Sunday, September 5, 2010

Ivonne Fills In the Gaps

Ivonne, who was with me every day in ICU, kept a detailed diary of everything she saw and most of what she heard. She wrote many pages of quotation and observation, along with taking a few photographs.

Isn't it wonderful when you love your wife?

It doesn't seem possible that I could have missed so much, including the unhappy fact that, all-in-all, I spent eighteen days on three separate occasions in ICU, not eight as I had written below. I came close to death more than a few times. The doctors were hamstrung: if they treated one problem, another might intensify and kill me. I was held in precarious balance while lost in a paranoid fantasy of spies and lies.

To take my mind off that, I'll tell you a story. Twelve years ago last July I was diagnosed with multiple myeloma, an incurable, universally-fatal cancer. The average survivability was five years with an immediate autologous bone-marrow transplant, less without. Sometimes the cancer works much more quickly, sometimes it takes longer, but incurable is incurable. This a fact difficult to absorb and move beyond.

My general practitioner at the time, who is by profession a fine nephrologist, was Doctor Robert R. (back then there were few GPs, so I had to find a specialist willing to double as one).  He told me I would have to find a new doctor, a hematologist or oncologist, to treat the myeloma because myeloma was too far from his specialty to treat me himself. A few minutes later, after a fateful decision or two (I'm not sure my writing is adequate, yet, to describe my oncologist), I told him that he wasn't off the hook: "Although the disease is a blood cancer, what kills us most of the time is not the cancer but kidney failure — you're my kidney man — you'll be there in the end!

He moved his practice to the northern, pretentious wilds of the county (Encinitas), alas, so I had to find another nearby specialist willing to be subverted to the general good cause. I've seen Dr. Robert now and then but mostly because I like him: I never had a kidney problem or other serious disease (other than the cancer, that is).

Last night Ivonne told me he was my nephrologist in the ICU! I had no idea. I gather there was quite an heated debate over the issue of dialysis. Insofar as I can tell, he resisted considerable pressure to put me on dialysis. I remember a stentorian voice breaking through my on-going delusions: NO DIALYSIS it shouted!  He was right. Last most recent test of my creatinine was .9 with no dialysis.

What was he doing in the La Jolla ICU watching over me when his practice is in Encinitas, miles to the north? Perhaps he was taking a shift there for some other reason when they carried me in. Ill find out before too long, but I prefer to think that he heard I was in the ICU fighting kidney failure, along with pneumonia and other disasters, and, remembering our conversation of twelve years before, came to help.

This Picture is Not Obscene!