3. Kidney Stones II: Nat and Megan's Bogus Journey

In Neal Stephenson's Baroque Cycle (I think it's in Quicksilver, the first one), there's a character named Daniel Waterhouse. He has a kidney stone, which is a much bigger deal in the 17^th century; in fact, he's pretty sure it's going to kill him.

Now, this book (and by book I mean all three of them) is about so much more than kidney stones. It manages to make the rise of modern banking and scientific thought in the 17^th and 18^th centuries read like cyberpunk. It is one of the most awesome books I have ever read. And it came into my mind while we waited in the ER.

Come with me after the jump to find out why.

At the point in the tale that my own time in the ER put me in mind of, Daniel has not urinated in several days. He watched his mentor die of the same thing some years earlier, and has no illusions as to how it will go. In order not to go into too much depth, some stuff happens, and he awakes to find himself naked and elaborately tied down; movement is impossible. His friend Robert Hooke(Yes, that one) has decided to perform a lithotomy on him (note: do not do a google search for "lithotomy position". It's cringe-forming). Hooke reminds him not to beg for mercy, for he has none. Daniel recalls a time several years earlier (we are getting into Inception-level layers of memory, here) when he and Hooke and several other later-famous natural philosophers had vivisected a dog and were manually working its lungs to get an idea of how all that stuff operated. He remembers the look in the dog's eyes, all memory of sunny days and rabbit-chasing gone, washed away by the tide of pain.

This came to me as I tried to pee in the ER's waiting room bathroom. First, because I peed a tiny dribble despite the pressure in my bladder and that reminded me of the stone in Daniel's , relentlessly robbing him of the ability to micturate and threatening to poison him with his own urine; and second because the empty seat on the opposite side of the intake desk, merciless and blind to my pain, reminded me of Robert Hooke as he prepared his blades to slice Daniel open, sans anesthetic.

I don't think the tupperware is period-correct.

By the time I came out of the bathroom, though, someone was behind the desk and Megan was talking to them. I sat down, face apparently grey and eyes sort of glassy. And lo and behold, despite all the people already waiting, the door into the wards was opening! For me!

“But what about all those other people?” I asked nobody in particular, not because I was going to be noble and demand that they be seen first- there's nothing like pain to make you selfish and forget equality- but to understand why I was so lucky. Had Megan promised them one of my kidneys? No, probably not; at least one of them was currently less than donation-worthy. Had she promised one of hers?

“None of them are as bad off as you.” Megan took my arm and we went in to talk to the doctor. He was older and looked harried. After some words exchanged I was given over to Marc, a much younger- probably twenty-something- nurse who spoke some English. He took me out into the hall and pointed to a bathroom as he gave me a tray with some stuff on it.

“First you take, ah, thees,” picking up some gauze with a dark smear of goo on it, “and with it you clean your, ah, penis.” He pointed downward with an apologetic laugh. “Then you, ah, pee into thees.” He picked up a plastic cup with a lid. “Not first stream. First stream go in toilet, second stream go in cup.”

“Ah...je ne pense pas que...there'll be a second stream. Je ne peux pas pee very much.” I was a bit surprised at myself to be able to bring out any French; maybe pain brings out clarity. And je pense and je peux ('I think' and 'I can', respectively), were some early-learned and frequently-used verbs. You just add a ne/pas sandwich around the verb to negate it and bam!

“Ees okay. Try.” Marc smiled enthusiastically and ushered me into the toilet room.

The disinfectant goo smelled bad, or maybe with all the pain sweat and cold sweats I was just having a not-so-fresh situation down there. Should I include that? Is that gross? Anyway, sure enough, I had a brief first stream (that went in the toilet like a good boy) but only a drop or so for the second. Oh well; I tried.

I headed back out into the hallway and was instantly lost. Let me take a moment here to describe the French ER. The lobby looked kind of like one of those Monty Python WWII sketches, with folks all piled on top of one another, bloody bandages and stoic faces, yet chatting and laughing. Past the sliding admittance doors, the halls looked like you might think a hospital should. Maze-like corridors lined with gurneys and various kinds of equipment on wheels sat beneath the watchful eyes of nurses behind windowed nurse stations. Except that the nurses weren't there. Likewise, those gurneys didn't have people on them, which I guess was a good sign; it was unlikely that I would end up in one of them.

But, like, you expect a hospital to have people in scrubs running back and forth all over the place, and you try to figure out if the colors of the scrubs match some sort of rank like in Star Trek, right? Do the blue scrubs mean surgeon, the green ones nurses, and the ones with chili peppers on them mean interns who think doctoring should be fun? Well, there were some people in scrubs, and they all looked busy. But the overall feel of the place was deserted.  You know how prisons in the US are overcrowded? Like that, but the opposite.  Like on Stargate: Universe or Gene Roddenberry's Andromeda: a large space(ship) nowhere near filled by the people in it.

.

There's a whole scifi/anime trope thing about really big objects. It's affectionately called  The Big Dumb Object

Another thing about the ER? Dirty. Like, it looked like the place hadn't seen a mop in...well, long enough for me to notice that the floors were dirty. And eew, dirty with what? I mean, imagine a bunch of EMTs busting through the entry doors with a gurney on which some poor schmoe lies, having just unsuccessfully tried to cross the street.  I know, I know, the crossing light was green, why would he be worried about being hit by a taxi running the light? Welcome to Paris. So they come busting in, yelling about needing a hypospray and a hydrospanner, STAT (in French, of course). As they rush through, the taxi victim is spouting goo and bits all over the place. You'd want to clean that up, right? Think again, my friend.

In all honesty, there were no conspicuous stains in the hallway; they just looked more like they belonged in a high school than a hospital.  And many of those few staff running around wore sandals or Crocs. Now, aside from being just awful-looking (forgiveness, please, if you bravely ignore their fashion-bane properties in favor of their supposed comfort), I've heard that US hospitals have outlawed them because of their gaping holes and the tendency of syringes to fall needle-first (in accordance with a sub-category of the law regarding buttered bread). But not here. And it's the ER! In all the TV shows ERs are high-pitch, full-throttle, sexy, hilarious places, depending on which one of them you watch. No place for Crocs.

Anyway, back to me. I finally managed to find the doctor, but the room in which I left Megan was empty! I gave the doctor the pitifully-filled cup. He looked at it like, “What is this? How can I do anything with this?” I shrugged. Je suis desole. Sorry. The Doc gestured for me to follow him.

“Mais, mon epouse,” I began. Even more than usual in medical situations, I had no idea what was going on without her. But Doc just said some stuff and gestured for me to follow him. As millions have done before despite not really understanding why, I did what the doctor said. I followed him into a room with a gurney and some machines and a dusty computer.

Marc was there, which was a relief. He had got a tray with some stuff in wrappers.

“Now, while we wait on testing, I give you med-sin for pain.” What's funny, and a note of appreciation for Marc, is that medecin is French for doctor (so is docteur, but whatever). He unwrapped some plastic tubes and produced an IV bag from somewhere. Then he took out some needles. “Also, we will need some blood.” He began fiddling around with my wrist and the needles.

When I was in high school I had surgery on my back. I spent a couple days in the ICU afterward, during which a botched IV insertion in my wrist caused it swell up like a balloon and hurt terribly. So I was extra attentive as Marc bent to his task on this same wrist. In pretty much the same place, really; there must be a particularly juicy vein there.

Now I began to think that perhaps the wiring (blood vesseling?)my wrist was messed up, because Marc botched his first attempt at stabbing me with a needle. Fortunately, he realized it immediately instead of letting a nice little hematoma bloom under my skin for a couple days like that nurse in SoCal back in the day. He took the needle out, unwrapped a new, fresh one (nice nod to medical hygiene, there) and went to work again. This time he got it right.

While he's doing all this, a lady in familiar scrubs-colored green scrubs came in and started talking to me. Her name was Dr. Roberts, and she started asking me specific questions about the pain. In English! Go France; I feel sorry for any French-speaking people in America having to go to the ER and looking for a French-speaking doctor. Go 'Merica!

I was trying to lie on the gurney, but lying still hurt too much after a few seconds. So I sat back up. Marc obligingly raised the top half of the gurney, so that when sitting up hurt too much, I couldn't lie down. The effort involved in explaining what was going on was too much, so I just sort of took it. Sat there. Half lay down. Sat back up. Dr. Roberts kept talking. Her English was pretty good.

“Now I need you to take off shirt.” As I did so she stepped away, to the far corner of the room. “And now I need you to...” She made flailing motions at her waist. “Take off top of pants.” I stared dumbly for a minute- my inference and charades programs were offline while my guts roiled like a decapitated snake- then realized she wanted me to undo my belt. I did so.

“Open top of pants. Not all the way.” All of this from the opposite side of the room. Marc was right next to me, still trying to get the needle into my wrist, made difficult because I was using that hand to undo my britches.

Finally I got my pants undone and the fly down. Only then would Dr. Roberts approach. “Now tell me where it hurts.” And started punching me. Lightly, yes, but exactly where it hurt the most. Calculatingly. So she wanted to be far away while I undid my pants. That smacked of some sort of anti-sexual harassment process, there. But then once they were undone, she comes over and starts punching my junk. Oh well.

“Tell me where is the most pain.” She'd punch me, then say, “Here?” Punch. “Here?” Each time I would say, “Umm, yeah? Sort of.” She started to look vexed, so I tried to explain. “It all hurts, so it's hard for it to suddenly hurt more.” She pursed her lips.

“I think you have kidney stones. But I wait on the blood tests.” She looked meaningfully at Marc, who was finally finishing up. They did some French at one another while Marc hooked the needle in my arm up to some tubes. Then he hooked those tubes up to an IV and some little vials that sucked out some blood. He passed these to Dr. Roberts, who headed for the door.

“Oh, excuse-moi. Ou est mon epouse?” 

[A frustrating thing, here, in recounting this tale is that I can now ask that question more appropriately than I could then, even if I hadn't been in pain. And I didn't record all this; this is done by memory. So I'm purposefully making what I say sound...less grammatical than I have to. I can speak better French than this, mes amis! Not much better, admittedly, but still.]

Dr. Roberts stopped. “Oh, she is in the front room.”

“Could you...can she come in here? I'm sure she wonders what's going on.”

“No, she is okay. I saw her.” The Doc took a step for the door.

“Well...could you maybe go to her and get my cell phone and bring it to me so that I can text her and tell her what's going on?”

Dr. Roberts just stared at me blankly. I'd overshot her English. I repeated myself, slowly, realizing what an annoying favor that was to ask. So I added, “It's just that I know she's freaking out.”

The doc nodded at Marc, attaching a small bag to the IV. “First this. You want pain to stop or wife in here?”

“Oh. The pain to stop, s'il vous plait.” Damn pain and its overwhelmingness.

Marc smiled and Dr. Roberts laughed a little. “You see? We see what is important.” Then she left.

While Marc did some things with machines and tubes, I realized that I had been sitting still for several minutes without writhing. “Is...has the pain medicine started yet?”

“Ah...not at last. Will be soon.”

“Merci.” Why was I not hurting as bad? “We say 'not yet'.”

“'Not yet.' Thank you! I want to speak better. Thank you.” Marc finished doing something. “And...now. Soon the med-sin should start. For now, I go and see other patients. I send your wife.”

Megan came in, and there was much rejoicing. Over the next few minutes the pain receded. I still felt tender; I could feel the pain lurking like a pack of wolves at the edge of the painkillers' campfire, but for now that was fine.

But now began Emergency Room Part Deux: The Waitening.

Megan told me how while she was out in the lobby one of the orderlies or something came out and told the guy at the desk, “Why are all these people here? Have you told them they won't be seen until tomorrow morning?” It was about 1:30 in the morning at this point. Then the guy said to all the folks in various degrees of injury, “You'll be having breakfast in here!” Then the orderly stormed back behind the admittance doors.

This little old lady with her wrist wrapped in bandages and a plastic bag  on her hand approached the guy at the desk and asked, “Well, then what time should I come back in the morning?” She'd been here all night already. Guy at Desk shrugged; he didn't know. Guy at Desk was the definition of noncommittal. Hey, if you don't answer any questions, you can't be wrong.

A long time passed. I was relatively comfortable once my gurney had been fixed so I could lie down. Megan was stuck on some little stool. I explained how if I was a better person I would offer to trade with her- you know, chivalry and shit- but that I was not a better person. She said that was okay. More time passed.

We wanted to sleep but could not. Things got hazy. I babbled. The lady with the bag on her hand was finally admitted, though it looked like she still wasn't seen by anyone. Megan found out that she had been making dinner when she slipped and mashed her hand on the burner. It was all cooked and stuff under that bag. I got all worried.

“That's not what you're supposed to do with a burn! You don't want to deny it air! Well, not unless it's a third degree burn, but if it was that I bet she'd be getting more attention.” It bothered me. I wasn't a good Boy Scout, but I really liked the first aid stuff, and it bugged me that no one was at least telling that lady she shouldn't have her burn in a bag. Maybe she'd even spread butter on it; they didn't know. Hmph. But no love for her.

The same story with us. We watched people in scrubs go by in varying degrees of looking like they were actually doing something. I saw Marc a couple times, but each time he looked like he was doing legitimately good stuff. I loved Marc. Sure, maybe he wasn't the best at sticking needles into people, which is probably something you want to be able to do well if you're going to be a nurse, but look at him over there. There was this young couple in the room across the hall from us, the girl curled up fetal on a table with a hospital smock over her, the guy sitting on the stool, touching her protectively. And there's Marc, talking to 'em, getting them to smile, reassuring them.

I felt pretty stoned. It turns out that all I was given was a high dose of what was essentially Advil, but that coupled with the exhaustion (plus the endorphins of not being in agony, I bet) made for quite a cocktail.

You know who gets attention in the ER? At least, this ER on this evening? Crazy people. While Megan and I were staring at each other, having nothing else to do and being too tired for spirited conversation, we started hearing yelling. It sounded like a lady in distress. It turned out that it was a lady demanding to be admitted, and screaming whenever she was told she'd have to wait. Eventually she was admitted. In fact, she was admitted to the room right across the hall from us (the young couple had left). In facter, she was admitted into that room strapped down on a gurney! Five point restraints, ladies and gentlemen.


 She sounded less enthusiastic about being there, now. She said she needed to pee, over and over, yet no one would let her. I began to feel bad for her (besides wishing she would stop yelling), but as the evening- well, morning- wore on we learned things. One, she only yelled when she was left alone in the room with the light off. Which was what they kept doing. Two, whenever someone came in to see her she stopped yelling until they left, at which point she started yelling that they had raped her. I heard one nurse telling an intern- well, we both heard it and Megan translated- not to listen to her about needing to pee. “Pee-pee n'est pas pee-pee, tu sais?” Apparently this was far from their first experience with this lady, and whenever they let her up to pee she attacked someone or got into some other mischief.

Okay. I totally felt bad for this woman. Obviously she had some sort of mental instability. And nobody kept coming for her. She didn't appear homeless; she seemed in pretty good shape, physically. So she was used to having some sort of assistance. It must have been really scary to be in that situation. And sure, maybe it did happen a lot; maybe she tended to stop taking her meds or taking too much or something. It was really sad that this lady was left all alone, tied down to a gurney in a dark room. I felt bad for her and bemoaned how something had gone off-kilter in this lady's life and she didn't have the tools to handle it.

But OH MY GOD SHUT UP.

It's 3:00 in the morning. Then it's 3:30. Then it's 4:00. And she kept it up. Sometimes she would slip into broken English. It drove all empathy out of one's head. Plus, I felt fine now. Again, the pain was out there, lurking, but I could ignore it and there was supposedly the promise of a prescription for more. If someone would ever come see us. It felt like we had been forgotten.

Later, when we finally got to talk to Marc again, it turned out that while we hadn't been forgotten, exactly, pretty much everyone in the ER was dealing with something relating to the yelling lady in one way or another. Megan said to him, “So it seems like the way to get lots of attention here is to scream and shout.” Marc answered very quickly, “Please don't do that.”

I noticed that my IV was starting to run a bit backwards. My tubes were turning red, and as far as I knew they weren't supposed to be doing that. I had been getting up with some regularity to go pee. I still felt like I needed to go, but when I did there was only a trickle. But the process of walking down the hall and pushing open the door to the bathroom (which was heavy) and fiddle with my belt and zipper and stuff was, I figured, increasing blood flow to my wrist and overcoming the pressure of the stuff coming down from the IV drip bag, rattling along beside me on one of those hat racks on wheels.

This is the only picture I managed to take while in there. Note the gaping infectious waste bag. Ooh! Also a nurse in sandals!

Well. I can go on to describe the four hours of boredom that followed the first hour we spent in there. Besides the screaming lady, of course, and even that got boring, just boring and annoying. But while one of the goals in writing is to make your reader feel what you're trying to convey, I don't want to bore you. Eventually, Dr. Roberts returned with some papers. She said she thought that I had kidney stones, and gave me a prescription for more of what I'd had in my IV drip, and a prescription or written pass to get an ultrasound, find the thing, and then go from there. And that was it. We'd gone in about 11:30 pm (er, 23:30 Europe time). We walked out of that place at a quarter to five in the morning. Nobody ever asked us for money or gave us a bill.

As we left, the dude with the busted nose and the bloody shirt was still in the lobby, waiting. His friends were not.