Tuesday, August 18, 2015

Appendicitis and the Narrowed Clarity of Purpose

This past Thursday, at the stroke of midnight on our sixteenth wedding anniversary, I awoke from surgery, cleared the anesthetic cobwebs, and was overcome by one singular sweet sensation that flooded my mind as both a thought and a feeling: the pain was gone. That awareness, the exquisiteness of that recognition of relief, brought a sudden halting laugh and a few tears along with it, thus announcing to the battle-hardened PACU nurse that I was indeed alive and well, and rather loopy.

It wasn't just the drugs--though I had some good ones on board by then that I'm sure obliterated any residual pain and augmented my loopiness. But between closing my eyes in the OR and opening them an instant (actually forty-five minutes) later, the poison had been removed. My festering appendix that had reduced me to a moaning quivering shell of a man was gone, surgerized by the expert Dr. Quan and her staff. With the appendix gone, so was my pain.

And my next thought was even more sweet: where's Elizabeth? She had suffered with me, staying by my bedside on a most unromantic evening for a good seven hours while I waited for surgery, a bright angel on a dark night. I just wanted to hold her hand again. Happy anniversary, sweetheart.

I don't mean to present my appendicitis as some sort of true catastrophe. No, in the big scheme, this is small potatoes. (Actually, about the size of a green bean, a vestigial hollow piece of colon attached like a stalk at the base of the cecum.) It's a common condition and a safe surgical procedure, done laparoscopically so all I'm left with are three pencil-width wounds on my belly. Five days later and I'm feeling almost back to normal. I'll be back at work tomorrow.

But in the context of my normal life, the timing and setting could hardly have been worse or more dramatic. The pain was as severe and unrelenting as anything I've ever experienced, so I'm going to call it a mini-catastrophe. And within this mini-catastrophe, something surprising but altogether welcome occurred: a swirling vortex of impending and seemingly weighty life decisions and their accompanying angst just drifted away.

Without going into details, I've had a stressful few weeks concerning the future of my clinic and my career. This is my prime excuse for not writing recently, for not expounding upon this quixotic spiritual quest I embarked on nearly twelve months ago. (I know, you've been biting your fingernails waiting for the next installment.) But I've had no available bandwidth to engage deeper existential questions. On the spiritual spiral, I've of late regressed into contemplating more mundane problems, namely, how am I going to steer my career, chase my dreams, and still put food on the table. (Or last Thursday night, how am I going to get some dang pain relief?) I haven't been sleeping well, feeling on edge, flailing in the uncertainty of it all, which perhaps suppressed my immune system and allowed the appendicitis to develop . . . ? Nah, I've had way more stressful times in which the appendix held up just fine. I think in the end this was a random lightning strike, no matter what meaning I might attribute to it. But the fact is that this event did occur, most strangely, at a time of heightened anxieties, and what feels like a crossroads.

But suddenly none of that mattered. Well, not suddenly. I had woken up Thursday morning after a nearly sleepless night due to a) worry and b) what I thought was indigestion. Dull ache right around my belly button. Greasy hamburger the night before. No big deal. I was consumed with thoughts about my clinic and staff. But as the morning progressed, so did the belly pain. Maybe just constipation? I thought it would fade. I was still hoping to pull off the romantic anniversary trip that I had planned for Elizabeth, which unceremoniously ended thirty minutes after checking into the hotel, when I found myself laying on the floor next to the toilet, moaning, dizzy, feverish, nauseous, strong indications that a) this was more than just constipation, and b) our impending couple's massage was not going to happen. I pushed on my right lower abdomen. Yowzers! So that's McBurneys! At this point, any halfwit second year medical student could have made the diagnosis. My wife explained the situation to the hotel manager, who graciously offered us a raincheck, and we headed to the ER, a torturous twenty minute stop-and-go ride hitting every possible bump through rush hour traffic on the way to Swedish Hospital.

By the time we got there, my pain had crescendoed. I staggered into the waiting room, barely able to compose a complete sentence to the completely unimpressed triage lady. "Why are you here?" Uh-uh-abdominal pain. "On a scale of one to ten, how would you rate your pain, ten being the worst pain imaginable?" (At this point, a Brian Regan skit came to mind.) Eight. No, no . . . nine.

Before long, I was in a room with the IV running, pain meds on board, but still writhing in pain. My incredible primary doctor and friend, Dr. Groce, came personally to the hospital to deliver the news. White blood cells, 16.8. CT scan positive showed a fecolith, fat stranding, and dilated appendix. I met the nice surgeon, Dr. Quan who would soon ride to the rescue, but . . . it was going to be another six hours before an OR suite became available. I would be moved to a room upstairs and brought back down to pre-op in about five hours.

This was most disappointing news ever. In spite of powerful meds, my pain had actually gotten worse, and now seemed inescapable. They gave me another and then another dose of potent narcotics. I became somewhat sedated, but still with the awareness of this bone-deep ache in my belly that hurt with the slightest movement. There was a poison wreaking havoc inside of me that nothing could mask. In all seriousness, in that extremis, death did not seem an unpleasant alternative. I gripped Elizabeth's hand, and began counting down the hours. Absolutely nothing else mattered to me. The operating system of my brain had frozen on the word PAIN. I had regressed all the way down the spiral, my brain a ball of red hot neurons. I was white-knuckling it and just hoping to outlast the pain until relief came.

And then . . . I was whisked to the OR, closing my eyes and quite literally before I knew it (so weird how anesthesia renders the passage of time instantaneous) I was awakening to that most glorious, definitive relief of pain. Hallelujah. Cue the laughter and tears.

We have friends, Megan and Rick, whose home burnt down this week. (Here is a website where you can help their recovery.) I was speaking this weekend with Megan's mother, who relayed to me that two nights after the fire (coincidentally on the same night as my appendectomy), Megan and her kids celebrated Rick's birthday in a hotel room, newly aware that everything--photos, clothes, appliances--in the home had been destroyed and that their family would be displaced for at least six months. And yet as they ate birthday cake while sitting on the floor, they looked at each other and began to cry, but tears of relief. They had lost everything, and yet they had everything--each other, their kids, their dog, their health, their lives. Everything of value. Everything they needed. Their community had reached out to them in love and relief. They would survive this Catastrophe (this one with a capital C.)

As she shared this story, it resonated acutely with me. I've just experienced a similar unexpected life simplification, induced by a mini-catastrophe. I'll call this disruptive epiphany the Narrowed Clarity of Purpose.

All this other stuff that has seemed so weighty? The job negotiations? The search for meaning and purpose? So first-world. I'm honestly grateful for this experience, for the brief respite it has provided in my ongoing mental and spiritual exertions, for placing in sharp relief what matters most. I've got a wife and children I love. I'm going to have a job. Food will be put on the table. (No greasy burgers for a while, just to be safe.) Life is good, and in a way that has much more meaning than a week ago, I'm pain-free. What a relief. I'm also appendix-free. One less thing to worry about.

Though there's always the gall bladder . . .

1 comment:

  1. Mark, I am so thankful you are healing from your surgery. My prayers continue for you and your family. Stay well! Love, Kimball