Rough Night

Yesterday was one of those days.
It had been a rough night at the CER (Saturday Night)
The ward was short staffed, I think only four nurses instead of six
And it was raining like mad. the ward was packed (22 patients, about 10 Acompanhantes)
it began to leak LOTS of water INTO the hallways outside the ward. At about 2 AM someone got a sledge hammer and chisel and was working on making a drain hole in the marble slabbed floor (don’t know where to, as I never saw the hole, just the tools and the guys talking about how well it worked to drain the hallway)
the Dr.s were stretched thin with the sudden spike in new cases, the nurses cranky that they were doing double time to make up for those who were missing.
Through most of the late Saturday night and into the wee hours of Sunday morning Dad and I talked over the din of the bustling ward, the banging of chisels on stone and claps of thunder. We spoke so long that one of the nurses, on her third or fourth round by our berth gave us a backhanded compliment – on how lively Dad was and how much he liked to talk. This in contrast to the other patients that either were being scolded for getting up, for wriggling about in their electrode leads, bemoaning the relatives they were missing at their bedside, calling out for assistance from the scant nursing staff, or simply moaning groaning and crying out in pain. And there we were, carrying on as though it were our living room, with no outward sign of distress.
After the comment from the nurse we tried to pipe down, and as three am dragged on to four and five in the morning I began to wear out, as was dad. At five thirty am I bid him a good night, recommended that he get some sleep before the day began again, and headed out to Tavares Bastos for some much needed rest. I’d been there in the hospital since Thursday afternoon, the day I arrived from Denver, and had only been back home twice for a shower and change of clothes. I’d slept in one of two large chairs that were kept in the ward for acompanhantes, but with the surge of new patients and their family members there had been several other more qualified users for those accommodations, and the chairs had gone deservingly to them.
Leaving there at 5:30 AM I found it difficult to land a bus that passed near where I needed to go, and when I finally did get on a ride, it took an unexpectedly circuitous route about town to get to Largo do Machado. All in all, it took me two hours to get from the hospital doors to Rua Tavares Bastos 238.
Unfortunately, just in the last twenty minutes of my day, from 7:10 to 7:30 AM, I missed seven text messages from Gilbert. If I’d caught them, the day would have played out differently – but I was too addled to notice the phone quietly vibrating in my pocket.
I laid down by 8AM, and somehow half heard several phone calls come and go (unanswered)…
I finally yielded to a caller that persisted – now noon – and found myself in a rather important and lengthy talk with Uncle Peter. He hadn’t been brought up to speed since I’d landed, and so it was catch up time. About an hour with Peter on the phone, and then another hour with mom on the phone, who I also had not spoken to directly since landing – and I was finally, really moving.
I had hoped to be at the hospital by about one PM at the latest – but after a cup of coffee, a shower, a change of clothes and stop at the head I found myself on the street headed back at almost three.
Before I got to the subway (about a 15 min walk from the front door) I pulled out the phone and saw that I’d missed seven texts from Gil – and called him.
“Hello – hi, where are you?”
“On my way back to the hospital now.”
“Oh! Ok, if you’d have told me I’d have been there with him. On my way out to him now, I’ll see you there.”
“Ok.”
Hopped onto the subway, popped out at Sigueira Campos in Ipanema, directly into the “metro na superficie” bus … and waited almost fifteen minutes for it to get rolling (from where I was I had no other idea of how to get to where I needed to be). The bus started up, rounded the first right turn, got half way into the second right turn, and came to an abrupt halt. In the curve, half way into the only lane available for thoroughfare and the bus, was a police car and ambulance attending to an accident victim. Another ten minutes go by before someone from the accident scene is persuaded by the driver yelling out of the open front doors of the bus, to move a vehicle and allow us to pass. Some time during the short trip from there to the hospital I got wrapped up in reading Gil’s texts, and missed my stop – ending up six blocks from the hospital.
When I arrived Gil was at my father’s bedside, talking to the Dr. on duty responsible for his care.
Dra. Natalia was very helpful, and unlike the Dr. the evening before, actually suggested that Bill be released that day, without a catheter, and suggested measures for his care and monitoring.
Gil, who’d clearly been upset with finding Bill had been left alone, briefly broke out in tears on hearing the Dr. pronounce to us exactly what our best possible scenario would be. Bill, out, now, no conditions on his release other than to be watchful of his diet and his eliminatory functions.
Once she’d left us I turned my full attention to dad, and was stunned to find the man who’d I’d spent hours talking to the night before was incoherent, and incapable of keeping his mind present with us. It frightened me to see my father dozing off at a moment’s notice, and when roused to find him unresponsive, and even under the vigorous prodding to only be able to produce half mumbled or only gestural responses with no eye contact.
The patient sharing my father’s berth, in a stretcher labeled #11 extra (that is, the second occupant of a space designed for a single occupant), remarked that the shift nurse had brought by his breakfast that morning, but than no one had really tried to feed him, and then they’d taken away the meal by mid day. Meaning – Bill had been without food since dinner the night before, because I had not been there to feed him, and the nursing staff was not paying attention to the fact that he’d not eaten.
Meanwhile, Gil saw a little box of fruit juice on dad’s table, and coaxed him to drink it even though the only outward sign that Bill understood what was being asked of him was that he closed his lips around the straw and sucked on it when asked to do so.
We got dad to drink two boxes of juice, one after the other, and his state of mind seemed to shift subtly from incoherent to merely incapacitated. When prodded, he could engage you by sight, and give a direct yes/no answer, but would not really speak, and would drop back into something like sleep immediately after every reply.
While we stood there and waited for the doctor to complete the exit paperwork and the nurses to give dad one final change of diapers before the trip home, Bill appeared to doze. It was a troubled kind of shallow sleep, with lots of mumbling. At one point he raised both arms straight up into the air. I was still standing right by his side, so I grabbed his left hand, and he brought his right hand over mine.
“I’m right here Dad.”
“I’m slipping away.” said he.
“Hang in here with us! We are going home now.”
He mumbled and relaxed his arms again. I kept a hold of his hands for a while.
Eventually Gil was handed the a summary of Dad’s six days in the hospital, and a copy of all his lab results – and with some more prodding the nurses on duty were cajoled into cleaning him up and dressing him for the ride home.
The specialty cab – equipped to move people in wheel chairs, which we did not have – had been waiting outside with it’s meter running for over an hour.
On the way home, Bill was relatively alert but only gesturing his responses to the occasional question.
Once at Tavares Bastos 238, Jalves brought down the wheel chair that Wendy brought with her from the ‘States, and he and I together were able to carry dad up the flight of stairs to and into the house.
It is not an exaggeration to say that dad was totally and completely whipped out – but at least present, if not communicative.
Six days in an emergency ward was clearly more than anyone should have to endure – and nearly did him in. Now that he’d achieved his immediate aim it was all he could do to get into bed with our help, and conk out.