|Entry to round 4 of:
The needle pointed to “ERI” – Elective Replacement Indicated, meaning I still had two months left until the needle would point to “EOL” - End of Life. I’d been through this before and wasn’t worried about my Pacemaker quitting and ending my existence. Replacement was a simple procedure – small slit in the upper chest, pull out the old model and slip in the new – a morning procedure. But, that was in Canada; now I was in the Middle East where different rules applied, they wanted me in hospital for three days.
I showed up at the Hamad Heart Hospital where I was met by a friendly crew of Arab administrators in their white kandoras and guthras.
“Welcome to Hamad Hospital. Are you being admitted today?”
“Yes, thank you.”
I didn’t realize that the doctors and the admissions department were not on speaking terms. When I couldn’t produce the required admission slip, I called Doctor Kassim, who whisked me to the emergency ward, where I was treated like a heart attack victim. I was beset by half a dozen nurses (called “sisters”). Their competence or lack thereof, made me think that Larry, Curly and Moe had a bunch of daughters who all ended up at Hamad Hospital, as they tripped over each other to deal with my “emergency”.
They stripped me down, put me in an emergency bed, strapped to every imaginable wire and gadget, and began firing questions at me. “How do you feel? Do you have pain? Is your chest tight?” They started filling out forms and each took a turn, in broken English, asking the same questions over and over. Each wrote the answers on a form, but no one stopped to read the previous reports. This became standard procedure for the rest of my stay at Hamad.
I was the only patient in emergency and had the full attention of every one of the plentiful staff, who seemed to be waiting for an emergency to appear. Doctor Kassim had disappeared and I was left to the mercy of the daughters of the stooges.
The emergency room doctor showed up and asked the same questions that had been written on the previous forms, which he never read. He told me I would be sent to my room shortly, because they had a standard of no more than one hour in emergency.
The stooges abandoned me to visit and giggle around the nursing station, with a large dark skinned gentleman in hospital garb, who resembled a character in a gangster movie. Other than the occasional visit from one of the mauve clad sisters, I was left alone to wait. The one-hour standard had come and gone. I asked one of the nurses “visiting” at the desk. She said the doctor would sign the admission form whenever they could find him.
Fifteen minutes later, I asked the “gangster” when I would be going to my room. He got on the phone and I was off to the wards, to see more daughters of the stooges in action.
Doctor Kassim visited assuring me I would be in the operating room at 8:00 the next morning. True to his word, Doctor Kassim showed up at 7:00 telling me that everything was set for the operation and to re-inform the nurse to have me in the operating room in one hour At 8:00, an orderly wheeled the stretcher to my room. Then I waited, and waited. At 8:45 my nurse came in and started getting me ready for the operating room and wheeled me down for a 9:00 start.
I was wheeled into a little “holding” room where I was told to wait. Based on my experience to date, I wasn’t confident that anyone would remember where they left me. I heard Doctor Kassim shouting at my nurse, “I told you 8:00. I put it on the chart 8:00. I reminded you this morning that it was 8:00. Look at the time, it’s now 9:00 - we are an hour behind and we have two more procedures. We almost had to cancel.” He continued to chastise the negligent nurse. I feared the procedure would be canceled and I would have to repeat this dreadful process.
Temped to jump out of bed and bolt for the door, I shouted, “Hello, I’m in here. Are we ready to start soon?” After ten minutes they moved me into the operating room – over an hour behind schedule.
I was surrounded by five nurses, all busy doing nothing productive and arguing about whose job was what. Doctor Kassim, Doctor Saeed, an unnamed heart surgeon plus other assorted males mulled around the operating room brining my entourage to ten people.
Everyone seemed to have a task, setting up monitors, IV’s, operating table and prepping me for the procedure. It was chaos with lots of fussing and arguing. The nurses fiddled with my clothes and bedding when one of them shouted, “OK, all the men out.” One of the few times the nurses could tell the doctors what to do. The males all exited the room while the females, continued to fuss over my “appearance”. It was their job to make sure that I was appropriately covered in all the right places so none of the men could get a glimpse of my personal parts and become corrupted. When all the modesty coverings were in place, the men were summoned to return. Thank goodness this was not an emergency, as the daughters of the stooges would have caused my demise.
Upon re-entry, Doctor Saeed looked at the scene and blew a gasket. “I told you, her pacemaker is on her right side. You set up the whole procedure on her left. Get that fixed and now.” The nurses hopped at his order, moving the paraphernalia to the other side of the operating table. The door looked very tempting – maybe I could catch a 10:00 o’clock plane to Sanityville. Doctor Saeed could see I was agitated and restless - big deal, it’s only my life at stake.
Doctor Kassim took charge with the task of hooking me to a temporary pacemaker. Being fully reliant on the pacemaker, I couldn’t afford to be without an electrical impulse to my heart for even one minute. Doctor Kassim took a scalpel and sliced into my inner right thigh which was numb from a local anaesthetic. I could view the monitor as he shoved a wire through my vein to my heart. “A little to the left, no right, OK, looks good,” someone barked as Doctor Kassim pushed. “Now, let’s see if this works,” Doctor Kassim proclaimed. I wished he would keep his commentary to himself – what if it didn’t work? What was the back-up plan? Then cheers as he flipped the switch and the beeper started and waves appeared on the screen. This was supposed to be a standard procedure, not a shuttle launch. Being hooked to the machine removed any further temptation to run for the door, which still looked appealing given the gong show I was experiencing. I feared for my life, as Doctor Kassim gave the signal to the heart doctor to disconnect my current pacemaker that had kept me alive for the past ten years. Again, more faint cheers from the crowd as I had survived another milestone, still alive.
The heart doctor sliced my frozen upper chest to start the process of removing the old unit. “Scalpel,” he demanded of the nearest nurse. “Scissors,” he continued. “Screwdriver.” Did he say screwdriver? What the hell does he need with a screwdriver? Is a tire iron and hammer next?
He dug and gouged for what seemed like an hour. I was pushed and pulled in every direction as he tried to extract this piece of metal that had become a part of my body. It popped out and he held up the bloody tissue-encrusted plate showing it to me with pride in his eyes. I don’t know why, but I uttered, “Can I keep it?” “Sure,” he said as he passed the contraption to a nurse to clean it.
Now for the new, smaller, but fatter, model to take the place of the old clunker. Doctor Heart again prodded and pushed, exclaiming that he couldn’t make it fit. Why can’t these guys keep their mouths shut when they are working? “Maybe if you turn it this way,” said one of the extras. “Put it in the other way,” offered another. More confidence building commentary making me wish I had just let the old one run its course and allow me to expire.
He got it in, turned it on and disconnected the temporary machine. I was still breathing, causing more cheers in the operating room. The worst was over. “Pass me the glue,” he ordered, as he proceeded to “glue” my incision shut, fanning it dry with a piece of paper.
It was over and I would live to see another day.