Dreaming ICU

She gives me a piece of paper so I write the word ‘water’, but then she laughs and points at the tube in my throat. I’ve stopped breathing and yet my lungs still inflate and deflate at precise, clinically-governed intervals. I am a machine.

Someone says – “Temperature thirty-nine, heart rate one hundred and thirty-two, blood pressure one hundred and thirty-four over seventy-nine” – but I don’t know what this means.

There’s a priest stalking the corridors but, please don’t worry, I’m not afraid. And I’m not in pain, but I am lonely. They check my vitals every half hour, so I’m told, but time doesn’t exist here. My watch has been replaced by a bruise that stretches from my knuckles to my wrist and there isn’t a clock affixed to the white-washed wall: no second hand to remind us that time is ticking.

“Condition: Critical…” they repeat among themselves.

A face floats into focus, eyes lock with mine, and a mouth opens and closes: “We have to be honest with you. You might not make it. You might not pull through.” I smirk at my failed attempt to shrug. The same mouth too promptly fires medical jargon to a crowd of clipboards: “Positive tachypnea. Positive respiratory distress. Positive sepsis. Persistently tachycardic. Febrile.” The words are muffled. I may as well be in a tin can or underwater in a bath. Speaking of, I must be pretty ripe by now.

It’s time to clean the tube. When she tells me I won’t be able to breathe for a while, she doesn’t mention that she’ll hold me down as I drown in bile and saline, so it comes as a bit of a shock. Air evacuates my chest as liquid floods into it, but I can’t choke because I’m not in charge of my lungs or reflexes anymore. The machine doesn’t struggle, splutter or fight back on my behalf. I lie there in a kind of silence while the nurse decides when she’ll let me breathe again.

A button is pushed. Drugs surge into my veins, ice-cold rain cascades over my skin, as darkness and silence reel me in and pull me under. Everything is in slow motion and a great nothingness descends and engulfs my being. It occurs to me that lots of people have died on this bed. (Am I on a deathbed or on my deathbed?) I wonder who the last person was and my lip wants to curl in sympathy but it can’t.

I’m distracted because the dinner party guests are completely unaware of my existence. Cocktail dresses float across my exposed limbs and the fabric catches on the wires that are sprouting out of my wrists and neck. I’m too weak to reach up to the trays that are circling like vultures. Even though I have no mouth today, I want a cocktail. There’s laughing and chatter above the clinking and clatter of glasses that dangle from jewel-laced, gloved hands, which wave precariously above my hospital bed. I’m not looking my best. I’m torn between wishing they’d leave and praying they stay. Because it’s lonely here and I like their company even though none of them are looking at me. And thank God, because this gown barely conceals my catheter.

“Thin, pale twenty-four year old female college student, previously healthy,” someone dictates as a pen etches my fate onto paper. “Negative for tobacco. Reports rare alcohol use. Denies illicit drug use.”

I think it’s rude that they’re talking about me as they sip from champagne flutes. I try to roll my eyes but they’re facing the wrong way in my head.

While all this is going on, you’re giving me a leg massage. You’re making me feel awkward because this isn’t the time – but I don’t want you to stop because it feels so nice and it’s so nice to feel. Incidentally, do those legs really belong to me? They’re so small and white. Made of rubber. Look, stop now, please, because I won’t be able to return the favour. I haven’t got a mouth, remember?

“She’s tachycardic!”

There’s shouting and I beg the machine to silence the high-pitched warning that my heart is about to implode. Panic sets in and I start pulling at the wires, ripping the needles out of my veins, except the one in my neck which, thankfully, I’ve forgotten about. I need to get away – the lights – the noise – the wires – too bright – get me out – too loud – let me go – I DON’T WANT TO GET ON THE BUS!!!

“Your name is Joanne Sutherland.”

Call me Jo.

“You’re in St Mary’s hospital.”

Yes, I know.

There’s fumbling overhead. Coldness seeps into the hole in my neck. My jaw tenses up but it’s hard to gurn without a mouth, so instead I have to splutter on the razors that I can’t swallow, while each limb shakes, shudders, slackens, until the blood that’s being pumped around my body by the machine slows down and meanders around my veins like a stream of worms – thin, transparent worms eating their way through a corpse.

I wonder how much weight I’ve lost. I wonder if I’ll be able to do that dress up now and whether that gorgeous doctor will ask me out; the one who kissed me on the forehead before he knocked me out. Tom, was it? Was his name Tom? Yes, maybe he’ll take me out and show me the sights of San Francisco. Since I came all the way here, it would be rude not to, especially as I’ve only seen a ceiling and a crucifix since landing. Then again, you probably wouldn’t like it if the hot doc took me out, would you? But you’re not here because my white, rubber legs are alone. Through the sweet haze of bliss-laced-terror, I realise you’re a machine, like me.

I dribble as I dream. Then a bolt of lightning shoots down my left arm and the entire lifeless limb spasms in protest. I cannot scream. For the first time since I got here, I feel intense pain. I’ve felt it before, of course. Like the time when my body rejected the anaesthetic, the time I awoke half way through the procedure, the time paralysis struck my horizontal form, the time the trainee shoved a needle into my neck – incorrectly – and the second time, and the third…

“CT of the chest with IV contrast shows severe multifocal pneumonia. Procedure: endotracheal intubation.” – Endo-trach-a-what-now?

I remember the way the medics to the right of the hospital bed observed their superior inserting a tube into my lungs; a hollow pipe the same size as the bone in my left jolting arm. I recall the time my chest cavity was invaded by a machine, the time hands held me down, the way hundreds of fingers pushed plastic and metal into flesh, bone and the gristle in-between, the time I suffocated silently, and the moment, the split second I wished it would all be over.

“The procedure was explained to the patient, including that she would be sedated and paralyzed while the tube was placed.” – No! I was never told this!

The time I willed my eyes to blink, the time my head lulled to one side despite my best efforts.

“The patient consented to the procedure.” – No, I didn’t!

The fire in my lungs, the hammer upon my throat, the vice around my head, the pressure on my neck as a needle dug, danced and burrowed itself into an artery. The sound of flesh being pierced, the echo of a muted cry as the suction pump slurped up what I could only assume was blood, my blood. Nobody noticed me even though I was the only thing they were concentrating on.  Subsequently, hysteria came knocking. I’m a patient patient, I thought. I’m an attentive corpse, I joked to myself as my mind rolled around in agony in an otherwise still and peaceful skull.

But I can let the machine breathe a sigh of relief on my behalf because that time’s passed and now I’m sprawled out on this bed, medicated into oblivion, presumably somewhere in the present.

Do you remember how I got here?

Aside from being dropped off at the wrong hospital entrance by the unconcerned taxi driver (calling an ambulance would have been too expensive), I don’t remember much about my admittance. I remember stumbling upon the hospital wing that was closed for the night and desperately banging on the locked door, as a knife eased in and out between the fleshy hollows of my back. I recall sliding down the wall, crouching there on the damp ground, head lolled forward, trying to trap the warmth between my collarbone and my mouth… the thudding of the security guard’s feet, half-running as though he was annoyed I’d ruined a quiet, uneventful evening. He probably had a bad back and didn’t fancy dragging a body across the car park. Or parking lot. That’s what they call it, isn’t it? Americans call it a ‘parking lot’. When the security guard realised I wasn’t dead, he made me walk behind him until we reached the correct entrance. I could barely keep up but he didn’t turn around so he didn’t notice. He didn’t care to notice. He didn’t care to care.

‘Emergency Room’. But it’s not a room. It’s an empty space, like a school assembly hall, with magazines and pens-on-chains littered across every available surface, where nostrils are forced to adjust to the smell of disinfectant and death.

“Help me, please.”

“What’s the problem, ma’am?”

“I can’t breathe.”

“Fill out this form.”

WELCOME TO AMERICA and to the best medical care the world has to offer (as long as you’re insured).  I have no name here; I’m patient one-zero-four-two-one-eight-one-two but where I lack a name, I gain an account number. Not a bank account, oh no, a patient account. Because I’m special. Because I’m insured.

Would you thank Moya for me? Please thank her for putting my life before the paperwork, for covering me with a blanket, for touching me like she cared about the outcome, for stroking my face like my mum would have done. Tell her that I will name my daughter after her if I have one.

That feels like a lifetime ago now, although I’m not sure this is ‘now’ and I probably shouldn’t say ‘lifetime’. I think about the word and I start making jokes – in my head, of course, because there’s a tube where my mouth used to be. It turns out I’m not scared of dying. Right now, with this magical mystery tour cycling around my insides, I don’t care if I live or die. I don’t care in intensive care. I intensively don’t care, so there, HA!

It’s time to remove the tube. I presume this is because I’ve survived the ordeal but they don’t tell me that I’m ok or that I’m out of the woods, they just say: “Temperature thirty-seven point one, heart rate eighty-six, blood pressure one hundred and twenty-four over eighty-four.”

Then somebody looks at me and I become real. I nod to indicate I understand and the tube extraction begins. I can’t really describe the sensation. I guess it’s like being sick, like puking up a drainpipe. My first self-sufficient breath is a raspy gasp. I’m desperate to talk but it’s a struggle because glass has just shattered in my throat.  And then this same somebody – this angel who’s given me the gift of voice – tells me not to breathe as they pull the needle out of my neck because, if I inhale any air, I’ll swallow torrents of my own blood.

“Ready…?”

The needle scurries out of my neck, leaving a hole in its wake, and I taste metal. In a bid to hold onto the molecule of pride I have left, I don’t cause a fuss. There are bed baths, catheters and shit buckets, but then there’s swallowing your own blood. So I pretend it didn’t happen because there’s something shameful about ingesting your own fluids, isn’t there?

It’s right at this moment that the priest decides to pop in. He glides into my cubicle with the air of the ordained and suddenly I’m aware of how naked and vulnerable I am.

“I’m here in case you want to talk, my child.”

Jesus Christ, the last rites! I try to talk but my pleas melt into the plastic that never left my throat and my words gag on mucous. My lungs and my language drown as my head jerks, my torso spasms and my arms flail but, once again, I’m wired to the machine, and so the panic is in vain. There’s beeping and someone shouts – “Temperature thirty-nine, heart rate one hundred and thirty-two, blood pressure one hundred and thirty-four over seventy-nine”. The white collar slides out and the white coats slide in. A button is pushed and darkness lures my consciousness to spiral down into an all-too-familiar void.

“Several attempts were made to reach the patient’s family. The patient is visiting from London and knows no one in California.”

I close my eyes and when I open them I discover I’ve been transported to another now. She gives me a piece of paper so I write the word ‘water’, but then she laughs and points at the tube in my throat.

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