Halloween

I regained consciousness in the ICU after transplant number three. Following a liver transplant you have an intubation tube in your mouth, a tube in your abdomen draining into a bile bag, two or three surgical tubes connected to grenade-size acrylic containers that can be squeezed down to suck blood and interstitial fluid out of your side (Pratt drains), a tube in your dick draining your pee into a bottle. A machine is forcing you to breath through the intubation tube which is a very uncomfortable feeling. The surgeries back then were very long. My first transplant was eighteen hours and they used seventy pints of blood. I don’r remember the stats for number three. You are very weak after such an ordeal. And on the third i was very weak already going into the surgery. I had taken a beating and was nearing the bottom of a long decline from a young fire trail runner (a 700 foot climb from the Campanile to the top at the Lawrence Hall of Science who also did push-ups and used a chin-up bar) to a ninety pound sack of bones and organs. All of my muscle mass had been wasted by large doses of cortico steroids, long periods of not eating, high fever, etc.

As the anesthesia wears off you start to feel incisional pain. You remember those little boxes of rice krispies we used to eat as kids, the ones with the perforated fronts that you could open up, pour the milk in, and eat the cereal right out of the box? That is what my abdomen looked like, closed up with stables. And back then they were worried that morphine would badly effect the newly transplanted liver, so they didn’t use it post-op. That means the pain comes on like a freight train. What they do give you is very high doses of cortico steroids (I call them roids). These alone in a healthy patient induce mild hallucinations, like seeing fluorescent colors on walls. (After transplant number four I saw glowing green writing that I couldn’t quite decipher on the wall in front of my bed. This sort of thing I so expected at that point that I wasn’t phased in the least.) What I saw was the clock from The Persistence of Memory by Dali hanging over my bed. (There was a clock on the wall in front of the bed. By the way, that Dali painting has been a favorite of mine since high school.) I had this distinct thought-- “Gold, you’ve been fucked up before, but you’ve never been fucked up like this! But just hang on and try to enjoy the ride.” That was basically my oney clear thought. I looked over at the chair next to my bed. On the back in glowing red letters was written a word. What did it say? Isolation? I’M DEAD, DEAD, DEAD! Resurrection?’M DEAD, DEAD, DEAD! Rejection? I’M DEAD, DEAD, DEAD!

Eventually they take out the breathing tube which is an enormous relief. Then you have to do breathing exercises to keep your lungs open and prevent pneumonia. This is hard and painful work fighting against the incisional pain. Meg was there to encourage me to use the incentive spirometer (breathing) and to feed me ice chips. My throat was sore from the breathing tube and my mouth was so dry, but all I was allowed was to suck on some ice chips. There is no day or night in the ICU. This disorientation alone can send you over the edge, especially with the roids.

Yet, I was not so lost that I could not appreciate a pretty face. Meg’s face was the prettiest in my eyes. She sat in a chair next to my bed. She leaned over my bed to smile at me and reassure me that I was doing well and everything would be fine. Meg is my Jack-A-Roe. I cannot listen to that song, especially the version on Reckoning, without a few tears. And there were some pretty nurses. Something to give me hope, to urge me on to keep breathing deeply against the pain.

Then there was a shift with a nurse that was not very pretty, she had a pudgy face with a pushed in nose. Meg said, “Its Halloween”. It was late and she was going home to rest. I said, “Don’t leave me here with Miss Piggy”. She replied, “You’ll be fine, I had to go.” I started hearing voices and laughter from the hall. A halloween party in the hall? I struggled to make out what they were saying. Were they talking about me? I thought I heard voices saying things like “He’ll never get well” and “He’s not going to make it.” When the nurse came in her head was the pink head of a pig. A halloween costume?

An orderly comes into my room and says its time for my chest x-ray Oh no! This has happened before, and they are going to kill me! But I cannot talk, So they wheel me out on my bed, down the hall into the elevator. The elevator takes me down to the basement. They take me into the x-ray room. They attach electrodes to my chest. When they turn on the x-ray machine, everything goes black.

I wake up in the ICU, but with the clear feeling that I am back in time, before the chest x-ray. I wait in fear for the chest x-ray that I know has already happened and is inevitable. Since it has already happened it cannot be undone. That is why I cannot talk and tell them not to do it-- it has already happened.

This sequence repeats itself for some time During this time Meg says I kept saying, “They took me down of a chest x-ray and I got zapped!”

A doctor comes in and looks over me in my bed. He pulls up my gown He tells me I have had a fourth transplant. Due to all my past surgeries they were unable to put it inside. They have left the liver attached to me but outside my body. He covers me up with my gown and sheet. “No one will ever no” he whispers into my ear, and then walks out.

I find myself in swirling waters. The current is very strong and pulling me away. There is a pole and I try to grab onto it. But I can only reach out with my tongue. I am nothing more then a long tongue, like a rubber band. I wrap myself around the pole to keep from being swept away by the strong currents. I have to hold on very tight, with every ounce of strength. Then I hear a voice. The voice is demanding that I open my eyes and talk. I am so weak, and I do not want to loose my grip on the pole. If I do, I know I will be swept away. But the voice is so angry and insistent. I open my eyes. It is my brother, yelling at me, telling me to come out of it. But I can’t let go of the pole. I think, “I love you, but I am holding onto this pole with my tongue and I cannot let go to talk. If i do, I will be lost.” I try to communicate this with my eyes, and then I close my eyes and return to concentrating on not being swept away by the swirling waters.

I open my eyes and find myself back in the ICU. There is a person by my bed talking to me. I struggle to talk. Then I remember the story “Johnny Got His Gun”, and how the guy in the story communicated by blinking his eyes in Morse code. But I didn’t know Morse code, except my father had taught me the universal distress signal: dot dot dot dash dash dash dot dot dot. I open my eyes briefly for dots and longer for dashes. I repeated the signal. The face said, “I think he is trying to communicate with his eyes! Michael, if your are trying to talk with you eyes, blink once for yes. I blinked. “Yes, he is not in a coma, he is conscious!”

Later Meg told me that the face was her mother, my mother in law to be. I had looked her straight in the eye and said with a very serious look on my face, “If I blink my eyes once, It means I am fucking Meg. If I blink my eyes twice, it means I am fucking Meg two times. If I blink my eyes three times, it means I am fucking Meg three times.” Many years later, this became a private joke between Meg and I.

So Meg had them give me a shot of dilantin. It had a dramatic effect, and I immediately came out of my delirium. I said, “How in fucking christ did you figure it out?” Later on, after leaving the ICU i felt myself slipping back. It felt like my conscious mind was pulling back into my head and my eye holes were getting smaller and smaller and the world inside my head was expanding. “Meg, its happening again. I need more dilantin.” She got me more, and the world outside my eyes grew back to fill my visual field.

Years later, I was at an art gallery. I remember it being an exhibit of Goughan. I saw a painted mask. I have never been able to find it by searching among Goughan’s work, so perhaps it was the work of some other artist. It was a mask of a man’s face. The face was rather unremarkable. The mask was painted not on the outside, but on the inside. It was painted with a scene from a tropical paradise. I went up to the mask and put my face inside as if to wear it. I looked out of the eye holes. Then I slowly pulled my face back, and the eye holes became smaller and instead of looking out I was looking in at the tropical scene painted on the inside. Yes, this was precisely what if felt like.

The road back from the three liver transplants involved more complications. I had a systemic yeast infection which was hard to treat. Then my third liver became unhappy. They thought it was either the return of CMV or rejection. One of the surgeons came into the room one day and presented me with my options. They could treat me for rejection with some new, experimental gamma-globulin from horses., or they could assume I had CMV and do nothing. If they gave me the horse serum and I had CMV it would kill me. I reasoned that if Ihad CMV I was dead anyway, so I went with the horse serum. It was a very painful series of a week or so of injections in my legs. Each night I would wake up sometime in the middle of the night with shacking chills. The nurse’s aid that week was a very large, very smelly woman who impressed me as being not too smart. She would grab me with her big hands to turn from side to side. She would pile blankets on me that, because I was so weak, left me immobile. After she left I would lie immobile under the pile of blankets until morning. If me fever came down I would get hot, but there was no way to call for help because I was unable to move under the blankets to reach the call bell. I called her the bear and I told Meg that each night I was mauled by the bear.

The first time I was allowed to leave Pittsburgh I went to my Mom’s house in New Jersey and Meg went home for a much needed break. In the afternoon of my flight to NJ,  I was lounging on a lawn chair in the backyard of my youth, taking in the early spring day and listening to 

Comfortably Numb (Pink Floyd) on a hand-held tape player (do you remember the Walk Man?) .  This song reminded me of one of my lowest points in the hospital in Pittsburgh, when a raging CMV infection was frying my brain with  fever of 105 and above.  My hands had puffed up from fluid retention and looked like two balloons.  Listening to that song that afternoon in NJ was a bit too much for me.  I turned if off and went inside.  I felt a bit warm.  I went up to my room and (to be safe) took my temp-- 103!  I made a call to Pittsburgh who told me to take a plane back that very same day.  (My mom held up well and drove me to the airport.)  Meg met me in the ER.  In the Pittsburgh ER they knew me and they knew my history.  Reasoning that nothing ever happens on the weekend, the ER doc sent me back to my local apartment on Tylenol with instructions to watch my temp and return on monday.  He did not do a blood gas.  Meg and I went back to the apartment.  A few hours later I was having trouble breathing.  Meg looked very worried (bad sign!) and said I had to go back to the ER now!   Back in the ER, they did a blood gas.   I was admitted on IV Bactrim.  I dodged intubation  and a trip to the ICU by a matter of an hour our so. 

 

After leaving (really leaving) Pittsburgh I had a long list of things I wanted to do.  One of them was to go to MOMA on one of my trips to visit NYC area relatives.  I spotted this painting By Ensor "Masks confronting death" (1888) from across a long gallery and immediately interpreted it as a celebration of temporary triumph over (cheating of) death.  I was in the process of rebuilding my personal illusion of immortality, without which it is impossible to function in the everyday world.  One reconstructs a personal mask with which to confront death and your own mortality.   I got a small group of friends together for the following halloween to dress up as if we were confronting death in this mocking, confident way.  I have a picture in my office of this group -- Meg and I and Peter and Drew.  Meg looks lovely dressed as an angel.  I of course was dressed as death.

Obviously Meg and I made it back to Berkeley. I had a hideous scar on my chest because after number three they had to remove the stables early and let my wound heal by filling in with scar tissue to avoid infection. I was swimming to regain strength, and the day I got back I went for a swim. Later I went to visit a friend and I told him s had been to the pool that day. He said, “Me too. Did you see that guy with the horrible scar?” He was very embarrassed when I told him that that was me.

We were not that close back then so I don’t think I invited you to my wedding, but in 1985 Meg and I got married. We also had a big party in Berkeley for friends including lots of people from the department (you had already graduated and moved on). We rented a boat and took everyone out for a cruise on the bay. Peter and Drew were there, and Gerson and Judith came. It was a blast of a celebration. Everyone got drunk (except me) and had a great time.