The only certain thing

Reflections on contracting a serious illness

The moment that signified a quantum shift in my experience with the bodily wear attendant to living came at 6:30 on a Thursday morning.

On the physical-health level, my experience to that point was within the average range. The childhood illnesses typical of the mid-twentieth century. A few odd, short-lived anomalies, the changes one expects during adolescence. In my early adulthood, though, I put my resilience to the test. I delved into the opportunities for psychoactive entertainment with abandon. I also had a cigarette habit and was never far from a spiritous beverage. A few years of that, plus amassing some adult responsibilities, and eventually getting married, had the effect of inching me toward a longer-term view of what this thing called my existence was all about. So I started training regularly at a gym, a lifestyle feature I’ve maintained until, um, fairly recently, and eating a far more health-conducive diet than I ever had.

As I moved into what we can call the later stages of middle age, various nagging signs of time-imposed limits to an assumed level of capability began to manifest. The more favorable insurance situation that becomes available to Americans of a certain age allowed me to start looking into some of them.

Such was the case with an ever-more annoying pain in my right hip. An x-ray last fall confirmed what I’d suspected: no cartilage left between the ball and socket. Bone against bone.

So I underwent a replacement procedure in mid-May. The first three weeks were basically what I’d been told to expect from recovery. A physical therapist visited me three time a week and was pleased and even a little surprised at my recovery. I began driving again, even going back to the gym.

Then came a Sunday - I think it was my fourth after getting home - when I became a complete mess. Chills, chattering teeth, hands going numb, fever, nausea. A trip to the ER, tests, a return visit to my surgeon. At that visit, he was disinclined to connect my weekend sickness with my hip incision. Two days later, when I was back in his office, there was no mistaking the connection. I have pictures, which I’ll spare you, to prove it.

So the following Monday I underwent another surgery, to clean out the nastiness. My surgeon didn’t feel the need to replace any of my bionic parts. But there were tests. Oh, there were tests.

I actually found the upside to my four-day stay back at the hospital quite quickly. For one thing, the chow was actually notably appealing for hospital fare. Biscuits and gravy and sausage links for breakfast! Chicken quesadillas! Tomato-basil soup! Carrot cake! I found my way of interacting with the various staff personnel that added some humanity to the sterility of the experience.

There were the night nurses with whom I had to resign myself to forfeiting all my privacy and a not-small degree of my dignity. There was Dee, my physical therapist, who came by twice a day to run me through some exercises and walk me around the floor. She was receptive to my coinage of terms for various points of protocol and general need to put a personal spin, with abundant touches of silliness, on my regimen. Andy, my day-shift nurse, was immovably technocratic. Completely checklist-driven. I tried all week to evoke a laugh, but never succeeded. Kevin, the kitchen-delivery guy who brought me my meals, clearly had the heart of a servant.

What kept me there until Thursday was the wait for one culture-test result. It was my surgeon, who had clearly mastered the art of keeping his encounters with patients terse, who gave me the news that morning: MRSA. Methicillin-resistant Staphylococcus aureus. It’s impervious to nearly all antibiotics. The go-to treatment is one called vancomycin.

I was assigned an infectious-disease doctor. A much more personable fellow than my surgeon, he and his office came to be a more frequent contact for me, even after my discharge that Thursday evening.

On my first day home, a nurse came by to demonstrate how to self-administer my daily vancomycin dose. It was a rather involved procedure. I had a PICC (peripherally inserted central catheter) in the crook of my left arm. The treatment needed to take place at the same time every day. Based on my nurse’s visit, that was established as 2:30 PM. Each day, about two hours prior, I’d have to take a small vancomycin-filled globe out of the refrigerator and let it reach room temperature. Then I’d flush my line with saline and then hook up my sphere of hope. It would take 90 minutes for the contents to transfer to my body. Then I’d flush the line again.

I became quite adept at the entire ritual. I was well into the second week, and the rash occurred.

My nurse adamantly ordered me to cease and desist. A search commenced for another antibiotic that had the chops to take on MRSA. The first alternative, called daptomycin, was going to involve a similar daily practice. It was also going to cost me $459 out of pocket weekly. I requested a further search by the infectious-disease doctor’s office.

They found something, which I’m currently using, but I missed two and a half days of getting the MRSA addressed.

I’m taking an oral antibiotic called linezolid twice a day. Various people have asked me why a tablet one simply takes with water, and is the least expensive of the medicines used or discussed to date was the third alternative.

I don’t have an answer that satisfies me, let alone those asking. Is there an answer that can be condensed into an arcana-free paragraph that I can recite whenever the occasion arises?

While I have come to understand the importance, in an ever-more-bureaucratic health-care environment, of being one’s own advocate and taking ownership of the disparate sources of information, treatment and consequences one encounters, I have also come to understand that the “system” is for the most part peopled by human beings who earnestly do their jobs primarily to make a difference, to increase the sum total of light in the world. The health-care realm could easily come to be characterized by pushiness, by an insistence on instant answers, instant relief and assurance that all will be well, and in fact too often has.

It seems to me that the health-care setting particularly requires all parties involved - the patient, the specialists, the nurses and therapists - to bring as much compassion a possible to their interactions. For all the authority that those with the most refined types of knowledge bring to their roles, there are still limits that are going to become apparent. In large part, this is because of the uniqueness of each of us. While a patient’s biochemical behavior and reactions may be highly predictable, there are still going to be little mysteries in the way certain practices play out. Who knew I’d have an allergic reaction to vancomycin? It was my best shot at licking this wicked bacterium, and it was something of a gamble.

So now, twice a day, I go to the kitchen and engage in the mundane act of swallowing this substance that is now my best shot. There’s not nearly as much elaborate preparation to remind me of the stakes. But I never lose sight of them.

I also have compassion for all those in my life who ask me if I’m getting better, however tiresome the question becomes or however frustrating it is to not be able to offer a linear and rapid picture of a return to a baseline of functionality. They have the best of intentions. They want to see the old me back.

What I need to muster more compassion for is my own drive to stay on top of some semblance of a normal life. I have some writing deadlines looming, and each day I get up resolved to make headway, to make the necessary calls, research loose ends, sustain a session at the keyboard. So far, my body has told me, “Not today.” And so another day of four, five naps unfolds.

There are low-level chills and a diminished appetite that serve as constant reminders that this is a slog. This isn’t a case of popping a few doses of a new medicine and and heading back to the incline-dumbbell press machine, or my bicycle. Life has slowed down to a one-day-at-a-time pace, and it’s largely out of my hands.

One might wonder how my faith life is affecting by, and is affecting, this situation.

This aspect of it requires the most honesty and self-inventory of all.

I won’t rehash my engagements with religion over the course of my life. Suffice it to say that not much of my mainline-Protestant upbringing stuck with me. Coming of age as I did in the early 1970s, when attempts at entirely new explanations of human consciousness and what it means to be fulfilled proliferated like mushrooms after a spring rain, I was ripe for accepting the invitation to explore various modes of inquiry. Some were put forth by sincere and earnest seekers and others, as I see now, were scams peddled by charlatans.

Cut to the last ten years. I have become a Christian. It happened with me kicking and screaming. I began my steps in that direction tentatively, dwelling on the theological sticking points that my reading of Scripture, as well as about the doctrinal fissures one finds in pretty much any denomination today, would not allow me to gloss over. The night I can pinpoint as having definitively said yes to Jesus was filled with pleadings to the Creator to exhaustively eliminate any other explanation of reality that might be plausible. Isn’t there some other answer besides giving myself up to you, Lord?

I have regularly attended a few churches. I became involved in one to the point of helping with Vacation Bible School and holiday pitch-ins. I did the Emmaus Walk. I participated in some jail ministry.

But now, as I hinge my prospects for beating this sinister malady on my twice-daily tablet ingestion, can I forthrightly say that a confidence about how I’m going to spend eternity, and a heart full of desire to live in imitation of the Savior is sustaining me?

I’d be jiving you if I said so.

I just can’t articulate a basis for my faith that doesn’t smack of boilerplate. Yes, there’s a quiet assurance in the core of my being that it is well with my soul, but it’s well-buried under layers of uncertainty. Believe me, I am moved mightily by certain Scriptural passages and words of the great apologists throughout the ages, but there’s still the complicated matter of not being to give myself, let alone those who love me and inquire after me, a definitive answer as to how this will turn out.

This whole episode has brought to the fore a question I’d academically entertained throughout my life, but never explored from levels of the gut and heart. What if I were to have to say goodbye to all these people? My wife, my family, my friends, my professional colleagues?

There’s the level that I suspect particularly presses upon men that haunts me. Have I really accomplished anything with this life? Left a legacy?

Not that I can do anything about that this morning. As is the case each day, I’l take the baby steps that I can to move the obligations of my life forward, and then I’ll need another nap.

At this point, about the only conclusion I’m willing to draw is that, apart from the lodestar constancy of Christ, all else in this universe is fraught with unpredictability. We must hedge any pronouncements we make, even about scientific laws, with an acknowledgement of the limitations factor. No matter how much we are able to map out the contours of creation, the element of surprise persists.

So I’m getting ready to venture out with my wife for a bite to eat. I’ll try once again this afternoon to move some writing assignments forward. Nothing too momentous in the overall scheme of things.

But there’s a sheen on the people, places and things that constitute my life that is new and borne of something happening inside me.

I think back to the first couple of chapters of Genesis. What God had wanted his man and woman to see was the preciousness, the sacredness, of his creation. They were able to be talked into seeing otherwise - by a lowly snake, of all creatures. Their perspectives came to be hemmed in by fear and shame. Maybe most sad of all is that they developed the capacity for boredom. All these apples taste alike, no matter which tree they come from. Mundanity, mundanity, all is mundanity.

It’s not a case of abrupt transformation. The day will surely unfold in a recognizably ho-hum manner.

But a moment comes along now and then during which I realize that this is a special world indeed, and that seeking to properly estimate its value is the main work that any of us bring to the numbered days of our trek through this plane.

And, yes, then we have the opportunity to go home.