Geoffrey Kurland - My Own Medicine: A Doctors Life as a Patient

My Own Medicine

A DOCTORS LIFE
AS A PATIENT

Geoffrey Kurland, M.D.

Copyright 2002 by Geoffrey Kurland.
All rights reserved. No part of this book may be used or reproduced in any manner whatsoever without written permission from Don Congdon Associates, Inc.: the agency can be reached at dca@doncongdon.com

To the memory of my parents. To the memory of Michael E. Spike Miller, M.D., mentor and colleague. To my friends and family who watched me live through my illness and recovery. To Kris, whose encouragement and support allowed me to write about the experience.

It is quite true what Philosophy says: that Life must be understood backwards. But that makes one forget the other saying: that it must be livedforwards. The more one ponders this, the more it comes to mean that life in the temporal existence never becomes quite intelligible, precisely because at no moment can I find complete quiet to take the backward-looking position.

Sren Kierkegaard, journal entry, 1843

Pain is inevitable; suffering is optional.

anonymous ultrarunner

True autobiography cannot contain direct quotes, unless one constantly carries an instrument like a tape recorder. Instead, this is a memoir, a recollection, and a remembrance. I do not intend the quoted statements in this book to be taken as absolute truths. Their essence, however, is true to my memory. I have elected to change the names of many of the people in this book. For some, it is to protect their privacy. As individuals, however, they will see themselves in these pages.

My Own Medicine

I awake to the night as out of a bad dream, suddenly aware of the darkened room around me. The soft lights in their louvered recesses along the baseboard filter a reluctant glow into the darkness, allowing me to see the bare wall beyond the bed, the blank ceiling above me. I can hear, from behind the partially pulled curtain between us, the stuttered snoring of my elderly roommate. I try to raise my left arm and feel the pull of the adhesive tape, which secures my intravenous line. The door to the small bathroom on my right sways in the half-light, and I feel myself quietly weakening as I will myself into sleep. But there will be no sleep, at least not now. The jolt that has ripped me from sleep is my fever, now rocketing once more to the upper reaches of the thermometer, the sweat building beneath my skin, my muscles about to start the shivering that has been the focal point of my nights now for more than two weeks. With my free hand I reach for the cord and press the small button to summon the nurse. Lying back, I mentally prepare myself for what I know will happen in the next several minutes. As if to mock my preparation, my teeth begin to chatter, now in small spurts, then within moments, in full throttle, threatening to break my jaw, gnash through my own tongue, while my arms, shoulders, legs all shake with a false cold, now uncontrollable even with the meager remnants of a strength that has ebbed from me on a daily basis, perhaps never to return. My roommate, oblivious to my trembling horizontal dance, sleeps deep within his own cancer-driven nightmare. I close my eyes, trying to stop the fever, the chills, the river of sweat that now pours off me, soaking into the bedsheets. The light in the room fades.

Dr. Kurland...

I look up at the nurse, dressed cleanly and efficiently. Her face is fragile, worried, her eyes somber. Shed seen me several hours ago, near midnight, as she started her shift. Back then, shed told me to try to have a better night than the previous dozen or more. Her look now reflects our combined disappointment.

It looks like youre having another chill... put this under your tongue. She hands me the electronic thermometer. I hold the palm-sized box with its digital display and put the plastic-sheathed probe into my mouth, holding my jaw as still as possible to avoid biting the thing. I curl down into a ball, pulling the sheets around me and watch the light on the dial spin madly, as the reading screams past the normal 37 degrees Celsius before slowing and finally stopping well above 40, which is 104 degrees Fahrenheit, pretty warm for a baby, but downright hot for a forty-two year old. I take the plastic protector off the thermometer tip, holding it as if it were some prize Ive won (highest temperature on the ward tonight?), and hand the rest of the device back to the nurse. She gives me some medication and a glass of water, and I blandly take the tablets.

For an unknown reason (the fever? delirium?) I brighten: Hey, to the nurse, do you know the difference between oral and rectal thermometers?

She looks blankly back at me. Uh... I dont know, doctor. Whats the difference?

The taste, I cackle as she rolls her eyes upward.

Very funny.

I am suddenly very tired from shaking, but the intermittent waves of unwanted and undirected movement continue to pass through me. Lets let that work, she says. If this is like other nights, you should feel better in a half hour or so. At least they stopped ordering blood cultures every time you spiked. She talks familiarly with me, for she knows I understand that spike means the sudden burst of fever which, when plotted on a daily temperature sheet, gives it the look of a mountain arising from the topographic plateau of 98.6 at which we all normally live.

I lie back on the bed, feeling the medicine take hold, slowing my shivering, bringing me back to euthermy. I feel as though Ive run ten miles on a humid day in June, which, in fact, it is: June of 1988. But there is to be no running for me, at least not now, not tonight, just as there has not been any for the last two weeks or more. Perhaps, I tell myself, Ill run again, later, when Im better. Or perhaps, I tell myself, Im not going to get better; perhaps Im going to die from this fever that drains my body and soul, this fever that has suddenly appeared in the midst of my treatment. The soaked sheets gather me into their grip as if foretelling a shroud.

The nurse sees me in the wet white linen as she bustles quietly into the room with an armful of clean and dry sheets. Now, if were feeling better, perhaps we should change the sheets. Why, I wonder to myself, do nurses, and doctors for that matter, use the pronoun we so much? My enviable roommate still snores in his bed only a few feet from mine.

I pull myself out of bed and uneasily stand up. I try to help as my bed is stripped, but I am so weak I can barely lift the pillow.

Gee, this stuff is kinda wet, the nurse says.

Kinda is an understatement. Maybe I could wring them out for you. Now I finally know what patients mean when they say they have night sweats and fevers. I hobble the two feet into the bathroom, close the door, and change into dry pajamas, an act that itself takes several minutes because I have to stop after each stage of undressing and dressing just to rest. I shuffle back out and watch the final stages of new sheet placement as I suddenly began to feel better, drier, more awake. I know its only temporary. Like all the previous nights in the hospital, my shivering has stopped almost as fast as it started; I can feel my temperature, so high a few minutes ago, drifting toward normal. I hope that I will be allowed to stay with the rest of humanity at 98.6; but, as Id learned on many other nights, uncertainty is my constant companion.

The bed is ready for my cooler body and I lie down slowly, carefully, as if afraid I might somehow shatter in the movement. I look back up at the nurse, then over at the pile of sheets and pajamas, looking like a misplaced snowbank against the far wall. The night is more than half over, and I just want my illness to end. I want to have something else to think about, talk about.