erik lundegaard


Sunday June 09, 2024

Room 715

It's Friday night at 6:00 and I'm with my 92-year-old father in Room 715 at M hospital in the Twin Cities. I call it the Henry Aaron Room. Dad gets it if not many others do. He's sleeping. We were watching “Jeopardy” but he'd been sitting up in a chair for three hours and that proved wearying.

Last week, Dad had a mild stroke and the paramedics took him here. I had been at the Mariners game in Seattle, had called him with the good news of the Trump convictions (“Guilty on all counts!”), and got his wife Ingrid instead with the news that he was being loaded into the ambulance. Initially, I thought: “This again.” Six weeks earlier, maybe eight, he'd had something similar—suddenly unable to lift his left arm—and been taken to A hospital, where they'd determined that it wasn't a stroke but a TIA. You can look it up—I had to. He recovered from it pretty well. This wasn't that. The paramedics determined this was a stroke, and took him to the nearest hospital, which was M hospital.

I left the game early, and called Ingrid when I got home. On the phone his voice sounded very, very slurred, and I flashed back—not to six or eight weeks ago—but to 2016 when my mother had a stroke in her apartment over the weekend and wasn't found until Monday morning. She lost the ability to speak for the last three years of her life.

“Was he given the TPA drug for immediate stroke aftermath?” I texted.

“I haven't seen the doctor yet,” Ingrid texted back, “and the nurses can't tell me. But the paramedics told me this is a top stroke management hospital. Wish you were here.”

“I'm just googling it. Apparently it's called tissue plasminogen activator.”

“Yes, I know about it, but he doesn't have an IV. Great stuff if you can get it.”

That back-and-forth took place around 6 PM Minneapolis time. At around 6:40, an emergency room doctor burst in on him and Ingrid, demanding to know when exactly the stroke happened because they were thinking they were reaching the outer limits of when the TPA could be given safely. The trouble was, there was no “exactly.” He'd had lunch, felt off, went to take a nap, and when he woke up: this.

I knew about this back-and-forth because I was on the phone with Ingrid. During a pause, I asked what the tests suggested and were they sure it was a stroke? No, they weren't sure. Everything was too inconclusive, and in the end they didn't administer the drug. Instead they ordered an MRI. Which told them—the next day—yes, it was a mild stroke. Therapists (occupational, physical, speech) were assigned to him.

And then things got worse. Over the weekend he kept coughing when he tried to drink water. He ate cut-up meals just fine—so Ingrid and my sister Karen said—but the water was problematic. Too late the hospital staff ordered thickened water. By then he'd aspirated something—probably water—into his lungs. Now he had pneumonia. Now he was on oxygen. Now he was in the ICU. And I booked a flight to come out to Minneapolis.

I'm still not over this initial fuckup. If you have a stroke patient, even one with a “mild” stroke, how do you not guard against aspiration? What precautions are taken? That seems like the No. 1 thing to watch out for. But they didn't. And things cascaded down. They took a semi-healthy man with a stroke and within days brought him to death's door.

People kept showing up—now PT, now OT, now the nurse to check his blood sugar, now the nurse with the nebulizer, now the RN to move him in bed. Strangers kept waking him up, screaming “BOB!” in his face. They keep asking the same questions:

  • Do you know where you are?
  • Do you know what month it is?
  • Do you know what day it is?

To see if he regresses in his answers, I'm told. But it bored and annoyed him. He's a sharp man in a weakened body. Dad doesn't suffer fools gladly and now he was being treated like one. One time, he was so bored telling them “June 6,” he just said, “D-Day.”

There's so many of them, and they never seem to know who he is. “BOB! HOW DID YOU GET AROUND AT HOME? DID YOU USE A WHEELCHAIR OR A WALKER?”

Dad, through slurred speech: “I walked.”

A feeding tube was ordered but that was another disaster. On Wednesday morning, the nurse inserted it before I arrived but X-rays indicated it wasn't in the right place. Or it was kinked. So she did it again. I was standing outside the door and could hear his cries of pain. And even this wasn't right. And the third time wasn't right. My sister to the nurse: “Should we get someone else to try this?” Even the fourth or fifth go, which seemed OK, didn't work. It got clogged. The processed food wound up overflowing onto the machine. They wound up turning it off and inserting his tube the next morning via X-ray. Fifth or sixth time's the charm.

He still has his sense of humor. We were watching the Twins play the Yankees other night and a nurse interrupted to give him a blood-thinning shot in his stomach. “BOB, I'm going to give you a jab, it'll be a little painful, and then you can go back to watching the Twins!!” Dad: “I don't know which is more painful.”

I keep wondering over the illogic of so much of what they do. When his oxygen levels go below 88%, his monitor beeps, and sometimes someone shows up to investigate; other times nobody shows up to investigate. I asked why. “Oh, we can see it back at the nurse's station. We're monitoring it.” Got it. After she left, I wondered, “So ... why do you need the monitor to beep in his room then? You already know what you need to know. And isn't that keeping him awake?”*

* Apparently they have readings and alarms from one of the monitors (breathing, heartrate, etc.) but not from the feeding tube. Point still stands. 

They reduced the nebulizer from four to two times daily. Why? Because he's improving, they said. Is he? I said, listening to his wet cough. We take shifts—Ingrid has the brunt of it—so he has an advocate. So the medical staff gets a sense that it's a person there.

I envision a horror movie, Kafkaesque, about someone entering a facility and slowly, bit by bit, losing mobility, health and agency by a staff of cheerful, chipper people who think they're doing good. They're not evil. They think they're helping. But they keep blowing it. Until there's nothing of him left.

That's all of us eventually.

Posted at 08:04 AM on Sunday June 09, 2024 in category Personal Pieces