Now I'm not the sort to complain, but...

Thanks go out to my loyal readers, especially those who gave me some vacation advice.  I'm not sure where I'm going to go but I think I'll put something together at some point, even if just to have something to look forward to.  I always advocate that to other patients who come to me with questions on coping.  This is unrelated to the post title, by the way, I'm not going to complain about you guys.  Anyway, onward.

I really am not the sort to complain.  I usually trust my doctor's word and follow his or her advice, as I think it's kind of a waste of money to go to a doctor only to ignore them.  If a lab tech can't find my vein and has to dig around a bit I grin and bear it, and if they apologize I wave it off (with the arm they're not sticking) as though it's nothing, and really it isn't a big deal.  So in general I have no expectations or demands as to my own comfort or preference.  If I'm in pain I'll tell my doctor, but only so my doctor is aware of it as a possible symptom.  If I'm worried about something I'll ask a question.  Usually I won't make any demands for action.  I understand that what I'm going through is not going to be fun and sometimes I need to be brave, for everyone's sake.  I also have near endless sympathy for the sheer volume of bullshit most doctors must endure from all sides, and would not like to contribute to it any.

However, in my line of work I've learned to recognize patterns, and when the facts don't match the patterns, I start looking for reasons why.  And yesterday, that lead me to, for the first time ever, ask a medical professional to redo a test.

Last week, my platelet count was at 83,000 per microliter: improving, but still half the minimum limit on "normal."  Yesterday, they did a finger stick and it came back at 36,000 per microliter.  They asked me if I've been taking my chemo (I haven't, since the reason I'd come three weeks in a row was to see if I was ready).  Then they got that grave, pregnant silence a doctor gets when they don't know enough to tell you what's wrong, but none of the possibilities are good.

So I asked the lab tech if it's possible for these tests to be wrong.  Brief note here; I am extremely lucky that everyone in my oncologist's office is both knowledgeable and humble enough never to take a question like that the wrong way.  The tech told me that the rest of my levels looked normal so it seemed unlikely, but that she'd be happy to run the test again if I wanted.  I agreed, and this time she took blood from my arm.

This wasn't the cute lab tech that usually draws my blood, however she passed by the exam room, saw me in there, and came to sit with me while I waited for the results.  Very kind of her.  If there are any lab techs, nurses, doctors or other medical staff reading this, do not underestimate the value of simply being there for a worried patient, even if you have no reassurances to offer.

The results came back, showing a platelet count of 158,000 per microliter.  8,000 over the minimum to be considered "normal."  My doctor told me to go home and take my pills. 

I'm still not the sort to complain.  Sure, I now wonder about the validity of my results all the other times they ran a CBC from a finger stick, and I wonder what would have been going through my head right now had I not asked for a retest (leukemia.  I'd be worried that I had leukemia), but I don't blame them for what happened.  I'm not angry that I had to get stuck twice instead of just once.  I'm not going to complain about something that's necessary just because it's unpleasant.

Still, if something doesn't make sense to me, I'm going to ask questions.  Imprecise though it may be, medicine is a science.  Every effect has a cause.  As long as we can leave blame and fault out of it, looking for that cause can be to everyone's benefit.

Testimony from a Brother in Arms

I saw this over on BoingBoing, a beautifully written account about the latest in a line of surgeries to cure a talented man of an abdominal cancer that threatened a "radical penectomy," one of the most horrifying procedures known to science.  He was treated at the same facility and I, by a man whose name I recognize, and spent some time in a hospital I remember on my darkest, coldest nights.  I'd recommend it to anyone who has found my own account at all interesting for whatever reason.

I've thought, from time to time, about how brain cancer stacks up to other cancers.  Mainly whether it would be better to have a more embarrassing, more survivable cancer.  Brain cancer is, relatively speaking, pretty dignified.  Despite its high fatality rate, it's more akin to growing old before one's time.  Rectal cancer or urethral cancer tend to be more survivable (though are still extremely serious, of course), but I shudder to picture the trials patients of those terrible diseases must endure.  A "radical penectomy" is a real thing, and a man can live without a penis much more easily than he can without a brain.  At least, physically. 

Anyway, it's good to hear that Mr. Dery appears to have dodged that bullet with his member intact. 

Turns out I'm just grumpy, entitled, and possibly elderly

In this revealing article, Jordan Rau notes the hospitals across the nation with the highest and lowest patient satisfaction rates.  I'm going to tip my hand a bit and say that I was treated in Manhattan.  Manhattan's rated in the bottom six (though that includes more than the hospital I attended). 

No one has proof why New York does so poorly, but everyone has a theory. It could be all the old, cramped hospital buildings that make patients shack up in double rooms. It could be the cranky mix of lots of poor patients in especially bad health and wealthy, entitled patients. It could be the frenetic environment of teaching hospitals with a plethora of residents and specialists poking at patients.

Well it's certainly true that the building itself isn't terribly comfortable but notice how quick Rau is to blame the patient.  In fact, take a look at the opening line: 

Not all hospital patients are alike. Some are harder to satisfy.

 Yes, that's right.  It's not that I had to drink phlegm, or that I was turned into a human pincushion, or that I never got a moment's privacy.  It's that I'm entitled, cranky, poor, wealthy, elderly, and eager to be nasty to people.  Every hospital delivers completely identical care: it's the patient that's the variable.

Why don't you try it for a while, Rau?

Survey Results

I'd like to take a step away from my little memoir for a moment as I have something more current for you today.  I promise that tomorrow we'll return to the epic adventures of a 29-year-old man living with his parents. 

Today I received the results of the investigation I mentioned, the one they initiated in response to my survey about my hospital stay. Let's take it point by point.

First of all, they note that their staff does try to monitor visitors while respecting each patient's desire and ability to receive guests.  That doesn't really tell me much, other than that they knew what was going on and didn't act upon it.  I suppose that's reasonable enough, given the circumstances.  It's kind of cruel to tell a cancer patient they can't see their family or friends, even if that is a detriment to their roommate.  Would have been nice to know their official policy on it, though.  What does it mean to "monitor" something?  They could have "monitored" someone trying to smother me with a pillow; doesn't really make a difference unless they take action on it.

They also informed me that they weren't required to give me a private room, which I know, and I understand that too.  It seems to be more of a legal argument than a patient care one: you have no legal right to a private room so you have no recourse if we don't give you one.  They go on to note that I could have paid extra to ensure a private room.  Maybe they don't want to spoil us greedy patients with free privacy. 

They note that they try to pair patients by gender and care needs, which makes sense to me as I was paired with another young man with cancer, who needed observation and some occasional routine care, same as I.  I'm guessing that particular policy went out the window after they started moving me, as Mr. Liver was actively dying and I don't think I was doing quite that bad.  I also don't think my medical needs (or gender) are similar to those of an old lady who wants ice cream.

Next a bit about the night nurse, the one who had me drink my own spit.  He's sorry about that, and should have brought a filled cup from outside the room.  They also inform me that when I was having trouble sleeping, he contacted my physician to get permission to give me a sleeping pill, but when he returned to my room he found me asleep and decided not to wake me.

I find that fascinating for two reasons. 

1) When I'm trying to sleep, not even my own parents can tell that I'm not actually asleep.  Furthermore every time a nurse entered my room to administer care I was awake and aware of them as soon as they entered the room.

2) That man must have a remarkable memory, or take very good notes. 

No sleeping aid appeared on my invoice either, which was specific enough to include the exact date and cost of each individual treatment I received - from pills to blood glucose tests - though perhaps it wasn't listed because I never actually received the pill.  Or maybe because that nurse is full of shit. 

For my remaining complaints, the noise levels, my perpetually open door and the delay in response to my call bell... Sorry.  They apologize for it, they regret it happened, but it doesn't look like they'll be doing a damn thing about it.  They didn't even mention the alarms.  Maybe they're worried if they admitted to that it would be actionable or something.  That sort of thing could cause a patient serious harm, after all.

In conclusion they wish me a delightful autumn, which is nice.

Even if they aren't taking any real action, at least I was heard.  Someone read the thing and took it seriously enough to respond to it.  It's a start.  If you disagree, don't tell me.  I'm looking for a silver lining here.

Liberation

Usually when a nurse spoke to me, it was either to give an instruction (sit up, swallow these, lift your arm) to administer care, or to go through a series of rote and uninteresting questions (what's your birthday, what is today's date, where are you) to gauge my mental state.

On July 3rd, my usual nurse - about whom I have no complaints whatsoever - was taking a much-deserved day off.  Let's call her replacement Sally.

Sally was young and pretty, and while she sounded a bit like a "Valley Girl" she was obviously intelligent and performed her duties - including getting me ready for dismissal - with skill and efficiency.  She also seemed to actually care who I was.  Hers were not the usual questions about the setting of my own personal drama.  Instead she asked me what I did for a living.  My title is long and far more impressive than it ought to be (to be honest I could never remember it without reading it off my own business card), and caught her interest, so she asked me to explain my work (I write reports analyzing market opportunities in the aerospace and defense industry, and no, I'm 100% civilian with no security clearance of any form).  She complimented my hair, which at the time made me look like an extra from Mad Max: still as long as ever but rather messy, save the part they shaved for the surgery and the resulting incision, which was sutured with 45 metallic staples.  She asked me where I lived.  If I had a girlfriend. 

It was the first time in days anyone had really acknowledged that I was not a disease, and that I did have a life beyond the hospital, one to which I would return.  Two weeks prior to that moment, I had no idea I had cancer.  I had hopes and dreams for my future.  Not ambitious ones but you take what you can get.  A 401k.  I thank Sally, deeply and sincerely, for remembering that, and I admire the tremendous amount of strength it must require.

Unfortunately not all of my nurses were quite so courteous that day.  They didn't want to dismiss me until they got a clear blood test, and as I've mentioned my platelets have a tendency to clump.  They drew my blood four times, even after my doctor confirmed that yes, my blood does that, and no, you don't have to keep jabbing the patient.  Each nurse assumed the previous one had done it wrong, or missed, or didn't get proper suction on the vial.  One in particular scolded me for having "bad veins," yanked my bed away from the wall, and stabbed the butterfly directly into my left wrist without the slightest warning.  I had never had blood taken from my wrist, and he did it with such little regard that it hurt more and healed slower than any of the IVs. 

The next nurse apologized for his co-worker's behavior, and sadly said that yes, sometimes nurses do forget that their patients are people.

Then he drew my blood again.

They finally did release me from the hospital.  They didn't even give me a wheelchair.  Three days where I couldn't even stand up without a nurse present, then they just give me a pat on the back and send me on my way.  They also gave me a scrip for oxycontin, which was nice of them I suppose but I really didn't need it and never filled it. 

As a side note, the hospital did send me a survey about my stay.  My response included an additional three type-written pages, including all of the complaints I've recounted here along with a handful of others too minor or mundane to make for a good story.  A few weeks later I received a letter in return, the address hand-written.  In response to my experience, a patient care advocate had launched an official investigation.  I'm still waiting on the results.

As I put my clothes back on, they felt strange.  So different from the hospital gown, and I had to be so very cautious putting them on.  I needed help with my shirt as I couldn't see my sutures.  Socks were an ordeal since I was forbidden to bend over; too much pressure could have caused a brain hemorrhage.  Fastening my belt felt like an odd triumph, like a buckle was somehow the clearest of all indicators that yes, I was wearing real people clothes again, and yes, if I had the uniform of a real person I could go be a real person. 

Even with my new-found freedom, I had to move slowly and intentionally.  I was still weak, and while I never felt unstable I was acutely aware of what might happen if I fell and hit my head. 

As we started the drive home we had to contend with the usual traffic, exceptionally dense and moving at a fair clip.  Minutes from the hospital, my mother decided to change lanes early to make sure she got in the proper lane for an upcoming exit.  Seconds later, there was a six-car accident in the lane we had just occupied, the lead car slamming on his breaks to avoid hitting some debris, the cars behind him left with no room to stop.  I saw it happen right outside my window.  There was no doubt in my mind that had we been in that accident, I would have ended up right back in the hospital or just plain dead.

My parents and I had decided it would be best were I to stay with them until I was confident I could live on my own again.  Never before had a bed looked so inviting.

Semi-Private

My parents arrived around 10AM, and when they heard of the previous night's delights they again insisted I be moved.  This time they demanded an empty room.

It's a selfish thing to demand since actual private rooms (as opposed to semi-private) cost far more, and we couldn't expect them to just toss out another patient so I could sleep better.  Except they didn't have to.  They never had to.  Half of the floor was totally empty; they'd paired us up so the nurses had to check fewer rooms on rounds.  Finally I was brought to an unoccupied room, and the staff said they would attempt to keep the other side empty, but they couldn't promise anything.  Reasonable enough, as another patient may need that bed more than I needed my rest.

Just as I started to fall asleep, I got a new roommate.  An old woman had fainted, and though she seemed to have recovered they still brought her into a patient room where she and her family loudly discussed what they would have for lunch.  Most of her family was already in the building, as she was Mr. Liver's mother.  She had refused to be put in the same room as her son because she "didn't want him to see her like that."  At that point I'd been at the hospital for over two days (three if you count the day of the surgery) and had managed about three hours of actual sleep.  I think they decided on ice cream.

After two hours or so she left, and her side of the room remained vacant for the rest of my stay.

Dr. Brain came to see me that day, and was pleased at how well I was doing, though he was surprised to see that I still had my drain.  It had long run dry and should have been removed the previous night, but it seems no one ever got around to it.  One of his assistants would later finally remove the tube, though the incision required additional stitches.  Two, to be precise.  He told me I could either take it without anesthetic and feel two pokes, or I could take it with anesthetic, but that would require two injections directly at the site of the incision (in other words, feel two pokes).  I opted to go without the drugs, and my scalp was numb enough that I barely felt it anyway. 

I received some more detailed neurological tests.  First I was asked to memorize three words, which I had to repeat at the end of the test.  I copied a simple symbol on a page, drew a clock from memory, and wrote a fake check (at least I really hope it was fake).  I could still write, though my normally messy scrawl was even less legible, my hand weak.  I was asked to do some basic math and count backwards from 100 by 7s.  They asked me how many boroughs were in New York City, which I got right despite having only been to the city about four times in my life.  Their evaluation was heartening to say the least: no physical or mental deficits.  They wanted to monitor me for one more night, but felt confident that I would be able to leave around noon the next day.  That meant a total of three in the hospital; they'd originally anticipated up to five.

My parents had brought me my laptop, which helped me to pass the time immensely.  Up to that point I'd had nothing to do at all, as they hadn't anticipated I'd recover quickly enough to be able to use a computer (or even to simply be bored, I suppose).  Netflix streaming video is a wonderful thing, as is Steam.

I'd told myself to hold off on communication.  Between the drugs and the surgery, I knew I couldn't trust myself to maintain proper conversational etiquette and decorum.  It was not only possible but probable that I'd say something depressing, or offensive, or embarrassingly nonsensical.  To those of you who may be faced with a similar situation in your future, this is really good advice, and your friends will totally understand if they see you online but you don't say "hi."

So I pretty much ignored my good advice and sent out a few e-mails, sent a few private messages, etc.  I did not completely abandon my plan and kept my conversations very short and basic, simple reassurances that things had gone well and hey, check me out, I'm totally still literate, and so I did manage to avoid later embarrassment.

I actually managed to sleep that night.  Sure, it was less than perfect.  A nurse still woke me up every hour to give me some medication, or check my blood pressure.  I called a nurse so I could go to the bathroom and no one ever showed up (I was helped half an hour later by one who came with a nice cup of pills for me).  They left the lights on and I had to sneak out of bed to turn them off myself.  Four separate nurses cheerfully said that of course they would close my door, and then immediately failed to do so.  Even so, I managed to fall asleep quickly after each interruption.  Compared to the previous night, it was quite restful.

I slept about eight hours that night, enough that when morning came I felt rested.  The steroids they gave me were partially to thank (or blame) for that. 

I also felt very ready to leave.  I was tired of being treated like a slab of meat.  No nurse offered me any opportunity to bathe, at any point during my stay.  Not even so much as a toothbrush.  I felt greasy and sticky.  I stank.  My hair was filled with dried blood and gel. 

You can imagine my surprise when a nurse started an actual conversation with me.

Waiting for Sunrise

A cancer center has to be a devastatingly difficult place to work.  I wondered how many people the staff had watched die.  How many never left my floor alive.  How many of my fellow patients, at that moment, were breathing their last breaths.  It must be enough to numb the soul.  I can understand why some people simply shut down and refuse to recognize their patients as people.  No sense getting attached when they'll be gone before long.

I pondered that as I was stuck with yet another needle.  One of so many I barely even felt them any longer.  They had me on steroids to reduce the swelling in my brain, which in turn threatened my blood sugar levels.  Finger sticks became as common as giving my name.  I was handed small cups of pills and told to swallow.  No one explained to me what I was taking, or why, or what the side effects might be.  The only time I got any sort of explanation was when I noticed an unusual-looking pill among the others, and asked if it was the correct medication.  It was, just a different brand.  I only noticed because I was aware of my surroundings and thinking with relative clarity.  What about patients who were not so lucky?  Those without the capacity to ask?  Must a brain surgery patient be so responsible for his own care even in the hospital?

The sound of alarms seared itself into my brain.  For a week after I left the hospital, I could hear that same repetitive buzzing in any white noise, especially that of an air conditioner.  Everything in that hospital began to beep wildly when it stopped working, or was about to, and everything in that hospital broke frequently and spontaneously.  It was so common there was not a single instant I could not hear an alarm somewhere.  The nurses did not seem to notice or care, possibly too common an occurrence to address.  They did not care if the noise bothered me.  I was not a person.  I was a chart.

That night, that awful night, one nurse placed a pair of sleeves over my legs, the sort that would inflate and deflate regularly to prevent blood clots.  It worked for about ten minutes, then promptly stopped and began to emit a loud, repeating tone.  I called for a nurse.  Twenty minutes later, no one had come.  Still it was beeping.  I called again, and informed the nurse that if someone did not come in and handle the situation, I would smash the device on the floor.  It was removed from my room within two minutes.

I couldn't even try to sleep during that night.  Every hour someone was in to inject something into me, or have me take some pills, or otherwise disturb my attempts at rest.  I begged for something to help knock me out but they could offer nothing, as they needed my mind to be clear, so they could monitor me for any abnormalities.  My lungs were weak and a chronic cough became constant.  They gave me a lozenge, but only one.  I was informed that if I somehow got a bag of them from outside I could have as many as I pleased, but the hospital could only give me one every two hours, as if it were just as strong as the morphine I was no longer receiving.  They left lights on.  They left the door open.  They laughed and chatted in the hallway. 

Meanwhile, Mr. Liver groaned.  Frequently, loudly and in agony.  His daughter was spending the night with him.  I can understand his pain.  I can understand her desire to be with her father in his last hours, though it may have been nice if someone had informed me I'd be spending the night with an unfamiliar woman in my room.  I had slept only about an hour in the previous day, only an hour since awakening from brain surgery, and I was running out of sympathy.  I did not understand how anyone could be expected to recover under such conditions, or if they weren't actively harming my brain as it struggled to repair itself.

Then came the high point of my stay.  As I mentioned I'd been coughing a lot, and had taken to spitting whatever I could produce into a paper cup.  It was one of many, the others stacked upside-down beside it, clean and unused.  Yet when the night nurse came to give me some pills, that was the cup he chose.  I didn't notice until I felt a wad of my own spit slide into my mouth, to which I responded, "this is the very wrong cup."

He chastised me.  He told me that I should have torn the edge of the cup, as though he would have noticed that in the darkness, as if that were the universal symbol for, "spit cup: do not use."  It was my fault that he'd made me drink my own spit.

I suspect he later gave me the wrong medication as well.  I was feeling slightly nauseous and asked for some Zofran, which had calmed my stomach quickly and effectively throughout my stay to that point.  He gave me a pill and claimed that was what it was, yet its familiar effects never came.  Not until the following day, when another nurse gave me another Zofran. 

Though I saw it only as a subtle and growing brightening of my room, the light of dawn was never so beautiful.

Waking

I'd been warned that I might awaken slowly, bit by bit.  They said I might regain consciousness before I regained any motor functions, even the ability to open my eyes.  Instead, I came to with such clarity that I noticed that was not what had happened even as I said, "Hi Mom."

There had been no guarantee that I would recognize her, or anyone, or that I'd be able to speak, or even that I'd ever wake up again.  My next words, to my father, "Am I dead?"  That, in relation to some conversations I'd had with him before the surgery, addressing the questions in my, "Who am I?" post; I was not questioning whether I was in some sort of afterlife but whether I was still the same person.  I probably could have phrased the question better but hey, I just woke up from major brain surgery and was drugged out of my mind.

After the brief greeting I was wheeled off to the ICU.  I felt surprisingly good, all things considered.  My pain was so minor that the dryness of my throat was a greater discomfort; even drinking water would have made me vomit at that point and they had stuck a tube down my throat during the surgery, so I had to make do with the occasional tiny wet sponge to suck on.  It wasn't until the third or so that I realized I was allowed to suck on it instead of just holding it in my mouth.  Again, brain surgery, drugs.

It was actually quite remarkable how little pain I felt during the entire ordeal.  It stands to reason, of course.  There are very few sensory nerves inside the skull, and those in my scalp had largely been severed, leaving much of the top of my head numb.  What little pain I did feel was quickly controlled, and by the second day of my stay I didn't need anything for the pain at all.  During my entire recovery after that point, I never even needed a Tylenol.  What I did feel were strange sensations on my scalp and across my suture.  At first it felt like a wet dripping, which I mistook for blood.  A close examination revealed no bleeding at all.  For weeks after I would feel strange twinges from time to time.  Also an itch.  Intermittent but completely impossible to satisfy, as it was located on part of my scalp so numb I couldn't even feel my own touch.  But again, I'm getting ahead of myself.

Even with the drugs in my system and the fatigue from my surgery, I could not sleep in the ICU.  My nurse was constantly checking on me - which is to be expected - and my oxygen tubes kept slipping out, and I wasn't sure if I was supposed to have one or both in.  Maybe they didn't want me getting THAT much oxygen, I reasoned.  They frequently checked on a drain inserted into my head, a thin tube with a suction bulb on the end, which steadily drew a thick red fluid from my incision, lighter in color than blood.

As they wheeled my bed to the MRI, I felt kinesthetic shifts throughout my body.  I felt like they were wheeling me down a slope, and when they stopped I felt as though they were slowly pulling me backwards.  At one point I felt as though I was rising into the air, though looking around I could easily tell I was stationary.  Most of all I felt very heavy, which was an effect of the morphine.  That seemed to be all morphine would do to me: make me feel heavy and numb the pain.  No hallucinations or highs, or anything so interesting.  By that point every person I met would ask me for my name and birthday, and most would also run through a series of basic neurological tests to assess my condition.  It became so routine that one nurse would simply say, "tell me a story."

This is where things started to get kind of bad, and before I go on I want to make a few things very clear.  First of all, I feel that my doctors and most of my nurses did an excellent job caring for me, and I know that staying in a hospital is never fun.  Secondly, I have a great deal of sympathy for my fellow patients and wish them all the best of luck.  Third, I think that there's a point at which it becomes totally reasonable for a brain surgery patient to want some goddamn sleep and to hell with the doctors, nurses, and other patients.

They brought me to my hospital room, to let me rest.  At least, that was the theory.  The room had a nice view of the city and was really quite comfortable, except that it was a "semi-private" room, meaning I shared it with another patient and had all the privacy of a thin curtain.  For some reason they'd designed that particular room so that the patient farthest from the door (my new roommate) had to pass directly through the other patient's (my) area to get to his own bed.  My roommate, another young man who had been at the hospital for more than a month due to a spinal tumor, had several family members over and seemed to be having a small party.  They left entire food trays along my windowsill to be picked up by hospital staff, while talking loudly about how good the food was.  They blasted Christian rock constantly, even when none of them (patient included) were in the room.  For my benefit, you see.  My parents informed them that we are not a Christian family, to which they replied, "that's OK, Jesus will take care of you anyway."  Very kind people, very sweet and thoughtful, but they seemed deathly afraid of silence and would not shut up.  It was around the point that I heard my roommate on the phone saying, "we can't fit more than a dozen people in here so not everyone can come at once," that I thought maybe the situation was worth addressing.  My mother got me transferred to another room.  The next day, my former roommate had a party in his room, the entire day.

My next roommate seemed better.  I'd prefer not to identify another human being as a disease but as that's all I really knew about the man, I'm going to call him Mr. Liver.  Mr. Liver was suffering from liver failure.  Jaundiced and bloated, he didn't have much time left.  His family was there to see him and they were quiet and polite.  They seemed to be trying to get Mr. Liver to hospice care but were unable, as the hospital was short-staffed due to the upcoming July 4th holiday.  Either way, his family was courteous, he didn't seem too bad and my heart really went out to him as I knew he didn't have much longer.

He also peed all over the shared bathroom several times, and seemed incapable of speaking lower than a shout.

At the time that wasn't a big concern to me as I was still attached to a catheter.  They had me stand and try walking with the aid of my IV stand - less than a day after brain surgery and they already had me doing laps - and it was a little dizzying at first but I did manage it.  It made me very aware of how weak the surgery had made me; my gait had changed significantly, and while I never felt unsteady I did feel unsure of my footing at times, and had to walk very deliberately and carefully.

Once they determined that I could walk, they removed the catheter.  That experience was more socially unpleasant than physically, as my penis (and anus) were somewhat numbed from the anesthesia, or perhaps from the surgery itself.  Sensation would slowly return over the next two or so weeks, to my great relief, but at no point did I lack control of my bowels and bladder.  The problem was that I was still hooked up to a saline drip, which meant I needed to go to the bathroom every hour or two, yet for liability reasons they refused to let me get out of bed without help.  Unfortunately the nurses would rarely come immediately after their summons.

The nurses wanted to keep track of our urine so we each had separate containers, and my nurse (who herself was very kind and skilled) was rather horrified when she saw that my urine had apparently turned nearly black.  My roommate didn't take the time to read the labels on the containers. 

As visiting hours drew to a close I was less than thrilled with my circumstances but found them tolerable, even though at that point it had been about twenty hours since I'd last slept.

Thus began one of the worst nights of my life.