Part 2, Blue Water, White Water

My mouth fills with more mucus than I can swallow. My nose runs and the machine sounds a dreadful honk. Rikki is pushed aside by a nurse who quickly stops the awful noise and suctions me. More alarms go off—they’re always going off. Are they mine? Does anyone know; does anyone care?

The nurse, in her rush, neglects to close the curtain. So Rikki sees the suction tube jammed in my mouth, then in each nostril. Her face contorts with the effort to hide her anguish. I want to tell her that it’s okay—that things are not as bad as they look. I want to hold her in my arms to comfort her. Instead, I wink again. I cannot speak. I am totally mute.

She holds my hand. “The doctors say you’ll make a full recovery. You know you’ll make a full recovery.” It is more of a plea than a statement, but I nod my head in agreement. I need no reassurance. I know I will recover.

“Do you want me to stay all night?” I shake my head no. She looks exhausted. Her blue eyes seem dull with worry; her blonde hair looks lank. She’s a trim, athletic woman, normally full of pep but this has been a long day. What would be the point of her staying?

“There are no visiting hours in this part of the hospital,” she tells me. “You can come when you want and stay as long as you want. I can stay.” I vigorously shake my head no! I want her to take care of herself. She is my love.

Again, the flood of mucus is overwhelming me. “Nurse! Nurse!” Rikki cries. An Indian nurse comes in and starts opening the clear plastic box, containing the suctioning material. Hurry, please, hurry. I’m drowning again. Look at her! She’s taking her bloody, sweet time opening the fucking box. It’s as though it holds something precious.
She asks Rikki to leave, then closes the curtain.

I can’t stand this. Jesus! Finally, she’s suctioning my mouth. Oh, thank God! Oh, the relief! Wait a minute you dumb bitch, what about my nose? Don’t leave. You forgot to suction my nose. I try to lift an arm to point to my nose, but I can’t. I don’t have the strength. I try to stop the respirator, to breathe against it, but it is too powerful for me.

Rikki is back. I want to show her something is wrong. I shake my head—I move my leg. Jesus, do something please. “Nurse, nurse!” she cries again. I’m swallowing gallons of mucus. The stuff covers my upper lip. Alarms are sounding somewhere.

The Indian nurse responds. “What’s wrong, darling?” she asks. Her voice is so sweet, her touch so gentle. My nose you bitch! My fucking nose! “Do you know what’s wrong?” she asks Rikki.
“His nose is running terribly.”

“Oh, yes, I see,” she says gently. “I suction.” Again, Rikki must leave and the curtain is drawn. Everything this nurse does is slow fucking motion, slower than the beat of the respirator. She opens the box. She dons the gloves. She inserts the suction catheter into the vacuum tube. Now she’s suctioning my nose. “There darling, isn’t that better?” she asks me, throwing away the catheter and her gloves. No bitch, my nose is fine but now my mouth needs suctioning.

“Your husband is okay now,” she tells Rikki as she leaves. But I’m not okay. My mouth is full again. I can’t swallow all this stuff. I can’t. I shake my arms and my leg as much as I can to signal Rikki. Again Rikki calls for a nurse. This time we get a young girl. Quickly, she suctions both my mouth and nose. Some difference!

Rikki is reluctant to leave but Dr. Fields is telling her that she should go and I nod in agreement. Now the Indian nurse is stroking my head and talking to Rikki. She says her name is Doria. “I take good care of your husband tonight. Don’t worry. I take good care. Go home and rest.”

Rikki wants more. She wants to establish some human contact with this nurse. “Are you Indian?” she asks.

“Oh yes I am.” Doria’s voice is a singsong.

“My husband was in India recently and he loved it.” I didn’t love it but it fascinated me. I know Rikki is trying to give the nurse a reason to like me.

“Where was he?” They’re talking about me as if I’m not here.

“Bombay.” Oh, no, it wasn’t Bombay. It was New Delhi. I’m shaking my head no as hard as I can but they don’t notice.

“How long was he there?”

“Just one day but he visited the Taj Mahal. He loved that.” Oh, Jesus, Rikki, you can’t visit the Taj from Bombay in a day.

“Are you sure he was in Bombay?” asks Doria. She realizes there is a geographical error.

“It was Bombay, wasn’t it darling?” I shake my head no so very weakly.

“New Delhi?” Doria questions. I shake my head yes and mucus spills from my mouth and nose. She asks Rikki to leave and again the curtain is closed. This time she suctions both my mouth and nose, but it’s slow.

Now Rikki is back. “I fly to New Delhi tomorrow,” Doria tells Rikki. “I go home for a holiday with my husband and baby.” I’m overjoyed by the news.

“Oh, that’s too bad,” says Rikki. “After tonight you won’t be able to take care of Bob.” Has Rikki lost her mind?

“I come back in a month. I take care of him then. Don’t worry.” Doria says. I’m outraged. A month! I won’t be here in a month. How can she think I’ll be here in a month?

“Bob won’t be here in a month,” says Rikki in a shaky voice. “He’ll be better.” Of course I will.

“I hope so,” says the nurse, “but if he’s here, I take care of him.”

I don’t have enough strength now to push the call button. They’ve rigged a string to it so I can pull it to call a nurse. The first time I try, I find I’m even too weak to do that.

Rikki realizes that isn’t going to be a way for me to summon help during the night. Doria promises to check me frequently. Rikki says I should twist my left leg vigorously if I need help. It’s the only part of me 1can still move with any strength. “Don’t worry,” says Doria.

Will Rikki ever go? “You’ll be all right. Doria will take good care of you.” She is trying to reassure herself. “Are you sure you want me to go?” she asks again. I nod yes. “I could stay. I could spend the night,” she pleads. I nod no.

It is pointless. She needs sleep. The dog has to be walked, usually my job, and fed, her job. There will be phone calls on the answering service about skating lessons—orders at the post office for our mail order business. To the rest of the world this has been an ordinary day.

“Good night darling,” Rikki says, fighting away tears. “I love you.” I cannot respond. “You love me, don’t you?” she asks. I nod my head. God, do I ever! I watch her go.

I need suctioning. I twist my leg violently. Where the fuck is Doria? I hear the sound of my respirator. Alarms are beeping all over. The bells are ringing for me and my gal. There is mucus running from my nose and mouth. Why did I let Rikki go? How will I get help? I twist my leg as hard as I can. Maybe someone will come. I see nurses passing, but no one notices my turning leg. I swallow more mucus. Now there’s a bell ringing near me. It’s one of my alarms. A nurse comes to check, to turn it off and sees I need suctioning. Finally, relief!

There is a night in this tomb. As the hour grows late, they turn off some of the lights but it is nowhere near dark. It grows quieter, but it is nowhere near silent. The public address system stops paging doctors. I hear my respirator if I listen for it, but already it has become part of my life. Its rhythm is now my rhythm. Could I breathe without it? I don’t know. Alarms ring and nurses move about. The sound of something going kerplunk comes from the nurses’ station. Because I am lying down and can’t move my head, my visibility is very limited.

“Mr. Samuels?” asks a young, bearded doctor. I try to answer but of course I can’t make a sound. Doria materializes from somewhere and confirms that I am indeed Mr. Samuels.

“Mr. Samuels, my name is Davis. I’m a resident here. I’m supposed to give you a nose tube so you can be fed while on the respirator. Do you understand?” I try to nod but I discover I can no longer even do that. I can’t respond. “Mr. Samuels, blink your eyes if you understand.” I blink. “Mr. Samuels, I have to give you the tube because you can’t eat normally while on the respirator.” I blink again.
They put up the back of the bed, which pitches my head forward. Mucus pours from my mouth and nose. “Nurse, Mr. Samuels needs suctioning,” says Dr. Davis.

For a change, Doria hustles. She’s afraid of the doctor. She pushes my head back and it hits something with a conk. It is strange to hit your head and not be able to rub it. A sensor rips off my chest and an alarm sounds. She puts the sensor back. Now I feel a pull at my penis. Something has snagged the tube attached to the catheter and pulled it out. No alarm-sounds for this and there is no way for me to tell them. But all I really care about is lying down again. Sitting up is incredibly uncomfortable. Hurry, please hurry!

Under the glare of a strong light, Dr. Davis slips the plastic tube up my right nostril. He works smoothly and easily. “I have to be sure you have this thing in your stomach and not in one of your lungs. That could cause real problems,” he says.

The nose tube is in place. He attaches a rubber bulb to its end and places his stethoscope against my stomach. Then he squeezes the bulb. I feel my stomach rumble. “It’s in the right place all right,” he says. “I can hear it. You’re all set.”

He senses my discomfort and quickly gets Doria to help him put me back on my side and get me settled. Oh Lord, sweet relief! He’s gathering his stuff to leave. He doesn’t know about the catheter! I’m blinking like crazy, trying to get his attention.

He notices. “What’s wrong? Something’s bothering you, isn’t it?” I blink once. He looks around the bed and spots the problem. “Jesus,” he swears softly, “one of us pulled out your catheter. “Thanks for letting me know.” I blink again, trying to say you’re welcome.

The catheter is back in place. Dr. Davis has gone. I miss him. He’d talk with me and I’m lonely. No one is around. Things are quiet—quiet as they ever get. I hear just an occasional kerplunk from the nurses’ station. I know that noise. What the hell is it? There’s some white stuff flowing through the nose tube into my stomach. I taste nothing. I’m not being fed, I’m being filled.
The nose tube has set off a fresh eruption of mucus. The alarm sounds. It’s insistent. Doria responds, she suctions, the mucus flows, the alarm sounds, Doria comes, she suctions. On and on it goes. Just when it seems it will never stop, never even slow, it does slow.

Time passes. I think of my father and my stepmother in Cuernavaca, Mexico. They found the ideal place for them to retire. They have such a nice life there. Jesus, it would kill my father if he knew where I am.

Suctioning, I need suctioning. How the fuck does this happen so quickly? One minute I’m fine, the next I’m drowning. I twist my leg but it only moves a little. The myelin must be burning away there too. “The lights are going out all over Europe,” said Winston Churchill at the beginning of World War II. Now, the lights are going out all over me.

Where the fuck is Doria? I’m going to die before she comes. Oh, Jesus! “Medic! Medic!” they yell in war novels. I can’t call.—I can’t even whisper. That dumb goddamn fucking Indian cunt! Get your fucking ass over here! Jesus, this thing is making me a racist sexist, a delightful combination. It’s so damn difficult to breathe. I say, Doria darling, while you’re up get me suction.

The loud respirator alarm is sounding. She can’t ignore that goddamn thing. It’ll wake the dead. Who knows, in this ward maybe there really are dead to wake. “Where is Doria?” asks a young nurse. “I wish I knew where Doria disappears to,” she sighs after suctioning me. “Let me look at you.” She peers down, brown eyes moist and sympathetic. “You’re Mr. Samuels, I heard about you. You’re sick now but you’re going to make a complete recovery.” You’re fucking A right, baby, fucking A! You’re my kind of nurse.

“You’re a mess,” she tells me sweetly. “You need a bath. Doria should do it but I don’t know where is but I’ll clean you up. We can’t leave you this way.” She draws the curtains around my bed and brings a basin of warm water, washcloths and towels. Now she pulls back the bedclothes and, with gentleness, strips my hospital gown, all the while talking to me. Her name is Jenny, she tells me. She’s been a nurse since June when she graduated from Rockland Community College. She is getting married in the spring.

Jenny loves working in the ICU, enjoys the twelve-hour shifts, and the time off. I adore her. All the while she’s talking she’s washing my body. She touches me gently where no one but lovers have touched me since I was a child. Although she is young and very attractive, there is nothing sexual in this. Even so, her touch is personal. She’s not washing a car and she knows it.
I smell the Ivory soap and, as always, the odor brings back memories of my mother. She had bathed with Ivory too. I remember that although I was just in kindergarten when she died during an operation for stomach cancer.

Many primitive peoples believe that as long as someone remembers you, you are still alive. Although I reject the mystical and have no belief in a hereafter, I think there is an undeniable truth to this.
So, because of my hazy memories, my mother lives again and again. Some of the things that evoke her for me—her monuments—are Ivory soap and her favorite foods, corn on the cob, coffee ice cream and lamb chops. They say she had a marvelous sense of humor. I think those things would have made her laugh.

Before Jenny can get a fresh gown on me, I need suctioning. As she starts to do my mouth, Doria pushes through the curtains. “What are you doing with my patient?” she demands in a voice that whines into an indignant squeal.

“You weren’t around and he needed suctioning,” says Jenny, a little defensively.

“What happened to his gown?”

“He also needed to be washed. He was a mess.”

“I’ll take care of my patients. You take care of yours!”

“Fine with me,” says Jenny, whirling on her heel, and pushing out of the cubicle.

Doria stuffs my arm through the sleeve of the gown. She’s angry and rough. Electrodes pop off my body, an alarm sounds. “You are my patient, you understand! I don’t want you with her!” I feel guilty,
like a cheating husband, but what the hell have I done? It’ll make a funny story when it’s over.

I have to remember to tell it to my father. I’ll see him soon. Rikki and I have reservations to go down in February. We’re spending three days in Cuernavaca with him and my stepmother, then four days alone on the beach in Puerto Vallarta. We’ll certainly be ready for a vacation. This’ll seem like a bad dream by then.

My father is a great storyteller but he also loves to hear a good story. I have several I’m saving for him. One involves our answering service machine.
On a recent evening, Rikki was waiting impatiently as I arrived home from work. She had gotten in a little before me and had played the messages on the machine. “There’s a call I’ve been saving for you. You have to hear it,” she said, switching on the machine.

“Rikki,” began a pleasant sounding male voice, “I have feelings for you. Do you have feelings for me? If you have feelings for me, I would like to get together with you.” Then the voice added, “There is no need for Robert to know about this call.”

Of course, Robert, me, was listening and I immediately recognized the caller. Rikki is poor at identifying voices but she agreed with me about who it was. The incident would be perfect in a John Cheever or John Updike short story: attempted adultery on an answering service.

We thought of having a dinner party and inviting the caller, his wife, and several other couples. Toward the end of the party, we’d announce that we had a something we wanted everyone to hear. “See if you can identify the mystery voice,” I’d say, playing the message through our stereo. We didn’t do it. We erased the tape.

My legs ache. I’m so uncomfortable. How long has it been since I saw Doria? I don’t know. There are no clocks in this place. Without glasses, if there were I couldn’t read the time. Besides, a curtain Doria carelessly left partially closed, blocks any view. My secretions are building, but they’re a long way from setting off the alarm. Where is Jenny? She won’t help me now. Bitch Doria!
I have to move off this side. Rikki would help if she knew. Why did I let her go? I could blink my eyes and she’d understand I need help. She would try to find out what it was I wanted. She’d call Doria. She’d do something. She wouldn’t have left if she’d known what would happen. She wouldn’t have gone.

Charlie would help if he knew. Charlie, our only child, is a student at the University of Maryland. If he knew, he’d break in here and ask why they weren’t helping me. He’d be polite—he’s always polite — but he wouldn’t let them ignore me. He’d demand they help.

To think of Charlie, is to smile. He’s everyone’s favorite kid, not just mine. The best brief description of him was my father’s: “He has your optimism and Rikki’s enthusiasm,” he’d said.

JESUS, BITCH DORIA! I have to move, don’t you understand?

Charlie doesn’t know. Rikki wouldn’t tell him. She wouldn’t tell anyone, not yet anyway. We’re both like that. We have many friends but we seldom open up with any of them. Maybe we’re so close that we don’t need anyone else. We’ve always been open with Charlie, but why worry him now before we know how bad things are? Why worry anyone?

I’m drowning again, Goddamnit! The alarm is going to go off. It’s so hard to breathe. Can you actually drown this way? I don’t know. No, you can’t, they wouldn’t make a respirator that would let that happen. You’re so naive. You’re an asshole, a real asshole. They’ve knowingly built cars like the Ford Pinto with deadly design defects. So why wouldn’t they build hospital machines with fatal flaws? I don’t like to think this way. I could die? I could die! I don’t believe that—not really. But why doesn’t the alarm sound? How the fuck should I know. Oh, it’s so hard to breathe.

Who’s this? “You’re really juicy, aren’t you darling?” I blink a yes. The nurse is older than most, heavier. She suctions me quickly. Now turn me, please. No reaction. I demand you turn me! “There, that’s better,” she says, gathering all the disposable suctioning junk. Turn me! Please, get me off my side. I’m blinking as hard as I can. She doesn’t notice. She’s away, off into the gloom.

First I brood, and then I console myself. After all, there have been some net gains. I no longer need suctioning and she’s pushed back the curtain. Although I can see, there isn’t much to see — some other beds, the nursing station lights and the occasional ghostly figure of a nurse, moving quietly, almost floating. As each passes, I strain to see if it is Doria.

Can this really be happening? I have a profound sense of detachment. But this is not a Franz Kafka short story. This is not The Metamorphosis. This is me! This is happening! I still don’t believe it.
I see bitch Doria. Turn me now and I forgive you everything. I’ll love you forever. I’m blinking frantically. Don’t you see me bitch, cunt; don’t you notice? “You don’t need suctioning,” she says. Brilliant fucking observation, brilliant! Now turn me, bitch! “I’ll be back in a short while to turn you, darling,” she says, moving silently away. There is hope now. She knows I’m here and she’ll be back soon.

What time is it? I haven’t slept. I’m not the least bit sleepy. How can you sleep when you’re so uncomfortable? Uncomfortable, hell, I’m in pain. This is all so unreasonable. No one’s ever told me anything about this kind of hospital experience. All the complaints I ever heard about nurses have been somewhat humorous. I never heard a story about a horrible nurse like Doria. People don’t remember the terrible things that happen to them.

Where the fuck is Doria? Has she already left for India?

Do I have a better memory for bad experiences than others do? Maybe I do. In 1955, after graduating from high school, I joined the Air Force. It was only a couple of years after the end of the Korean War where Air Force took some heavy ground casualties. The generals said those losses occurred because airmen weren’t given any combat training.

They were determined not to repeat that mistake with us. Our training was brutal. Everyone said the Air Force was trying to make it tougher for us than Paris Island Marines had it. As far as I’m concerned, they succeeded. I remember them telling us that no matter how unhappy we were then, we’d remember all we were going through fondly.

As they were saying it, I knew that I would never forget the raw fear, the humiliation and the bone weariness of that terrible hot summer. I wouldn’t let sentimentality cheat me out of a real memory, no matter how awful. But they were right: most men remember basic as if it were a hilarious fraternity party. When I was there, I didn’t see anyone having fun.

Within months after I finished my training, the Air Force forgot the lessons of Korea and returned to its old, sloppy ways. It cut basic training down from 12 to six weeks and relaxed the discipline. So it is with the military mind.

Just as I remember basic, I will remember this night. Doria, I will remember you forever, you bitch. There is someone here. It’s Doria! She didn’t forget! She came back! Oh, God, she’s turning me. Oh, ecstasy! I love you, Doria. I’m drowning again but you’ll save me. That’s it, baby. Suction, suction! Better now. Sensors are yanked away. Alarms sound. Another nurse is helping Doria replace the sensors. Now I’m sweating—terrible sweats. Swimming. They change my gown. They’re filling me again with white stuff through the nose tube. I prefer ham and eggs with home fries, please.

Sweet Jesus! I hear Rikki! Could the night be over? They’re turning more lights on. The night is over!

I can’t see her yet, but she’s arrived. I hear her. She’s thanking Doria. As soon as I can talk I’ll tell Rikki how awful it was. How I was ignored. “Your husband is a nice man. When I come back next month, I’ll take care of him again.” Never!

“That’s very nice of you,” Rikki says, “but by then he’ll be back home. He won’t need a nurse.”

“I hope he’s better,” says Doria, “but I think he’ll still be here.” Fuck you, bitch! What the hell do you know? Are you a doctor?

Ralph’s friend was in the hospital three months. Don’t think of him.

To read more go to:

www.bluewaterwhitewater.com

Part 1, Blue Water, White Water

People have clicked in here some 5,500 times to read this gripping true story.  You can still find part of it here, but the entire tale is now a handsome book in hard or soft cover, or as a download from both Amazon and  Barnes & Noble online. You can connect to them quickly through the book’s website: www.bluewaterwhitewater.com

Part 1 begins after this review.

Books

Sleepless, Bored and in Pain, a Patient Watched

By ABIGAIL ZUGER, M.D.

Published: March 12, 2012

New York Times

Just when it seems long past time for the age of memoir to be over — just when it seems impossible that any ailing person with literary inclinations could find anything new to say about illness, and the list of not-to-be-missed “patients are people too” books should be closed and locked — yet another book comes along.

Read an excerpt of “Blue Water, White Water.”

And despite all the above, no one with even a passing interest in the experience of illness should miss Robert C. Samuels’s “Blue Water, White Water,” a memoir drafted about 30 years ago and published without fanfare a few months ago; it stands head and shoulders above the crowd.

The details are slightly obsolete, to be sure: Mr. Samuels endured his many months of dire illness tethered to a respirator back in the 1980s, the Stone Age of modern intensive-care treatment. Nonetheless, his story from the wrong end of the tubes is timeless; the technology may evolve briskly, but the experience changes glacially, if at all.

A former beat reporter for The New York World-Telegram & Sun, Mr. Samuels covers his own story like a pro. He was healthy, 44, just returned from a trip around the world in December 1981, when he got out of bed one morning with a weak left leg. He wandered into the local emergency room half convinced he was imagining things.

By the next day he was completely paralyzed with a respirator breathing for him: Guillain-Barré syndrome, an autoimmune disease, was rapidly and efficiently stripping his motor nerves of their myelin sheathing, short-circuiting them all. Only his eyes still moved a little, from left to right. Nothing was wrong with his brain.

It would be many months before any part of him but his eyes moved again. He spent all that time in intensive care, first in his local hospital and then in one of New York City’s premier teaching institutions, a particularly grubby and uninspiring place. His mantra throughout, and the encouraging phrase on everyone’s lips: Guillain-Barré patients always get better.

That cheerful thought calmed his fear a little but did nothing for his constant discomfort. Completely immobile, incommunicado save for eye signals, sleepless and bored out of his mind, Mr. Samuels endured more pain than anyone might imagine — including, predictably enough, his own doctors and nurses.

His biggest enemy was gravity itself, as his flaccid muscles could no longer cushion his tender bones from any pressure, including that of mattress and pillow. Holding any position for more than half an hour meant misery. A tiny empty syringe left forgotten under his shoulder spelled agony. His primitive system of communication (eyes to the left for no, right for yes, back and forth for help) was seldom up to the challenge.

But others have covered the pain-and-helplessness story at greater length and complexity than Mr. Samuels. What makes his version so compelling is its mural of the medical personnel who wandered in and out of his shrunken world. With nothing to do but watch and remember, Mr. Samuels assembled the sketchbook of a professional observer, brisk, unsentimental, sardonic and altogether deadly.

His doctors were a well-meaning but erratic crowd, wise and foolish in equal measure. Their enthusiasms often seemed to have little to do with anything, certainly not the patient lying in front of them. One doctor guiding a fiber-optic tube through Mr. Samuels’s congested lungs was dazzled by their geography: “Right upper lobe,” she called out with passion. “Left lower lobe!” (No one in the room knew that Mr. Samuels was silently making conversation with his own list of lobes: his friends Werner and Nedra and their children, Susan, Janice and Chuck Loeb. Were the married daughters still Loebs? His mind spun a welcome momentary distraction.)

But it is the nurses who get the brunt of his attention, only because they ruled his days and nights. Seldom has anyone provided a better illustration of the simultaneous power and powerlessness of that complicated profession. Mr. Samuels’s good nurses struggled against the arbitrary constraints of their routines, while his bad ones drifted in a haze of marginal competence. Candy, Ingrid, Doria, Vinnie and the altogether fearsome Clare Ann — they are a terrifying, inspiring, nuanced and completely human bunch.

Mr. Samuels limits his own moralizing, but provides enough grist for any philosopher mulling over the essential conundrums of health care. Whose fault is it when a patient doesn’t get better? Some of his caretakers took every setback as a personal affront — a foolish reaction, or one that is essential to the enterprise? Some blamed the patient instead — misguided or brilliant psychology? There’s plenty to debate here, particularly because Mr. Samuels flouts all predictions and, sadly enough, does not get completely better, for all that he writes with the jaunty triumph of the survivor.

People with the terrible luck to get Guillain-Barré these days will be spared some of his misery. Certainly techniques of sedation and pain control are more sophisticated now, and accessories for the paralyzed body a little more streamlined and comfortable. But the essentials of the experience remain, and health care personnel who live through it in this book will appreciate the dreadful familiarity of the reflections from its author’s perfectly placed mirror.

PART 1

By Robert C. Samuels

December 2006
The evening is resplendent. It is a 70th birthday party for me and my friend, Charles Mouquin. We met when we were 12 years old so this is not the first one we’ve celebrated together.
Some 20 people, mostly members of our families, are gathered in Charles’ house, a Victorian mansion owned first by his grandparents. Charles and I are wearing tuxedos. I thought years from now my grandchildren might remember the evening as the night grandpa and his friend dressed up in those funny suits.
There are five grandchildren. Only Cassidy, the year and a half year-old daughter of my son Charlie and his wife Erin, is genetically connected to me. The other four are the grandchildren of my girlfriend Karen Brown. That doesn’t matter. I’ve known and treasured them all since the day they were born.
I am a happy man. Karen is my love and we are devoted to each other. We share a beautiful house and we travel widely. Because I’ve had enough sense to follow Charles’ advice (he’s a semi-retired securities analyst), I am financially comfortable. We have many good friends. My health is fine. I stay busy with magazine assignments and local civic affairs.
A French restaurant is catering the meal. Waiters are serving champagne and hors d’oeuvres in the large living room with a tall Christmas tree in one corner. It is time for dinner. We enter a candlelit dining room a glitter with sparkling crystal and silver. I settle at my place at the table and switch off my power wheelchair.

December 1981

“When there’s a bed open, we’re going to move you down to the intensive care unit,” the doctor says.

“When will that be?”

“It shouldn’t be too long.”

“Why do you want me there?”

“We want to watch you closely. We can do that better in the ICU.”

“Oh.”

He is matter-of-fact, calm, but so am I. I am stepping back and looking at this as I would an assignment. I am detached. I am covering my own story and I want to get it right. If it doesn’t turn out to be something to write about, it certainly is something I’m going to talk about, maybe for years to come.

Being admitted to a hospital is a significant event in most lives. It certainly is in mine. It had happened to me only twice in my 44 years—once to have my tonsils out and once for a broken wrist.

When I got up to use the bathroom early this morning I noticed a slight weakness in my left leg. I started to worry, but then I remembered all the yard work I’d been doing. That’s why the leg feels strange. I went back to bed and quickly fell asleep.

Six a.m. and the clock radio snaps on. The usual routine—my wife, Rikki, heads for one bathroom and I go to the other. The odd feeling in my leg surprises me until I recall the earlier trip to the bathroom. The leg is worse. I shower, shave and pause to tell Rikki about it. We agree that I probably pulled a muscle climbing the ladder to clean our roof gutters.

It’s a little difficult going upstairs. I tell myself that if I ignore the weakness it will go away. Dressing is no problem, but going back downstairs is tricky. Fortunately, the house is very old and the stairs are narrow. I use the walls for support.

Rikki and I have our coffee and talk about other things. “Let me try the leg again,” I suddenly say, walking to the sofa at the far end of the room. Something is definitely wrong—something serious. This isn’t a pulled muscle. I’ve had those. This feels different from anything that’s ever happened to me. Maybe I’m having a stroke.

“I’m calling Wanda. She’ll know what to do,” I say, sitting on the sofa. Wanda Heistand teaches nursing. Her husband, Dale, a good friend, is a Columbia University professor who had a very mild stroke not long ago. That’s probably why I’m thinking about it.

I calmly tell Wanda my symptoms. As I talk, I look outside. It’s a mild, overcast December morning. It is not a good day to die or to do anything else in particular. It’s a real nothing day. Wanda is sympathetic and concerned. She doesn’t mention the possibility of a stroke or try to guess what’s wrong. She suggests I call a doctor. It’s not yet seven am.

The problem is we don’t have a family doctor since we’re almost never sick. Then I remember that several months ago Rikki had strep throat and went to a young woman doctor who recently opened a practice. In general, my wife is not crazy about doctors, but she liked this one, Dr. Julia Palmer. I’d said then that if I got sick I would also use Dr. Palmer.

I reach her answering service. I have a weakness in my left leg and it could be an emergency, I calmly report. No, I am not a patient but my wife is. The operator seems unimpressed. As I’m telling Rikki that I don’t think we’ll hear from Dr. Palmer, the phone rings. It’s Dr. Palmer. She’s very concerned. Go directly to the Nyack Hospital emergency room, she advises. No, she can’t meet me because they haven’t yet admitted her there to practice but she’ll call a colleague and he’ll meet me. Good, I say, I don’t have all day to spend on this; I have to get to work.

“You sure you want to drive?” asks Rikki. Yes, I want to drive. I always want to drive. We have two cars and I take the one with automatic transmission. I tell Rikki I don’t believe my leg is strong enough now to push the clutch pedal on the other one.

During the first part of the short trip to the hospital I think about death, but I’m not frightened. The road is so familiar. I drive this way every morning on my way to work. The day again turns strange when I reach my usual entrance to the New York State Thruway and don’t take it.

For the first time I tell Rikki that I think I may be having a stroke. As I say it, I wonder if I believe it. If I believe it, why am I driving on Route 9W, a dangerous highway? Am I play-acting? I honestly don’t know. “You’ve given me a wonderful life,” I say, as if it’s over. Violins please, Mr. Previn.

Our mood is appropriately solemn as we reach the hospital parking lot. “Parking for Emergency Room Only,” says the sign. Jesus, I suddenly think there is nothing wrong with my leg. I am a total asshole! When I get out of the car I’m actually delighted to find the leg is weaker than before. For once, the car didn’t fix itself on the way to the mechanic. I find I can’t walk without a limp. I’m not making this up.

Dr. Palmer’s colleague hasn’t yet arrived. Instead, an emergency room doctor, ending his shift, examines me. He’s an American in his late fifties and he looks exhausted. It’s more than the long night that tires him, its life itself. He’s a defeated man. Booze? Drugs? Bad marriage? Malpractice? Something got him. He takes a brief history. I tell him that I recently returned from a business trip around the world. I was in Sumatra. I was in New Delhi. Do I have a tropical disease? He’s doubtful.

I remember a sophomoric joke from high school: “Doctor, Doctor, I’m suffering from a strange tropical disease.”

“What’s the disease?” asks the doctor.

“Lack o’ nookie,” replies the patient. I refrain from telling the joke. My temperature, heart rate and blood pressure are normal.

He tells me to lie on my back on an examining table with my knees bent. “Push your left foot into my hand. Now your right foot. Now again. I don’t think your left leg is weak,” he says, finally. “I can’t find anything wrong. Why don’t you go home.”

“No,” I tell him, “I’ll wait for the other doctor.” Rikki joins me in the curtained off cubicle. We whisper.

“What if this new doctor also tells you there’s nothing wrong?”

“Then we’ll try another hospital. I know there’s something wrong.” Rikki has bought The New York Times. We split it and start to read, I can’t concentrate. There’s a sobbing child in the next cubicle who needs stitches; a victim of an auto accident in another.

I call work to let them know what happened. “So I’m going to be a little late,” I tell Warren Jones, my boss and one of my best friends, as I hang up.

At last, Howard Long, the doctor Dr. Palmer sent arrives. He’s in his thirties—youthful, bearded, and self-assured. He listens carefully to my story and tests my legs. “Your blood pressure is normal. I don’t think you’re having a stroke but there is some weakness in your left leg. I’d like a neurologist to examine you.”

Dr. Leon Schwartz, the neurologist, is an elegant dresser. I suspect the cuffs on his suit jackets actually button. His examination is quick. I lie on my back and push my feet into his hands. He tests my reflexes. They’re normal. Doesn’t everyone’s leg jump when you hit it with a hammer?

I tell them about the trip. I’ve been back about a month. “Did you have shots before you left?” asks Dr. Schwartz.

“Yes. Typhoid, small pox and cholera, I think.”

“Any upset stomachs, colds anything like that?”

“Yes, as a matter of fact I had stomach cramps and diarrhea over the Thanksgiving weekend.” That was the weekend before last. “What do you think is wrong?”

“I’m not sure what you have, but I suspect it’s Guillain-Barré syndrome. It’s a neurological disorder that makes you very weak. We’d like to admit you and do some more tests.” Dr. Schwartz seems like a man at the top of his game. He’s in his forties, old enough to have all the necessary experience, but not yet tired of the job. I trust him.

They have me undress and don a hospital gown. A nurse folds everything neatly and slips it into a clear plastic bag. She gives it to Rikki to bring home. “That doesn’t make any sense,” I protest. “I won’t be here all that long. Why don’t I keep my clothes?”

“You don’t know how long you’ll be here,” the nurse says. “Your wife can bring clothes in when you’re discharged,” For the first time it occurs to me that I might not be home in a few hours.

It’s already afternoon. Rikki needs to phone some of her skating students and do some household chores. I’m to call when I know my room number. She’ll be back in a couple of hours.

An elderly hospital volunteer is pushing me on a stretcher. It makes me feel silly “You’re heavier than you look,” he says.

“Yeah, I know,” I say sharply. I hate nothing more than discussing my weight. I weigh about 190, up from the 178 I’d reached several months ago after strenuous dieting. Before that, I’d been around 230 and that wasn’t my all-time high. I am exactly six feet tall and always look as though I weigh less than I do. At 190, I feel I don’t look bad.

My bed is by the window on the backside of an upper floor of the hospital’s new wing. It looks across the highway at a cemetery that rises steeply up a hill. Tombstones and monuments bearing the family names of people I’ve lived with much of my life fills the place. The hospital faces Nyack High School. I graduated from there in 1955. I have lived in and near Nyack since 1949. My roots are here.

My roommate is an Italian-American in his seventies who nods hello when I arrive then quickly dozes off. I gaze out the window. I’m tired of this whole business. I want to go home.

When my roommate’s wife and son visit I try the paper again but I can’t avoid their conversation. “You should be happy,’ Pop,” the son tells him, “The doctor said you’re going to be all right.” Pop looks anything but happy.

“Everyone is asking about you,” his wife adds. “They’re glad you’re coming home.” She’s at least ten years younger than he is. The son is about my age and sloppy fat.

The son starts a conversation with me. He lives in Connecticut where he’s a manager in a Sears, but he grew up in Haverstraw. His parents still live there. Nyack and Haverstraw were bitter sports rivals when we were in high school. He was on the Haverstraw football team. Do I remember the Nyack teams? Sure I do. Do I remember two Nyack players from that era that went on to play in the National Football League? Is the Pope Catholic? “What are you in for?” he asks.

“The doctors want to do some tests. They think I may have Guillain-Barré syndrome. Ever hear of that?” His pleasant face is suddenly troubled. “What’s wrong?” I ask, frightened.

“A buddy of mine was laid up in the hospital three months with that, but he’s better now.” That can’t be, I think. I don’t have three months to spend in a hospital.

“But three months,” I say.

“Yeah, I know. Maybe you don’t have it so bad,” he says. Maybe I don’t have it at all, I think.

“Tell me all about your friend.”

“A whole bunch of us were down in Acapulco on vacation. The day before we were to come back, he felt very weak. We practically had to carry him on the plane. As soon as we landed, we took him right to a hospital. He had a rough time, but he’s better now.” He looks at his watch. It’s time for him to leave.

“Pop, I have to go. After I drop Mama home, I have that long drive home but just think, next time I’ll see you, you’ll be home,” he says, bending awkwardly to kiss his father.

“Ralph, Ralph,” the old man says.

“Yes, Papa.”

“Lose some weight, Ralph.”

“I plan to Pop, just as soon as the holidays are over. There are so many parties and such good food. I’ll start right after.” I feel Ralph’s pain and humiliation but I think Ralph could start before the holidays. After all, it’s only December second.

I’m supposed to call Rikki. I reach for the bedside phone and find that my hand is too weak to pick it up. I can’t believe how feeble I’ve become. I’m not frightened. I think it’s funny.

I want the back of the bed up so I can read the paper but the control has slid down the railing, out of my reach. I call a nurse to help me. “Why would anyone put the control down there?” I ask.

“To torture patients,” she says with a wink. Only a short while ago I could have reached it easily. I find I only can read the stories at the bottom of the front page because the paper is too heavy to move. Again, I think it’s funny.

When Rikki arrives she’s annoyed with me for not calling her. She is one of world’s most reliable people and doesn’t easily tolerate missed calls and appointments. If you asked her to meet you on the south walkway of the Golden Gate Bridge at noon on July 4 ten years from now and she wasn’t there you’d assume she was dead. As a competitive figure skater, she’d had to show up on time for lessons or catch absolute hell from her coach.

I explain that I’m too weak to pick up the phone. I try it again, so she can see. I still can’t. I also repeat Ralph’s story about his friend. Then I show her how heavy the newspaper has become. “I’m turning into the world’s weakest man.”

“You better watch it or I’ll knock you into next week,” Rikki threatens. We laugh like fools.

Now Dr. Schwartz and Dr. Long arrive with Dr. Peter Fields, an internist. They don’t seem surprised when I tell them how much weaker I’ve become. They ask Rikki to wait outside. Dr. Schwartz wants to inject my leg with something. “If it is another disease with the same symptoms,” he explains, “you’ll immediately start to regain your strength.”

“That sounds like the princess kissing the frog. You know, like something in a fairy tale. That sort of thing,” I say. They smile tensely and Dr. Schwartz gives me the shot in the left thigh. Nothing happens. Now Dr. Fields, who is a respiratory specialist, has me blow as hard as I can into a metal device.

“We’d like to do a lumbar puncture,” says Dr. Schwartz.

“What’s that?”

“It’s also called a spinal tap.”

“I don’t want it.”

“We really need this test.”

“Is it so important?” I ask.

“It’s vital. It’ll measure the protein level of the fluid in your spinal cord. It’s the one way we have of determining for sure if you have Guillain-Barré,” Dr. Schwartz explains.

“Why don’t you want it, Bob?” asks Dr. Fields, his balding forehead wrinkled with concern.

“I’m afraid of it. I’ve read it’s dangerous and painful.”

“It is really a routine procedure,” Dr. Fields says, reassuringly. “As for the pain, you’ll use extra Novocain, won’t you, Leon?”

“Sure,” says Dr. Schwartz.

They are the doctors. There is no way for me to argue with them unless I’m willing to be totally unreasonable and unscientific. I agree to the spinal tap.

“I don’t think I ever heard of Guillain-Barré,” I tell Dr. Schwartz when we’re alone.

“I bet you have,” he says. “Remember in 1976 people got sick from swine flu inoculations. What they had was Guillain-Barré. There was a great deal of publicity about it then.” Now I remember. It paralyzed some people.

“Dr. Schwartz, if you were me,” I ask, “would you rather have a stroke or Guillain-Barré?” I am thinking about my friend Dale, the Columbia professor. He was in the hospital for less than a week when he had his stroke, not three months.

“Guillain-Barré, no doubt about it.”

“Why?”

“Because you recover completely from Guillain-Barré. Strokes usually leave some terrible aftereffects.”

I’m confused. The only aftereffect Dale suffered was some slight restriction in the movement of one thumb. I have read a great many popular books and articles about medicine and the life of doctors, and now, when it counts, I can’t remember one helpful fact.

Before I have a chance to ask another question, Dr. Schwartz has me turn on my side and he injects the Novocain somewhere above the small of my back. After a short while, the area goes numb. Now he’s ready for the spinal tap itself. He’s got me bent as much as possible on my side. There’s terrific pressure against my back as he forces the needle between my vertebrae and into my spinal column. I feel no pain but I’m ill, nauseous. I’m glad it’s over. I hope I never have another. That’s when he tells me that they want to move me to intensive care.

Rikki and I are holding hands as I give her a report on everything that’s happened. She knows even less than I do about spinal taps and strokes. We share a sense of entering an alien world.

“Some real friends ordered this for you,” jokes the nurse as she delivers my dinner tray. It has only ice cream, milk, and coffee on it. I haven’t eaten all day, but I don’t care what they serve me. I’m still queasy from the spinal tap. My hand can barely hold the spoon. The ice cream is half melted and tastes grainy. I sip some of the milk through a straw. It’s been years since I had milk this way.

I ask Rikki to find a nurse. I need to pee but I know I’m too weak to walk to the bathroom without help. The nurse tells me to use a urinal. She draws the curtain between the beds and she and Rikki step out. I’m inhibited. If I could hear some water running it might help. She can’t do that. “Could you bring me a basin of warm water for me to put my hand in?”

“What good will that do?”

“In the Air Force, sometimes when someone was sleeping we put their hand in warm water. It made them wet their beds.”

“Why don’t you try the urinal again?”

When she draws the curtain again, I think of a Colorado mountaintop I visited this spring while getting material for some stories. Water from melting snows gushed down the mountain with a tremendous roar. Someone told me that they film beer commercials there. These watery thoughts don’t help.

“I guess I didn’t have to go so bad,” I say when Rikki returns. I’m lying.

“Have you gone since you’ve been here?” she asks.

“Well, no.”

“Darling, that’s been all day.”

“You know how I am. I don’t go often. I’ll go later.”

“Mr. Samuels?”

“Yes.” It’s a very young, attractive nurse with a clipboard.

“I have to ask you some questions.”

“Sure, but tell me what’s happened to my bed in intensive care?” Am I the first patient ever to be in a hurry to get to the ICU?

“I guess it’s not yet ready.”

“Are we waiting for someone to die to free it?”

“You’re terrible,” she says, but her tone suggests I may be right.

I’ve already answered most of the questions on her form. Again I tell about childhood diseases and family mortality. My mother died of stomach cancer when I was a small child and my older sister died of a brain tumor in 1975. My father is alive and well and, at 79, living in Mexico, I say with relief.

Finally, they’ve come to get me. Several months ago I had visited my mother-in-law in the intensive care unit of a hospital in Port Chester, New York. She had suffered a mild heart attack. The ward was a large, cheerful room with a distant view of Long Island Sound.

The elevator descends and they roll me into Nyack’s ICU. It’s a tomb, a bunker. If it’s not in the basement or sub-basement, it might as well be. This grim place has no windows. The center of the ward has a nursing station with desks and equipment. Around the perimeter are a dozen beds with patients, all seemingly hooked to machines. Thank God I need no machines.

My doctors are standing by the one empty bed. They look like hosts waiting for the overdue guest of honor. “Sorry I’m late fellas,” I say cheerily as two nurses slide me from the stretcher to the bed. Dr. Long laughs politely and the others smile.

“How are you feeling now?” Dr. Long asks.

“Fine.”

“Any problems?”

“No, none at all.”

“He hasn’t been able to urinate,” blurts Rikki. I’d almost forgotten that. Now, as she mentions it, I again have to go badly.

I think my problem is psychological, not physical, I say.

“When did you last go?” asks Dr. Long.

“When I got up this morning.” The doctors exchange glances.

“The reason you haven’t been able to urinate is physical, not psychological,” says Dr. Long. “I think he should have a catheter,” he casually tells the others. They nod in agreement and I nod too, as if I also think it a splendid idea. Actually, I’m nodding in terror.

I remember visiting my father in a Manhattan hospital some 10 years ago, just after his prostate operation. It was early evening on a steamy August day and I was on my way home from work as a reporter at the World-Telegram and Sun.

In the dim room light, I thought my father was dead. Then I saw he was breathing but asleep. Through the open fly of his pajamas I could see his penis, a stainless steel catheter stuck in its end. The shock of seeing that catheter in my father is still with me. For a long while the memory gave me nightmares. Every time I hear the word prostate I think of that catheter. Now, they want to give me one.

I am speechless with fright. They draw the curtain around my bed and ask Rikki to leave for a few minutes. She has no idea of my terror. I had never told her about the catheter in my father. I’d never told anyone.

It turns out that something that I had secretly feared for 10 years is nothing to fear at all. The procedure is quick and painless. It is a great relief to have it over, but mostly it’s a relief to urinate. It’s the true pause that refreshes.

They’re going to leave the catheter in, they explain, because it will be impossible for me to urinate for a while. The nerves to the muscles that control the bladder have stopped working. I don’t care, as long as no one sees the catheter. No one else should have my nightmares.

“Are you sure I have Guillain-Barré?” I ask Dr. Schwartz.

“Almost certain. The protein level of your spinal fluid is very high.”

“Do you know how I got this disease?”

“No, not positively. It may have been an allergic reaction to the inoculations you had before your trip. Then again, many cases report upper respiratory infections or stomach flu before coming down with it. You said you had stomach problems over Thanksgiving,” he points out.

For the first time he explains what’s going on inside my body: “Your nerves have a fatty covering called myelin. It acts as an insulator. With Guillain-Barré, this insulation is burned away and messages sent from your brain to your muscles are short-circuited. As a result, your brain isn’t able to tell your muscles what it wants.”

“When will it stop? How far will it go?”

“We can’t tell,” he says, “but one thing for you to remember is eventually that the myelin grows back and you do recover.”

They’ve hooked electrodes to my chest. My heart rate and other information are displayed on a digital readout. There are tubes and wires all over me. Every time the slightest thing goes wrong with one of these devices, an alarm rings. They go off so often that no one seems upset when they hear one. I wonder what happens when there’s a genuine emergency.

Dr. Fields again has me blow hard into an instrument. You’re having trouble breathing,” he declares. I don’t feel I am at all but what do I know? He wants me to use a respirator. Although I can breathe on my own now, I may have real problems later on, he says.

Rikki and I know almost nothing about respirators. All I can remember is that my friend, Stanley Spiegel, was on one for some hours following open-heart surgery. They’d shoved something down his throat and when they removed it he was left with a terrible sore throat.

Why don’t you go get some dinner now, the doctors tell Rikki. They’ll put me on the respirator while she’s gone. Somehow they neglect to mention that I won’t be able to talk when she returns. We have no last words.

“Why not use an iron lung?” I ask after she’s gone. I remember all the dramatic newsreels I’d seen as a kid of polio victims in iron lungs. It would be a way to avoid that sore throat. It had sounded terrible.

Iron lungs are old fashioned, Dr. Fields explains. They’re seldom used today. Respirators are better. What do I know? My ignorance is vast.

The procedure is quite simple. They are going to spray my throat with some fluid from an aerosol can. That’ll keep me from gagging. Then they’ll shove this thick tube down that will be hooked with a hose to the respirator. It doesn’t occur to me to ask how, with the tube in my throat, I’ll eat, drink, talk, or even spit.

Now it’s happening. They’ve sprayed my throat. Dr. Fields is pushing the thing in. Christ, no wonder Stanley had a sore throat. This hurts like hell but the spray works—I’m not gagging. Did Linda Lovelace use it in the movie “Deep Throat”? The tube is surely larger than anything Linda had to swallow. What kind of mind do I have?

I’m choking. Jesus! A nurse has a thin, clear, plastic tube and she’s suctioning mucus from my mouth and my nose. The plastic tube steals my breath; making my extremities tingle from lack of oxygen. When she jams the catheter down my throat, I feel as if I’m gagging, except I cannot gag. When she pushes it up my nose, my eyes tear and the irritation makes my nose run even more. I’m a damn fountain of mucus!

“Relax, let the machine breathe for you,” says Dr. Fields. That’s easy for you to say but it’s not so easy to do. I’ll try. One breathe, two breathes. I can’t do this—it’s impossible. The machine has a rhythm that is its rhythm not my rhythm. It has a sound that’s all its own too. It’s the noise of a bellows driven by a powerful electric motor.

Again, I’m choking. More suctioning. I’m drowning. How long are they going to keep this tube in? I haven’t asked. Can’t ask now. Don’t think about that.

“Relax, Bob, relax,” Dr. Fields is saying. “The machine will breathe for you.” I’m drowning again. More suctioning. My nose is a river.

I’m so uncomfortable. All I can move are my arms, one leg and my head—that’s all. The rest is too weak. I want to turn over but I can’t. “I’m going to put you on your side,” says the nurse who has been suctioning me. Sweet Angel, how did you know? She rolls me to my left, skillfully stuffing pillows behind me so I don’t slide back. Comfort, relief, but now I’m drowning again. More suctioning—nose, mouth. I’m a fucking fountain of mucus!

I hear Rikki’s voice over the sound of the respirator, but I can’t see her yet. Now she’s here and she looks stunned. She didn’t know what it meant when they said they were putting me on a respirator. I can’t tell her that I feel all right now, now that she’s back. Because of the tube, I can’t talk. Instead, I wink.

“Oh darling,” she says, clutching my hand, her eyes brimming with tears.