Accountants use them. Sailors use them. Surfers use them. Stage Managers use them. In fact, I bet there are not many jobs that don't use them at least occasionally. What are these magical things I am alluding to? Charts!
An episode of ER, or any other hospital show, will enlighten even the most backwater person to the fact that hospitals function on the use of charts. Any complex system that requires organization and order can be made to run smooth with the implication of some form of charting. In the hospital scenario, charts can be a matter of life and death. From allergies to injuries, charts are what keep hospital staff from making serious mistakes, and help avoid millions in malpractice allegations. Protection of the staff and the patient are the reason that charts are kept accurate and up to date.
There is one problem that comes up when using charts; you actually have to read what is written. This week, a few occasions have occurred, where if my chart had been read properly, then much stress and angst would have been avoidable. Would have been. Unfortunately (I seem to have typed that word way to many times since coming to the hospital, for some reason that makes me very nervous) my chart seems to have a very bad habit of collecting dust. If the chart was in the hands of a responsible person, then you could bank on it being checked. The staff this week have proven themselves to be less than responsible.
Well, preamble aside, pull out your scalpel it is time to dissect my week. (there are also a few people I would not mind taking said scalpel to as well...)
Day 21
You wake up on Monday morning after hitting the snooze button one too many times. In the shower you discover the bar of soap has magically turned to a small white sliver stuck to the bottom of the soap dish. There are grounds in the coffee which spilt on your shirt as you rushed out the door. And you just creep along in in bumper to bumper traffic, till some full of sunshine person bumps your bumper. And since your car radio is shot it isn't until you get to work half an hour late, that you are reminded you were supposed to change your clock over the weekend, and you are an hour and a half late (or half an hour early, they both suck). I would put serious consideration in to trading your Monday for mine.
The boredom of the weekend or the monotony of the same old...it is hard to pick which is more draining, both mentally and physically. By the time Monday rolls around, the confining importance we impose upon our system of time is welcome. The problem with Mondays here is that while the daily schedule is refilled, the events that happen on Monday are so loosely slotted in to the course of the day that they are like invisible and very comfortable handcuffs. You don't even know they are there, but you are bound none the less.
Rounds. For those who have kept up to date with my posts, I think one simple word is needed for you to taste the bile that rises in my throat even thinking about Monday afternoon. As expected this Monday proved to be no less of a circus parade than previous weeks (for once I really wanted to be proven wrong.) The doctors gather in the nurses area in the middle of the floor at half past three. The patients are encouraged (and I use that word with more flexibility than a Chinese acrobat) to their rooms. The eve of Tuesday has usually fallen before the doctors finally start the parade in which the audience is actually the spectacle.
When they finally reached my room, I was half pleased (that he was actually there, and thus 'justifying' our imprisonment), and half repulsed (read previous post regarding doctor worship) to find that Dr. Akizuki was band leader. Being fluent in English, Dr. Akizuki asked me to remove my brace, examined my knee, and commented on his findings, all in Japanese. That was before they were out the door and off to their next performance (or is is viewing). I'm glad I understood none of what Dr. Akizuki explained to me, because that way I could break a sweat trying to imagine that there was actually a purpose to me waiting all afternoon for the exhausted one to grace my with his presence.
Day 22
Why am I keeping track of the number of days that I am in here? At first, I thought it would be like etching lines in the stone walls of a prison cell. I always imagined that doing so helped people in prison stay sane and keep track of time. I now realize (quite literally as I hit the 2 key twice) that it is very depressing, and is almost like further incarcerating myself. I have locked myself in to keeping track of how long I have been stuck in here, but with no set number of days in which I can earn freedom, I am in a sense just morbidly celebrating how long I have been holed up.
Lunch was a barrel of fun (if you are in that barrel and fun is a wild pack of rabid monkeys). The fun had nothing to do with the flavour of (or lack there of) the food. This fun stemmed entirely from the appearance of a new item on my lunch tray. For some reason I received an extra cup of water, with what appeared to be a wrapped tablet of some sort. I couldn't read the kanji characters on the tablet, and it didn't look like it was standard fare, so I called the nurse back into the room. Miraculously she asked for my electronic dictionary, but my elation that the staff actually asked to use my dictionary quickly faded as I saw the work that she had looked up: anaemia. She proceeded to explain that the results of the last blood test performed indicated that I was anaemic. She continued by telling me that the doctor had proscribed this supplement. When I arched my eyebrow in query, she took that for me thinking it was gross and explained that it was indeed delicious and dropped the sucker in the water and let it fizz
That arched eyebrow was less about the taste of the supplement, and more about the nature of my anaemia. For starters, I have had more blood tests than I can count on my hands (literally, I counted and I ran out of fingers) since starting the preoperative process until today. Not one of this myriad of tests has shown me to be anaemic. If I have recently developed anaemia, the most plausible cause seems to be the hospital food (which I have said from day one lacks proper balance). Furthermore, the last time blood was drawn was last Thursday, and on Friday the doctor made a point of showing me the test papers and telling me that everything was normal. So that arched eyebrow was really me wondering what test showed I was anaemic, and what the reason for my anaemia was.
After eating the edible portions of the meal, and leaving the supplement in the cup, I called in a nurse. I asked for an English speaking doctor, and she got a funny look on her face and ran off. The head nurse came in and explained that there were not any English speaking doctors in that evening, but she would help me. Starting by explaining that any rudeness would have to be attributed to the frustration of trying to do this in Japanese, I began enquiring into the nature of this anaemia. The nurse did a good impression of my arched eyebrow, and went to retrieve my chart. It turns out I have a very rare (or they would have you believe) form of anaemia: clerical anaemia. This is the kind of anaemia where the patient is actually fine, but someone makes a mistake, which is further compounded by incompetent people not checking charts. In other words, the kitchen staff screwed up and put some other patients drink on my tray, and when I asked about it the nurse just assumed that I had anaemia and proceeded to lie through her teeth about the test and the doctor proscribing the supplement.
Now this supplement was not going to kill me, or do any damage what-so-ever to most people. However, there is a principle here that needs to be addressed. A supplement is a form of medication, and here in the hospital there are many forms of medication that can have very harmful side effects if given to the wrong patient. There is another equally large problem that was illuminated by this situation. When a patient raises a question about a medication (even one as benign as a supplement) the staff should follow through with due diligence and check the chart, other wise what is the point of doing all these tests and recording everything (and I mean everything, they quite literally asks me every morning how many times I went potty the previous day. And none of them seem impressed when I say I can't remember and turn the question back around on them...probably because they can't remember either). It just seems to follow logical sense that if one has a chart that one would consult it before making assumptions about the situation, that is unless one is trying to experience the defending side of a malpractice case at some point in one's career (which would undoubtedly be cut short).
Today did manage to offer a breath of fresh air, in the fact that I went out side...for a breath of fresh air (now I am either lazy or a grammatical genius). Yuriko visited this afternoon, and I managed to get day parole for a few hours. The necessary stop at a bank machine provided me with a small window to partake in a wonderful spring tradition in Japan that I would have otherwise missed out on. Sakura is the Japanese word for cherry blossoms, and indeed they are as beautiful as their name. It was still a little early for viewing in this area, but there is an old saying about opportunity and knocking. Two brief stops at famous (well known and famous are the same thing in Japanese, I really think the former applies to one of these places, and the latter to the other) sakura viewing spots left me with a few dozen digital shots of sakura, and a sense that I am not missing out on all the beauty of the Japanese spring this year.
The weight of the supplies procured from the local supermarket and corner store, was noting compared to the weight of the invisible yoke that settled on my shoulders the second I re-entered the hospital. Quite literally the moment I stepped through the second set of double doors at the entrance to the hospital I felt a massive weight pressing down on me. My breath became shallow, and my steps laboured. It was an incredible feeling, though one I wish I had never had to experience. The sheer difference in my whole state of being changed in two steps. While this is a very depressing idea (and feeling), it does take me back to Kenan's comment on stepping out of the hospital at the end of everything and getting back into the Real. I can only hope that my feelings at that moment are the exact reverse that they were at the moment I re-entered the hospital. It is pretty hard to doubt that they will be anything but.
Day 23 – yes I am still counting days, I started so I might as well see it through.
Day 23 – yes I am still counting days, I started so I might as well see it through.
Day 23 – yes I am still counting days, I started so I might as well see it through.
Is it just me, or does it feel like that movie Groundhog Day?
Is it just me, or does it feel like that movie Groundhog Day?
Is it just me, or does it feel like that movie Groundhog Day?
Ok, I'll stop having fun with the word processor.
Ok, I'll...
This morning was going well, all to well, until it suddenly felt like Monday all over again. I knew that this day would come eventually, but I had no idea what to expect. Not much, and lots of waiting. Pretty much par for the course (of getting screwed around) at Matsushiro General Hospital. Today brought about more pointlessness, that really further helps me understand how all my money is being misappropriated. Today's version of the Sponsorship Scandal, is called 'Reha-kaishin' (Physiotherapy room rounds) but it might as well be called “please touch you toes” (and not because they are checking your flexibility).
Today the standard Monday afternoon parade goes on tour to the Physiotherapy room, starring everyone's favourite egoist (not me, I'm not that famous) Dr. Akizuki. Reha-kaishin involves a change of roles, in opposition to the patients sitting around waiting for the doctors to walk around, today the patients sit around waiting to walk around themselves. The doctors, smartly dressed in their embroidered white coats and starched self righteousness, make a large semi-circle. The nurses line up all the patients, including the elderly and feeble (like lambs to your table...there's a step that I'm missing in there...what could it be) When it is our turn to stand in the circle of judgement, we are asked to turn around and walk the other way (I swear I felt the laser sight of a rifle on my back). After getting about five steps, the next one in line is sent along. Is this a ritual dance? Some form of seance or evocation? No, apparently the purpose of this is for the doctors to observe our gate (not like Monday's rounds, which are more mysterious than how the caramel gets inside the Caramilk bar).
That in itself is an entirely reasonable and necessary observation, but observation alone is entirely unreasonable and unnecessary (I will try to stop using these mirrored sentence patterns - and breaking the flow of my sentences with amusing musings [shit, I did it again {the inserting too many parenthetical insertions}]) As I was saying, if they are going to go through the effort, or put us through the effort rather, of observing our strut (and might I add mine is mighty fine {I gave up on my resolution [remember the one about parentheses]}) they should at least provide feedback on their observations. As far as I could see not a single patient was told how to improve their walk.
To be fair his Highness Dr. Akizuki, director of the Hospital, God of the limp-ed, did come up to me (to my disdain) after everyone had finished their best super model impression. His exact words, and I quote (hence the quotation marks) “So, what do you think about this hospital?” Good one, you just made a few soccer teams worth of mostly elderly and currently mobility impaired people walk for you, and the most intelligent thing you can think of saying is “So, what do you think about this hospital?” Had I been witty I would have asked “What is the fee for this reverse consultation?” but instead I tucked my tail (saving my big words for the blog) and gave him the very political and quite transparent answer of “I think the doctors are all very qualified for what they do.” I left it at that. So did he. I am still wondering how much I am going to be charged for my opinion (and what it is the doctors actually do).
Day 24
Newton's first law of motion is “Inertia is a property of matter” which is better expressed as objects in motion tend to stay in motion (objects at rest tend to stay at rest). Newton's third law of motion is “For every action there is an equal and opposite reaction.” These definitions work really well when talking about vectors and velocities, but when applying these to my life I see them in these terms:
Adam's applied version of Newton's first law: When shit gets bad, be happy, cause it is only going to get worse.
Adam's applied version of Newton's third law: When you waste my time, I will take time to get pissed off at you.
These laws, while slightly vulgar, are generally considered universal unless you are operating under the auspices of special relatively. Unfortunately (I used it again) here at Matsushiro General Hospital, the standard laws are in full effect.
Today is a happy day (and by happy I mean getting bit by fun ). This day marks three weeks after my surgery. As is the same with every passing week, my then angle of my knee brace and my physio “menu” changes. The three week mark however is like a sweet sixteen, a coming of age of sorts. So I put on my cutest little pink dress and put my hair up in pigtails and headed down to the physio room to the the first one there.
At the stroke of quarter to nine, I was indeed the first one in the room. Knowing that the angle of my brace would change, and seeing the big changes that the people who have already reached their sweet sixteen, I took a seat in a very visible spot in the physio room. A few minutes later my physiotherapist came in the room, and started checking some papers and then left the room. Within a few minutes she came back and stood around. I was across the room, but very obviously looking right at her. She never came over, and never even seemed to acknowledge that I was there. Since my knee brace was off and ready to be changed, I couldn't hobble over to her, and I thought she would eventually come help me.
Twenty five minutes, passes and she was still doing (look) busy work. At that point, I decided that, as I have finally received the English instruction manual (and I saw it done before), that I would change my knee brace myself. It really is dead-simple, four screws, two plates, pop out two stoppers and replace them with the ninety degree ones. It was as I was finishing this process that she finally noticed me, and I overheard her comment to herself “Oh, it's Thursday.” Real quick in the morning. The next words were about me changing my brace myself, and more irritation directed at me regarding waiting for her to change my menu (what exactly did she think I had been doing for the last half hour?)
When she was convinced that I had performed the in-her-opinion open heart surgery on my brace successfully, she told me to do the standard first set of exercises. This was quite strange, since it was obvious to me that all other people at three weeks stop the normal warm up for a more difficult one. My attempt to raise this issue was cut short, as she turned and left to go administer massages to some other patients. Two points: the physiotherapists are very busy, and I had some time left on my internet which I was planning on using to listen to the hockey game and make some phone calls.
I am going to cut this story short, because it is long, and makes my other rants look like sunshine and lollipops. If you refer to my applied version of Newton's laws, you should being to understand that this downhill slide continued, and feeling my time was being wasted, I got pissed off. The big reason I felt my time was being wasted comes down to simple time management skills, or more precisely the lack of them that my physiotherapist displayed. It makes simple sense to me that if a massage takes fifteen minuets to administer, and instructions for new exercises take about a minute to teach, that you teach the instructions then give the massage. That way the person receiving the instructions can exercise with the massage is happening. Maybe that is just the way I think, I could be entirely off base. I mean, maybe it actually makes sense to some people to have one person wait around for a quarter hour just to receive a minutes worth of instruction, and then be sent to do it themselves. Either way, I spent most of the morning sitting around between my new exercises watching my physiotherapist go from one massage patient to an other, and occasionally remembering “Oh, it's Thursday.”
Anyone who saw my face this morning would begin to use grapefruit instead of honey to sweeten their tea. There was a point when my physiotherapist asked why I looked so angry, and I just asked how long it was going to take. I even held in my rage when she told me that teaching my new “menu” takes time. It was true, just not the amount of time that it was taking. Noon was fast approaching, time for lunch and also the time that physio closes for an hour and a half. I left about five minutes before twelve, and at that point there were only four patients left in the room (and they were only there because they were waiting to be wheeled back to their rooms by the nurses.) First in, and nearly the last out.
Every ounce of my being wanted to skip out on the afternoon, and veg out in my bed, or skip outside for a break. I fought that urge, realizing that while her inability to manage time affected my schedule, I was not going to let affect my recovery. I pulled up my socks, and pulled down my cap, and prepared to enter the pit of doom with out snapping into a rage induced Hapkido fit where I start breaking arms and legs (the former being other people's, and one of the latter most likely being my own) Gladly, my perseverance held, and my rage seeped out in a few, less than under my breath, questions to my friends about why my routine was different than other people at the same stage.
Those comments were, as intended, overheard by another physiotherapist, who must have passed the news on to mine. When I approached her later with that very question, she very quickly said “oh, you mean the sitting leg raises? Yeah, you can do those from now on.” Now I really do have to give her credit for not showing a hint of shame in saying that, but I something like that is usually paired with an “oops, I forgot” or a “yeah, sorry about that.” This one, she was stone cold. Battle of Wits? This is the championship match.
A little later in the afternoon, she came over to see if I understood exactly how to do the leg raises. This could have been extending the olive branch, but if it was she ended up with olive juice smeared on her face. I answered no, as honestly I didn't understand, but also proceeded to question why other parts of my “menu” were different. It was at that point that she continued with the theme for this week, and went to check my chart. A novel idea if it was done in the beginning, or if not the very beginning at least the first time that she realized “oh, it's Thursday.”
In checking my chart she realized that she had made a few mistakes in my exercises. Now, I am not one to gloat, but if I were I would have been gloating then, with a big I-told-you-so smile plastered across my face. I am not one to gloat, but quite coincidentally I had a muscle spasm at that point that tightened my cheeks into what may have appeared to others to be a slightly crooked smile.
Day 25
This is going to be a record. It is almost ten, the lights here in the lounge have been out for sometime, I am about to eclipse seven pages, and I still have two more days worth of things, that would be extremely hilarious if I were to read them not write about them, to write. You can stop reading and come back to this spot. My internet time is going away faster than the Canucks lead in the series, so I just gotta write.
TGIF. Thank God (or was that Dr. Akizuki) It's Friday. I was definitely thankful (to neither of the aforementioned) that it was indeed Friday, for no other reason than the roller-coaster ride that was Thursday was undeniably over. Physio went well, save all of us ACL patients getting in trouble for having too much fun (I honestly wish I was joking, but we seriously got told off for a little bit of harmless goofing off. There is one physiotherapist here that definitely need to get himself a girlfriend...or whatever gets him going...and get rid of some tension.)
Morning and afternoon physio went smoothly, as I no longer need to receive (or not receive) instructions on my new routine. When I got back to the sixth floor, I met my favourite (and I mean that seriously this time) doctor, Horiuchi-sensei. This guy not only did a superb job (I'm taking his word for it) on my knee, but he is really understanding. It is unfortunate (I said it again) that I have to lace into him a little now.
In our conversation, I inquired about when I am up for parole. His reply was either next week or the week after. That week after part threw me for a loop, and I decided to see what the criteria for discharge is exactly. He told me that when the muscle strength of my injured leg was half that of my other leg I would be eligible for discharge. It was at that point that I informed him that on Monday my left (injured) leg strength had indeed been well over half of that of my right. To his credit he did this immediately, but again why was this not done earlier, he consulted my chart and low and behold I was telling the truth. It was then that he said that I should be good to go next week, and my release date would be discussed at next weeks Monday meeting. Next Monday during rounds I will be informed of which day of the week I can go home. At least one set of Monday rounds will have an obvious purpose.
Day 26
Having briefly mentioned the ACL gang, and as we lost a member today, I think I should elaborate a little more (also it is a good way to fill up a rather boring days worth of events). The gang happened to be four of us. Myself, Hiro, Shouhei, and Nonoka. Profile time:
Shouhei is a junior high schooler from Iiyama (my neighbouring city). He is in third grade, and was invited onto a pretty elite alpine ski team. That is how he tore his ACL. Shouhei did his time and earned his parole today.
Nonoka is also a junior high school student in the third grade. Remember her name, because if her recovery goes well you might well hear it again during Vancouver's Olympics. She lives in Hakuba, arguably the Whistler of Japan, and just happens to be a junior member of the Japan National Moguls team. She tore her ACL after a bad landing off a back flip. She's getting out on Monday.
Hiro is a twenty-six year old back country snowboard guide, which is another way of saying he is a bum. He and I get along like a pair of bad kids in the third grade. Hiro has spent a fair amount of time in this hospital, as this is his fifth time in here. He is lucky (or unlucky) enough to be using his knee brace for the second time, and this is indeed the second time he has torn the same ACL. He's got a week in here after I'm out.
That's the gang. Over the last few weeks we have hung out in the lounge here on the sixth floor, and down in the physio room. In the evenings, Shouhei, Nonoka, and I have studied English a few times (I really want their AETs to be surprised they haven't fallen behind in English). On other evenings we all play cards and Hiro spouts out the English swear words that I taught him.
The worst is when it is just Hiro and I. We have made a game out of teasing the nurses, and getting up to no good. It started with wheelchair races. Then we told the nurses we were going to go drinking, then we sent the elevator to the first floor and hid up here on the sixth. Listening to the nurses fret about whether we had left or not was a riot. At night we set the alarm clock at the front desk for just after breakfast in the morning, and listen for how long it takes them to figure out what is making the noise. We got a bottle of grape juice that looked like red wine, and started yelling “kanpai” and acting drunk in front of the nurses station.
Now we only do this when the nurses with good humour are on shift, and for the most part they laugh and smile. I think we make their night a little more fun, and it sure as hell helps us break up the monotony of long boring evenings. I am really glad that Hiro is here, because I have someone my age (and obviously my maturity level) to goof around with. His friends and I get along really well too, and I am sure that when this is all over the he and I will continue to hang out and be friends.
And speaking of things being over. I have more to write, and is just going to have to wait. Hope you enjoyed this instalment. Looks like there might only be one more before I am home!
