Monday, April 27, 2009

Prologue: the Beginning

Welcome to Beneath the Gown, a chillingly honest portrayal of the life of a hospital patient. AMA, lock up your daughters, 'cause the gown is coming off.

I am a 32-year-old man born with Tetralogy of Fallot, a rare series of congenital birth defects in the heart. Tetralogy of Fallot affects roughly 5 babies in 10,000, who typically experience a failure to thrive and are referred to as "blue babies." I was fortunately anomalous and did not experience failure to thrive, nor was I a blue baby. I was squatting a lot, however--a sign of fatigue in toddlers--and at 22 months had my first open-heart surgery. This was the beginning of my lifelong odyssey through the world of a chronic patient.

Needless to say, as I've grown, my relationship to my health, my doctors, and my health insurance "providers" has evolved and transformed and, at times, devolved into blind murderous rage. For instance, on the day Blue Cross of California settled the lawsuit brought against it by the state in 2008, it also refused to pay for a biventricular pacemaker for me (a pacemaker with a built-in back-up wire so I won't, y'know, die). Somewhere an insurance company medical reviewer just got his wings.
An insurance company medical reviewer gets his wings by denying a sick woman necessary medical treatment. Raping her is optional, but it can only help him achieve his dream of one day becoming medical director.

On Thursday, April 23, 2009, I was admitted to the UCLA Medical Center--now officially known as the Ronald Reagan Medical Center, presumably a nod to the $150 million in private donations raised in the "Bedtime for Bonzo" star's name. Other forces of evil whose names grace the engraved and illuminated glass plaque in the lobby of the Nancy Reagan Tower are: News Corp., the Walt Disney Company, and Diane von Furstenberg. So the new name is either in honor of the Gipper, or it's a long-overdue concession to UCLA's shameful history of selling weapons to Iran. Don't believe me? Take a look at this picture from the June 4, 2007, dedication.

First of all, what are those two stubby little things poking out of Nancy Reagan's bright orange missile silo, if not Lockheed Martin Hellfires? But that's not even the worst part. The funny little guy with the Governator is not who he appears to be. Say hello to Mayor Antonio...Ahmadinejad! Yes, yes, he's quite deceptive sporting the clean-shaven look, but the evidence is as undeniable as the fact that there are no homosexuals in Iran.
Fig. 1, "In Iran we don't have homosexuals like in your country."

Fig. 2, "In Iran we don't have homosexuals like in your country." Note the cunning absence of the beard, Iranian flag, and crescent-and-star symbol.

Scariest of all, however, is this meeting of the minds.
What an unholy dyad: one is an unstoppable robot assassin from the future hellbent on destroying humanity, and the other is Arnold Schwarzenegger! But enough about movie stars and widows of movie stars. This blog is about me and my ongoing stay in the hospital. But don't worry, I am at UCLA, so you can rest assured there will be plenty of movie stars making a cameo or two! As long as you count Britney Spears as a movie star, we'll get along just fine.

After suffering almost a year of cyclical protracted periods of fevers (culminating in a 105 fever and loss of consciousness on the morning of the 23rd), I was emergently admitted with a presumed case of endocarditis, an infection on my heart--likely originating from my pacemaker, which was replaced in July, 2008. With no real hospital rooms available, I spent the first 35 hours in the ER. The fevers and rigors persisted, though fortunately I now had people drawing blood every 15 minutes and giving me unnecessary, but very painful, abdominal injections of blood thinner. I was tethered to the wall behind my bed by an antibiotic IV drip and 02-sat clip on one arm and a blood-pressure cuff on the other. The ER gurneys are basically the dimensions of an ironing board, minus the plush cushioning. At 6'3" and 200 lbs. (all muscle and brain), my lying on the gurney was like a cat lying on a tongue depressor. Although much cuter, of course: they can bind my arms all they want, but nothing's going to stop this kitten from wagging his tail!
Typical kitten. Note, not a photo of the author.

Friday night I was moved to a proper room, about which I can't complain. It's private, big, and has an adult-sized bed and a flatscreen TV with cable. My friend lent me a laptop and the hospital's got free wi-fi. Which means I've got it much better here than I do at home. Plus, the endless parade of androgynous Southeast Asian nurses to excite and confuse me. I told one that my second open-heart surgery had been performed at Boston Children's Hospital, and she said, "Oh, in Boston?" You can't teach that in androgynous Southeast Asian nursing school.

Graduation ceremony at an androgynous Southeast Asian nursing school.

Friday and Saturday nights were rough, as the fevers returned and the rubber hospital mattress did little to stem the flow of sweat. While the echocardiogram and ultrasound could not visibly detect endocarditis, the blood cultures came back positive for coagulase-negative staphylococcus, bacteria typically found on the skin that are quite common and harmless...unless they enter the bloodstream. And after a thoroughly boring weekend, on Monday I had a transesophageal echocardiagram (TEE), which entails an echo camera being shoved down my throat so it can snap unobstructed pictures of my heart. Thankfully the hospital food had already dulled my gag reflex.

The TEE verified that, in fact, there is bacteria growing on my pacemaker, and possibly on my tricuspid valve. In my next post, I will discuss my doctors' gameplan for how to treat me. (See "ID, Please" above for details.) Hint: it involves wishing. And leeches!


  1. Let's not rule out cupping, and a draining of certain humours. Tally-Ho!!!

  2. as both a doc and a recurrent patient, nicely done! Did you write this well in HS? And is that really Ahmadinjed?????

  3. Hi, Anne,

    Thanks for the kind words. I don't know how well I write NOW, but I certainly didn't write as well in high school.

    No, that's not really Ahmadinejad at the UCLA dedication. (That is, however, a real picture of him above the pic of Mayor Villaigarosa.) Can I ask what kind of doctor you are?

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