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ater for now the plan was to get iv saline infusions to bring the potassium levels down to a non life threatening level one of the nurses brought over a pole with an iv drip and the infusions began the problem was the er was so crowded that there was still a wait for a gurney as we waited one man in particular caught our eye he was tall and burly with graying hair and blue eyes he wore blue scrubs indicating he was one of the support and operations staff but carried himself confidently and had a calm and steadying manner with the patients as he delivered oxygen tanks and answered their questions after a while we noticed that the other staff even occasionally doctors and nurses seemed to rely on him to know what was going on and even defer to him occasionally he seems like he s running the place vlad commented and indeed he did possibly because he was older than the mostly 30ish staff where do you think his accent s from vlad asked me rhetorically because it was obvious russia i said promptly sure enough when the man stopped by to let us know a gurney was on the way he inquired about vlad s name and background vlad reciprocated and it turned out that the man whose name was sergei had been born in ukraine when it was still part of russia he was probably a doctor back in russia i said half jokingly could very well be vlad replied in all seriousness noting that he d had a laboratory tech with advanced degrees back in russia because the united states didn t recognize the russian medical system people who came over in the 1980s and 1990s often ended up working in jobs adjacent to their original professions but at a much lower level former doctor or no sergei became our guardian angel for the next few hours once he located the gurney he suggested i stand guard over it while vlad went to the bathroom because the gurneys were in high demand and he would wander over to check on us every now and then initially while we waited for a bay to come free the gurney was in a row of four lined up on the open floor of the er there were very few chairs and no room for one anyway so i sat on a corner of vlad s bed we both had books but little desire to read so we passed the time by watching the controlled chaos of the er by around 2 am one of the bays came free and we were happy to note that it was a corner bay meaning that there was a wall on one side instead of curtains on both definitely top er real estate sergei wheeled the gurney in and moved the iv we were settled in our new home though we had no idea how long we d be there the doctors had indicated that if the tests showed vlad s blood potassium was coming down he d be discharged to go home if it wasn t he d be admitted to the hospital and who knew what would happen after that i tried not to think about the possibilities kidney damage dialysis wait listed for a transplant maybe the third time will be a charm i said the last two times we d gone to the er we d gotten bad news first vlad s cancer diagnosis and second emergency surgery for a ruptured intestine maybe this would be the time we d escape relatively unscathed at any rate there wasn t much else to do and noplace to sit so i crawled onto the gurney beside vlad and we both fell asleep we were awakened a few hours later by the frantic screams of the young orthodox woman in the bay next to us fortunately for her far more than for us the pain medication seemed to work and the screams were replaced by her soft murmurs in yiddish once we figured out the accent we both drifted back off to sleep we woke again a few hours later when vlad s doctors arrived the news was good but not great vlad s blood levels had improved but not enough for them to send him home we re admitting you the doctor said flatly meaning to the hospital vlad s face fell and i realized how much we d both been counting on being allowed to go home in the morning but at least they didn t seem to think the kidneys were permanently damaged there was yet another twist as i discovered after venturing out for breakfast i wasn t sure i d have enough time to eat before he was moved to a hospital room so i checked with the nurses one rolled her eyes at the question you won t be going anywhere soon honey she said the wait for a hospital bed is 24 to 48 hours one to two days well that certainly left me enough time for breakfast so i went down to the cafeteria and savored some quiche and sausages and best of all strong hot coffee the mt sinai cafeteria is actually surprisingly good with a wide variety of fresh food back at vlad s bedside i noticed the young couple next to us was gone temporarily it appeared as their belongings were still on the bed the chair i d noticed earlier now stood empty against the wall i sat down right away and plugged in my laptop to the power strip along the wall as the morning progressed i read and vlad alternately read and dozed as the saline solution continued to course into his arm the young couple reappeared and i stood up here s your chair back i said to the man like many orthodox men he appeared both younger and older than he probably was his fresh unlined face and gentle eyes a contrast to his severe clothing and erect posture he could have been as old as 30 or as young as 20 no no he demurred you keep it no it s yours i insisted we will share he said firmly and gestured to me to sit down again so i sat back down and read for a while then vlad announced he was hungry this was a positive sign vlad s appetite had been returning slowly since the surgery but the rate of increase appeared to be accelerating he d eaten breakfast both our breakfasts actually a few hours before when an orderly delivered two sealed boxes each containing a dry sandwich water and an apple i was amused to note that the seal indicated the contents were kosher no lunch appeared to be forthcoming i found out later why so i suggested that i pick up some lunch for us both from the cafeteria we shared a picnic of fried chicken and salad for me and sandwich pudding and juice for him on the hospital bed then we had a long afternoon of reading and dozing with the curtains closed it s like being in a tent vlad commented and in a way it was urban camping but instead of the dramatic forces of nature we were surrounded by human drama the young couple next door once again left for tests and returned the young man repossessed the chair while i napped chatting with his wife in yiddish the sound was strangely peaceful and lulling then the doctors came by for a discussion which of course was in english i couldn t help but overhear since they were inches away separated only by a cloth curtain they asked her if she d ever had surgery i had two ceasarians she said in her gently accented english with an unmistakable note of pride so young i thought and wondered who was caring for the children they couldn t possibly be very old then they explained her condition kidney stones just the thought made me wince the pain was terrible but they had medication for it hopefully she wouldn t end up in such horrible pain again and then they said the magic words we ll be sending you home later today my heart leapt with happiness for them oh good the man said do you know when it usually takes a little time to process the discharge papers the doctor said that we would find out would turn out to be the understatement of the year i see the man replied i am hoping we are hoping we have a wedding to go to tonight everyone chuckled we ll do our best the doctor said i thought of the joy of a jewish wedding i ve been to a few though never orthodox and hoped the young couple would be able to make it they stayed for a surprisingly long time at one point when the young man was gone i was returning to vlad s gurney and saw her sitting up in bed i hear you re going home i said yes she replied with a radiant smile i smiled back i m so happy for you thank you it felt good to have a connection with her and with her husband who so decently shared the chair and who despite my many urgings never once asked to use it when i was in it dinner was another hospital picnic from the cafeteria the young couple departed and the bay was left empty for a while to be replaced by a large hispanic family the rules dictated one visitor per bed but the staff tended to look the other way and this patient had at least two or three visitors chattering away animatedly in spanish i dozed for a bit the curtains were closed and the background noise from the er floor was loud machines beeping people talking patients moaning but over all of it i could hear someone speaking rhythmically a man s voice deep and gravelly reciting something it seemed the accent was pure new york but the cadence was strangely familiar as it was in the beginning is now and ever shall be world without end amen it was the glory be i realized one of the canonical catholic prayers often recited as part of the rosary and sure enough the man moved on to the our father and the hail mary i d heard those prayers thousands of times in my childhood i found myself reciting silently along with him the words and phrases appearing as if by themselves on my lips and then i drifted off to sleep again i was awakened by the arrival of vlad s night nurse leilani a slight ebullient young filipina with a kind demeanor she introduced herself changed his saline solution and said she d return in a bit to check on him sergei reappeared too on his second twelve hour shift you guys still here he asked incredulously we nodded you are the most patient man in the world he said to vlad he was right patience is one of vlad s strong suits but there didn t seem to be anything else to do complaining wouldn t get him a hospital room that didn t exist and he was getting the treatment he needed plus he wasn t in pain in fact he was feeling better than at anytime since the surgery the evening wore on and even sergei acknowledged he was tired on a rare break in his duties he leaned on a stool and chatted with us he d only gotten an hour or two of sleep himself thanks to a busy schedule and the gridlocked traffic outside then leilani appeared you should go home and get some sleep she said to me my friends had been urging the same thing via email but i worried that if vlad were moved to a hospital bed during the night i wouldn t be able to find him so leilani kindly gave me the er main desk phone number to call if i needed to know where vlad was of course vlad had his phone with him and could easily send me email if he was moved in my sleepy state i d forgotten that at any rate i took everyeone s advice and went back to the apartment for a few hours of restful sleep i set the alarm for 6 am but surprised myself by waking up a few minutes early there was an email from vlad sent moments ago surreal night going to draw blood soon latest i heard if potassium and creatinine are lower i can go home but we ll see surreal that sounded interesting i showered made coffee and packed up optimistically packing vlad s new boots which had arrived the day before in the hopes that he d be released soon one of his feet had been a bit floppy after the surgery and the physical therapist had suggested wearing ankle boots to stabilize it vlad also said he was hungry so i brought cheese crackers yogurt and juice remembering the dry breakfast of the day before and come to think of it that had been the last food they offered us in the er after vlad had finished breakfast he told me the story apparently it was a good idea that i d gone home because the er had gotten even more chaotic overnight and vlad had gotten very little sleep at one point he woke up to the rolling cadences of a southern accented sermon one of the patients a black man who said he was a preacher had launched into a sermon about aaaron and moses in traditional call and response style it was surprisingly good vlad said and the er congregation had listened approvingly even the doctors and nurses there were a few other stories but that was the best one i thought about the ever changing range of cultures and religions packed into that room eastern european hispanic filipino orthodox catholic evangelical overnight the hispanic family had left and the bay next to ours had been occupied by an elderly black woman she occasionally moaned in pain and seemed a bit disoriented poignantly there was no one beside her she was neatly dressed with strikingly well cared for nails in a becoming coral color and she returned my smiles as i came and went though we didn t speak i was sitting beside vlad reading when i heard a doctor come by he was young male and obviously trying to be kind but he clearly didn t understand human dynamics do you have any family he asked the woman i couldn t hear her reply daughters sons brothers sisters is there anyone with you he asked again ask her who does her nails i thought they had clearly been done with love and attention she seemed both too ill to have done them herself and too frugal to pay for a professional manicure find out who did her nails i thought and you d find out who was standing in as next of kin but that detail evidently escaped the doctor who was growing frustrated finally he just broke the news he d come to deliver that leg is looking very bad it s going to have to come off do you hear me we are going to have to amputate my heart stopped and vlad and i looked at each other with shock vlad s eyes crinkled with empathy probably cancer he whispered or diabetes i said he nodded we both winced what a horrible way to find out alone and in the er the only saving grace was that it wasn t clear whether or not the woman understood him that wasn t the only down note of the day we d been in the er nearly 36 hours by this point and the mood seemed to have grown bleaker somehow more patients were moaning or screaming in pain or at least it seemed that way to me the staff was as attentive as possible but the constant onslaught of human misery was draining one woman asked me for pain medication i explained i was just a visitor but she begged me to call a nurse so i did thinking all the while how difficult it must be to be bedridden in pain and alone i was happy to note that a visitor had finally arrived for the woman in the bay next to us a young black woman very poised with an ethereal sense of calm i couldn t figure out her relationship to the older woman but i was gratified by her first question who did your nails see i said triumphantly to vlad she gets it her presence evidently soothed the older woman who started speaking more coherently and animatedly than she had in hours i wondered again if she understood about the amputation i was just about to get some breakfast when vlad s medical team appeared with joyful news he was to be released although his potassium was still a bit high the kidneys were functioning normally he would need to keep drinking water and get another blood test before the chemo but otherwise he was fine all they had to do was s...
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