Wednesday, April 13, 2011

The Kindness of Strangers

(I was using the                                       adjacent  mat but distinctly heard the kitty mutter, "Hmph!  USED to drink water from the garden hose but NOW I have to use the 'bottle' because          I  USED to be playing OUTside but    NOW I have to be INside -                 exercising, staying in shape.  And       good health.  I chant, do mantras and breathe deeply.  And I STILL feel like scratching someone in the face,           ya  know?  Like maybe one of              those Vet Hospital Administrators in charge of Managed Cat, er, Care.  "I have always depended upon the kindness of       strangers."  In the classic drama, "A Streetcar Named          Desire", these are the final words of Blanche DuBois, a        faded  Southern beauty who is plagued by neurotic,            genteel pretensions.  She speaks these words as she is being escorted out of her sister, Stella's, home to a  sanitarium by a doctor and a nurse.  They are the "strangers" to whom she ostensibly refers.  Having just witnessed this   tragic heroine's mental and moral disintegration, one can't    help but see an allusion to Blanche's sordid history of  prostitution in her   fateful parting line.  But the GOOD news  for ole Blanche was that she didn't have to wait around for -                             precertification.  That is, the strangers came to get her            and her sanitarium bed was waiting.  Her family didn't have    to   endure the railings of her tortured mind, unable to ease her suffering.  That was 1948.)                                                    
     On April 6, 2011, I drove up to Richmond to be with my     granddaughter, Mia Lorane, and her parents - Julie and Matt(certifiable in another sense for several months now) - for an old-fashioned, home-made, Italian Four Cheese Ravioli           supper on pre-op evening.  We even had Puttanesca Red         Sauce - the MOST flavorful (but not SPICY) of the reds.         Got its name in the Old Country.  The 'Ladies of the              Evening'  would spend the day whipping up a batch of red       sauce that would outdo ALL competitors in the AROMA    department. The heavy, iron pot would then be set out on the window sill to 'cool'.  'Gentlemen', as was their wont,          followed their noses, filled their bellies and lingered to enjoy an after dinner aperitif.                                                                                              
     And so it was on the night before our Mia was FINALLY      going to lose her tonsils and adenoids - those glands we have in the back of our throats and below our ears that FIGHT       INFECTION when they are working.  I know this stuff.  You remember.  You did "the cap" ordeal?  The Neurology ICU?  And how WE were worried about potential 'Doctor' (Joe)        Zivagos on the ward? NOW our worry was just getting Mia     ON TO a ward.  The months were long, tedious and, MOST concerning, detrimental and dangerous for Mia as SHE          endured the repeated 'sick time' with temps of 104-105,        feeling miserable while accumulating the EIGHT                documented, required - by the insurance company - Strep    Throat infections that netted her the sought-after referral to an ENT specialist who would remove these glands - while we could only watch, unable to ease her suffering.                          
(Because of changes in the health care delivery system over    the past forty years, we arrived at the threshold of the new     century embracing Blanche's coda.  We, too, depend on the   "kindness of strangers.  We depend on decisions made by        amorphous group of overseers - let's call them medical         directors - to adequately address our symptoms, make us       whole, cut out the malignancy, truss the splintered bone,       guide our children into the world.  Then, it is hoped, they'll   see to it that their journey into adulthood, plagued with its    own particularized and threatening set of medical/surgical     misadventures, is as safe and negative incident-free as             possible.  This because of due diligence, vigilence and the       absence of vapid indifference.  We can ONLY hope they          make the right call because they are the SUPREME call-         makers.  And if they don't?  IF SYMPTOMS ARE NOT              PURSUED AGGRESSIVELY, the malignancy festers, the        bone deforms or decays, the bough BREAKS AND THE          BABY FALLS?  Quite simply, the medical director - and the   'Care' Organization whose costs he is charged to contain -      DID IT.  IN THE NURSERY. WITH THE 'MAGIC' DENIAL    WAND.)                                                                                             
     So Wednesday night, those four cheeses, in their                   Puttanesca-dripping pillows, slid down with roller coaster-     ease, washed down by chilled, fruit-flavored water with many glass-tingling "Saluts!"  A joy to watch.  Mia had lost at least     12 pounds.  Those "necessary, documented" antibiotics can     confiscate even the best of two year-old, raw tuna-loving         appetites.    And although beautiful AND bright, the constant pain (doc said she'd probably NOT been without throat pain    for SIX months) can put a dent in the sunniest of                       dispositions in the most popular of "Princesses" in any pre-    school.  So, even though she told me that Rocco - the pre-        school boyfriend - was in "Time Out" again that day for             taking her hair bow, her heart just wasn't in it.  But her            HANDS are another story.  Between my Italian heritage          'hand-speak', the Rocco affair and that ravioli, she was             HAND-EMBELLISHING during ALL communication with     
us and the staff until the OR doors dropped the curtain on       her baby-blue paper capped bobbing head, her face                   punctuated with her usual grin of expectant                               adventure.                                                                                        
(And what is the role played by the doctors and nurses             today?  As you may recall, back in the day, when Millie pil=  
ferred my cap but I was still a crisp, white, moving container  
of concern for MY PATIENTS, we still depend on them. But,  
interestingly, they are doing the bidding of the medical 'care' 
organizations that cut their checks.  This, so the cutting does  
NOT involve their jobs because of a misunderstanding about  
priorities.  They must provide the care deemed necessary        and appropriate by the call makers.  Whereas, to put it ano-  
ther way, there was once a clear delineation of where the "I"  
stopped and the "thou began", NOW "I" is all there is and      
"thou" no longer has an existence.  You see, "I" will only pay  
for treatment and testing that IT has pre-ordained. There-    
fore, the hands-on (formerly 'real' doctors and nurses)            treaters provide a sanctioned service and THEN, they are     
PAID!  They, too, depend on the "kindness of strangers",         much like Blanche did in HER profession.)                                
     Fortunately, the surgery went smoothly.  The doctor was   
QUITE surprised, however, at the SIZE of the adenoids           (twice normal) noting as well that they were wearing a        
foul coat of bacterial film, which, as you can imagine,               scotched any notion that they could have been functioning   
as part of Mia's immune system.  Once home, she could           depend on familiar family, free care and one-on-one loving,  
un-managed care.  And she, as is HER wont, had plenty of       whine to go with her post-op cheese.  I daresay, late at night  
we did as well.  That Mia was on her way to hearty health was apparent by the increasing number of princess costume           
changes per diem.  I returned home - humming Disney tunes in lieu of Dory Previn - tired but oh-so-glad to have been part of the healing-cum-loving experience again.  Where DID I        store my cat, er, cap?  Later, Lorane. . . .                                           
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