I AM A SICK MAN…. I am a spiteful man. I am an unattractive man. I believe my liver is diseased. – Fyodor Dostoevsky, Notes from Underground
Story the short: on Thursday, February 12, I underwent an extended right lobectomy at the Cleveland Clinic. This is a radical kind of hepectomy in which the whole right lobe of the liver and part of the left are removed along with the gallbladder. The surgery went well, all visible cancer was removed, and I am now home recovering. Soon I’ll be meeting with doctors for post-op appointments, getting new CT scans, removing the staples from my stomach, and preparing for 4 more months of chemotherapy. During this last difficult week my family and friends saved my life a hundred times and I thank everyone for so many sacrifices and warm wishes.
Story the long: I was under general anesthesia so was only able to get one image from a medical resident. It was taken just before surgery, when my muscle tone was a bit better. You can see that the doctors have attached two IV lines to my wrists and that I’m just losing sight of the heavens:
After the operation I came in and out of morphine-colored consciousness in the PACU (post-anesthetic care unit) for about 24 hours before being transferred (on Friday the 13th) to G101, a ward with many liver surgery patients, including transplants.
When I awoke I found the following attachments – full-size, alas, not Lilliputian – to my body: a foley catheter, a jp drain, an NG tube, 3 IV lines, and oxygen tubes to each nostril. There were also 6 telemetry hookups (rubberized squares) on my chest, each attached to a different wire, all of which were coiled up and attached once more to a heavy metal transmitter dangling down my front. It, in turn, broadcast my heart’s movements wirelessly to a monitor. Of course many of these attachments were also attached to an IV tree carrying a welter of bags and canisters.
I was not a big truck. I was a series of tubes.
For the next 3 days I couldn’t eat or drink anything (literally: everything was immediately expelled again via the NG tube), couldn’t sleep, couldn’t breathe out my nose, couldn’t take anything but the shallowest breaths due to pain, couldn’t talk more than a word or two at a time without choking (from NG tube & drymouth) or move without feeling the painful itching from my Erbitux rash. I had severe abdominal pains, stomach pains, and a crushing sinus headache (the NG tube goes straight through the sinuses). As Emily Dickinson put it:
There is a Languor of the Life
More imminent than Pain –
‘Tis Pain’s Successor — When the Soul
Has suffered all it can –
A Drowsiness — diffuses –
A Dimness like a Fog
Envelops Consciousness –
As Mists — obliterate a Crag.
21st-century surgeons now call this pain-beyond-pain condition the Cheney point. They knew I had reached it when I began telling everyone in a white coat who “the other terrorists” were (the patients in rooms 19 and 26, as well as nurses Jennifer, Dina, and the other Jennifer, unless it was the same Jennifer all along) and where “all the weapons” were (mostly in the fur of my Scottish terrier, but she is very sneaky and might also have hidden some near the piano bench.)
For three days I found myself looking up deliriously at white coats from my hospital bed. Edgar Allan Poe understated but nonetheless captured something of my experience when he wrote about it in the “Case of M. Valdemar”:
“I presume that no member of the party then present had been unaccustomed to death-bed horrors but so hideous beyond conception was the appearance of Jed Deppman at this moment, that there was a general shrinking back from the region of the bed… Upon the bed, before that whole company, there lay a nearly liquid mass of loathsome—of detestable putridity.”
Then suddenly the NG tube came out in a rainbow of blood and bile.
Then I began to begin to begin to breathe.
Then I drank some juice and did not vomit, clutched a sheet and slept upon it.
Then Hsiu-Chuang waved her hand and the roiling, mutinous tubes began to part and recede. She strode through them like an angel untouched, took me by the hand, and with my parents and children we emerged once again to see the stars.