Ralph W., ME

Preface

April 1, 2019

Today is the 10th Anniversary of my second craniotomy. No foolin’. That is, I have been cancer-free since April 1, 2009. Some of you may have read my account of that day and the days following, but I hope you don't mind if I post it again. For cancer survivors, 10 years is a pretty big deal. So yay me.

The 10th Anniversary of My Second Craniotomy By Ralph Warnock

Johns Hopkins Hospital was, as we used to say in the restaurant business, “in the weeds.” They were canceling surgeries because there was no room in intensive care. They couldn’t get people out of ICU into regular rooms, and they were having day-long delays getting patients released with their instructions and medications to transition to their out-patient or home care.

I was in pre-op at 5:00 Wednesday morning where I was poked and prodded and pricked and I signed releases and advanced directives and I was given a very skimpy hospital gown that revealed my bottom in all its lovely curvaceousness.

The charge nurse responsible for patient logistics came in, and slumping into a chair with a weary sigh, told me she had picked “a bad week to quit smoking.” After reviewing my medical history and medications, she actually recognized me from last July. (Must have been the gown.) She went on to tell me two craniotomies are more than enough for one person and I should share the doctors, nurses and the rest of the JHH staff with others, please and thank you very much.

My surgeon paid us a visit and gave me a little boost of confidence. He assured me that whatever the hell was inside my brain -- and he wasn't really sure just what it was, -- he would get it out of there. The tumor was small and cancerous and surrounded by necrotic brain tissue that was lightly affixed in the site of the cavity wall left from my

first tumor resection. This time around he would be removing a few millimeters of surrounding healthy brain tissue along with bloody scar tissue, and a blood vessel that might be hiding a cancer cell or two.

He anticipated scooping away all that mess from inside my head. I think the actual medical term he used was “schmutz.”

I woke up from my surgery, passed my cognitive and neurological tests repeatedly with flying colors and spent the day in ICU trying to doze, sweating in my bed with a splitting headache that made me nauseous. Of course, since I was allowed no food or water, I merely heaved helplessly into the echo of my bedpan.

Actually, I was lucky to be “stuck” in ICU for over 24 hours until Thursday afternoon. It was quiet and I had plenty of attention from my nurse who gently engaged me in conversation to keep me awake through Wednesday night and finally – Oh, Lord have mercy! -- allowed me a piece of ice and a few sips of water in the morning.

Johns Hopkins is a teaching hospital and I was accustomed (from two recent previous surgeries) to residents making their rounds very early in the morning. I listened to them filing slowly through the rooms, and when they got to me, they chatted with me for a just a few minutes and moved on, which I took to be a very positive sign. It never occurred to me that it could have been a very negative one.

<>I kept busy on Thursday morning taking scheduled medications and routine neurological exams, physical therapy, as well as having my tubes and IV’s, EKG and anti-clotting booties removed from my body. I will spare you most of the details, but the stinging extraction of my catheter does stand out in my memory. The tearing of the layers of medical tape from my head that secured my “brain cocktail” tube draining into a plastic bag runs a pretty close second. But I was able to finally get out of that gown and into pajama bottoms and a t-shirt and start wandering around the floor in my skid-proof socks.

 

I actually enjoyed the diversion of a trip to my post-op MRI on Thursday afternoon that at least got me out of my room and off a floor that would make the previous night in ICU seem like a sensory deprivation chamber in comparison. I was very grateful my sister Elizabeth and her fiancé Ed stopped by with Thai food. I discretely disposed of the remains of my canned green beans and my iceberg lettuce salad and some other items on my tray that remained unopened and unlamented.

Thursday night on the neuro-care recovery floor had all the bustling charm of a third-world bus station. When there was a brief respite from announcements, pages, the random moaning of patients, and room alarms, there were the voices of hospital personnel sharing their gossip in none-too-hushed tones just outside my room and the rumbling and squeaking movements of hospital equipment through the hallways. I suppose I should be grateful that I was actually aware of all these things.

I shared a room with a younger patient suffering from the traumatic effects of an automobile accident who was a falling risk. I realized through the course of Thursday night that this meant that, although he was not an overly effusive conversationalist by any means, he did have the increasingly distressing habit of trying to get out of bed on a regular basis in an attempt to use the bathroom -- I suppose he was unaware he had the convenience of his own catheter -- and his efforts would set off an alarm that not only rang with urgent intensity in our room but alerted the entire staff on the floor. (Not that I was actually trying to sleep, of course.) The door to our room remained open all night, the hall lights remained illuminated at full fluorescent intensity and the movement of equipment and staff continued until some natural light started creeping through the blinds. It was actually quieter on the floor after 8:00 on Friday morning --- my roommate began snoring peacefully, his bladder blessedly empty, and I began my 4th hour of SportsCenter.

I had my appointments with physical and occupational therapists early Friday who approved my release. I received follow-up care printouts and medications were prescribed by mid-morning. I was packed, dressed and ready to leave by about 10:00. But my transport tech and wheelchair were nowhere in sight and there was yet another all-call diverting the attention of the staff.

It was around 3:30 in the afternoon that it finally dawned on me that it was time to take matters into my own hands and I simply walked to the elevator, went down to the lobby and left the building. My Red Sox baseball cap hid the approximately 60 staples in my skull and, for the most part, I looked like a departing visitor and not an escaping patient. I am sure this was contrary to the protocols established by the hospital, but I was feeling a little obstinate by then. And very lucky.