  Dried blood at the stereotactic pin points.  Atop her head, a white bandage.  She looks like a grizzled sergeant who survived a shelling attack.  The top of her head is bruised, a purple ponding, clusters of short hair sprout like reeds near shore.

Mom is tough.  Closes her eyes for short stints, too uncomfortable for sleep.  Courageous yet compromised.  In hazy reverie, mom recalls the soft hands of one of the assistants, caressing her arm during the surgery.

She takes a bite of graham cracker.  “Would you like peanut butter?”  The nurse asks about pain, “Does your head hurt?  Feeling nauseous?”  Yes to both.  Drugs for both. Mom says the ride on the bed through the halls made her dizzy.  She swallows a pill, sips water, and immediately calls for the throw-up bucket.

The nurse, Shelby, performs neural tests.  Shelby is young, upbeat, and energetic.  Okay Miss Sybil, every hour on the hour until 1:00am.  Grab my hands.  Push.  Pull.  Hold your arms up Miss Sybil, like you’re holding a pizza box.  Perfect.  Close your eyes.  Keep your arms up.  Perfect.  Lift your right foot.  Left.  Perfect.  Push your toes down.  Now up.  Perfect.  Okay, worst part, I’m going to blind you.  Don’t move your head.  Look left, look right, up, down.  What’s today’s date?  Where are you?  What’s your name?  Okay, I’m going to change things up on you.  Who is the president?

Shelby says the neuro step-down visitation is 24 hours.  “You can sleep here if you want, but you probably won’t get much sleep.” This discouragement is welcome.

7:45pm

Rose wants to meet the second shift nurse.  A singing custodian changes the plastic waste container linings.  He sings about love as he shakes out a fresh plastic bag.  He sings on the other side of the divider curtains.  He sings as he talks to patients.  I ask what song.  “Why, it’s my own.  I just make it up as I go along.”  He is a handsome man, around 60.  

We meet Katelyn, another young nurse who mom says is gorgeous.  “Hold your arms up, like a pizza box.”  We leave mom for the night around 8:30pm without hearing results of the cat scan.  I fully expect mom will require one more night.

9:15am Wednesday June 5th

The next morning, Rose and I find mom sitting up, alert.  We’re pleasantly surprised – she’s cleared to go home.

The cat scan had revealed a complete absence of blood on the brain.

Rose helps mom get dressed as I turn my back.  I realize Mom is returning to normal when she makes me uncomfortable, saying “Oh I’m sure he’s seen a boob before.”  I consider a joke but make a silent offering instead. If I were the type to keep a gratitude journal, this moment would be etched on the cover, grateful for my little sister as I contemplate the limits to my caregiving.

A pastor and his trainee walk up to mom’s bed and chat.  Mom gets emotional as she describes the difficulty writing her name, “It’s so frustrating.”  They wish mom the best and we hold hands in a circle and pray.

Mom scratches her name on one last form.  An attractive Latin woman stops pushing her swiffer and smiles, keeps her eyes on mom and wishes her good luck.  The wheelchair arrives.  The Latin woman watches as a male nurse helps mom into the wheelchair. In three weeks, mom will return for the left hemisphere with a little more confidence and a little less fear.