Today I said goodbye to the hospital, the surgeon, and the staff that saved my life.
I also said goodbye to the sixty-four acoustic tiles on the ceiling on my private room. Over the last week I'd studied them so intently that they became as familiar to me as a chessboard to a Grandmaster. On those squares, I plotted out the steps towards discharge, but did not allow myself to think too many moves ahead. Recuperation so far has been humblingly linear; there is no L-shaped cantering of the knight or diagonal zooming of the bishop, just one tiny increment of progress leading to the next in straightforward gradations. A selfishly small part of me wishes that I could go back through my residency training enlightened with this firsthand knowledge of the inpatient experience, such that I might consider anew whether each & every order I placed was moving those under my care closer to their goals, towards a healthy exit. Because regression is hard, as is disenfranchisement.
Preparing to come home was emancipation by degrees. Each day brought the removal of one more tube, catheter, or drain that had restricted my movement. This morning, when the final IV was pulled from my left hand, I had a fleeting sensation of phantom limbs, not quite believing that I was back in possession of unencumbered arms & legs. Never again will I take for granted the able-bodiedness that then allowed me to walk into my house and up the stairs under my own power to my waiting family.
One of my favorite songs lately has been How A Resurrection Really Feels by The Hold Steady. It's about a troubled young woman who comes back to the church after overcoming abuse both chemical & physical: "She crashed into the Easter Mass with her hair done up in broken glass ..." I experienced a similar return today, one not triumphant but born of incompleteness. There is a tidy anatomic inventory of what I lost in the Whipple -- the head of my pancreas, my duodenum, my gallbladder, my once-enviable six-pack -- but no pathologist can record what I've gained. As I've waxed in and out of consciousness since the surgery, I have had the most wonderful realization that my mind & spirit are separate from my broken body. Call it a chemically enhanced epiphany if you will, or a hazy recollection of studying Cartesian dualism in college, but I've never been more certain that there is more to us than just a collection of cells prone to going rogue, that there are parts of the human being inviolable by either cancer or knife. What the scalpel did to split my flesh and soul I will gladly keep asunder.
This marks my last entry in this blog. Normal broadcasting will now resume via Twitter, Facebook, and even face-to-face conversations (but not too many, please; I'm British).
When I first set out to write this series of posts, I wanted to remain accountable: to myself, to my family, and to a larger audience who would keep me honest throughout moments of doubt and pain. I wanted to document a period of suffering so that my future self, if ever tempted to wallow in a foul mood, might be reminded of a true nadir, and then find their day gilded by even the faintest light. I wanted to bear witness to a how a patient really feels, in the hopes of becoming a more thoughtful doctor.
As I've mentioned before, I was tremendously inspired by the testimony of Paul Kalanithi. When Breath Becomes Air is, truly, a heartbreaking work of staggering genius, notable for its bravery as much as for its turn of phrase. I never aspired to hit such literary heights, but I did mention to one friend that I hoped post-op opioids would allow me to mimic Hunter S. Thompson's Fear and Loathing in Las Vegas. Alas, my prose style has remained pretty much the same, with no flights of lysergic fancy to take my creativity to the next level. As much as I love the Beatles, my magical medical tour did not inspire rapturous posts about tangerine trees or girls with kaleidoscope eyes.
The one woman who was -- almost constantly -- in my sight deserves mention, however. My indescribably wonderful wife vivified our 15-year-old wedding vows with a fresh commitment to stay with me in sickness. I look forward to rejoining in her health and to redoubling my efforts towards her happiness.
My mother also kindly came in from out of state to sit vigil, and has been a vital comfort at home too, providing stability for my children along with my helpful mother-in-law who lives close by.
Beyond our small family, for whom I could not be more thankful, I can only close by echoing my father who described, through the travails of his own disease, "the discovery of whole new levels of resourcefulness and love, and of wide, unimagined networks of caring and support."