On A Pale Horse (42 page)

I hate push-ups, but I like the body they give me, so I grind my teeth and do them. On this day I felt indifferent, physically; to my surprise, the push-ups were exceedingly strong. In fact, I broke my speed record, doing my seventy-five in four minutes and seven seconds on the stopwatch. Terrific! I unkinked my digits—these pushups are done on the tips of ten fingers, which is part of why they get uncomfortable—and settled down for lunch. Then the mail came, and I was reading it at 2 P.M. when I felt a pain in my left side. Indigestion? Well, that would pass.

It didn't pass. It got worse. I struggled with it for an hour, finding no relief vertically or horizontally, and retched into the sink a couple of times before I asked my wife to call for help. Soon she drove me in to see the doctor. Yes, it was the same doctor who had wrestled with my Cat-Scratch Disease two years before, as noted in my prior Author's Note. By this time I had the cold sweats and my limbs were jerking, sometimes violently. The ride was interminable; every half hour or so I rechecked my watch and discovered it had only moved along five minutes. “You know,” I gasped, “I fear death, but if I knew the rest of my life would be like this, I would welcome death!” I meant it. Pain provides a special perspective, and that perspective is reflected in the novel.

People tried not to stare at me in the doctor's waiting room as I sat there, hunched over to my left, panting violently; that was the only way I could keep the pain bearable. My hair was wild, and I was in T-shirt, shorts, and sandals, with dirty feet, the way I normally am when writing at home. I didn't have a regular appointment, of course, but the doctor arranged to see me soon, and I don't think any other patients objected. I was wheeled into an office. I was beginning to feel faint, and motion only made things worse. Everything made things worse! But in due course we had an opinion. There was a trace of blood in my urine, and the symptoms indicated a colic of the kidney, probably caused by a kidney stone.

I wound up in the hospital with a shot of Demerol, which I understand is synthetic morphine: a powerful painkiller. It didn't kill this pain, but it zonked out much of my brain, and that helped. My wife tells me I was saying strange things, such as something about a fly on the window and steps on a cabinet; I remember none of it. If I had been able to write, I probably would have made bracket notes, and today would know exactly what was on my mind then. A fly? Do you suppose the Lord of Flies could have—? I do remember waking up long enough to inquire, “Am I making sense?” And my wife, in the manner of good wives with difficult husbands like me, assured me that I was. I faded in and out; the pain did not depart, but at least I was unconscious some of the time. Six hours after it began, the agony began to ease, and in another hour it was gone. I can't honestly say it was the worst pain I have suffered, though our book of medical symptoms says that kidney stones can indeed be among the worst agonies to afflict man. I think it hurts more when I stub a toe hard. But the toe hurts only a minute; this was six hours. The remorseless continuation of pain is, candidly, something else. I suspect even a mild pain could become unbearable if continued long enough;

I think that's part of the secret of the Chinese water torture.

Next day they gave me a complex X-ray series, a pyelogram, with dye in my blood to show the course of the various conduits. Yes, my left ureter—that's the tube between the kidney and the bladder—was distended, as if blocked by a kidney stone. Probably my exceptionally vigorous push-ups had dislodged the stone and sent it on its painful way. It had taken an hour to encounter a constriction, and then—wow! Nothing much; it was really only a grain, like a piece of sand, and with luck it would clear on its own. Meanwhile, the urine was getting by, so I was okay. All I had to do was strain my urine through a meshed funnel, to catch the stone when it came out so they could analyze it.

I was glad to cooperate. If this was a little stone, I didn't want to encounter a big one! But they had hooked me up to an IV bottle—I suspect this is standard hospital policy to make sure the patient doesn't walk out without paying the bill—and the needle was taped to my left arm. To go to the bathroom, I had to trundle the bottle-stand along with me. To forget would be a bloody mess as the needle ripped out of my vein. I understand it happens to absent-minded patients. And they had me in one of those hospital gowns—you know, the type that falls open at any pretext to bare your posterior. Everybody in the hospital wants to get at your posterior! Have you ever tried to, as they phrase it, void through a funnel into a plastic container, with a tube connected to your arm that tends to drape itself between you and what you're doing? And the hospital nightie falling off your front? Naturally they are worn backward, and no one had tied the apron strings on mine. If I lifted my arm too high, trying to get things out of my way, the blood backed into the IV tubing, making another mess. I discovered that by the time I got everything ready to go—Nature had changed her mind. I think it is called “bashful kidney.”

There were other little niceties of hospital life. One night I had a headache. I asked the nurse for a pill—but she informed me the only medication listed on my chart was Demerol. Synthetic morphine for a headache? This was like shooting a sparrow with a cannon! So I had to struggle along with the headache until the doctor came to apply some common sense. I had the usual hassle with the food, too. I am a vegetarian and diabetic, so I stay off all meat products and sugars, and I don't drink coffee or tea. Naturally my lunch consisted of coffee with two packs of sugar, gelatin (which is made of protein from the bones of cows, mixed with sugar), sickly sweet fruit, and a piece of cake with horrendously thick sugar icing. Fortunately, there was also corn, beans, and mashed potato, so I didn't starve; and my wife visited and fetched me some water—naturally my pitcher hadn't been filled—so I survived. Not that I really needed to eat, with the IV dripping sugar water into my vein.

When I finished, I wanted to go to the bathroom, but discovered that the bedside table unit that overhung the bed would actually tip over rather than swing out of the way. I think if more doctors got sick and had to wrestle with these little matters, some improvements would be made. I explained gently about the food to a nurse, and that brought the dietician, who remembered me from two years before, and we finally got the matter of no-meat, no-sugar, no-coffee straight—just about the time I was to be released from the hospital.

Then there was the Candy-Striper. These are teenaged girls who bring fresh water and juice and such to patients, thereby gaining experience in the operation of a hospital. They wear cute pink-and-white-striped uniforms with sweet little matching caps. This one showed up about 4 P.M. my second day. She had golden hair flowing to her bottom. She not only filled my water pitcher, she brought in her family and they sat around my room and ate pizza and chatted. Then she made me brush out her hair and braid it, so she could go on duty in decent order. She seemed to take such attention for granted.

Oh—perhaps I neglected to mention that this particular Candy-Striper was Penny Jacob—my mundane daughter. Penny-Candy-Striper, Heaven-Cent. This time she had me right where she wanted me. I understand some fathers don't pay enough attention to their children; obviously they don't have children like mine.

The consulting urologist prescribed a gallon of urine a day. Uh, no, not to drink; I merely had to imbibe enough fluid to generate a full gallon of void each day. Have you any idea how much drinking that entails? The purpose is to dilute the urine so that no additional stones would form. It seems that kidney stones are the province of middle-aged men and that I live in a kidney-stone region; there is much calcium in our water (though they aren't sure that's the cause) and the local heat causes body dehydration, concentrating the urine, so that stones form. So I must, for the rest of my life, be constantly drinking water and passing it through. I can no longer sleep the night in one haul; I have to get up once or twice to you-know. But if that's what it takes to keep the stones away, so must it be.

The first night home, I got up at 2:30 A.M., did my business with the funnel and container—and then could not get back to sleep. I didn't want to turn on the light to read, lest that disturb my wife, who had had problems enough, with her father so ill recently, then losing her mother, then having to deal with my illness. Problems had been striking like explosive shells around us, and that gets wearing. So I dressed and went off to my study in the pasture to type some more on Pale Horse, which novel had been interrupted by my hospitalization. Naturally our horses thought it was feeding time, and Blue knocked on my door—with her hoof. I went out and explained that it was 3 A.M. and that feeding time wasn't for three hours yet, but she resumed banging the moment I went back inside. I was afraid she would break down the door, so finally I went out with the broom and swatted her on the rear. That moved her off—but when dawn broke, she would not speak to me, and I felt like a heel. Such is life-after-kidney-stone.

I had not let the time in the hospital go to waste. I continued reading books, including Dream Makers, edited by Charles Platt, which tells what other genre writers are like. They are all oddballs, almost as strange as I am! I will be in the companion volume, however, so I'd better not criticize. I also had my clipboard along. Remember, I was reworking Chapter 6 and adding scenes. So while I was there I wrote the scene about the atheist—whose attitude is basically mine, with the fundamental difference that I do believe in doing good in this life and try very hard to benefit the universe, whether by being kind to a wild animal or by writing a novel like this one. And yes, I also wrote the scene about the old woman in the hospital. I could hardly have had a better environment for that one. But if the hospital staff had caught on, I might have had trouble getting out of there. As it turned out, there was one nurse who was a fan of mine, but she did not realize who I was—remember, I use a pseudonym—until too late to catch me. However, my daughter the Candy-Striper arranged to have that nurse visit me at home a month later, so all was not lost.

I settled back into my routine. My run series was broken at eighty-four, and I was awash in fluid, but life went on. The neighbors (the ones with the contract-negotiating boy) had to take off suddenly because a parent had a serious complication of the pancreas; we had learned the hard way about that sort of thing and knew it was terminal. Death is ever with us. While they were away, their prize mare, Navahjo, went into labor, and there wasn't anybody around who knew what to do. She was having trouble; the foal was hung up with one foot protruding for the better part of an hour, and we feared a stillbirth. But another neighbor came, took hold and pulled, and got it out: live birth of a colt. What a relief! The little horse was healthy and soon was frisking about; I suggested mischievously that they name him Colt 45, or maybe Colt 46. Thus, with our neighbors, life was originating even as it was ending. This, too, is as Nature decrees.

My funnel caught no stone in a month, so I had a follow-up pyelogram. I had to drink a magic potion concocted from senna fruit to clear my bowel. It was awful stuff, as these brews are, but I gulped it down. It had no effect. Then about eight hours later, in the middle of the night—FWOOM! Mount St. Helens!

I had been through the pyelogram procedure before, but this time the details differed. They put me in a hospital gown with three armholes; I wondered whether triple-armed alien creatures patronized these facilities. They injected the dye into my arm—and suddenly I felt sick and dizzy and generally spaced out, and then sneezed several times. They said it was normal, though none of this had happened the last time. In between the spaced X-ray shots, I lay on my back and read a science fiction novel I planned to review; no sense letting blank time go to waste.

We took the pictures directly to the urologist. There was no sign of the kidney stone; apparently it had cleared at the outset, and we hadn't caught it. Too bad; it would have helped to know what kind it had been. But this latest X-ray showed a spot inside the bladder. Oh-oh—could that be a tumor? The doctor decided he'd better have a direct look. So we made an appointment for a cystoscopy, four days later.

It was a nervous wait. With everything else that had been happening during this novel, it could be just my luck to discover—but maybe it was nothing. Old scar tissue, maybe. I know my readers like stories with definite conclusions, so I held up my typing of the last of this Note for two days to await the dread verdict.

That cystoscopy was sort of scary to approach. There I sat in the doctor's office, a yard-square paper napkin draped around my quivering naked loins, eying the torture instruments laid out for the procedure: a black box with an electric connection, an IV bottle with transparent fluid, sinister gray tubes, and two immense nine-inch-long monster metal needles. Ouch! They gave me a good five minutes to examine that array before the doctor arrived. I know psychological torture when I experience it!

The doctor squirted an anesthetic solution up the conduit; it felt like voiding backward. Then he inserted the larger-diameter needle, sliding it up the urethra to the bladder. Unfortunately, that particular channel has a natural curve in it. What do you do when you have a straight instrument and a curved channel? I found out! You straighten the channel. WRENCH! and my curve was straight. No, it didn't really hurt, but it was uncomfortable, physically and psychologically.

Then the doctor slid the lesser needle into the larger one, sending in a mirror and a light bulb or whatever so he could see through the tube and look about inside. The IV bottle filled the bladder with clear fluid; I dare say that improved internal visibility. I could picture that light flashing around all the crevices, spying out excrescences, kidney stones, pebbles and boulders, and whatever other garbage there might be in there. Finally he closed up shop and drew out the instruments, letting my anatomy try to recover its curvature.