Chapter 14
The next day was busy from morning till night. It started with Walt again helping him with his morning ablutions. What wouldn't he give for a proper shower, but it was obvious that was out of the question at the moment. Breakfast this time was scrambled eggs on toast and tea. The eggs were rubbery, and the toast was soggy, but it was food and he knew he couldn't afford to turn it away. He hoped Mike would bring him something in later. He still had two of the doughnuts that Bill brought in and he decided to eke those out. Perhaps one mid-morning and one mid-afternoon, unless Mike brought him something better.
Soon after, Liz Kendrick pushed a trolley into the room. She lifted the back of his bed, so he was sitting upright and had a good view of what she was doing, and then proceeded to spend the next twenty minutes with him cleaning his pin sites and instructing him on the correct way to do it. He felt rather sick watching her do it so closely. Every time it had been done before since his operation Steve had always averted his eyes, but Liz insisted he had to watch and learn.
"This all takes time, Steve, and we have so many other patients to look after. The sooner you learn the technique and take over the care of the sites for yourself the better for all of us. You'll have to do this twice a day every day for as long as the frame is in place, so you'd better suck it up and take note. You'll be supplied with the necessary dressing packs and cleaning solution that you'll need while you're here, but you may have to buy your own when you get out of here, so pay attention to what you'll need."
Steve felt suitably chastised. He also started to feel very uncomfortable and nauseous as the cleaning began. It was the first time he'd had to watch closely and really study the pin sites in minute detail and, as Liz pressed around them with a moistened cotton swab like a Q-Tip, he felt the bile rise and knew his scrambled eggs were in danger of coming up to greet the light of day again.
"Liz, I think I'm going to throw up," he tried to warn her.
"Oh no you're not!" Liz exclaimed firmly. "Now, put your head back on the pillow, close your eyes and breathe slowly, deeply and evenly until the nausea passes. Count slowly to ten with a breath in and out between each count. Now, with me... one... deep breath in and breathe out, that's it... two... deep breath in and breathe out. Well done that's it... three..." And so it went on till Steve began to feel he would hold on to his scrambled eggs after all.
"I'm sorry, Liz. I'm not sure what came over me. It's all just a bit..."
"It's a bit daunting isn't it? I know, Steve. You've had your wobble and you've fought against it and won, so you know you can do it. Now, I'm going to clean these two sites here then I want you to clean the last three."
"Oh I don't know about that... not yet anyway." Steve's eyes pleaded with Liz.
"Well I do. You have to master it, and I know you can do it. Now watch me again." And so the cleaning went on with Steve watching intently trying to control his breathing with every wipe of the cotton swab. When it was his turn to take over he steadied his breathing and started the cleaning process till all three had been cleaned to Liz's satisfaction. When he was finished he felt quite proud of himself.
"Well done! See I told you you could do it. Now I just have to teach you how to wipe the frame clean every time too and then we're finished." Finally, it was done, and his purgatory was over. "There now that wasn't so bad was it? I'm proud of you for managing that, and even prouder of you for holding on to your breakfast." She laughed at the grimace on his face and then stood up to tidy the soiled items on the trolley before pushing it towards the door. "How about a nice cup of tea? I think you've earned it." She beamed at him.
"Not just at the moment thanks. Maybe in a little while. Those eggs are still knocking on the door to be let out," he laughed.
She lowered the back of his bed a little and he lay back and wiped the sweat from his brow with a tissue, then rested quietly till the door opened again and Dr Cranmer breezed in.
"Good morning, and how are you today, Steve. My, you're looking a little peaky I must say. Are you feeling unwell?" He reached out and put the back of his hand on Steve's forehead.
"I'm okay, Dr Cranmer. Nurse Kendrick has just spent half an hour teaching me care of the pin sites and the frame. It's just sent me a bit queasy that's all. It's passing off now."
"Ah yes, not a pleasant task I must admit, but a very necessary one. You'll soon get used to it." He picked up Steve's chart from the foot of the bed. "How's the pain? Is there much breakthrough on the morphine dose you're on now?"
"Well, the pain is pretty bad without the meds, but I've been having some weird experiences and I wonder if it's all due to the morphine. I was wondering if I could reduce the dose still further. I'm taking the Tylenol eight a day like you said and it seems to help."
"What kind of experiences, Steve?"
"Well, I'm kind of very light-headed and easily nauseous, and I'm sleepy a lot of the time too, but the worst thing is I'm tetchy and short tempered with people and for no obvious reason, but I just can't help it. I'm usually a pretty easy-going sort of guy but, if I keep getting these mood swings and biting their heads off, I'm not going to have any friends left. It's so unlike me that I feel it has to be the morphine, so I would just prefer to try reducing the dose till I can stop it altogether and take less powerful meds instead, if that's okay with you of course."
"Hmm! The nausea, sleepiness and light-headed feeling I'll possibly go along with, though it's also only to be expected, but don't you think the short temper and mood swings could just be due to the pain and the circumstances you've been thrown into?"
"Well I've been shot, beaten up, run over and even trampled by a bull, so I'm no stranger to hospitals, but I've never been this bad before. I don't know what else to think it could be other than the morphine. Of course, you could be right too, but I won't know unless you agree I can try something else... please." He looked pleadingly at Dr Cranmer.
"Hmm! I'm certain Tylenol on its own is not going to be strong enough to control the pain without the morphine? You have an extremely serious injury there and its very early days. I'm not happy to stop the morphine completely, but I will reduce it a little more, and I'll also put you on a stronger strength of Tylenol at a dose of eight per day. I'll add in an anti-inflammatory drug with less side-effects to compensate for the reduction in the morphine. If that doesn't prove sufficient there are other avenues we can go down, but I cannot stress strongly enough that you must speak out if the pain is bad. You can't expect to do the necessary exercises that Dr Truman will insist on without adequate pain relief beforehand. Don't let yourself be a martyr to the pain. Is that clear? Are you happy with that plan?"
"Yes, sir, I think I can manage on that and I'll promise to speak up if I can't. I have a high pain threshold Dr Cranmer," he looked down at his leg and grimaced, "but not that high."
"I see from your chart that your other wounds have been cleaned and dressed and the staff are happy with their progress. We'll take the stitches out at seven days. Any other questions?"
"How soon will I be able to shower? Am I even going to be able to shower with this frame on?"
"From the point of view of the injuries under my care, I'd be happy for you to shower once the burns have dried up, so maybe at about ten days, but with regard to your leg... well that's more in Dr Truman's jurisdiction rather than mine, so you'll have to be guided by him. I think he'll probably allow it about ten to fourteen days post-op providing you're on crutches by then, but you really must take it up with him. You'll have to manage with Walt's strip washes in the meantime. Now if that's all?... then I'll be off. I'm pleased with your progress, but don't rush it, young man. Remember it's still early days." Dr Cranmer left the room and shortly after Walt came in with a mug of tea for Steve.
"Liz asked me to bring you this. She thought you might be able to stomach it by now." He smiled broadly and placed it on the bed table, turned and left the room again.
"Thanks, Walt," Steve called after him all the while thinking that Walt's strip washes were no real substitute for a lovely warm, relaxing shower. Steve drank the tea, savouring it slowly. It was the one thing that always tasted good in here. He'd hardly finished it when the door opened again and Rick and Dr Truman walked in.
"Good morning young man. How are we today?" He picked up the chart and studied it.
"Well, I'm doing okay, sir, thank you, though I obviously can't speak for you!" Steve replied a little peevishly.
Dr Truman didn't speak. He didn't need to. He simply took his eyes off the chart to give Steve a long stare.
"I'm sorry, sir, that was rude and uncalled for. I apologise. I'm just feeling a little fragile this morning. Dr Cranmer and I feel it might be to do with the dose of morphine so he's going to try reducing it."
"Yes, I can see that from the chart for myself. I'm not sure I'm too happy about that. Adequate pain relief is essential, Steve, and especially to provide cover prior to the exercises." He turned to Rick. "Has he started the exercises yet?"
"Not yet, Dr Truman. We're going to start the programme today with gentle massage and work our way up."
"Oh whoopee-do!" Steve murmured under his breath. "That's something else to look forward to."
"Did you say something?" Dr Truman asked as he again stared long and hard at Steve.
"I said I'm looking forward to starting the exercises, sir. The sooner the better!" Steve was trying to avoid looking at Rick who was struggling to hold it together.
"Hmm! Now why don't I believe you... eh?" He paused... then turned to Rick and continued. "I expected you to begin with light massage and exercises yesterday. What happened? Why weren't my instructions followed?"
Rick fixed Steve with a stare and Steve realised he was willing him to stay silent. Then Rick spoke up in Steve's defence. "Steve was excessively sleepy yesterday. It was my considered opinion that he wouldn't have been able to concentrate sufficiently to comply and absorb the instructions being less than 24 hours out of the ICU. I felt I would get better results with him today. I've drawn up a programme and will start him on it after you've finished your ward round... sir."
"Harrumph!" Dr Truman made a strange disdainful snort.
Steve didn't dare move a facial muscle, but he could see the man was none too pleased.
"I don't like my orders being countermanded, but it makes sense I suppose and I trust your judgement, Rick, but make sure he does start today. Every day of delay now means a day lost from his recovery. Let's have a look at this leg. Have you been instructed on the most important pin site care?" he barked.
Rick and Steve visibly relaxed a little.
"Yes, sir, fully instructed." Steve shuddered at the memory.
"That all looks very good I'm pleased to say. No signs of any infection but we'll keep you on the antibiotics for another couple of days as a precaution and for your other wounds." He made a few notes on the chart. "Any questions young man?" He fixed Steve with yet another stare that almost willed him not to answer.
"No, sir, I'm happy to start the massage, though I have to say I'm somewhat concerned about the exercises at this stage due to the pain in my thigh and particularly in my knee but, as you say, the sooner I start the sooner I'll recover." In light of what Dr Cranmer had said he decided not to ask about showering. Rick could fill him in on that later.
"Very well. I'll see you in a few days. I'm away for the weekend. Dr Cranmer or my resident, Dr Greenberg, will monitor your pain and general care and Rick will update me on the progress he makes with your physical therapy on Monday. I'll be off now but... remember to do as you're told. It's all being done for your benefit. Just hold on to that thought when Rick is pushing you."
"Yes, sir. Of course, sir," Steve bridled, but then thought it was best not to push it but to keep his mouth shut.
Dr Truman turned and left the room with Rick closely in tow. As Rick reached the open doorway he turned back and quickly gave Steve a smile and a thumbs-up sign and said "I'll be back later."
"I'll look forward to it," Steve replied with a sarcastic look, but all the time he was wondering how hard this therapy was going to be and would he be able to stand it?
He settled back against the pillows again. Gosh he was tired. He wondered if he had time for a brief nap before Rick returned. He lay back and shut his eyes willing himself to just drift off. Sleep was beginning to envelop him when he heard the door open again and he lifted his head off the pillow.
"Good morning, Buddy Boy. How are we today?" Mike swept through the door with a bright and cheery smile on his face.
"Good lord, it's busier than a BART station in here today!" Steve said as he frowned at Mike. "I've already been asked that several times this morning and I'm fine thanks, though I can't speak for how you're feeling." He knew he was being unreasonable but couldn't help himself.
"O-Oh! A little touchy again aren't we?" Mike frowned back at Steve and Steve felt really bad for snapping... yet again.
Steve took a deep breath and sighed. "No, Mike, you're not... I am. I'm sorry that was uncalled for. I didn't mean it. It's just been non-stop for the last 4 hours, one person after another. I think they should just put a revolving door on my room." He said as he tried to make light of his bad behaviour.
Mike looked him over and coaxed gently, "Come on, it's not like you to bite my head off like that. What's up? Are you not feeling so good, is that it?"
"No, I'm just getting tired I think and I don't think the morphine is suiting me so Dr Cranmer is reducing it, and Liz has been in teaching me pin site and frame care, and Dr Truman has been in to see me and he's been laying the law down again, and now Rick's coming back soon to start me on my exercises, and then you..." He began to shudder and forced himself to take some deep breaths.
"And then I walk in all bright and breezy huh? Is that it? You're tired, Steve, that's all. What's happened to you in the last few days would break a weaker man. Don't be so hard on yourself. If it helps, I won't stay. Perhaps you need some shut-eye before Rick descends upon you."
"No, I'm sorry... really, Mike, please stay. I think I need you to calm my ruffled feathers!" And with that he smiled and held out his hand to Mike who took it and lightly squeezed it.
"What's in the bag?"
"In the bag? In the bag?" Mike looked around him. "Oh, you mean this bag?" He looked down at the bag he'd placed on the foot of Steve's bed. "Well, I brought you the Chronicle and the Financial Times, and I went by your apartment and brought you some more clean underwear and clean pyjamas. Oh, and I picked up your mail too and brought that in... not the circulars but just what looked like the important stuff. I cleared your fridge and larder cupboard of anything that wouldn't keep, and there were some dirty towels in your bathroom and dirty washing in your laundry basket, so I've taken that too and I'll launder it at home for you and take it back. Then I went to that Deli you like on Folsom Street and got you a pork and stuffing roll with a Caesar side salad and one of those slices of blueberry pie that you like so much. Did I do right?"
Steve looked at Mike as he spoke and swallowed hard as his throat tightened and his eyes welled up. He thought he'd been having a busy morning, but it was nothing compared to Mike. He'd no doubt been up since the crack of dawn, spent time in the office, and then found time to go round to his apartment to clean up and then put himself out again to go buy him appetising food... and all before noon. And all he could do was feel sorry for himself and bite Mike's head off. He hadn't got the heart to tell him his boxers and pyjamas weren't going to be suitable. There was time for that later. God, how he loved this man.
"Hey, hey. Don't upset yourself." Mike patted his arm then gripped his hand as he sat gently on the side of Steve's bed.
"It's just... just... oh I don't know... everything I guess. I don't know if I can do this, Mike, you know... all this wound hygiene and... and the sheer thought of exercising gives me the shakes. I can't have a shower, and I'm sick of lying around, and the morphine is making me feel so strange, and I can't control my temper and..."
"Enough, Steve! Enough! Now just take it easy and take in some nice deep and steady breaths till you calm down."
Steve knew he'd heard all this before earlier in the day from Liz, but he said nothing and just did what Mike told him. Slowly he felt himself settling again.
"You mustn't beat yourself up like this, Steve. Everything you've just said is just you having a perfectly normal reaction to an absolutely dreadful situation. It's a lot to take in and an awful lot to face in the future, but you'll do it, Buddy Boy, just like you always do. You're probably the strongest person I know, and you don't have to do it alone. We'll do it... together... you and me. You know... when I took you on as my partner it was like committing to a marriage." He laughed at the expression on Steve's face. "Oh, you may mock but it's true... you promised to obey me for better or worse... in sickness and in health... only without the fringe benefits. Ha ha!" He laughed out loud, and Steve had to smile too.
"You forgot the 'to have and to hold, to love and to cherish' bit," Steve sniggered.
"Oh well, that goes without saying, Smiley." He touched Steve's cheek. "Together, Steve. We're in it together and don't you forget it. You tell me any time it all gets too much for you and I'll help you find a way through. Okay? You got that?"
"I got it, Mike... and thanks." He pulled a tissue out of the box on the bed table and blew his nose. "Just one more thing." He looked up at Mike as he stood up to leave.
"Sure, anything."
"Did you remember the cranberry sauce on the pork roll?"
Mike reached out and grabbed the back of Steve's neck. "Did I remember the cranberry sauce? Yes, hot-shot. I did."
After Mike left, Steve managed to eat just half the roll and then left the rest for later. He lay back as exhaustion from his recent emotions and his busy morning washed over him and within minutes he was asleep.