A TRIP TO THE HOSPITAL IN CUENCA

I learned early in life that I am not in control.  Most of us who have lived about seventy years, if we reflect back upon how we thought our lives would unfold over the next fifty years, we would never  imagine the ways our lives have played out.  Daily events in our lives generally follow the pretense of a routine; and even here, the unpredictability of life from one day to another is often something to behold, especially when events are within the context of a brief moment of time in our overall lives.  Here is a vignette of just two weeks in the life of Jim Mola here in Cuenca, Ecuador:

It was two weeks ago this past Friday.  I became aware of a medical problem the day after an amiga and I had visited a friend in Giron.  Giron is at a little lower elevation than Cuenca.  Therefore, it is warmer and produces more insects.  It was raining hard when we went up to the waterfalls for which Giron is famous.  My friend  was from Rochester, New York, and was only here for one more month before she would return home.  Therefore, we either see the falls then or not at all.  Actually, it was a magnificent time to be at the precipice of the lower fall as the heavy rains truly had the falls gushing water with a crescendo of thundering sounds.  The whole scene of the falls, and the immediate area across from the falls and behind us with its wisp of fog was like out of a scene from the movie Camelot, when King Arthur would visit Merlin in the primeval forest.  It was pretty thrilling to be in the midst of it all.  

It was the day after our venture to Giron that I noticed I had a red spot on the back of my left leg with a large puncture hole in the center of the spot.  At first I thought it might be jiggers.  I had a couple of bouts dealing with jiggers back in 2012 and 2013.  Unlike Jiggers, the spot did not itch, and I figured it would disappear in a few days.  I had no idea, however, if I was bitten/stung while on my friend's property, while up at the falls, or if it even happened in Giron.  I can't remember ever seeing spiders in my apartment.  The doctors eventually verified that whatever infected me was airborne.  

A few days passed and the original infected area did not disappear and had become bluish/purple in color, and now was joined by a much larger semi-circular red ring that was hard as a rubber ball.  I should have thought, "Maybe it's time to go see a doctor."  I thought instead, "Oh that's interesting, maybe, it will go away in a couple of days."  The next couple of days it became very inflamed with pain.  Now, I am not a lover of pain, so I decide that it is time to go see a doctor.  My doctor gives me a couple of antibiotics and he says, "James, come see me one week from today, by then your infection will have subsided, or I will have to lance it and clean out the pus.  One evening a couple of days later, my leg is in excruciatingly pain.  I almost decided to go to the emergency room of the hospital, but it was 10:00 p.m.  I didn't want to shower, dress, and go out in the Cuencano rain.  Over 5,000 taxis in the city, but most are not operating in the late evening, and all our occupied when it's raining.  I think this line of reasoning is called misplaced priorities, and thinking with my feelings instead of my brain.

About 12:30 a.m., I am ready to go to bed.  Just as I am about to climb into bed, I felt something dribbling down the back of my leg.  I checked it out, and I thought, "Oh great, my infection is beginning to drain itself, and the excruciating pain began to subside as well.  The next day, I explained to the doctor what was happening, and how the purple spotted area has enlarged, the outer skin has broken, and while I said to the doctor that the infected area wasn't looking good;  I did not tell him that it looked like rotten meat covered in maggots.

The doctor meets me in the emergency room at Monte Sinai Hospital the next day to lance the infection.  He takes one look, and is astonished at how quickly it has grown and changed from just four days ago.  Actually the change from when he first saw it had happened only in the last two days.  He says, "James (Every Ecuatorinano in Cuenca always call me James.)  we will need to clean it tomorrow, and take a specimen for a biopsy to better focus the most effective antibiotics for your very progressive form of bacteria.  Also we will need to schedule the anesthesiologist, since the procedure will be too painful for you otherwise.  In the meantime we need to check you into a room.

The following day, I am wheeled to the surgical unit.  I am relieved that I will be put under during the procedure.  The anesthesiologist informs me I am going to have, what for me will be a first, a spinal tap.  "What! You are not going to knock me out?"  The doc says, "Would you like to be put completely under?"   I reacted without a second of hesitation,  "Oh yea!"  In what must have been a moment of Ecuatoriano humor, the doctor, replied, "No you will have a spinal tap."  Well, I am sitting on the side of the surgical table.  Needles do not bother me, but when whatever the doc was injecting higher in the spine would hit the left kidney, that was not fun.  No empathy here.  Just with each dollop from the injection, "Do not move."  

Ten minutes later, the doc asks me if I can move my legs.  That's the first time, I realized I didn't have any legs,  It was like there was just me from the waist up and everything else just wasn't there.  I was actually trying to decide what was better, being totally free of my body or having to deal with one.  At one point during the cleansing, the surgeon dangles this elongated strip of what looked like pork in front of my face, and says, "This is the piece we will use for the biopsy.  Look at all the green pus on it."  I provide him with a stoic nod, and I am just relieved I am not feeling pain.  The doctors informed me that the infection had gone deeper than they suspected.  A few more days, I may have been at risk of losing a leg.  I asked one of the doctors, if I had to lose a leg would I be able to choose which one?  I didn't receive a response, just a puzzled look.  Maybe he just doesn't get American humor.  I spent another three nights in the hospital, while the doctors waited for the biopsy reports, and then determined how to adjust my antibiotics based upon what they learned.

Now during my life since I was a kid, God has put me in many humiliating situations whether of my own doing, someone else's, or just what appears to be random misfortune. I long ago reached the point in my life that I can no longer be humiliated, and at my age generally care little about being self-consciously in need of fitting other people's mold of expectations.  So I will continue with my tale,  you are about to read about the rest of that day that even my closest friends and family have not been told, including those who visited me at the hospital, and who until they read this post have no idea how the rest of my day transpired.

A few hours after I am returned to my room,  I am getting back substantial feeling in my legs.  I decide it's time to give my legs a try.  I get out of bed.  I am standing in what feels like a very solid stance, and I am relieved--only to suddenly without anticipation collapse.  Now it's bad enough that I didn't call for assistance; even worse, that I knocked over everything on my tray table which cascaded to whatever else was in the immediate vicinity; and much worse, that my I.V. was ripped from my arm.  Suddenly, there is blood squirting everywhere.  It takes me about thirty seconds to get to the gizmo I press to contact the nurses.  The first nurse enters the room, immediately does a 180; and returns with a bevy of nurses, aides, whoever was available.  The first priority was to stop my bleeding.  Then get me out of my blood-stained gown, which means I am standing there in the room for the next what seemed like ten minutes in the nude, while eight to ten women are scurrying around trying to put everything back in order and clean and mop up all the blood.  Notice, I'm standing through this entire duration.  The scene was chaotically surreal, and I looked around just thinking of the movie title, "There Will be Blood."   All these women eventually got everything in order without ever missing a beat, as if they handled situations like this everyday.  Maybe they do.  Nobody treated me like I had done something terrible.  Eventually, I was given a fresh garment, and I was no longer conspicuously exposed.  None of the women went into heat over my nudity, probably because none of them had a microscope on them.  (That's meant to be a joke.)  

I literally can't recall if this next incident happened in sequence or later the same day.  I needed to use the bathroom.  "Yo necessito usar los banos."  Generally, those magic words would get me sprung from my I.V. and I could move about, and get away with  lying continuously on my back.  For some reason beyond my understanding, the nurse did not understand what I wanted to do.  Granted, a container was beside my bed for urination.  The problem is I don't know the Spanish word for urination or for bowel movement, or defecation--a word I  hate, it always sounds much worse to me than using the other "f" word.  I can't recall how my room became filled with women again.  I guess nobody wanted to miss what I might do for an encore.  Also, everyone was trying to figure out what I wanted.  

Oh my God, how during my time in the hospital, I wished I had learned a great deal more Spanish, and practiced, practiced, and practiced.  Life is full of regrets.  Now, I am living one of them.  

I am desperate to get these women to understand, because I really needed to get some serious business done, and I did not want to have an accident on the floor, which just would be the frosting on the cake to a day people just don't choose for themselves.  Finally, I hoped that maybe "I have to do number one and number two"  works in Ecuador like it does in the U.S.  No such luck, the women just give one another quizzical looks.  I figured my only hope is to act this out.  So I begin to act as if I am peeing, and making a vocal pissing sound the entire time, in what was definitely a teaching moment and comedic besides.  Suddenly, in unison, the light went on for all the women. They got it, they all began to laugh, and I am granted release and relief.  There was actually something endearing about the episode, one I'm glad I had, and will long remember.  

I was always delighted when any of the women could figure out what I wanted or was trying to say.  They were anxious over wanting to understand me, and their faces would light up whenever communication was successfully made.  The young women in particular, all of whom are diminutive in size; whenever two or more were present,  were like groups of giddy girls in that twelve to sixteen age bracket in the states.  What brought tears to my eyes was whenever more than once some of the women would apologize to me because they did not know more English.  Here I am in their country, and they are apologizing to me.

Well, I wasn't home free yet.  My last evening in the hospital witnessed my blood pressure rising.  I don't have blood pressure problems, what's going on?  Within twenty minutes I had my answer, I looked down at my right arm and it doubled in size and had that hard rubber feeling to it.  Oh God, no, don't tell me I have another infection with which to deal.  The nurses were having a very difficult time finding a vein large enough for an I.V., so I'm already like a pin cushion.  It turned out the catheter for the I.V. was faulty, and the saline and antibiotics were not passing through my vein.  Problem resolved.  My blood pressure eventually subsided, and by morning the swelling in my arm has gone down.  I've spent much time in hospitals, if not for myself, then for family members in particular.  Things will go wrong.  Nothing out of the ordinary.  Nothing is perfect.

I was really happy with the overall care by all staff involved.  No real complaints there.  The doctors and nurses all did a fine job.  The better hospitals in the big cities in Ecuador can hold their own with the better hospitals in the states.  Ecuador, however, can not provide some of the latest and most sophisticated medical attention that may be found in some of the specialized and research hospitals in the states.  

Hospital food is universally hospital food,and you better love rice as much an Ecuatorianos do, because you're going to eat plenty of it in Ecuadorian hospitals.  Toward the end of my hospital stay, I was given real soup not primarily broth, which had big, rounded white beans that made the soup substantial, tender, and tasty.  The chef could do no wrong when it came to preparing fish, always savory, and cooked to perfection.  My final evening meal, which ironically was on the night of Holy Thursday, the night of the Last Supper, had what appeared to be a pastry cup filled with fish.  Upon further investigation, the chef must have taken two or three fillets and somehow encircled them in a rather artistic mold that did not require an external pastry to contain it.  I must admit, the medical cost although inexpensive by American standards was higher than I anticipated for my four day adventure.  A buddy said, "They must have charged you for that gourmet chef you had."  Possibly, possibly.

Now I report to the emergency room every other day, so the doctor can examine the area, dress it, and put a new bandage on it. He warned me that there would be a big hole there, and not to panic  when I see it, it would eventually fill out.  Today, he took a photo and showed it to me.  Well, at least now the once infected site looks like dried meatloaf.  Yes, it also looks like a lunar crater, or the effusive end of a volcanic crater.  Doc says it is progressing nicely.  I hope so.  I have two weeks to make a final determination as to whether or not I will be able to follow-through with my month of travel later this April to Italy.  I have had so many medical and financial hurdles arise to challenge me from getting this trip off the ground.  I am determined to make it, and hope no more impediments emerge.  In the end, it will work out as it is intended.  There is only so much I can do to pretend I am in control.

I thank my friends who were bearers of flowers and gifts, visits (not visitations), prayers, dinners, and concern.  A friend who also brought me elegant chocolates, and hard salami from our very own Italian, Italian cheese and sausage maker; in a country where local cheeses leave a great deal to be desired, and imports are almost an impossibility due to government restrictions.  Needless to say, hospital personnel had no intention of letting me eat any of these things.  A very special shout-out to my Ecuatoriano friends who late at night and over the wee hours of the next day were busy--and--about running back and forth getting items I needed from my apartment, and just willing to do anything for me.

In the end I thought I would just share my story with whomever may be interested in the read.  In the bigger scheme of things, it doesn't mean much, and in years to come no one will remember.  For the moment, it is significant to me; even if in the grander scheme of things, like most of us, all our shared experiences will be lost floating on some inaccessible computer cloud somewhere in eternity.  Maybe, life is meant primarily to be experienced.  Well, this was one of my experiences.