I am a week out of the hospital, sitting in one of the surgeon’s three viewing rooms, headache and nausea rising within me, as they do when I am upright longer than a few minutes. This is due to the loss of cerebral spinal fluid (CSF) caused by a staph infection that developed in my lower spine following an outpatient discectomy that removed parts of a ruptured disc pressing on my spinal cord. It’s complicated.
This surgeon, Dr. Flight I’ll call him, performed the original discectomy, but was away on Air Force reserve duty when I needed the second surgery to clean out the staph infection. That surgery was done by another surgeon I’ll call Dr. Rush. Dr. Rush spent all of ten minutes with me as I lay in a hospital bed with a morphine drip in my arm, a catheter inserted in my piteously contracted penis, and clear liquid dribbling out of the surgical wound, soaking the sheets as if I was wetting the bed. Dr. Rush confidently identified the liquid as cerebral spinal fluid, but then scheduled me for corrective surgery three days out, by which time I probably would have been dead. The intervention of the head nurse coming on her midnight shift at the end of day two saved my life.
Now, back in Dr. Flight’s office, he explains to me that the brain produces enough CSF to replace an entire batch in a matter of days. So the symptoms I’m reporting of extreme headache, nausea and chills when I’m upright really don’t make sense. He makes me sound melodramatic. Later he will meet Dr. Rush outside their adjoining surgical theaters at the hospital and learn how deeply the infection had penetrated my spine and how intensively Rush had to scrape it. But now, without Dr. Rush in the conversation, Dr. Flight and I are like the remaining two from a threesome gone awry; short of some new development, we will soon be thoroughly bored with each other.
But then it happens. A huge swelling appears around the surgical wound, big as an avocado. Dr. Flight, not encouragingly, says he has never seen one so large. He calls in another doctor to see it. That doctor murmurs non-committal clinical commentary, which I’ve learned translates roughly to What the fuck is that?
We fear the staph has returned. That is, I fear and Dr. Flight speculates.
Happily, my SED number, the blood sedimentation rate used to measure the presence of infection, keeps dropping and I have no fever. Nevertheless, Flight, a surgeon, a man of action, wants to insert a needle in to the avocado to take a biopsy and learn for certain what that fluid is. However, he warns me, if it’s a reservoir of CSF leaking out of the dura, the bag that encases the spine, which seems fairly likely, the CSF will not allow the needle prick to heal. I will need surgery to fix it.
I don’t say it, but I think Flight’s suggestion is ludicrous. What I do say is that I am not going back to the hospital.
“Was it that traumatic for you?” he asks.
For now, we agree to disagree about the biopsy. Dr. Flight will see me again in a week.
The following week the avocado is as big as ever. Yet my SED number has decreased steadily, and I’ve no fever or heat around the wound. My head condition is improving, and I can remain upright for longer, perhaps an hour, before needing to lie down.
“I’m feeling better,” I tell Flight.
“But you’ve got a baby coming out of your back,” he says.
Now who’s being dramatic?
Flight wants to do what he does: surgery. But I am never going under the knife again. Never. I don’t tell him; it would be like telling a tarot card reader I no longer follow the zodiac.
Friends, disturbed by my pain, constantly ask me what the doctor says. Their answer to my pain is to go get answers. They think there’s a book somewhere, that if a doctor just knew the right page to turn to, and he could read the language in which it was written, it would tell him how to stop me from hurting.
After six months of escalating pain, and two surgeries, I am not getting better. But I am getting better at crying. The stone swells in my throat and I don’t swallow it. It rises toward my tongue, and I don’t suffocate because the stone crumbles into tears and words float off like butterflies and are gone. I am getting better at not swallowing stones.
It’s not easy on Bernie, my girlfriend, and I can’t make it easy. Sparing people what I’m experiencing was always about sparing myself anyway, to not have to feel people feeling me, a form of emotional invisibility. Pain is bringing me into plain view.
Boredom is pain’s ally. Boring meetings, a staple of my copywriting career, will become tortuous. In the past, I would simply space out, nodding bobble-head style, my mind in a better place and time. But pain and boredom will force me to speak up, just to keep the throbbing at bay. I’ll challenge wrong-headed assertions, even change the subject when the conversation veers into irrelevance. In social conversations, when I hold back, the pain needle will move up. When I speak out, it will go down. And I’ll feel relief.
My friends have a five year old named Avi, an avid storyteller, so intent on advancing his narrative of birthday parties and Spider-Man and the dog and his buddy Alysio, that he strings clause after clause together—and and and—in one long propulsive sentence about everything on his mind.
I’ll adopt Avi’s style. I’ll tell Bernie: I did the agency meeting, and got a web project, then I was hungry so I ate at that falafel place, I don’t know why, I just felt like falafel, even though my back hurt, but then I ate a baklava for dessert and suddenly my back was relaxed, I wonder if it’s something in the honey, which they say is anti-inflammatory, or is pain just a non-linear event, and what does that say about the body, and thank you for hearing me like this, I really appreciate how you are with me.
Bernie, a great lister of the day’s activities herself, will listen with interest and find nothing strange about me. Nevertheless, I’ll explain myself: I’m saying everything because it relaxes me somehow, and if I don’t my back lets me know about it, so sometimes I think of saying something and decide not to because it’s too trivial, or too vulnerable, or too off the cuff, and then I say it anyway, it just pops out, right or wrong, it doesn’t really matter, right?
Avi would be proud.
But before any of that can happen, I’ve got to get through these first weeks out of the hospital. It’s August and I’ve been hurting since April. And as if the spinal nerve pain and residual CSF imbalance aren’t enough, I’ve still got to worry about the return of the staph infection. Everything I try in order to feel better—physical therapy, cryo-therapy, acupuncture, ultraviolet, infrared sauna, Epsom salts, homeopathies, Ayurveda––makes me feel worse. There is a pattern to these failures, an initial suspicion of improvement soon followed by setback. I don’t expect total relief. I just want some sign, some vector to follow, out of this maze of pain and towards progress.
I tell this to my housemates in our kitchen one evening, not without tears. Once tears meant failure to me. The failure to hold them back, if nothing else. Now tears are simply part of my vocabulary, the only honest response. Not crying would just be a lie. Perhaps it always was. Why are we men raised as liars?
My housemates—Bernie, Chuck, Jim and Ilana—don’t know what to say. Their own rationalizations of my condition have been exhausted. We’re not going to be able to figure this one out. So they simply touch me. In front, in back, from the sides. I’m surrounded by their touch. They touch me where the swelling is, but also on my shoulders, my arms, my stomach, my legs. In my weakness, I have no strength of separateness left. My skin forgets the difference between itself and their hands. The barriers between inner and outer fail, leaving me defenseless against their caring. Their touch rushes in, their warmth conquers.
The next morning, the skin around the swelling is not drawn quite so tightly; within a couple days, the avocado becomes a plum.
I see Dr. Flight to review an MRI. These consultations, which have so much riding on them, seem to stream past at the speed of TV commercials, leaving only an impression of information, and little depth of certainty. I show Flight the wound, not expecting him to remember how it looked last week.
But he sees it right away. “Wow, it’s gotten smaller,” he says.
For a moment, his surprise unmasks him; he’s authentic, emotionally liable.
But then he starts studying the MRI. It shows two large reservoirs of fluid, one within the normal outline of my back, one protruding out. He analyzes the images for a surgical solution to the two-reservoir problem. He says, “We can figure this out.” Figure it out?
He speaks about sawing off bone, of reconfiguring fleshly pathways, stitching the spinal dura like so much sailcloth for a journey. He goes on for quite a while, interested in his own innovation, as if developing some kind of custom plumbing solution. But I already know I will undergo none of it. I’ve seen my sign. I’ve got my vector.