Two weeks ago this past Sunday, I was seated on mine, and ready to get up. I stood, hit the button in the center of the tank, bent down to get my pants, and...almost passed out from lack of breath. I was hyperventilating like I'd just run for my life and my heart was pounding. It had come out of nowhere, but there I was, huffing and puffing. It passed soon enough, but I'll admit it scared me a little.
But only a little: my family has zero history of heart disease, and every time I've had a checkup that particular area has passed the test: a little enlarged due to hypertension, but otherwise strong. The aged alcoholic doctor I went to when I first moved here always told me I could have "one, two, manny women" and offered to write me a prescription for little blue pills. (I told him to write the prescription for the women first and we'd see if I needed the pills. He didn't get it.)
Anyway, in the ensuing week, this came and went. It was always a bit of a chore climbing the stairs to this third-floor (second, as Europeans measure it) apartment, but there were times when I'd have to stop and catch my breath while walking to the store. Still, I made it to the market and back on Tuesday without incident, and I did it again on Saturday, adding on a short walking tour of the town for some friends from Texas who stopped in. Once, though, I had to stop and regroup during the tour. Mid-week, I'd gone to E and J's for a simple dinner of lentils and sausage so that E (who's Swiss-German) and I could complain that the French just Don't Get sausage (J's a vegetarian, and so had no opinion). Sunday, though, was really bad. Just sitting up in bed meant a pause for breath, and I took it real, real slow. Tomorrow, I told myself, I'll call the doctor and make an appointment. I was almost out of blood pressure pills anyway, so it made sense.
Monday was pretty bad, too, so when I called I asked for a same-day appointment and the doctor told me she could see me at 5:15. So in I went, via the cash machine so I could pay her. A ten-minute trip took a half-hour as I poked up the hill, pausing every now and again to catch my breath. I still got to the appointment on time, and she was only 15 minutes late seeing me. The blood pressure was okay, she listened to my heart, and then started asking questions. "You must go to La Peyronie to the Urgences," she said. I had no idea where this was, nor did she have a clue how to get there on the tram, but we finally figured out that it had its own tram stop on Line 1, the one that stops by my house (although it took a phone call: I'm amazed at how many people here drive places). "Do I have time to stop at my apartment and..." "NOW!" she said.
So I shuffled down the hill and discovered there wasn't a bill-changer on the ticket machine. I walked over to the bakery on my corner and asked the gal at the counter if she could change a five. "Into what?" she asked. I told her I'd settle for two twos and a one. Ticket bought, I got on the tram at full rush hour and headed off to La Peyronie.
Whose emergency entrance was not visible from the tram-stop, I discovered. I painfully crept towards the main entrance, stood in line with a bunch of other people, and was re-directed to the right place by a fast-speaking woman. Fortunately, an African aide outside repeated the directions more slowly, and I shuffled on. I talked to someone at admissions, and was whisked onto a gurney. Not long afterwards, I wsa wheeled into a room where I was checked with a stethoscope for any immediate danger and then left lying there. It was 6:30.
Soon, a couple of young guys appeared, their whites bearing a sewn-on badge that said "Étudiant." It was quickly determined that I spoke French if I were spoken to slowly enough for me to understand what was being said, and some questions ensued: I told them my symptoms, answered family questions (no history of heart problems, no diabetes), and, mostly, waited. One of the students was an olive-skinned guy with tightly-curled hair who spoke excellent English. "Yeah, I'm getting good at it because when I graduate and get my MD, I'm gonna go to the States and get rich because there aren't any taxes." Lying there in the heart of socialized medicine, quite certain I'd be well taken care of, I bit my tongue. I wanted to tell him this was like moving to France because the women were prettier, a real "yeah, but.." moment, but said nothing. (My sister, who's a medical professional, laughed when I told her this: "He probably doesn't now that he's going to have to go through his residency all over again if he does this!" He also proudly told me he was a Libertarian and I told him that was okay; he'd grow out of it). He produced a huge Samsung smart-phone from his pocket. "You want to contact anyone?" Ah! E and J could get the word out. I gave him their name -- couldn't remember the e-mails -- and he searched. "Not in the white pages," he said. Hmmm. "What about Facebook? You have an account?" Another excellent idea. But...couldn't remember my password. It began to dawn on me how dependent I was on my computer being able to remember all this stuff. "Okay, I gotta go." And he did, to be replaced by an actual doctor (they wear red plastic badges) who seemed angry.
Actually, he seemed German, with red-blonde hair and a flushed complexion and very brusque manners. He set up at a computer in the room and asked some more questions as a couple of other students appeared to observe. I believe some blood was taken. He jumped up and left the room. Eventually he came back. He asked some more questions, which I answered as well as I could. One was whether I'd taken a long airplane flight recently, and I remembered my trip to San Francisco at the end of October, and being wedged into a window seat, unable to escape due to a couple of immobilized gigantic Russians who blocked my way to the aisle for nine hours. Finally, he asked me my weight. I didn't know. Really, I didn't: I don't have a scale at home, and I've always figured that as long as I didn't resemble a zeppelin or my weight wasn't causing me health problems, and as long as I was eating moderate portions of good food, I was okay. I'd slimmed down a lot since I'd moved here, and I figured that was good. "You don't know your weight?" he asked, incredulous. Well, no, I... He jumped out of the chair and left the room, saying something on his way out.
One of the medical students knew I hadn't heard or understood it. "Starting now," he said, in English, "you have lost the right to stand." I started to scoot up on my elbows and he put his fingers on my chest, firmly pushing me down. "Non," he said.
* * *
The rest of the night was a blur of medical technology: a set of x-rays, a scan in a futuristic-looking machine with an attendant who was full of jokes and jovial about his horrible English, which he insisted on speaking, blood being drawn and whisked off to labs, and a glucose drip being attached to my left arm. Finally, I was wheeled onto an elevator and taken to a room. It was 3:15. "I bet you're happy to finally be able to get some sleep," the nurse said as I rolled from the gurney into the bed, my arm still attached to the drip. I was, but it eluded me for a while. Finally, it came.
The next morning, I was raised slightly into a sitting position, and breakfast was served, along with a heapin' helpin' of pills. I was given a cup of coffee, a couple of biscottes (rusks), a pad of something that looked like butter but couldn't have been, and a little serving of a jam-like substance. Looking at the pills, I asked if there were some juice to help me wash them down. The servers were surprised, but went to check the cart. "We only have apple juice, is that okay?" Sure, I said, not really liking apple juice that much, but realizing that I hadn't actually had anything to eat in several days: I'd cooked dinner on Sunday, but it smelled and tasted awful (another reason I felt impelled to call the doctor), and, for the first time in a long time, I threw it all out, thinking of my diminishing cash reserve. There'd been a bowl of cereal on Monday morning, but that was it. I was ravenous, but would have to do with biscottes. And the apple juice was great. It was also the last I'd see.
Not much happened. I was alone in the room, which was nice. Since I couldn't get up, I had to pee into a pistolet, which looked like a turtle with a trumpet for a head. I dozed. There was lunch: a boudin noir, which was something I'd never had before, and couldn't really figure out because it was, shall we say, not of the highest quality. Alongside was some cauliflower in bechamel sauce -- utterly tasteless -- and mashed potatoes.
But I didn't get to finish it. At one point, a trio of women swept into the room with a computer station. One was wearing the red doctor's badge, tall, elegant, exuding a centeredness and a calm that was palpable. One of the most beautiful women I've ever seen, although way above my pay-grade. She was followed by two younger women, a round redhead and a thin, bird-like woman who'd examined me earlier, all business and just a bit tense. The tall doctor sat on a table bolted to the wall across from the foot of my bed, and, like in a Renaissance painting -- the lighting was right for this, too -- the redhead arranged herself facing the doctor on one side, the bird-woman on the other. "Aha," I said. "The Judgement." They laughed. "Right," said the doctor. "Tell me about the patient." Bird-woman rattled off the presenting symptoms, the treatment, and at one point said "The patient, Mr. Ward EDMUND," (that's how names are presented in France) "is an agreeable American writer and radio journalist" (I swear I'd never mentioned this to anyone, and wondered if she'd Googled me) "and speaks reasonably good French." The doctor thanked her and it was the redhead's turn. "The patient, according to his x-rays and scans, has a pulmonary embolism, which is being treated with medication." She then turned to me and asked me if I knew what this was. I told her I thought so, but she brought a piece of paper over to the bed and started drawing.
(You'll have to click this, and even then it might not make sense). "You have your heart, the right side and the left side. Your embolisms are blood clots which are sitting in your lungs, making the transfer of blood and oxygen difficult. We are dissolving them with medications."
I thanked her and she resumed her position next to the doctor, who was the next to speak. "In order to observe your progress, we're going to want to keep you here for about a week." "A week? But..." "I'm sorry, but it's necessary." Crap. And me without any way to contact anyone. "Is there someone here we can contact for you?" Again, I brought out E and J, and again, she searched the Internet for them and came up dry. This was bad. I had come directly from the doctor's office and now realized that not only had I not packed a little bag with necessaries in it, but my glasses were on my computer keyboard and even if I'd had something to read, I couldn't have done so. And a week like this? What was I going to do? "We'll be moving you this afternoon to another building," she went on. "I'm sorry we couldn't find your friends." And with that, she stood, and the three of them departed.
Sure enough, later that day I got a visit from two guys who wheeled me into an elevator and outside into an ambulance, my first. "We're taking you to St. Eloi," they said, and right away I felt better.
* * *
I first encountered St. Eloi at the Petit Palais in Avignon, back when my friend Suzy was researching her book about girls and horses. Like all of her friends, I was constantly on the lookout for horse-related stuff to pass on to her, so as I wandered around this small museum attached to the much more famous World Heritage Site-cum-concert venue, I was arrested by a small painting of a guy holding a horse's leg in his hand, with the horse standing in the background stoically bleeding and waiting for it to be reattached. When I got back home, I searched for a copy of the painting to send her, but without luck. (You can at least read about this miracle on his Wikipedia page, but without the bleeding horse with its bland expression, you're missing a lot). So when we stopped at St. Eloi hospital, I figured a place named for a guy who could chop off a horse's leg and then reattach it probably knew a thing or two about fixing bodies. (I didn't, however, realize he was the patron saint of goldsmiths and metalworkers).
Once again, I found myself alone in a double room.
My glucose drip was replaced by a machine that held a huge hypodermic that was verrrrry slooooowly injecting me with anti-coagulant. It weighed a lot, given its size, and it had to go everywhere with me. It was a pain in the ass and a pain in the arm. Wednesday afternoon, I got a roommate, or "neighbor (voisin)," as the French put it, a big guy about my age with a salt-and-pepper moustache whose nocturnal noises reminded me that this was the pulmonary ward. The next day, they took him off for a while and he came back and started packing. "They took it all out of me. It was disgusting! Agggh! But it's good now," was what he had to say about it.
I fell into bad sleep habits. With nothing whatever to do, I think I discovered the basic principles of meditation, a state that wasn't sleep but where I wasn't really "there," either. It had its points, I have to say. Awakened from one of these states by a nurse or somebody entering the room, I realized I'd formed a systematic plan for what to do in case anyone did contact me somehow. I grabbed the piece of paper on which the redhead had sketched my heart and lungs and began to write. Another time, I found myself having made some connections in a thing I'd started just before heading off to the doctor's office on Monday. And I rehearsed some of the stuff I'd write here. But mostly, it'd be dozing and staring at the wall.
|The patient is bored.|
I was getting out, too. Seeing how bored I was, one of the porters, the guys who help clean the rooms and hump beds and so on, said "Why are you just sitting there? You should get up and walk around." "I'm allowed to do that?" I asked. "Sure! It's good for you!" Well, hell, let's go! I had to put on my shoes over my compression bandages, but I strode around in a circle, doing the circuit of the not-all-that-big ward a couple of dozen times. (I'd been disconnected from the slow-injector several days earlier, although the faucet-like thing it had been attached to was still with me). Most of the residents I saw were quite elderly, and one shocking thing I saw was an old woman sitting up in bed, a table in front of her on which rested a bottle of some kind of liquor and a bottle of mineral water and two glasses, from which she sipped alternately, her eyes fixed straight ahead, probably on the television.
I probably shouldn't have been shocked. Shortly after the guy who'd had the disgusting stuff removed moved out, M. Lopez moved in. A short, balding guy in his early 50s with a doughy body, he was in for the second or third time. From what I heard of his intake interview, he'd had problems that had resulted in the loss of a significant amount of vision in one eye and was on all kinds of medication. He spoke a little English which he was happy to try out on me, and let me know that his sister was headed to Chicago, or Madison, because her son was graduating from high school there. He was bored, too, and really wound up. Every hour or so, he'd put on some clothing under and over his gown and slip out for a cigarette. His panic when he couldn't remember where he'd packed them was impressive. Now, if I'd had a blood-vessel go out of business, partially blinding me, I think the cigarettes would be the first thing to go. And if I'd just be re-hospitalized for phlebitis, that also would have been a signal.
Lopez' nighttime noises made the other guy's fade into insignificance. On his first night, he let out a long, high note that made me wonder if we'd hear any more of the Haydn trumpet concerto, but the action moved to his nose and throat, which also made impressive noises. He also sometimes called out, and although it was hard to understand most of it, there were cries of "ne touche pas!" and "arrête!" ("Don't touch! Stop!") in there. When the nurses came in the morning to take temperatures, the first few days he'd wake up confused and frightened and it would take him a minute to figure out where he was.
Things took a turn for the worse for me on Friday, when his sister showed up and paid for a television subscription for him. But not, I should add, headphones. Soon it would be the weekend, and football.
But then, on the flip-side, at one point someone came in and told me that I'd be going home on Monday. Then someone else told me that I'd have tests on Monday and go home on Tuesday. Seeing as how there wasn't much stimulation, just going anywhere was fun, and one day I was taken to a dark corner of the ground floor (I was one up), where a skinny, harried young woman had a machine with a screen and a bunch of controls, and wielded what looked like a Lady Schick razor, on which she kept spreading goo. This was electrolytic jelly, and she prodded my legs up and down. The right one passed, but she found a small clot in the left one. "It's just a little one," she said. "Ah, so no big thing," I replied. "No, it's only the size of the one you just had in your lungs," she shot back. "We'll get it with the drugs, don't worry."
On Saturday, a miracle occurred. There was a knock on the door in the early evening -- I'd just finished dinner -- and there stood J. They'd gotten worried, called the central hospital number, and I'd been found in seconds. E, however, had been willing to do the research, but was creeped out by hospitals, so he stayed at home. I dove for the list of stuff to do, and J took notes. At last, tomorrow I'd have glasses and my iPad, so I'd have reading material! And so it came to pass on Sunday morning. I was overjoyed, both by the human contact (E had come for the second visit and was surprised at how nice the place was) and by the fact that long after they left, I had the New Yorker, and Wired, and William Shirer's Berlin Diaries, which I'd been in the middle of, not to mention a few versions of Angry Birds and the never-ending cribbage game. And on Sunday, Marie de Montpellier paid a visit with her cell-phone, which has unlimited calling to anywhere, and we called a guy on the Well whose number she had and I gave him the news.
The iPad and the word getting out helped a lot, because definitive word came down: I was being tested on Tuesday and, if everything was okay, released on Wednesday. My news was better than Lopez'; he was being transferred to a cardiac ward soon, which terrified him. He made some phone calls. He cried a little. He kept smoking. His sister returned, and saw a copy of the New York Review of Books on the table. "Ah," she said, "you read English!" Lopez gave her a wry look and said "He's American, you know." There was an awful lot of football on Sunday (seven hours non-stop), some on Monday, and more on Tuesday (two matches). When it was over, Lopez couldn't bear to turn off the television. I learned to roll over and try to sleep, but along the way, I got to admire the striking skills of Zlatan Ibrahimovic, who plays for Paris St. Germain, and has some arcane ability to teleport into just the right location to receive the ball and kick it into the net. I'm no sports fan, but the cat's uncanny.
* * *
Which sort of leads to the last part of this long post. The teamwork displayed by everyone at St. Eloi was awesome. On one end of the scale was the elite doctors 'n' ducklings parade, a doctor followed by a string of medical students. All very polite, all very reserved. The trio I observed before I moved was exceptional by their camaraderie; for the most part, there's a strict hierarchy. But on the other end are the day-to-day folks. Medical students are one thing; nursing students quite another. We had some excellent ones, the best of whom was Super Marie, a skinny dyamo of about 30 who entered a room with the force of a controlled nuclear explosion. With Super Marie, stuff got done. Got a question? You'll get an answer. Need something? You'll get it or find out why you can't have it. Somebody forgot something? They'll be running into the room very shortly, embarrassed. I've been stuck with more needles in the past week than in the past 20 years combined, and anyone who was under Super Marie's supervision did it with the minimum pain and as quickly as possible. There were also the crews who served the food, changed the beds, cleaned the bathrooms, and so on. Here, the star was Island Girl, whom I'm pretty sure was North African, but with her brown skin, long black hair, and rounded figure, reminded me of one of Paul Gaugin's Polynesian maidens. She also spoke pretty good English, which sort of embarrassed her because none of her peers came close. (There was an African gal who I named Miss Miami because when she found out I'd lived in Texas, she said "Yeah! Texas! Dallas! Miami!")
Oh, and the food. It ranged from wretched to edible, most often leaning toward the former. It didn't help that utensils seemed to be distributed sort of randomly, although only Lopez managed to be served a meal -- three times -- without any at all, which caused him to surge out into the hall yelling for the servers. Maybe I can save a thousand words with a picture of my last meal there:
Not all visible, but the printed menu describes what's there. Most often, there was a vegetable soup made from unknown and unstated vegetables. Here there were cucumber slices in watery yogurt. The pork was gristly, the peas and carrots canned but not as bad as you'd think. There was a choucroute garni one day that was pretty good and one day Island Girl came in with dinner and announced "It's a fish with a West Indian sauce. You're going to like it!" and she was right. "Sauce Rougail," says the menu slip, and I'm going to look it up, because my guess is that a non-hospital version could well be worth the time, and I want to eat more fish these days, for some reason. Worst dish, besides steamed potatoes with no seasoning, which also came with that fish dinner, was a puree of some sort, made from unidentifiable vegetables with a decidedly nasty taste. And lots of it. Gack.
* * *
A last round ot tests halfway across the small city that is the University of Montpellier Medical School (the oldest in Europe, and a testament to the amity between the Jewish financiers, the North African Muslim sailors, and the French Christian merchants who ran the spice trade here and provided money, scientists, and property in which to build the institution over 1000 years ago) and I was good to go. I was provided with instructions for outpatient care (which includes shooting myself up in the belly twice a day with anticoagulants, which has proven to me that I'm braver than I thought, although Super Marie's example that it could be done fairly painlessly helped), the news that my next appointment at St. Eloi would be at the end of February to check that all was cool before I attempted to fly to Austin (although I'll probably do this in two phases as it is, because I'll probably need to stop in New York), and after that meal pictured above, I sat and waited three hours for my papers to be ready. Stepping out into the cold air in my thin jacket holding a bag with all my stuff in it, I couldn't wait to get back here to The Slum and see what I'd missed. A lot, as it turned out. And not so much.
* * *
What Happened: Frequent International Fliers Please Read. On my way back from California, unlike when I flew Barcelona-Atlanta and waited a couple of hours before flying to San Francisco, I got a direct flight SFO to Paris, nine hours. At the ticket counter, I was told that as a gift from my frequent flyer program, I'd been "upgraded" to a window seat. I've avoided window seats practically forever, because the curvature of the aircraft means less headroom, and there are usually two people between you and the aisle. As I said above, this time, the two were an immense couple, Russians, flying SFO to St. Petersburg, and they necked a handful of pills before takeoff and passed out. I managed to get to the bathroom once, but that was it, and they spread out as they slept, cramping me into the wall. Somehow, I managed to get to sleep, but woke with a pain in my right leg. Sore muscle, I told myself, and although it took longer than usual for the pain to go away, it did go away.
This was no twisted muscle. I'd developed phlebitis, deep vein thrombosis, a very common malady related to immobility and pressure. The above-mentioned Suzy e-mailed me this morning to say she knew of two other people, personally, to whom this has happened. I've flown internationally for years, not frequently, but pretty often, and never had anything like this happen before. It's not a factor of age, apparently, but of immobility. It's also not heart disease: the chances of this recurring are, well, the chances of it occurring in the first place. But it's nothing to play around with: that clot could have gone to my brain or my heart. It's just that, as I understand it, it usually goes to the lungs first.
* * *
Thanks to all, especially those who designed the French health care system. I haven't gotten my bill yet, but I'm thinking it'll be around €3000 or less. As my sister confirmed on the phone yesterday, I'd be into five figures by now if I were in the States. It's too bad my native land doesn't recognize health care as a basic human right. Here's hoping that changes sooner than later.