The Rub

I’d been sitting in a small padded chair for three hours, memorizing the signs and faces that populated the emergency room. I’d sent my husband off to do errands after we’d been waiting for two and a half hours, thinking it could be two and a half more before I was treated. He had yet to return. My breathing was strained, and I thought about my image in the restroom mirror, the gray pallor, the hollow eyes. I’d aged ten years in ten days. Finally, they called my name. I stood up slowly and followed the nurse through the double doors to a room at the far end of the corridor where a young doctor met me.

“So, you’re having trouble breathing?”

“Yes. That and lots of other things – I wrote them down. Shall I read them?”

“Please.”

I pulled out a crumpled note. “I can’t eat, can’t drink but small sips, can’t lay down, have to sleep sitting up, I have no energy . . .” I completed the full-page litany. “I think I might have pericarditis.” A few nights earlier as I lay in bed feeling and hearing my heart’s every contraction – squish, squish; squish, squish. It was rubbing on something inside my chest. Then a thought came to my mind but I’m not sure where I heard the term – pericarditis. It had been a strange revelation, and I wasn’t sure from whence it had sprung. When I got up in the morning, I looked it up on the internet, and I had all the symptoms.

“You might,” he said, nodding kindly. “Sit tight, we’re going to run some tests.”

Soon, I’d had a chest x-rays, then I was hooked up to an IV and a batch of monitors along with an oxygen mask before a nurse relieved me of four vials of blood. A robust woman with wild red hair rolled in a huge untrasound machine. She put ice cold jelly on what looked like a computer mouse and began rolling it around my chest over my heart area.

My heartbeat was wildly erratic. I could feel a fluttering in my chest before each bout of the palpitations that sent my heart rate soaring. A graph showed it was zooming from 70 beats per minute up to 170 every minute or so.

“Let’s get you into a gown,” the nurse said. The emergency room was swamped with people waiting for hospital rooms. They languished on the exam tables surrounded by concerned family members – about 40 rooms full.

“Are all these people waiting for rooms?” I asked.

“Yes,” the nurse said. “The hospital is filled to capacity.”

I spotted a phone on the wall of my exam room and lifted it to hear a dial tone. I called my husband’s cell phone. “Where are you?” I asked, my voice cracking, tears welling up in my eyes. “Come back. I need you.”

“I’ll be right there. I’m parking now.”

“Am I staying here?” I asked the nurse as my husband walked in. She nodded. He squeezed my hand and narrowed his eyes which revealed a mixture of concern and relief. He had watched my sickness develop and continue without improvement. At least now there was a probability that I would begin to recover.

After a few minutes I said, “Honey, you’d might as well leave,” He had a long drive. “I’ll call you when I get into a room.”

“Are you sure?” he asked, peering into my weary eyes. I nodded. He kissed me and slipped out the door past two more young interns entering with clipboards who began asking about my entire medical history. I’d never been sick in my life beyond a bad cold or flu, a strep throat at worst. Oh yeah, I once developed a weird lump in my tongue which proved to be a clogged salivary gland, much to my relief, as I had pictured myself with a mangled tongue, talking in garbled language after the deforming removal of a cancerous mass.

“Can we listen to your heart?” one of them asked, placing his stethoscope into his ears.

“Can you hear it?” one asked the other who nodded.

“Hear what?” I asked.

“The rub. There is fluid in the sac around your heart. The motion of your heart creates a sound known in medical circles as ‘the rub.’” I nodded.

“Don’t be alarmed, but we’re putting you in the Critical Care Unit – it’s just easier for the staff to keep an eye on you – you’ll get better care there. Also, I have to ask you this – if something happens, do you want to be revived?”

”Well, yeah! I’ve been in perfect health my whole life, and I’m only 55!” I answered, a bit surprised. Little did I know that agony of the Terri Schiavo case would soon dominate the airwaves.”

Finally, a nurse wheeled me past the other rooms where would-be patients still waited. My condition had priority. I hadn’t eaten since breakfast and it was five o’clock. My stomach rumbled. Earlier at home, my husband had called upstairs to see if I wanted lunch when I broke down crying. “I need help. I want to go to the hospital,” I cried tearfully after two weeks of a debilitating illness that wouldn’t go away. Now I was lying in a dimly-lit, private room in intensive care. Just as I was beginning to relax and have a bite of a cold dinner, another doctor entered and insisted upon taking down the entire story again.

“Have you had any changes in your bowel movements? Any bleeding, diarrhea?” I shook my head. “Actually, let’s go ahead and do a quick anal exam.”

“During dinner?” I asked incredulously. He gave me an impatient look and slipped on a rubber glove.

“Just roll over on your side.”

Suddenly, a rude intruding digit slid into me for a moment, and then I watched him walk away victoriously, holding the offending finger in the air. He returned shortly to announce all was well. Great, now go away, I thought.

Finally, I was allowed to eat something and given an injection of heavy-duty pain killer which sent me into a blissful nirvana. Wrapped around pillows in a semi-prone state, I drifted off to much-needed sleep. It seemed like heaven. My sister later told me that I called her the next day and said in a soft, dreamy voice, “I love it here. The food is so good and the nurses are so nice. These are the best drugs I’ve ever had.” She remembered my husband’s feeble efforts to provide me with palatable vittles during the previous two weeks. So few things sounded good – chili? Good grief, no! Chicken noodle soup? Yuck! He struggled and I munched sparingly, but now my appetite had returned.

I learned I had a ‘moderate’ amount of fluid around my heart caused by inflammation of the pericardium. They would first try a strong anti-inflammatory drug and hope the production of fluid would stop and the buildup would gradually dissipate on its own. If not, they would draw off the fluid with a long syringe inserted below my rib cage. Yikes!

Throughout the days, unfamiliar doctors appeared at my door, stethoscopes in hand, anxious to listen to ‘the rub,” a somewhat rare phenomenon, I learned, and I was a guinea pig of sorts. The two young interns visited faithfully and as my spirits improved, I teased them. “You two just can’t get enough of the rub, can you?” I’d ask. “Back for more of the rub?” They’d respond with suppressed grins, trying to ignore the double meaning.

I wondered what ‘a moderate amount of fluid’ might be. Maybe like the residue inside a plastic bag of vegetables, I thought. Finally, on the second day, I asked a new cardiologist, “How much is a moderate amount of fluid anyway?”

“Oh, a liter or so, maybe less.”

“A liter? You’re kidding!” I couldn’t believe I had the equivalent of a bottle of wine floating around my heart. No wonder I couldn’t breathe or eat – there was no room in my chest cavity.

Tests showed the cause was probably viral, eliminating cancer or inflammatory origins. Then at midnight of the third day, I was awakened by Margie, my CCU nurse. “We’re moving you, you’ve improved and there’s a room available.” I rubbed my eyes and nodded. Two other nurses busily unhooked me from my various tubes and monitors and gathered up my personal belongings.

“Sorry to do this to you,” Margie said gently.

“That’s okay, I understand,” I smiled, hugging my pillows.

“You have to get into this other bed,” she announced with a guilty look.

I sat up indignantly. “You guys are ruthless!” I said with a grin. They all laughed. It hadn’t seemed so bad when I could just stay under the warm covers. Soon I was being wheeled like a baby in a buggy whizzing through winding corridors moving at what seemed like a trot on the nurse’s part

I was in a ‘progressive care unit’ where I stayed for the fourth day and was released on the fifth with instructions to complete the tests by scheduling a colonoscopy within the month. Great. I knew I was at the age where I should get one, but had put it off for the dread of being rudely invaded from my posterior end. I will admit that seeing Katie Couric get a colonoscopy on live TV had assuaged my fears a bit, but I was still unenthusiastic. But I have now had the dreaded procedure and have to say it was like taking nap on great drugs. I don’t remember a thing past the doctor’s hello. And I’m healthy.

Meanwhile, my husband, who for 27 years has been the beneficiary of a traditional wife, was left to run the entire household single-handedly for six weeks. I could only watch from my permanent position on the couch as he progressed from ignoring the mess, hoping I’d soon recover, to accepting his fate and taking on the chores of cooking, cleaning, laundry, pet care and grocery shopping. He adapted fairly well and without complaint. And his cooking gradually improved. Before I went to the hospital I could barely eat, so a half a sandwich was fine, but would have been much better served on a paper plate rather than plopped in my hand. After my hospital stay, he made an attempt at real cooking as in standing at the stove, preparing hot meals.

After two weeks at home, I had an appointment with my cardiologist and my husband suggested I drive myself to his office 45 minutes away. As I sat on the couch anticipating the solo sojourn, I looked up at him with tears spilling down my cheeks, “I’m afraid to drive.” He laughed. It’s amazing how one’s confidence can be eroded by something like this. I was afraid to go outside and walk around. My ‘primary care physician’ told me I should be exercising a bit, but I didn’t feel like I could. But now I’m back – 100% - three weeks later. I’m hiking around my mountain with my dogs, back to work, going on appointments and have resumed my household duties, much to the relief of my husband who has had a huge reality check and gained a renewed respect for his formerly taken-for-granted wife. “Wifing” is not as easy as I make it look.

The good news? The silver lining behind that dark cloud of illness? I’ve lost the 15 pounds that I’ve worn around my torso for the last seven years or so, which also pleases my husband. My sister says I look ten years younger, and I even think I’ve gotten some admiring looks from men – could that be possible? Last week my husband said, “You look great, Denise!” Worth it? Probably not, but it’s sure nice to feel skinny again.