15 November 2008

Flashback: Vicki Burrito vs. Nurse Cerberus

High-back Manual WheelchairIt was unlike any wheelchair I’d seen before – a big green vinyl monster with a high, flat back that reclined like a Lay-Z-Boy. I didn’t go anywhere in it, and it didn’t go anywhere when I wasn’t in it. It just sat in the narrow passageway between my bed and the wall, waiting for me to either be dropped in or lifted out.

The nurses rolled the lift in; it looked innocuous enough, though perhaps reminiscent of the gallows the stick man dangles from in the game Hangman. The frame rose up from the crest of a metal U-shaped base that rolled on small casters. A small-scale model of your standard crane lift, but painted an institutional white, so as to impart the appropriate hospital effect. Looking at its combination of insubstantial metallic rods and loose hinges, I did wonder how it was they expected to pick me up and move me with the wheeled metal thing too sparse to warrant the term contraption. Of course I asked the nurses my usual questions – the questions I always asked whenever something new and potentially dangerous, or at least clearly not benign, was brought into my room – What’s that? What’s it for? What are you going to do to me with it? I rarely got an answer.

There were three of them, the ICU nurses, all blending into a bland composite of a grouchy lady in white shoes so as to make them utterly indistinguishable to me – not only now, so many years later, but at that very moment, in that very room.

“Ok, Victoria,” Nurse Cerberus said, (they always called me “Victoria” or “Ms. Popdan” like teachers on the first day of school or my parents when I’m in trouble, but never “Vicki”), “You’re going to get into this chair now. All right?” She tapped the shadowy object looming just beyond my line of sight. It wasn’t a question, or a request for my permission of any kind; more a statement of what they were going to do to me and a cursory confirmation that I had heard what she’d said. I couldn’t see what she was tapping, but deduced that that was the chair I was to be put into.

Hoyer liftTransferring from bed to chair or chair to bed was always an event. I dreaded it. Most people never have the experience of being put into a Hoyer lift – much the same as most people never experience a root canal or having their foot run over by a tractor. Those who are spared any of these harrowing experiences should indeed consider themselves lucky.

They began by rolling me from side to side on the bed and stuffing a large, nylon/canvas sheet under me. A sturdy metal rod ran through a reinforced hem on either side of the sheet, from which dangled a long chain at each end, meeting in the middle, to form a triangular shape. When it was flat out under me, the nylon sheet spanned the distance from just above the back of my knees up to the top of my shoulder blades. Next, they pushed the hangman frame up to the bedside so that the arm of it reached across my midsection, about two feet above me. I noticed a hook hanging from the end of the arm. Nurses gathered up the two triangular chains of the sling, which at that point traveled the length of either side of my torso, and attached them to the hook hanging from the arm above me. I suddenly felt like a big Vicki Burrito, but was too frightened by the situation to laugh at the thought as it passed.

Coming from the direction of the back of the Hoyer lift’s arm was a cranking, ratcheting sound, and I felt/saw a quick tug at the slack lengths of my nylon tortilla. I didn’t have that horrid collar on so I was able to turn my head enough at this point to see some sort of handle or lever being worked from the base of the Hoyer lift, but I also did not have my glasses on so it was tough for me to tell what, exactly, it was. The tugging continued, and I watched the arm across me lift up, watched the nylon go taut on either side of me, obscuring my view of the room, and suddenly felt that distinct sensation of weightlessness as I was lifted from the bed.

They couldn’t transfer me while I was hooked up to the respirator. The tube which ran from the trach in my throat to the respirator box wouldn’t reach far enough, or it got in the way. It also could possibly be pulled too hard and dislodge the trach, or damage my throat. So, they disconnected it.

The nurse told me, “Ok, take a deep breath and hold it. I’m going to disconnect you now.”
I shot a questioning look at my Mom, as if to ask if this woman were serious; to determine whether she knew/realized that my inability to both take in a breath and to hold it was precisely the reason that I was on the respirator in the first place. Mom wore a similar expression. She just looked up at the ceiling and shook her head slightly at me, as if to say “I know. Let it go.”
The nurse’s hand reached for my throat. A slight tug, and the tube was disconnected. My breath left me, lungs deflating like a tire that has just run over a nail.

The fact that the trach tube disconnection in this instance was intentional, rather than popping off by itself and leaving me without air until someone heard the shrill alarm and came to reconnect it, was of little comfort to me. Even though the nurses, and my mother, were all right there, could put it back at any time, I was still frightened. And I resented that it could be taken away or returned at will – at anyone’s will but mine.


Respirator (aka ventilator or vent).  Objects in picture appear much less sinister.I hated that respirator. I was terrified of it. So much so that I refused to look at it. For a long time I refused to lie on my left side because I didn’t want to face the nefarious machine with its sinister blinking lights, its delicate switches, its relentless, rhythmic gasping. I contented myself with the ridiculously infantile notion that if I couldn’t see it, then it wasn’t there. But always, I heard it. Gasp, whoosh. Gasp, whoosh. Rather disconcerting. Like listening to your own heart beat.

I hated it and was terrified of it for the same reason – because I needed it. I had never been so completely dependent on something in my entire life. There was not a single thing I could imagine that, if it were taken away, I could not function without. I hated it because I hated having to use it. I was scared of it because it was much too easy for someone to come in and flip a switch, turn it off; or for it to malfunction. I would be completely helpless. I would be able to do nothing but stare at the dead machine, and wait to suffocate.

The trach was uncomfortable in my throat. I could feel it bulging in my windpipe, straining against my throat, like being strangled from the inside out.

As much as I hated the respirator, and as scared as I was of it, I was even more afraid to be disconnected from it. The tubing they used to connect the trach in my throat to the respirator machine did not fit the trach properly. Consequently, it would pop off at random intervals, leaving me airless, the machine next to me shrieking its high-pitched alert to the nurses like a beeper with a bullhorn. My family and friends learned quickly enough how to reconnect it.


The nurses went on chatting back and forth to each other across me in the Hoyer lift. The weightlessness made me a little uneasy, but not nearly as much as the swinging and the lack of air. One of the white-clad army grasped the pole of the Hoyer lift and pulled it, plus one terrified burrito/passenger, away from the bed. And there I hung, ensconced in hospital-scented nylon, dangling from a hangman’s gallows, swinging just enough to make me extremely queasy. As she pushed, and as I rolled across the floor hanging in the pouch like a baby clasped in the curved beak of a giant metallic stork, the sling suspending me swung more and more. But it was over soon enough. I heard the ratcheting sound again, felt myself being lowered in increments, and landed against the cool, impersonal vinyl of the chair.

Then I passed out.