Saturday, October 12, 2013

What we talk about when we talk about crippling anxiety (Part 1)

I. The Kidney Stone

The thing that spurred my PTSD was a medical event. One day, during a semester studying abroad in southern India, I woke up in the most excruciating pain of my life (transition during labor was a close second). I felt like there was a knife in my back, and for some reason I was sweating, with chills, and retching like I had the flu. I had never experienced anything like it in my life. And it came on so suddenly, I had no idea what to do. For the next few hours, until I finally made it to the hospital and got a shot of morphine (or, you know, whatever they gave me, like I cared at that point), my brain only functioned in a primordial, reptilian state. All I could think was pain, need drugs, need hospital as I paced around the room in agony. The only reason I got to the hospital was because some very kind friends called a driving service and practically carried me out the door. 

In India, everything takes like three fucking hours, and is unbelievably inefficient. Need to buy some food? Nobody stands in a line. They just crowd and push each other in one big mob until you shove yourself to the front of the line and yell your order. So too, is protocol in an Indian hospital. When I finally showed up and waded past the mob of people just ambling around the door, I had to fight my way to the front desk and fill out a stack of paperwork that asked about my mother's maiden name and what my father did for a living. "Can I just get a shot?" I sobbed, probably sounding like a junkie, but in too much agony to care. "Can I fill this out later?" Alas, no. I had to fill out all the paperwork before being seen. And before I had an ultrasound, an MRI, or any kind of test, I had to pay for it up front, in cash. In between trips to the ATM, I ran outside to throw up. The friends who escorted (dragged) me to the hospital filled out the paperwork for me. 

So I'm running back and forth between the waiting room and outside, throwing up and in unbelievable pain. I would so much rather throw up in the bathroom because the thirty or forty people outside the entrance just wandering around are staring at me whenever I rush outside and vomit. I find a bathroom and duck inside, only to find that it's a squat toilet. I can barely stand I'm in so much pain, but somehow I shakily manage to position myself over this thing in what feels like an excruciating game of Twister. And by the way, the urge to pee is unbearable. I have to pee like I've never had to pee in my life. And the worst part is, I can't. I want to so badly, but I can't. Every time I try to sit down and fill out the "paperwork," I jump up and start pacing. "I have to pee," I keep saying. "I'm going to have an accident. I have to pee." Nothing comes out. But I keep running to the bathroom anyway, because that's what you do when you have to pee. Even when nothing happens, it's instinctual. I just keep running back to the squat toilet and hovering over it and praying that something comes out, praying for just a tiny bit of relief. Nothing. I don't know it at the time, but I have a kidney stone totally blocking my urethra. I squat over the squat toilet and retch while I'm trying to pee. 

The squat toilet. It looked like this. Only not as clean. 
Finally they grab me and take me back to a triage room and give me a little bowl to throw up into instead. They tell me I probably have a kidney stone and that I have to try to pass it on my own. They give me a water bottle. Great, I say, except I keep throwing up everything, and by the way, can you give me some painkillers or put me in a coma or something? Awesome. Finally - FINALLY - a doctor comes over and says they're going to give me pain meds. I look at the clock. It's been over THREE HOURS since I woke up in pain. They have to give me a shot in the "behind." Oh you mean my ass? Awesome, here it is. I yank down my pants in a very un-ladylike way and wag my butt in the air desperately. "Uh ... let me go grab the medicine first," the doctor says, disturbed, and pulls back the triage curtain. Every person in the triage room turns and looks at my lily-white ass. I don't even care. 

About three and a half hours after I woke up in the worst pain of my life, I'm given pain meds, and it's like a big bear hug from Jesus. I still have to pee badly, but the awful, white-hot, stabbing pain is gone so I'm delirious with glee. "I have to pee soooo bad, you guys," I keep saying to my friends, who, like guardian angels, are fielding the questions from the nurses and helping me retch into my bucket. I keep trying to pee in the hospital bed I'm on because the bathroom is way far away and also because it'd be kind of funny. Still nothing is coming out. Every nurse that comes by wants to know if I'm a student. And what I'm studying. I keep making things up because WHO CARES. Can't they see that I'm dying?




When was the last time you peed? The nurse asks me. Well, shit, if you put it that way ... three days ago? I start to panic. How did I not realize this? Who doesn't pee for three days and just figures that's normal? The nurse clucks disapprovingly. It's a kidney stone. We'll have to catheterize you to get the urine out. She goes to get the supplies and another nurse. 

Meanwhile: I call my dad. 

"Dad?" I say, when the call goes through. "I'm in the hospital." 
Click. The connection drops. I try again. 
"Hello?" My dad sounds gruff, concerned. "Sarah?" 
"Dad, I'm in the hospital." 
Click. Cut off again. 
I call my brother and finally get through. I tell him I'm in the hospital and the call drops out, AGAIN. There is no reception at all in the triage room. I can't leave because the nurses need to cath me. I start to feel faint. I'm going to die of uremic poisoning three thousand miles from home and nobody will know. One of my friends takes the phone outside, finds reception, and calls my dad back. She calls my fiance. They're concerned but ultimately can do nothing. I'm thousands of miles away. I don't know it at the time, but my dad starts looking up flights to India. 

The nurses start to cath me. Nothing. They try again. Nothing. They try a third time and still nothing comes out. It's the stupid stone that's blocking everything. They're going to run some tests and admit me until I pass the stone, since I have a fever and they're worried I might have some sort of infection. 

Here's something that's hard to talk about, because I'm afraid it sounds too much like a privileged, first-world problem: The hospital was kind of shitty. There were cracks in the walls. Dirt on the floor. Not completely run-down, but nothing like you'd see in the States. The whole building and everything inside it looked like a relic from the 1930s -- the IV drips were glass, instead of plastic. The paint on everything was chipped. Nobody wore gloves. There were puddles of water (I hope it was water) on the floor. There were no soaps in any of the bathrooms -- and I peed in a lot of different bathrooms. For a long time, I was ashamed to tell this story, because the condition of the hospital was part of what was so traumatizing, and if that isn't a First World problem, I don't know what is. Like, wahhh, I went to a poor person hospital, I'm so traumatized! The thing is, all of these weird things in the hospital combined -- the squat toilets, the no-soap, the no-gloves, the weird puddles on the floor -- made it seem not-quite like a hospital. And cumulatively, it added to me feeling generally terrified and unsafe. I went in for an MRI and the technician was in jeans and a hoodie. Was he a doctor or just some dude off the street? None of the nurses wore gloves -- didn't these people know how bacteria was transmitted? Every nurse that came to see me asked if I had a fever. They never took my temperature -- and to be honest I'm not sure if a thermometer existed in the whole hospital. I never saw one. Do you have a fever? They kept asking me. What's your temperature? "I think so," I kept saying. "Can't you take my temperature?" Nobody did. They just kept asking. How qualified were these people? And not that speaking English is a good standard of care, by any means, but the fact that everyone had broken English made it even more terrifying. I didn't know what was happening, and I couldn't understand them when they tried to explain. I had no way of knowing. I just had to trust that I was in good hands. And I wasn't so sure. It felt like a fever dream. Like a bad joke. 

Anyway. I get an ultrasound (I had to pay for it first, of course). I get an MRI. I get some x-rays. Doctors are still asking me if I have a fever. I've stopped throwing up but I still can't pee. They say if I don't pee on my own, they're going to admit me for surgery. I keep drinking and they keep running tests. They find a kidney stone on the x-ray and tell me to keep drinking water. I want to die I have to pee so bad. A few hours later, I haven't peed, and they admit me. I pay an extra three thousand rupees for an air-conditioned room with an "English" toilet. They schedule surgery for that night. I've never had surgery in my life. For anything. I've never even had a cavity. I have no idea what anesthesia is like. I have no idea what to expect. 

That night they prep me for surgery. A nurse comes in and shaves me with a single blade and a dingy cup of water and I decide that I'm going to get tetanus or hepatitis by the time I'm out of this hospital, if I don't die of uremic poisoning first. Being naked in front of this stranger shames me, and tears leak out of my eyes as I stare up at the ceiling. 

Why you cry? She asks, jostling me. You're okay! Don't cry! You're fine! 
I'm not crying, I say, wiping tears away. She keeps jostling me. 

The nurses come in and take me down the hall. I beg them to put me under because I haven't slept at all and hardly slept the night before. I'm exhausted and amped up on adrenaline. I've never been in surgery and I don't want to be awake when they're prodding me and cutting me open. Please just knock me out, I beg the nurse. He advises me not to use the phrase knock me out when I ask the anesthetician, but they agree to do it. 

We are going to catheterize you and then insert the scope, the doctor says, and puts the gas mask over my face.
Gotta ... buy me ... dinner ... first ... I whisper, and fall asleep. 

6 comments:

  1. Oh my God, Sarah!


    I'm just going to keep hitting refresh, so if you'd be so kind as to neglect your children and keep writing, I'd appreciate it.

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  2. Oh my... yeah... Wow... I just can't even imagine Sarah. And before you even mentioned the condition of the hospital I was freaking out on your behalf over imagining what the condition of the hospital would be like.

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  3. Yeah I would be suffering some severe PTSD after that. It sounds like one of those Lifetime movies.

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  4. Oh my goodness. You poor thing! I had a kidney stone in my safe First World Hospital and it was a nightmare of pain and bad memories. All my empathy for going through that much unexpected pain in the middle of India!

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  5. Shit. I'd never get over it. How you get through childbirth is the grace of God and the presence of a husband you love. Gads.

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