Waiting in the Dark
by Annette Gendler
followed by Q&A
On the third day, they move Harry, my husband, to a private room. We return from his smoking break to find we have a different view. The grid of gray glass rectangles of the hospital wall across the courtyard has been replaced by the steep black shingles atop red brick walls, dormers of the roof of the American School of Correspondence, and beyond it, the concrete rectangle of another University of Chicago building.
My eyes will come to appreciate the roof’s variety of shapes, the tar shingles that sparkle in the late summer sun, the green of the oxidized copper dormers, the red brick chimney, the blue sky beyond. For inside the hospital, all is square and all colors are muted. Mauve and mint, beige and gray. All those pastels lull me.
I smooth out our children’s paintings that the nurse brought over from Harry’s former room. Our five-year-old’s poster-size picture features a landscape in thick brushstrokes: a sun rimmed in red with orange rays, purple dots flying through the air, a tree with an orange trunk. Our middle son is not into drawing pictures, but he relinquished his favorite teddy bear to keep Daddy company. Our daughter, the fourth-grader, sends one picture a day: a heart with “I miss you, Daddy,” a rainbow with “I love you, Daddy,” and a pattern of interlaced curvy forms, colored red, purple, green, and yellow with the superscript “Get well, Daddy.” I arrange them on the bulletin board facing the bed.
It is an ordered society here, in the inpatient part of the hospital. Wide cotton gowns, their pattern of small gray diamonds filled with beige circles pale from many washings, signify the patients. White coats with names stitched in cursive blue letters on the left breast pocket are for doctors and registered nurses. Wildly patterned lavender and mint pantsuits are for regular nurses, navy pant suits for transportation or environmental services personnel. Anyone in regular casual clothes, like me, is a “family member.” Anyone in business clothes is part of hospital administration and rarely seen on the upper floors.
Stomach pains had plagued Harry for a week. When they worsened and he ran a fever, he had gone to Urgent Care. Intestinal inflammation, said the doctor. Take some antibiotics. For good measure, they had done a CT scan. The next day, the Saturday of Labor Day weekend, a call from our doctor: “The attending radiologist reviewed your CT scan. There is a foreign object in your stomach. It looks something like a needle. You must come to the Emergency Room at once.”
We had been sitting outside on the porch, reminiscing with Harry’s mom about the trip to Hawaii we all had returned from a week earlier. Her bags were packed; she was scheduled to fly home that afternoon. A foreign object in Harry’s stomach was hard to fathom, especially since he had no recollection of choking or biting on anything hard, but I could almost see our doctor’s serious look through the phone. She was not kidding.
Harry’s mom sprang into mother mode: “I will stay, no problem. I’ll take care of the kids. You go with Harry.” We canceled her flight, outfitted her with one of our cell phones, and vanished into the hospital world.
Something was in Harry’s stomach that was visible on only one frame of a CT scan. One frame out of a hundred. The ER attending physician clicked through frame after frame to show us the one. It looked like a needle.
We were told this thing had to be extracted because it seemed to have perforated the stomach wall and was poking into the pancreas. Two blood tests showed that not only was Harry’s white blood cell count up (signaling an infection), but his amylase and lipase, the enzymes produced by the pancreas, were elevated at 204 and 423. I learned that the normal range for amalyse is 28-100; for lipase 11-65. The pancreas, so I now understand, is a delicate organ that produces insulin and other enzymes needed for digestion. Harry didn’t have pancreatitis (inflammation of the pancreas) yet, but that was a danger.
Our doctor came to the ER that evening, in her workout clothes, to check on us. The surgery night team was ready to admit, if not to operate.
“Is this really necessary?” Harry asked our doctor.
“You’d be taking your life in your hands if you left,” was her reply.
Two months from now, I will attend a writer’s conference where a panelist will relate the story of Martha Frick, daughter of steel tycoon Henry Clay Frick. As a writer-in-residence of the Frick Foundation, the panelist had noticed the prevalence of children’s images in the artwork displayed in Frick’s mansion, and had become interested in the soft side of this man who had run the Carnegie Steel Company.
I will listen to this panelist’s account, an old fear spreading in my stomach. I will jot “Martha Frick” in my notebook, but I won’t be able to forget her story. I will research her, and I will find the following account:
- In the winter of 1889, the nurse who had been changing Martha noticed a small spot on the child’s right side that had split open and was oozing pus. Startled, the nurse wiped the pus away and was horrified to find a black pin exiting the wound. In thinking back over the onset of Martha’s illness two years before, and her constant suffering since that time, all realized that Martha must have somehow swallowed the pin in Paris during the summer of 1887--and that for almost two years, as the pressure of the abscess grew, the pin had been pushing through her body.
- […] Limited to the science of his day, Dr. McClelland made a half-inch incision, cleaned the wound, and considered the operation a success. But Martha cried day and night after the operation. The doctors could not tell what the trouble was, for the pin was out and the incision had healed over. Unknown to them, however, a peritoneal abscess had formed in the trail left by the pin, and infection was filling Martha’s abdominal cavity. Unwittingly, the doctors exacerbated the situation because their knowledge of bacteriology was so limited and the practice of aseptic surgery unknown. Instruments were not sterilized; nor had the surgeons scrubbed or worn sterile protective clothing.
Henry Clay Frick: An Intimate Portrait
by Martha Frick Symington Sanger
Martha died two years later, at age six, after her wound had reopened and pus poured out again.
A needle is such a small object, such a small detail. One person not minding a detail, like a pin lying about, can cause another’s misery, severe illness, even death. The if’s pile up in my mind: If Harry hadn’t gone to the doctor on time, if they hadn’t done the CT scan, if the radiologist hadn’t paid attention to that one frame, if we didn’t live in the time of CT scans. The if’s--fate’s icy breath--are in the small things.
It is not like the doctors know it all nowadays. We follow them on an exploration, and they are simply one step ahead of us, interpreting the facts as they present themselves. Harry and I have to rely on their expert knowledge to make decisions about his body. Expert knowledge of people we have just met. How do we know that the facts could not be interpreted some other way?
That is where community comes in. Community works in circles, not up and down like the hospital hierarchy. From the ER, I call a friend who has other people’s phone numbers. People who attend religious services with us, people we chat with at congregational events, people who are doctors at this hospital.
“Do you know Dr. F?” I ask one of these people. “Is Dr. F a good surgeon? He’s Harry’s attending.” I have picked up hospital speak: you don’t say “attending doctor,” you say “attending.” The attending is the master of your fate. It turns out that our acquaintance knows Dr. F’s boss, a pancreatic specialist.
The next morning, a Sunday, the doctor we know is on call and stops by Harry’s room and talks. He likes to talk. I figure the more expert talking from someone you know, the better. Calms the nerves. Yes, Dr. F’s boss is reliable, and he will call him, will tell him that a friend of his is under Dr. F’s care and ask him to keep an eye out. There should be nothing to worry about, we are told. Dr. F gets the highest marks in the medical literature and seems to be a fine doctor.
Later that morning, Dr. F, the attending, makes his Sunday rounds in civilian clothes, no white coat, with his two sons in tow. The boys must be four and five, and they do not make a peep, but sway around their daddy’s legs. Dr. F makes a good impression on us. I could picture him behind a deli counter, asking in his raspy Italian accent whether we want the sirloin or the shoulder cut. He has that competency in his craft about him. Even if the craft is unpleasant, it’s necessary. He takes the time to answer our questions, to explain his approach: “We’re not going in right away, we’re taking the conservative approach, do an endoscopy first as we don’t know what’s in there. Maybe we can see it from the inside of the stomach, chances are not high that we will, but it is worth a try.”
Problem is, this is Labor Day weekend and no specialists are in the hospital to perform this procedure, and this is not a life-threatening emergency that warrants disturbing someone’s holiday weekend. Dr. F does not say that, but we know. He says if he can find Dr. D, if Dr. D is on call, then maybe they can do it over the weekend. Dr. D is whom he calls to fish razor blades out of peoples’ stomachs. Harry and I must look puzzled.
“Yes,” he says, “there are people who swallow razor blades. Voluntarily.”
Does Harry have to stay on IV? No food, no drink until Tuesday? Why can’t he go home and come in for blood tests once a day?
“Too risky, that would not be advisable,” says Dr. F. “We don’t know for sure if the stomach is perforated, or how badly it is perforated. It could be leaking. The pancreas could flip out at any time. It’s too risky.”
So we stay in the hospital over Labor Day weekend. Harry with the hospital gown over his pants, pushing his IV pole along. Gone is the man who prefers polo shirts to T-shirts. Gone is the man who likes to wonder about his next meal, his jolly belly is now hidden under a pastel-colored gown.
We hang out where the smokers gather in the concrete-tiled courtyard off the hospital’s main entrance. Cigarette butts litter the gravel around a few scruffy bushes. I sit on one of the benches lined up along the wall; the grid of its seating surface imprints a pattern of squares on my palm as I press my hand into it.
Harry prefers to stand. He sneaks a few cigarettes. The only pleasure allowed. An elderly lady in a wheel chair holds up a light for him. As he bends down and his dark head hovers over her hand, she asks: “Were you in the ER Saturday night?”
“You’re the man from the ER! I remember you! I don’t forget nobody who was good to me. You gave up the restroom because I was havin’ a bladder accident.”
She surveys all of us smokers and smoker-companions and nods toward Harry: “And that man was already in the bathroom. And he came out for me.”
She zeroes in on me: “He your husband?”
“You got yourself a good man. A good man.”
I feel myself swell, just a little bit, with pride.
On Tuesday, they call us for the endoscopy at noon. We trek through the tunnel from the inpatient to the outpatient building where the procedure is to be performed. Harry’s bed is rolled into a cubicle, and I am assigned the guest chair that is squeezed next to it. The cubicle has about two feet of space on either side of the bed, and a wall of cabinets with a sink behind it. Artificial light, no window in sight. I have my tote bag with a lunch packed, so creature comforts for the “family member” are taken care of. Harry does not need creature comforts. Just his IV pole and the occasional trip to the toilet.
We leave the curtain open and look out at eight cubicles on either side of this white linoleum corridor. Eight cubicles where patients wait for their procedures, mainly colonoscopies. We are lined up like caged hens, waiting to produce an egg.
We watch patients being rolled in and out of cubicle number five opposite us. One patient with tightly cropped gray hair makes sure his nurse knows he is a gynecologist. Desperate to show that he is not an ordinary patient, that he is, under other circumstances, part of the white coat caste, he engages the doctor who is going to do his colonoscopy in a chat about rising insurance rates. When he is wheeled out, I only see his proper short hair and his socks, beige and dressy. After him, a girl is in the cubicle, tucked tight into her bed. She is crying, whimpering. Hearing her weep softens my reserve. I turn away and ask Harry if the blanket keeps him warm enough. It is the only time during all of this that I feel tears well up.
Other people come in and out of cubicle five, but after a while they blend together. Waiting changes your sense of time, makes things blend together. At any other appointment, in ordinary life, we would have flung down our magazines and left in a rage after an hour. But here we arrived knowing Harry was an “add-on” to the schedule, happy that this specialist would tend to him. And so the clock ticks on and we sit and stretch and talk and call Harry’s mom to see how she is getting on with the kids. We do not fidget, we do not sigh. We just sit in our cube like dutiful hens. Once in a while I glance at my watch, report the time to Harry. One thirty, almost two, three o’clock. Harry keeps saying this is an academic exercise. After all, this is a teaching hospital. They know they won’t be able to extract the thing. And I keep saying there is always the off chance, trying to keep his spirits up.
In the end, the anesthesiologist appears at 3:30, and later Dr. D, the one who fishes razor blades from stomachs.
I emerge from the double doors behind which I left Harry to Dr. D. If he is unable to extract the foreign object from Harry’s stomach, Harry faces surgery the next day.
I figure I’m in for at least two hours of waiting since Harry is under general anesthesia. Time for a cup of coffee. Since I’m in the outpatient building, the Au Bon Pain cafeteria in the inpatient building with its lattes and croissants is far away. I make my way to the food court four floors down, but find only brown- and orange-rimmed glass coffee machine pots, their contents thickened to a syrupy brown. I need some good coffee. I wander farther, out into the sunshine and over to the university bookstore café where Starbucks is brewed. It is warm outside and blindingly bright. I breathe in the fresh air. When you spend your days in cubicles behind pastel-patterned curtains, walking two blocks along a city street lined by young, promising trees is more than a luxury. It is freedom.
At the coffee shop, I marvel at life going on in its mundane way. People are chatting, buying books, ordering sandwiches, while just a block away, under fluorescent lights, a doctor is poking around inside my husband.
It is 4:30 by the time I return to 6A – Gastroenterology, and the lights are off, the lobby empty, the secretary’s desk abandoned. A puddle of fear pools in my stomach. I drag one of the chairs over to a skylight; sit down, cross my feet. I study my toes sticking out of my sandals. I’m in bad need of a pedicure. But there’s been no time for that. There’s just time for waiting, for being on call. I pull a magazine from my bag.
A voice pipes up in the emptiness: “Are patients waiting in the dark now?” I look up to see a small man in the twilight waiting area, wielding a stainless steel coffee cup.
I smile. “No kidding,” I answer. “I looked for a light switch but couldn’t find one. So I pulled the chair over here, closer to the skylight.”
He surveys the scene, including my disarrangement of the seats. “The light’s probably centrally controlled,” he says and plops down two seats from me.
“I don’t know about you,” he continues, tugging his long thin ponytail, “but I intend to be out of here in twenty minutes.”
Twenty minutes? The last four days have pounded any expectation out of me to have anything done in less than an hour. Now and then the double doors slam and someone in civilian clothes emerges from Gastroenterology, obviously on the way home. Every time, I expect they are coming for me. I have to be there when they summon me, so I tell my waiting compatriot when I have to go to the restroom. I leave my tote bag stuffed with Harry’s slippers and my magazines propped on my seat, evidence of my presence.
After the restroom break, I settle back into sipping my mocha and leafing through Parenting.
Half an hour later they come for the man with the ponytail. He was right; he didn’t wait much more than twenty minutes. I do not wait that long either, one and a half hours maybe, including my jaunt for coffee, to be called back into the gastroenterology cubicle where Harry lies under several cotton blankets. His bed is elevated so its railing reaches my chest. His forehead glistens; his voice is thick as he says: “Hi.”
We know it did not work when, within what seems like no time at all, Harry’s surgeon Dr. F appears with another doctor in tow. He introduces Dr. H, a specialist in laparoscopic surgery.
Surgery will be tomorrow morning. Show up at 7:30, they advise me. They will try to do it laparoscopically, meaning remote control surgery, meaning a few small incisions and a shorter recovery, hence Dr. H with his interested and benevolent smile. If that does not work, they will have to open Harry up completely. They’ve never seen anything like this. People ingest stuff they shouldn’t often enough, but it usually passes through the system, and if it doesn’t, it would cause trouble in the narrower passage of the stomach. Not up where the stomach is wide and next to the pancreas.
Harry makes Dr. F hold his hand, makes him promise he will perform the surgery himself, not a resident or fellow with only a few years of experience. They clasp hands while Dr. F walks us through the likely procedure, through the if’s and the risks. I look on, knowing that I should feel more anxious than I am. After all, Harry is the rock of my life. But my natural stoicism has taken over, has been augmented even by all the waiting and the if’s and the but’s and the lulling atmosphere of the hospital.
If anything, I feel slightly embarrassed by the drama. Later we will find that soliciting the promise was not necessary. Dr. H’s surgery report will state that “it was necessary for two attendings to adequately and safely perform this operation.”
“Sure puts things in perspective, doesn’t it?” a friend writes in an e-mail. I wonder. I have found that existential events have me obsessed with details. Maybe I focus on the little things because the big things are out of my control.
Twenty years ago, when my dad died suddenly, I asked a friend to go to the city’s fanciest glove boutique and buy me a pair of lacy black half gloves that leave your fingers exposed. I had to have those to attend the memorial service. They had the right unusual glamour for an unusual occasion. They evoked the requisite pathos for me who, up until then, had only seen funerals in movies.
When our children were born, the first thing I’d do as the contractions came on hot and heavy, was jump in the shower and shave my legs, while Harry stood in the bathroom doorway, holding a towel and urging me to hurry for the hospital and the midwife. But no, the legs had to be shaved, and lotion applied, even if I had to sit on the bathtub rim while contractions doubled me over. I had to be prepared; the legs had to look nice. They would be exposed, after all. But most of the time you don’t know when you’ll be exposed. There aren’t always contractions to warn you of your impending vulnerability.
Now, after we’ve made the trek back from the outpatient building to Harry’s hospital room, I wait by Harry’s bedside and obsess about my toenails. I really need to tend to them. What if I were in the hospital bed, not Harry? I would be stuck with toenails that are too long, polish outgrown. I’m not prepared, not in the best shape possible at all times. And I should know that fate can strike and any time, and that one needs to be prepared.
At midnight, after returning from the hospital, after the late night talk with Harry’s mom and packing tomorrow’s bag with Harry’s special requests, I’m rubbing off nail polish. Harry hates it if my toenails aren’t painted red. I figure if I go in tomorrow without it, wearing sandals because it is still warm outside, I will be able to tell how much he is himself by whether or not he notices.
The next morning, I am composed while I trot alongside Harry’s bed as they wheel him to the operating room. I smile when he jokes with the pre-op nurse, while he talks with the anesthesiologist. A final hug and squeeze of Harry’s hand, and then the doors close.
I have never felt so alone. For a few hours now, Harry’s consciousness is extinguished. The world already feels vast and empty. My anchor is gone. And if, just if, he were not to come back, then it would remain that way. I’d have to stay in the world because of the kids. I would be their anchor, but for me, there’d be unending nothingness without him. I would be utterly alone, like I am now. Everything would rest on me. No one to discuss everything with, no one who’d know where I was every given hour of the day, what I was aspiring to, or worried about. No one to care about my toenails. I’d just be going through the motions of being alive.
Numbness settles over me. I walk back along the corridors; follow the red line someone taped to the ceiling to guide family members toward the Surgery Family Waiting Lounge. I learn that I have to check in and out and that I can’t eat and drink in the lounge. But I need my creature comforts. So I check in and I check out. I study the hospital floor plan to make sure I can trace my way back and head for the lobby where the Au Bon Pain cafeteria offers coffee, cinnamon rolls, chocolate croissants, mozzarella and pesto sandwiches, pumpkin soup. I get a latte, a croissant, and a corner table. I can be okay sipping my coffee, scrolling through the e-mails on my BlackBerry. I find a message from my sister. All the best, she writes, we are sending good thoughts your way. I could call her, but if I heard her voice, I would break into tears. I must, however, call Harry’s mom. If I don’t, she’ll show up and then I’ll have to deal with her nerves. I call her: “He’s gone in. I’ll call you when I hear next.”
I start to keep track of time and then I don’t. What does it matter? Do I know if waiting two hours versus four means there are complications? It probably does but I don’t want to think about that. Better to wait until I get the facts. I finish the croissant, the latte. I check back into the lounge. There are stains on the speckled carpet, rips in the maroon vinyl cover of some seats. Why can’t they create a pleasant surrounding for those who are waiting? I don’t want to be here. Everybody here is waiting for a verdict.
A couple sits by the window, the woman’s head on her husband’s lap. Must be parents, must be a child in surgery. I head toward the bathroom, and am about to push open the door when the receptionist chirps: “Mrs. Gendler, call for you.”
“Can I just go to the bathroom?” Let me just get this over with, I think, let me feel ready for whatever I need to face.
“There’s a call for you,” she says sternly. You have to face this now.
I let go of the bathroom door.
It’s the post-op nurse: “Dr. F wanted you to know he’s out. It went well. They will come down shortly to talk to you.”
My heart starts pounding. I go to the bathroom. Then I settle back into my seat and flip through a magazine. I want to look composed when they show up. When Dr. F and Dr. H do saunter in, I fumble with my tote bag, trying to shove in my magazine. I stumble over the bag while they are waving me toward the private consultation room. Dr. H holds the door open for me.
Why do I tremble now? I know Harry is okay, and I must remember to ask the right questions. Harry is lying flat on his back in a room somewhere, eyes closed, monitors flashing. I have to be in charge.
“It was a small thin metallic black wire. About one and a half inches long. Anyone could have swallowed it. Concealed in a piece of food, you wouldn’t notice chewing on it,” Dr. F says.
Thankfully, they were able to do the small operation. Five incisions. If all goes well, he should be out in three days. The pancreas is okay. There was an abscess between the stomach and the pancreas but they scraped it out.
They put blue dye into the stomach to see if it leaked but it didn’t. Nevertheless, no food, no drink until Friday when he will have to take some contrast liquid and they’ll do an X-ray scan to confirm the stomach is not perforated. After that the nose tube will come out and he’ll be able to eat regular food.
I ask: “When can I see him? Where should I wait?”
“Best to wait in his room. It will be another two hours or so before he comes out of recovery.”
I wander back to his room; pick up lunch at Au Bon Pain on the way. I think about how somewhere, somehow, someone dropped a wire into tomatoes being canned, or a batch of sausage meat, or mixed it into a tossed salad, not on purpose, of course, but just hadn’t noticed when a clipping or a shaving fell in. Just like someone, somewhere, left that pin lying about that little Martha Frick picked up and swallowed. But I don’t think of that incident yet because I don’t know of it yet; the Martha Frick story will be for a later haunting, a reminder of the havoc a small carelessness can create.
I sit by the window in Harry’s hospital room. I study the copper green gables outside and I surrender, once again, to the waiting.
Four hours after surgery, Harry wants to get up. The nurse unplugs the suction tube that elongates his nose like an elephant’s trunk, hangs the catheter’s urine sack on the IV pole, pins the drainage bag from the tube emerging from the right side of his stomach to his gown, puts the IV machine on battery. Off he goes.
“Wait,” I say, I stumbling after him, “let me tie the back of your gown.”
“I don’t care if people see my behind,” he says while I fumble with the strings on his back.
“Well, you can’t go about flashing old ladies,” I say.
We make our way down the hallway with its Monet prints. Each patient’s heartbeats are zigzagging across the monitors installed outside the rooms.
We reach the end of the corridor where a large window looks out on the upper deck of the parking garage. In another 30 minutes he’ll stand here again and wave to me as I back out the minivan. But for now, we wait to watch the ball of the sun turn crimson before it dips beyond the horizon.
As we wait, he clings to his IV pole, and for a second looks down, and jerks his head in a double-take. He looks at me accusingly.
“Your feet,” he says, “look terrible.”
Annette Gendler’s essays and memoirs have appeared in many literary journals, most recently Natural Bridge. She’s currently finishing a memoir about an impossible love that succeeded (hers and her husband’s) even though it was the previous generation’s ultimate nightmare: the forbidden love between a German and a Jew. She holds an MFA from Queens University of Charlotte, teaches memoir at StoryStudioChicago, English composition at Kaplan University, and does communications work for her children’s school. She lives in Chicago with her husband and three children.
Q: How is Harry today? Any further complications?
A: Harry is fine except for a painful pancreatitis attack when we were traveling in Israel a year and a half after the surgery. The doctors in Tel Aviv didn’t believe the wire story until our doctor faxed over the documentation.
Q: What surprised you most while writing this piece?
A: Readers always want more emotion from the narrator. I’m by nature rather stoic, and even more so in a crisis situation, so I found it hard to capture the narrator’s emotions.
Q: You teach creative nonfiction writing--what models do you like to share with your students?
A: In my introductory Memoir Workshop we usually read excerpts from Russell Banks, Mary Karr, Frank McCourt, Lauren Slater, Jill Ker Conway, and Vivian Gornick. It’s always amazing to see how differently students respond to texts I’ve read many, many times. There’s something new to discover each time.
Q: Tell us a little about your writing process. After all, you’re a wife, a busy mother of three, and a teacher. How do you make time to write?
A: I get up at five in the morning and write before the craziness of the day breaks loose. I have a former teacher to thank for that, see my recent blog entry. Since I don’t work in the corporate world anymore and my teaching has settled into a routine, I’ve lately also been able to dedicate half a day on Mondays and Tuesdays to write, and I’ve been blessed with two residencies at the Virginia Center for the Creative Arts. All that made it possible for me to finish the book manuscript. You really have to live with a book and that’s almost impossible to do in tidbits of time.