Tuesday, April 12, 2011

The Kindness of Strangers

( I was using the adjacent mat but distinctly heard Kitty mutter, "Hmph. USED to drink water from the garden hose but NOW I have to use the 'bottle' because I USED to be outside playing but NOW I have to be INside, exercising, staying in shape. And good health. I chant, do mantras and deep breathe. And I STILL feel like scratching someone in the face, ya know? Like maybe one of those Vet Hospital Administrators in charge of "Managed Cats, er Care".
"I have always depended upon the kindness of strangers." Those were 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'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. The GOOD news for ole Blanche was that she didn't have to wait around for pre-certification. 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 Wednesday, 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 Putanesca Sauce - the MOST flavorful (but not SPICY) of the red sauces. Got its name in the Old Country. The "Ladies of the Evening" would whip up a batch of red sauce that would outdo ALL competitors in the AROMA department. It would then be set out on the window sill to 'cool'. The 'gentlemen' as is their wont, followed their noses, filled their bellies and so on. And so it was the night before Mia was to FINALLY have her tonsils and adenoids - those glands we have in the back of the throat and below the ears that FIGHT INFECTION when working. I know this stuff. You've been. Remember the cap? The Neurology Unit? And WE were worried about the potential Dr. (Joe) Zivagos on a ward! It had taken months of repeated "sore throats" until Mia had 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.
(Because of changes in health care delivery 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 the decisions made by an 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 - and then, hopefully, - see to it that their journey into adulthood, plagued with its particularized and threatening set of medical/surgical misadventures, is as safe and negative incident-free as possible. This because of due diligence, vigilance 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 with containing - DID IT. IN THE NURSERY. WITH THE 'MAGIC DENIAL WAND'.)
So Wednesday night, those four cheeses in their Putanesca-dripping pillows slid down with roller-coaster ease, washed down by chilled fruit-flavored water and lots of glass-tinkling "Saluts!" A joy to watch. Mia had lost at least 12 pounds. Those "necessary, documented" antibiotics can rob 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 Rocco - the pre-school boyfriend - was in "Time Out" again that day because he took her hair bow, her heart just wasn't in it. 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 double OR doors dropped the curtain on her baby-blue, paper-capped bobbing head.
(And what is the role played by the doctor and the nurse today? As you may recall, back in the day when Millie pilfered my cap but I was still a crisp, white moving container of concern for MY PATIENTS, we still depend on them. But, increasingly, they are doing the bidding of the medical 'care' organizations who cut their checks. This so the cutting doesn't involve their jobs because of a misunderstanding re: priorities. They are to provide the care deemed necessary and appropriate by the call-makers. Whereas, to put it another way, there was once a clear delineation of where the "I stopped" and the "thou began", NOW "I" is all there is and "thou" does not have an existence. And "I" will only pay for treatment and testing that IT has pre-ordained. Therefore, the hands-on (formerly existent 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) and noted 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, naturally, had plenty of whine to go with her cheese. I daresay, late at night, we did as well. That she 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 Dorey Previn - tired but oh-so-glad to have been part of the healing-cum-loving experience again. Where DID I put my cat, er cap? Later, Lorane. . . .
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