Part 10 (1/2)

I demand anesthesia. I cannot leave the hospital. I have to be unconscious. Now. She laughs. I try begging. ”Please,” I say, and my eyes tear for the first time. I repeat myself, screaming, so she will know I am not kidding. She is sorry, she claims, but she has given me the maximum dosage. That's not my f.u.c.king problem, and I tell her so.

She wants to cut the shoe off my left foot; I cannot let her. I love these shoes! They are Mary Janes, but they are soft and have soles like sneakers, and they are pink with red checkers. My swollen ham foot is bursting out of the left shoe, but I can still unhook the small silver buckle. I sit up, and while I am unstrapping the cute, salvageable, only slightly torn shoe from the ruined foot, another nurse, clearly Beady Eyes's nemesis, comes in. ”Here, I thought we should have given you this in the first place.” She plunges a needle into one of the connector sockets on the IV tube. The throbbing leg goes numb. The panic subsides. I love her. I have to know what she gave me.

”How do you spell it?” I ask, and as the room blurs and quiets, I hear: ”D-I-L-A-U-D-I-D.”

Semiconscious and calm, I am full of solutions. Emergency rooms need to be bright and well-lit, but someone should have remembered that all the sick and injured people are lying on their backs, scared and disoriented, and staring into rows of fluorescent lights doesn't help. I will mention it to someone.

It has only been a few minutes since the angel nurse gave me the medicine. Now a tall, handsome black doctor is standing at my feet, looking at my leg in a way that worries me. He is touching parts of my enormous Technicolor calf and ankle-my leg is now a column, the same size below the knee as above-and asking can I feel it. Sometimes I can. He touches my toes and asks if I can move them. I wiggle them. At least, I order them to wiggle. They refuse. The nurse and doctor exchange words about nerve damage and crush syndrome. I try again, try asking the toes to wiggle. Try cajoling, sweet-talking them. I revise: they don't even have to wiggle, just bend a little. They are unmoved.

My toes would have bent. My feet are pretty and obedient. They are slender with high arches. Yes, they are callused on the bottom, but they are nothing like this fat red blob that has had all the foot shape squashed out of it. ”We are going to operate right away,” the doctor tells me. ”We are going to do everything we can to save your leg.”

I have seen enough medical dramas to know that when doctors try to save a limb, it gets amputated. When I go to hospitals, I get st.i.tches or an air cast, not an amputation. If my leg is amputated, I will never fall in love and get married. I will either be a bitter, one-legged old maid or else I will have to troll around on the Internet and join some sort of online group for fetis.h.i.+sts of lopsidedness and half limbs. Maybe I will get a discount on pedicures-but no, actually, how could I even bring myself to paint the toenails on my remaining foot? Does a cyclops wear mascara?

This can't be real. Maybe I never went to the steamy, pulsing blue club outside which buses mangle legs and thrust people into metallic-smelling fluorescent hospitals. I have read about lucid dreaming; if you want to be lucid in a dream, there are a few techniques. Try to flip on and off a light-switch-it will not work. Or try to read text or numbers-you will not be able to. Your dream self has only to remember that if you cannot read and use light switches, you are dreaming. With practice, good lucid dreamers can control their dreams. I have done this only once. I dreamed I was in the ocean, about to drown in a huge oncoming tsunami. I panicked but then realized that I am never in the middle of tropical oceans in real life, so this could not possibly be a tsunami situation and I must be dreaming. I calmly flew into the air and hovered while the wave rolled past beneath me.

2.

Please remove any jewelry before surgery. I hand the nurse a fistful of tongue ring, nose ring, and earrings. The handsome doctor is an ”orthopedic traumatologist,” and he introduces me to a plastic surgeon who will help in the surgery. I gesture to my nose and say, ”Oh, no, I'm not here for this. It's actually my leg that's the problem.” He doesn't get it and begins explaining that plastic surgeons do more than cosmetic surgery; they work on all kinds of soft tissue. I already knew that, but I don't bother explaining because they have given me a little something to calm me down, and I sink into sleep.

I wake up in a dim beige room with soft light peeking in from the window where the blinds are drawn. My leg hurts. A lot. My leg hurts-it must still be there if it hurts this much, and I should be excited that it is still attached to me, but the ripping pain makes that impossible. My mom has come all the way from Kansas City, so it must be at least the next day. Mom, with her strong pianist's fingers and her brown eyes and brown hair, straight and fine like mine, only shorter-a familiar fixture in this strange room. She is stroking my hair and saying soothing things to me, which is nice, but medicine would be better, and I ask her to get the nurse. The ICU nurse, Joey, is a tall, muscular man in his forties with a trim, dark beard and mustache. I tell him my leg hurts, and he starts to talk about morphine and maximum dosages. This time I do not swear; I say simply that morphine does not work on me and I need something called ”Dilaudid: D-I-L-A-U-D-I-D.” He smiles and disappears into the bright white hallway, closing the door behind him and reinstating the dimness.

There is a faded baby-blue blanket over my legs, and tubes run from beside the bed up under the blanket. ”Will they have to-” I cannot finish the question, but my mom knows what I mean-she must be wondering too-and she says that the doctors do not think they will have to amputate my leg. They have cut some slits into the tissue and left them open to relieve the pressure.

When Joey returns, he plunges a needle into the IV socket, and a familiar warmth rolls gently into my brain, flus.h.i.+ng out panic and m.u.f.fling the pain. Joey says I have strong legs, and we talk about kickboxing, which I take at my gym and which he teaches at the Y. He has a high voice for a man so muscular and dark, and when he speaks, it is slow and friendly, with lots of inflection, not like the rushed, flat-affect speech of the ER nurses. He says I will kickbox again someday because I am strong; he can tell. ”Yeah,” I say, trying to mimic his cheerful tone, but as I say it I start to cry.

A few days have pa.s.sed. I have been moved from the ICU to the ”Med/Surg” floor, where my off-white wallpapered room has a large window that looks out at pale late-autumn sky and the gray of other hospital buildings. I still have the light blue blanket. Two plastics residents come and debride my leg every day. The muscle of my s.h.i.+n was torn off the bone. It has no blood supply, but the doctors decided not to remove it-they hope that if it sits there long enough, blood vessels will grow in and reattach the muscle to the rest of my body. Meanwhile, it dies a little every day, the muscle that used to move my foot up and down. In the first surgery, the doctors cut four long slits into my leg and left them open-now there is no skin on the front of my s.h.i.+n. It is wrapped in gauze and then a layer of plastic wrap to keep it sterile. When the doctors change the gauze, which they do daily, it tears off small chunks of dead tissue. This is supposed to stimulate cell regrowth, but it doesn't feel regenerative. The first few times they did it they put me under general anesthesia, but they can't do that anymore.

General anesthesia shuts down your digestive tract. The nurses told me this to explain why I need laxatives and suppositories. Using a bedpan is embarra.s.sing, but when it is difficult, it's worse. And so it is good to have less anesthesia. I try to remember this when the two residents come and change the dressing while I squeeze my mom's hand.

3.

My mom has moved into the hotel down the street from the hospital, and she is in my room almost all the time. She's an excellent patient advocate, making sure the doctors check on me frequently and demanding that the nurses up my pain meds whenever their maximum dosages are not enough. We talk about getting extra Valium for debridings, how to wash my hair, how to insert suppositories-not walking.

She has gone down the hall to talk to a nurse, or maybe to call my dad, when a new nurse comes in. He is my age, tall and slender and tan, with dark eyes, heavy eyebrows, and thick brown hair. I am feeling alert and more normal than I have in days, and we chat about ordinary things. He is in the nursing program at Northeastern; he knows someone I know, and I ask if he likes his program, and he asks me what I study. For a few minutes, while smiling and talking and feeling a little awkward and shy, I am like myself. Then he says he is going to give me a sponge bath, and I am again a crippled patient talking to one of her many health-care providers. I stink. I have been sweating into the once-crisp white sheets, and they are soft and damp. One of the medications makes my sweat smell tangy and chemical, and my hair is greasy, but though I badly need a bath, I am mortified at the prospect of this glossy-haired young man soaping and rinsing me limb by limb, and I ask him if we can do it later.

He leaves the room, and I can feel that the bed is wet and hot where I am sitting. I am not incontinent-but then again, until four days ago I was not a person whose legs got crushed by buses or had to worry about sponge baths. I reach between my thighs, and my hand comes back b.l.o.o.d.y. I am not supposed to have my period, but obviously my body is no longer trustworthy, and all the organs are working together to perpetrate the perfect betrayal. I cannot get out of bed, and if I press the nurse call b.u.t.ton the dark-haired young nurse will come back in here, and I cannot-will not-talk to him about my period. Despite my best efforts, I am crying again, and the only thing I can think to do is yell ”Mom!” repeatedly, like some terrible child at the grocery store.

The nurse comes back in and wants to know what's wrong and how he can help, and all I can do is sob and tell him to get my mom. I am regressing. But it's not even regression; I didn't tell my mom when I got my first period in the sixth grade. Now I am twenty years old, blubbering like some insane, menstruating baby. My mom helps clean me up and gets a female nurse to change my bedding and give me a sponge bath. The young male nurse, she a.s.sures me, will not be a.s.signed to me again.

4.

It is Thanksgiving, and I have been in the hospital for six days. My father and brother have come for the holiday, and my friend and roommate, Johanna, is here too. She is from Ireland and doesn't go home for the holiday. She always hugs me as soon as she comes in, and I love to smell the cigarette smoke in her curly blond hair and feel the cold that clings to her jacket; it is as close as I come to going outside. We all make fun of the hospital cafeteria's greasy and chewy attempt at Thanksgiving dinner, but we don't care. When I was about four years old, my parents made a tape of me talking about the first Thanksgiving, and they play it every year for anyone who will listen. On it, I talk in a baby voice about how the Indians made best friends with the Pilgrims and shout a singsong imitation of Miles Standish inviting Chief Ma.s.sasoit over for hot dogs. My parents imitate the whole monologue for Johanna. Normally I would blush and protest this performance, but tonight I don't care. I laugh along with the rest of them.

After dinner, my family goes back to the hotel. Johanna stays. Tall and thin, she can just barely curl her long legs and torso into a cozy ball on the chair next to my bed. She comes here a lot, though I am usually too foggy to be good company. Sometimes after I fall asleep she sits in the chair and presses the b.u.t.ton that releases the pain meds into my IV every ten minutes or so, and I stay numb and asleep that much longer.

After my family goes home, Johanna sits in the chair next to the bed, and we watch a movie on the little TV mounted on the wall. It is a romantic comedy, and it looks cheesy but good, I say. Johanna laughs-because, she tells me, we have watched the movie several times together already, and every time I wake up from my opiate sleep and see it on, I say as if I have never seen it before that it looks pretty good. The movie channel at the hospital plays the romantic comedy and two children's movies on a never-ending loop. Johanna reminds me that we have watched all three.

Tonight she reads me a funny story about an American tourist in Ireland, in her thick accent with its soft vowels and lilting inflection. Usually she takes a cab back to our dorm, where she sleeps in the room adjacent to my empty one. Tonight she hunkers down in the chair next to my bed, and when I wake up in the middle of the night for my next round of drugs, she is still there, wrapped in her long blue-gray sweater, sleeping.

5.

I have been in the hospital for more than two weeks, and I haven't seen my leg yet. The pale blue blanket stays on even when the nurse bathes the rest of my body, even when they move me into the chair next to the bed to change the linens. Usually I lie back and look at the ceiling during dressing changes, but I am getting curious, and today I am going to watch.

I promise myself to be stoic. I will not cry or bite my hand. Worse things have happened to better people, I sometimes repeat to myself. My dad used to say this in a fake hillbilly accent, the same voice in which he said, ”Well, it sure beats a poke in the eye with a sharp stick,” when things went wrong. Political prisoners, rape victims, starving orphans, homeless addicts-these people have it hard. You are a privileged college student whose leg hurts.

So, no crying. The nurse uses blunt-edged, crooked scissors to cut away the plastic wrap and the top layers of bandages. The gauze underneath is caked with blood, which I was expecting, but also with something surprisingly dark yellow, the iodine that they've swabbed onto the wound as an antiseptic. She wets the bandages, and as she peels away the final strips, with little bits of flesh stuck into the white gauze netting, she always asks me in between strips if I need a break. I don't take one because if she just keeps going, it will be over faster. My leg from my hip to the knee looks normal, just a bit shrunken, since the muscles have atrophied. My knee is swollen, and two inches below the knee my leg becomes a steak. The skin is gone from most of the front and side, and there is just a mess of red tissue about three inches across that extends nearly the length of my s.h.i.+n. Below the meaty exposed parts is what used to be an ankle, where my leg used to narrow, where you could see my Achilles tendon in the back and the little circular bones protruding on either side. Where my ankle should be, there is a thick yellow-and-purple cylinder connecting the wound area to the clubfoot, which is wider than it used to be. It's completely black on the top and bottom, but the sides are still fleshy. I am told that the black crust is dead soft tissue that probably will fall off and let out the new pink skin that is-maybe-growing underneath it. A few weeks ago the sight of this would have made me queasy, but I am sick of feeling weepy and nauseated with my brokenness. Today it makes me mad.

If you are in the hospital, people will say ridiculous things to try to cheer you up. ”Sometimes pain is its own form of prayer,” they say if you have told them you are not interested in praying. ”G.o.d has a plan for everyone,” they say with kind smiles. You will lie in your hospital bed and think that if there is a G.o.d-a possibility that seems more and more remote every time someone puts a glycerin suppository, blood thinner, or seizure medication into what used to be the beautiful machine of your body-he or she probably does not have enough free time to make individualized plans for everyone. People may scold you for your doubt-gently, because you are in poor health-and remind you that G.o.d works in mysterious ways. You will be tempted to shout at them that if G.o.d planned for you to get run over by a bus, then he is at best a poor plan-maker or, more likely, a s.a.d.i.s.t.

Simone, who studies religion, is a.s.suring me that ”everything happens for a reason.” I want to scream at her that people have two working legs for a reason and that her statement is a copout that weak people turn to when they realize they have zero control over their lives.

But it is impolite to shriek at people who have taken the time to visit you and who only want to help, so I murmur something noncommittal.

6.

The doctors do not talk about amputation anymore. They talk about physical therapy options, explain the various braces and orthotic devices that could make up for the fact that I cannot flex my foot out of its constant semipointed position. Every day Mom reads me the cards that come in the mail: sweet messages, votes of confidence. Many say they are proud of me for being strong, or being brave. These make me laugh. How would I be strong or brave? There is nothing for me to do here except take the medicine I am given, follow the doctors' instructions, and try to wiggle my foot. You have to make choices to be brave, and I don't have many. I can choose to tell dumb jokes to visitors, and I can choose to cry when I'm alone instead of in front of people.

There is comfort, though, in mottoes, and eventually I find my own, a trite and simple mantra but one inarguably true: All things must pa.s.s. My parents have the George Harrison alb.u.m with this t.i.tle. On the cover, the long-haired hippie lounges in soft lighting on soft gra.s.s in front of a stand of pine trees. When people talk to me about divine plans and mysterious ways, I know they are wrong, but I also know this: one day I will not be in this hospital bed anymore. One day I will wake up somewhere else, and on some day after that I will wake up and my first thought will be something other than dying muscles and opiates.

Sometimes the motto is not effective: when my leg hurts a lot, like now, or when being bedridden frustrates or humiliates me more than usual, I mentally scream at my leg. f.u.c.king b.a.s.t.a.r.d a.s.shole leg of betrayal! Et tu, motherf.u.c.king leg? If it had been amputated I could have gone home. I wouldn't have to have heparin injected into my stomach twice a day to keep the blood from clotting in the open wound or take Neurontin to dull the stabbing pain in my feet that is supposed to be promising because that is what it feels like when nerves grow back or take laxatives to counteract the effects of the narcotics that have shut down my intestines and made my mind so hazy that I cannot read the books that well-intentioned friends have heaped into my room.