the beginning of rehab

When I got out of the hospital, I could barely walk 20 feet. I began rehabbing by hobbling around with a cane in the gym the day after I got out of the hospital. (Caveat, this is NOT an exercise I recommend. There are better.)

Christmas in the call room

Not a pager was stirring. Nor even a phone. 

you can never break the chains

I pronounced the patient's death and eventually made my way to the hospital chapel followed by the ghosts and demons of my past. Some stories are too private, too difficult, too complex to put into words. Perhaps they are best illustrated by the mosaic randomness of a backlighted piece of stain glass in an empty, dark chapel.

pain scale

It is my day "off" and I'm back in the ER. The abscess has started trying to grow back. I'm lying in the uncomfortable bed and notice the Visual Analog Pain Scale on the wall. I hate this thing. It's utterly useless both as a physician and as a patient. I much prefer this scale. 

REAL PAIN SCALE. 

and the bottom is reached

Its 3 am and I'm in the hospital. The slow, rhythmic whir and click of the pump is somewhat of a comfort to me. It takes me back to when I was stronger. When I was there with my brother and dad. It's not nearly as impressive as my dad's or brother's IV pole which had two rows of pumps and countless bags. But when the doc pulled out Zosyn, I knew I was much, much sicker than I realized. I only saw Zosyn being used in the ICU and at MD Anderson. 

being weak

     I sit in my family doc's exam room. Well, sort of sit. I'm avoiding my left side altogether. It's less than 36 hours after my I&D and I'm feeling weak, tired, ineffectual. In retrospect, I had no idea HOW poorly. My doc enters into the room and the smile fades from his face. His change in demeanor should have clued me in. He exams me and I know what needs to happen. I just need to hear him confirm it. I need some reassurance that I'm not just being a wimp. Throughout everything with my brother, my dad, my son....I could always remain objective. I could split my psyche and remain clinically cold and objective. I was Atlas. But not with myself. I am afraid of being weak. Of being a failure. Of not being strong enough to get to work. I lose all objectivity. It's one thing to need time off for a dying relative. But it's a failure of self to need it for one's own self. I emotionally need him to validate what in my head I already know.
     "I need vanc, cefepime and flagyl, don't I?"
     "Yeah. Yeah, you do. You need to go to the ER."
     "I was just there. Can't I sleep in my own bed and go in the morning."
     His look says it all. "No. Now."

getting worse yet

....I crawled into a wheelchair writhing in pain, able to sit only on the right side as my left burned with flames.  Being in scrubs and a Smith Hospital coat got me admittance into their ER pretty quickly.  Doctors take care of their own just like any other profession.  The senior resident came in, examined it thoroughly throughout my screams and asked me what I wanted to do.  I could have it drained by the surgery team in the OR, or they could drain it at bedside.  Stupidly, I said, "I don't want a full work up.  Just lance the thing and get me back on my feet."  After all, I&D (incision and drainage) was the curative and definitive treatment for abscesses.  Besides, I had to get back to work the next day.  Well, the same day since it was already 1 am.
     The attending strolled in a bit later, took a very brief look, saw me jump off the bed and said, "I'll take the resident's and your word at it.  We'll get you set up here briefly."
     I desperately needed something for pain.  The doc again asked, "what do you want?"  The nurse quickly gave it to me and it barely took the edge off.  I asked for another dose when it came time to start sticking the lidocaine in my ass.  I knew the lidocaine was going to hurt.  I asked the doc if it was ok if I cussed a blue streak.  He replied, "of course, it's the ER."  What I did NOT expect was the incision of the scalpel to hurt so I let the expletives fly freely from my mouth...

IMAGINE NASTY, DISGUSTING PICTURES HERE (because I do have them but I won't post them for y'all's sake)

...as the pus and blood gushed out in substantial amounts.  I'm screaming and trying to breathe through the pain while the ER doc apologizes.  I think I may have yelled back at this point, "don't apologize, just open the damned thing up!"  So he does.  He appropriately warns me first and in go the hemostats to start blunt dissecting open any remaining deep pockets of pus.  Imagine sticking closed blunt scissors into an already gaping wound and then jabbing them around while opening and closing them.  The opening action bluntly dissects open any walled off areas.  It's necessary to open everything or the I&D won't work.  And he opens everything.  By this time I'm hoping to just pass out from the pain.  No such luck.  And I thought the scalpel pain was bad.  It feels like there are several poison tipped knives sticking out of my butt.  He finally finishes and I weakly ask for some more pain medication as well as an anti-nausea med.  Now I remember why surgery always did these in the OR under general anesthesia.  They let it passively drain for a bit and make sure I'm ok before cleaning me up and sending me on my way.  I foolishly forget to ask for more anti-nausea med when I get yet another dose of pain med for when the lidocaine wears off.  My wife drives me home and I remember little, being in a stupor by this point.  The next thing I know, I'm stumbling out of the car and bent over in my yard at 3 or 4 in the morning throwing up a lung.