1. Act I
  2. Act II
  3. Act III
Andy Holsteen

The Private Patient

Andy Holsteen

The Private Patient
Andy Holsteen
Act I

Scene i

According to his drugged, potentially false recollection (Sedatives work in mysterious ways, mold reality), the first thing he saw following the procedure was—during a brief, semi-lucid interlude when the anesthetic had worn off and the morphine hadn’t quite kicked in—grandma, masterfully veiling stoicism beneath familiar cheeks, standing approximately ten feet away, there but not there—a five-foot-two, brunette frame at the foot of his bed in a room that felt like a dream. Maybe someone spoke; words meant nothing to him, not in that lime, assless cotton gown, not in that narcotic daze, which soon flung him into a deep spell of unconsciousness, not in that place his mind failed to believe.

For three hours he had lain motionless, a malleable man-shaped figure draped across an operating table, simultaneously perished and drawing breath. It was all supposed to be routine, in-and-out.

“We’ll send him home today,” overconfident surgeons assured his parents before it became clear that wouldn't be the case.

Once opioids hit, there’s no control. They suck visions down through black hole eyes, keep the pain, ready to make its debut, dull a while longer.

Scene ii

Awake, once again in a foreign, dim-white space. This made five. It was the fifth (an assumption, but accurate unless something truly bizarre happened during his time under) location he unwillingly found himself within Advocate Good Shepherd Hospital that day—MRI room, waiting room, operating room, recovery room, shared dorm.

It’s nighttime, he thinks. The blinds are closed, but how could it not be dark outside? Demented figures scuttle about—vague outlines of medical-types and parents. Everything is shrouded in haze.  

His wisdom teeth were removed the previous month—Vicodin (candy compared to morphine) relaxed him, sometimes put him to sleep. Having no tolerance to high-power, addict-you-whether-you-like-or-not doses, he’s mostly dead-out, wading through hallucinations, with occasional dips back into the shadow-infested hospital room. This is nothing like smoking pot; this is Hydrocodone on acid.

His dangerous heart rate and rising fever keep those around him frenzied. So much sweat—that assless gown was becoming wetter, darker along the back and armpits, circulating through the air an increasingly dank take on its economical fragrance.

Too high to worry, acknowledge something might be awry, to him, everything’s going fine. In his defense, this is his first stint of medical misfortune—appendicitis. Every two hours (the drugs’ approximate length of effect) comes a short interval scarred by agonizing alertness during which the nurses for some reason adamantly pressure him to urinate into a frosted-plastic one-liter vat. Morphine drips, then he’s right back into the muddle. No matter, tomorrow he would be sent home.

Scene iii

Three days later, he’s still a patient, a patient now in a private room. He finds this somewhat somber, but is grateful, nonetheless.

Since he cannot eat food without barfing, at noon, a nurse must shove a bile escape hatch up his nose, finagle it down his throat. It’s basically a vomit catheter, a concept that doesn’t appeal to him. This stout, expressionless, day-shift R.N. breaks the seal on a packet of industrial-strength lubricant, slicks up a half-inch-diameter clear-plastic tube. Watching her motions, regardless of their utilitarian nature, makes him horny in a simultaneously earnest, desperate, and disturbing way. He hates himself, but luckily, does not get an erection.

It somehow exceeds his expectations. Unlike receiving a long-term I.V., which intrudes about ten inches into the bicep’s thickest surface vein, slithers up the shoulder—something that sounds God-awful but is actually, for the most part, innocuous (assuming no infection)—nose tube installation redefines his understanding of misery.

The lube barely helps. His nasal interior chafes against the synthetic material. He gags. He pukes into a tan-colored bed pan. He pleads for it to stop. That isn’t an option.

When the nurse finishes, she fixes the hose in place by wrapping medical gauze around his right nostril. Upon removing her blue latex gloves, gray-green liquid shoots through the translucent runway, emptying into a basin attached to the wall. He’s entertained by this and watches for a while.

Andy Holsteen

Scene iv

Some friends come visit him; it’s been about seven days. They’ve brought a brown wicker basket full of somewhat sentimental gifts: 4x6 frameless pictures of him smoking a twelve-dollar Macanudo over Fourth of July weekend (How can that be only two weeks in the past?), food he cannot eat, a burnt CD containing late-night T.V. shows he does not like. There is no DVD player in the room.  

He’s roosted in a white, cushioned rocking chair—where he often sits now because his back is starting to get sore from lying in bed. It’s fairly effortless to wheel the tower that holds the monitors and various bags of fluids attached to his arm from the bedside to this rocker. The nasal bile tube is sealed-off when he’s mobile—going to the bathroom, getting x-rayed, swaying in the pale chair—at this moment. Freedom from the petrochemical leash’s wall mount does nothing to relieve its incessant rubbing, hell-bent wriggling.

It’s two in the afternoon. These guests are nice and even do all the talking. But he wishes they would go away. He thinks he might lose control of his bowels.

To cue it’s their time to leave he migrates back to bed, chains his nose, adjusts the mattress’s foot elevation and back slant by remote control, and involuntarily spirals into drowsiness. They continue standing there, expecting more. What could they be expecting? Goodbye, friends.    

Scene v

The doctors believe he is suffering from an ileus—an unresponsive colon—no big deal. Sometimes peristalsis takes a while to restart after surgery in and around the gut. A ruptured appendix releases toxins, making these sorts of reactions even more common. In order to reboot normal intestinal function, he’s told to get up and walk around as much as possible—movement kick-starts the body. He’s also strongly encouraged to discontinue his pain medication, Norco (a Hydrocodone derivative often prescribed post-op. Morphine, despite its comparatively less synthetic-feeling side effects and unparalleled ability to make users feel good, instead of just not bad, can only be administered for short periods before putting patients at serious risk of developing an addiction.), because while it eases pain, it also slows recovery, which, after two weeks of little to no improvement, is his main priority.

So he methodically paces in glorified circles around the nurses’ station, using his I.V. dock for support—like a meta-crutch. Today he plans to do this more than a hundred times, periodically reversing direction.

Between walking bouts, he watches “Man v. Food.” People assume he does this to (subconsciously?) trigger his insides back into action. He thinks that’s kind of silly and probably wouldn’t work.

Daily, around five p.m., his surgeon, Dr. Chang, stops in to see if there’s been any progress since yesterday evening. She wears red high heels, a detail he considers pretty fucking dumb, and treats his one hundred-seventeen laps around the nurses’ station so far that day with astonishing disregard. He wishes the floor, rather than white tiles, was a network of her condescending facial expressions, giving each step vindictive satisfaction. But no, it had all been for nothing. 

Act II

Scene i

Today he’s finally leaving the hospital, and going straight, via ambulance, to another—after nearly three weeks of hearing the same cocky M.D.s spew the same cookie cutter drivel. His parents figure out the legality of moving, fill out the paper work. This is a much more daunting task than one might expect. For whatever reason, transferring between hospitals is highly detestable, probably because patients are customers, key components to profit margins, pocket liners.

Dr. Chang stops caring about his wellbeing altogether once she hears of his intent to change hospitals. He finds this aggravating, a synecdoche of the medical-industrial complex.

What a way to spend the summer between high school and college, as an eighteen-year-old, at the optimal combination of maturity and innocence: having no fun, harboring laparoscopic scars.

Scene ii

After a fresh round of x-rays at the new hospital, Children’s Memorial in Chicago, it’s immediately clear ileus is not the culprit, but an intestinal kink, which requires more surgery. He sees his black-and-white insides on a computer screen. He sees the knot in his colon. How could a medical practitioner not notice this?  What else did Dr. Chang screw up?  

He will go under the knife tomorrow morning. It doesn’t really matter when it happens, because it’s happening again, which means it could happen again, and again, and again. His intestines could just keep kinking indefinitely—a macabre thought, but he thinks it anyway.  

Sleeping in the same room as someone significantly younger makes him feel pathetic, like he should somehow do better at, well, whatever exactly he’s doing—do better at lying, maybe throw in a supine pose every now and then, do better at giving blood (Although, he’ll never be skittish about shots again after having two vials drawn every morning), do better at saying what hurts, do better at projecting optimism. Humbled, he realizes how terrifying this must be for an eight- or ten-year-old.

Andy Holsteen

Scene iii

Natural light greets him from induced sleep. Still alive, that’s good news.

He’s carted back to his room in a sanguine mood. Four people lift him from the recovery platform onto his bed.  

Upon further investigation, he discovers someone stuck a catheter into his penis while he was under, which makes him self-conscious and wonder how many people have seen him totally naked now. Unable to take morphine, he’s in quite a deal of pain.

The people hidden behind the ceiling-high, baby blue curtain (there are no private rooms here) won’t stop talking about the Stanley Cup. He wishes they would stop.

Scene iv

Surgery was three days ago, but now he needs to do something truly difficult: eat. He’s not sure he can do it. It’s been twenty-four days with no food whatsoever, just liquid nutrients pumped into his veins. His mom offers some Vietnamese soup. Normally he loves spicy foods, this, however, immediately burns his throat and stomach. He craves fried chicken, but knows that would be a disaster. There's a McDonald's in the cafeteria—delightful irony. 

A peanut butter and jelly sandwich on white is put before him. If he can keep it down, the surgery was successful; he can finally go home; this saga will be over if he can just keep it down.

Scene v

Do they really need to keep checking his vitals at four in the morning? Nothing has changed for days. REM slumber is nearly impossible.

Scene vi

He’s alone—parents are grabbing a quick dinner, nurses are busy, roommate is somewhere.

For the first time ever, he prays, he earnestly cry-prays to the God in which he does not believe. He doesn’t really know how praying works so he kind of just talks to himself, choking back runny eyes and phlegm. It feels real, even if it’s not.

Something is different now, in him, in his blood, in his gut, and it’s not simply the absence of an evolutionarily-defunct organ. He realizes he has not been alone in this struggle. He feels loved by people who love him, and by those who don’t. He wants to reacclimatize to the world’s massive beauty.  

Act III

Scene i

For some reason he thought sitting in the back seat of his parents’ exhausted Mercedes station wagon would feel better than this—cathartic. Outside the hospital confines, his body still ubiquitously aches. It’s not raining. But it’s slightly overcast. Driving northwest on Interstate-90 never felt this sluggish. The traffic isn’t even heavy.

He sees familiar sights along the roadside. These landmarks pulse reality’s warmth through his body, activate his blood.

Home, the first place he goes is the bathroom—to get on a scale. He needs to know. Twenty-five pounds gone is his liberal estimation, but he’s expecting the scale to read 160 or 165. The formal guess is 163.4. He doesn’t strip. Getting undressed is too difficult.

142 flat—that can’t be correct. He gets off, lets the digital scale reset, and then tries again. 142 flat—he lost forty-one pounds in twenty-eight days. He finds some kind of perverted satisfaction in this statistic. It’s physical proof that it all actually happened.

Scene ii

It’s three in the morning and this is the most pain he’s felt since the night his appendix burst, when barbed wire coiled around his stomach. He cannot breathe.  

His first thought is that something inside him is breaking—internal bleeding, slow death. He writhes down the hall to his parents’ room, guiltlessly wakes them. There’s immense pressure on his lungs. It’s the first time he has cried from bodily pain in the past decade. Maybe this is just what he deserves—eternally deteriorating health.

He’s held upright by his dad. Someone proposes the thought of going to the E.R.—no.

The intensity begins to subside. He can breathe again. His mom postulates that it was leftover air used during surgery to keep open the tiny abdominal incisions finally leaving the body, gas pain. He’s relieved, says goodnight, and goes to bed.

On his back, gazing up toward the ceiling shrouded in darkness—dumbstruck—he regains a sense of himself: I’m finally out for good. This is my life again, not circumstance’s. This is my life, and my body. This is my body, and it’s not self-destructing anymore. These are my eyes, my hands, my cruel visions, my excruciations, my todays, my tomorrows, my thoughts, and my lifted sorrows. It’s me. It’s me. It’s me. It’s me. It’s me and I feel alive.