Second Impact

by David Klass

  The truth is, if you think about it, it should make you nervous, this whole thing about not eating. They tell you not to eat right before surgery because they’re afraid that if there’s anything in your stomach, you’ll puke it up under anesthesia, and the vomit will get into your airway, and you’ll suffocate. So that’s a pretty thought from every point of view and should remind us that surgery really is full of dangers.

  Both my parents drove with me to the hospital. We took Dad’s car, since it has the Head of Hospital parking sticker on it, and they wanted me to sit in front next to him. But I made my mom go in front, because somehow it seemed more normal that way, the two parents in the front seat, the child in the back. And to be honest, we don’t go that many places that way anymore, because I’m grown up and I can drive myself (except for this little knee issue, of course) and because my parents are as busy as they are with their jobs, and for whatever other reasons come into play in our family dynamic. But it felt to me like the right way to get driven to surgery, with Mommy and Daddy both in place. Sorry, but I really wasn’t feeling very tough that morning.

  So we got to the hospital, and Dad parked in his super-high-powered parking space, which is ridiculously close to the entrance and has a little sign with his name and the CEO title. It’s part of a row of VIP spaces, the chief of surgery, the chief of internal medicine, and so on. My dad is kind of proud of this, and I was glad when my mom made a fuss when she said, “Wow, this is real status, Joe.” He waved his hand like it was nothing, but I could tell he was pleased.

  We walked slowly up to the entrance, me in the middle, like the little girl, Mommy on one side, Daddy on the other. He was carrying my soccer gym bag, which for some reason had felt like the right thing to pack, with a couple of books and a ratty stuffed animal for luck and some protein bars of the particular brand that I like for when they would let me eat again.

  So we went to Admitting, and with Dad there, of course, it’s totally streamlined. We were hustled right past all the other people waiting to check in, and the clerks couldn’t do enough to fill in the forms for us and hustle us off to Day Surgery. It’s the only way to travel, and I said so to my dad, as the people at Day Surgery, with similar alacrity, hustled me right into a changing room. But in the changing room, I started to feel weird. I had thought about bringing my own pajamas to wear, but at the pre-op visit they gave us a pile of papers, which I actually read pretty carefully—which I bet that not that many people do. That’s how I got started on the idea of not eating being about not puking and suffocating to death, though that’s not quite how the hospital puts it. Anyway, the papers said don’t wear your own clothes, there could be a problem with germs, though I’m not so sure why clothes that come out of the hospital laundry should be that much cleaner than the ones that come out of our perfectly good machine at home. But I felt weird, taking off my own clothes, as instructed, and putting on the yellow hospital johnny. I snapped it up the back, and then I put on another one, with the opening in the front, and used it as a bathrobe. I had to take off my necklace, which was a present from my parents on my last birthday, a garnet on a chain, and my bracelet, which was a present from Sophie, and I put them in my pants pocket. I didn’t have any barrettes in my hair, or I would have had to take them out, and I wasn’t wearing my watch, and I don’t wear glasses. But just putting on the johnnies makes you feel so weird, like you aren’t you anymore, you’re just patient number whatever.

  I don’t really like hospitals, which I know is kind of a funny thing for someone whose family fortunes, so to speak, are made on hospitals, but I’ve never really liked being around them. I’m happy to admire my dad’s parking space, but then, if it’s all the same to you, I’d just as soon go home. That’s why it’s so strange that since moving here to Kendall, I’ve become so aware of the hospital as the place that keeps this town going—the place where so many of my classmates’ parents work, the major employer for miles around now that the factory is closed. I’ve started to feel differently about it than the other hospitals where my dad has worked, but I still didn’t want to be a patient there.

  They moved me into a little cubicle with a hospital bed and all that weird stuff on the wall—dials and machines and tubes. I tried not to look at any of it. I sat on the bed, and my parents came in. There was one hard plastic chair, and my mom took that. Then the anesthesiologist came in and said to me, “So you’re the one who wants to be awake for her operation,” and all hell broke loose.

  Well, not all hell. That’s an exaggeration. But certainly some hell.

  The anesthesiologist was a wiry little guy in scrubs, with bushy white eyebrows and blue eyes that kind of matched the scrubs. He talked to me, not to my dad, which I appreciated, and clearly he did know about me, I mean, given what he said.

  “So you’re the one who wants to be awake for her operation.”

  “What?” said my father. “What did you say?” He kind of barked it at the anesthesiologist, and since he was maybe six inches taller and standing up and wearing a fancy charcoal-gray business suit—and most of all since he was the CEO of the hospital—you would have to say that his aspect was intimidating. But the little anesthesiologist with the bushy eyebrows seemed kind of unimpressed.

  “Hi,” he said up into my dad’s face, “I’m Dr. Dickinson. And my understanding is that the patient has expressed a strong preference for being awake during her procedure, and that Dr. Abbot has agreed, subject to my approval.” He turned and looked at me again. “Is that right?”

  “Yes,” I said, trying to sound very mature and very definite, though it wasn’t exactly how I was feeling right then.

  “Your approval?” My dad exploded. “She doesn’t need your approval, she would have to have my approval! What kind of nonsense is this?”

  “Dad,” I said, “I talked about this with Dr. Abbot. She said that normally she doesn’t give people the option of staying awake if they’re under eighteen, but I told her about my blog. I told her I want to see this so I can write about it. I told her I’ll be eighteen in a couple of months—”

  “And she agreed,” my mom said. “And so did I.”

  “You what?” Now my dad was turning on my mom. It’s what he does whenever he’s scared about anything: he gets mad at people, he barks, he announces that he’s in charge. It used to scare me a lot in return, but now it usually just makes me feel bad and sad, like people must be thinking he’s full of it. Which he really isn’t, or at least not usually. He’s a pretty cool guy, really, my dad. I could tell you some stories that would surprise you.

  But we shouldn’t have surprised him about the anesthesia. The thing is, after I discussed it with Dr. Abbot and she and my mom agreed it was okay, it never occurred to me that my mom wouldn’t have passed it on to my dad. I always think there’s this major-league top secret parental back-and-forth going on. Parents ought to be talking behind your back, that’s part of what makes them a team.

  “And neither of you thought to mention this to me?” my dad went on, still that accusing bark. “Neither of you thought I might have an opinion about violating hospital policy and allowing a teenager to be awake during a major operation?”

  I told him I was sorry that I hadn’t warned him about this, and I was. I pointed out that I had been pretty freaked out about the whole operation and that when I found out I could be awake, and I had this idea of blogging about it, that made the whole thing easier to face. I never stopped to think about whether that was kind of weird, I guess.

  Here’s the thing about my dad. He’s a hospital CEO who is kind of queasy about the sight of blood, and medical procedures, and all that kind of thing. When he’s not all mad and blustery, he can admit it about himself. He even uses it sometimes as a joke. Take him to a movie, and I happen to know he closes his eyes during shoot-outs—he also closes them if someone’s getting a shot. He’s always been like that, and as I said, I’ve seen him make a joke about it and get people laughing. But I know perfectly well that if he w
ere having any kind of surgery and they said, “Do you want to be awake?” “Do you want to see what’s happening?” he would be horrified. So I don’t think he can really understand why I might be more scared of the idea of going to sleep and missing it.

  “Dad,” I said, “I’ve been really scared about this. The idea of being awake made me feel better. Please. Please, Dad.”

  He didn’t look at my mom. He didn’t look at the anesthesiologist. He just looked at me. I thought about saying it again, “Please, Dad,” or even, “I’m sorry.” But I didn’t say anything, I just looked at him, and I shrugged a little, like, what can you do, I’m your weird blogging daughter.

  “Any other little surprises you two have in store?” Dad asked, and it was okay, just like that.

  “No surprises,” said Dr. Dickinson. “Just a pile of consent forms.”

  So that was how I ended up in the operating room, more or less awake. They had given me something to relax me, as he called it, but I told him really specifically, “Don’t relax me too much, I want to see what’s happening.” Whatever he did give me, though, changed my sense of time. After they put the IV in my hand (they let my parents stay in the room for that, and of course my dad couldn’t watch), I could just feel the time slow down, like there was some kind of syrup in the air. I guess it really did relax me—but by relax me I think they mean undoing some of the links that hold me into my life. I was watching everything go by, and it was all just fine with me. But I was not asleep.

  So I can tell you what they did to me. I can’t tell it exactly in my own voice, because the person in that room wasn’t exactly me, but I concentrated, and I checked it over again with Dr. Abbot when she came to see me after I was in the recovery room, and she laughed and said, “Pretty good, you got it pretty much absolutely right.”

  Here’s what she did:

  She put my knee in a legholder that propped it right exactly where they wanted it.

  She put a tourniquet around my leg.

  They put up a blue paper curtain so I couldn’t see what they were doing to my knee, but I could hear them talking and I know what they did.

  Dr. Abbot cut two little holes, one on either side of my kneecap. She called them portals. Then she put little tubes in through those holes, up inside my knee. And one of those tubes had a tiny camera in it, and all of a sudden, everyone could see the inside of my knee, up there on a video screen.

  So I was lying there in this really cold room, breathing that very relaxed syrup air, and I could feel that my leg was weird, weird, weird, but I was looking up on the video screen, like the other people in the room.

  Except not like Dr. Abbot, because she had on this science fiction headset, and I guessed that’s how she could guide the tools that were—I still feel weird saying it—actually inside my body, inside my knee. And there she was, under her mask and her headset, saying what she was doing: here’s the meniscus, here’s the torn ligament, I’m removing some fragments of this or that, I’m repairing, I’m preparing the bed for the ACL, I’m drilling a hole for the ACL.

  I might actually have fallen asleep once, because I kind of jerked myself awake, and Dr. Dickinson, who was standing near my head, said to me, “Hey there, you’re doing great. Stay calm now, almost done.” And I almost started laughing, probably again because of the relaxing drug, lying there and thinking, Here I am, people are digging inside my knee, and I’m falling asleep, and isn’t that just the funniest thing!

  Dr. Abbot took a piece—a long strip—from my patellar tendon, which is the tendon that connects my patella, the little roundish bone of my kneecap, to my tibia, the big bone in my leg. She just sliced out a rectangular strip of that tendon, and she used it as a graft, a kind of strap to hold my knee back together, instead of my old, torn ACL. I know this more from the diagram she drew me in her office, though, than I do from what I watched on the screen, and when I try to picture the graft, I see the neat little rectangle she drew on her pad. But I watched them, I really did.

  To attach the graft, they have to drill tunnels in your legbone and in your thighbone and pass the graft through. And then there it is, a new connector, and the knee has meaning again. My thigh and my leg were no longer separated.

  What did it look like on the video screen? The funny thing is, I thought a lot of it was beautiful, a kind of undersea world with these seaweed shapes waving—I think that might have been meniscus. Or maybe it was the pieces of my torn ACL. But it was really clear, watching on the screen, what were the pieces of my body, even the torn pieces, because they somehow looked so alive, especially in comparison to the metal instruments you could see moving in there like in a construction zone, trimming and prodding and constructing.

  Or, at least, that’s how I remember it. I did fall asleep, once and for all, after they had taken out the camera and the video screen went blank. Dr. Dickinson leaned over and asked me if I was okay one more time, and I said, “Yes, yes, I’m fine,” and he said, “Good job, Carla.” Then I have to wonder if maybe he dialed up the relax juice, because I think I passed out, right then and there, while they were cleaning up on the other side of the drape. I woke up in the recovery room, and my parents were sitting right there at my bedside. I was glad to see them and glad to see that they were holding hands, but the first thing I thought, when my vision focused and my head began to clear, was not actually about my parents, or even about me and my knee and my operation. What I thought was, Now I understand about bodies. What’s inside the knee is real, if you know what I mean, real pieces of bone and tissue, ligament and meniscus (and I still don’t really get what a meniscus is, even though everyone keeps explaining it to me). If something gets torn in there, then you can’t rest your weight on your leg, bend your knee, kick a ball into a goal.

  I don’t know, am I totally dumb not to have realized this long ago? I mean, I dissected my earthworm and my frog and my rat in ninth grade honors biology. Drew my diagrams, too. But somehow this was like stop the presses news, this idea that kept coming over me again and again, this understanding that everything we are and everything we do is made up of pieces of material, hooked together in complicated ways. That’s why we can do what we do—and it’s why we can get broken.

  View 3 reader comments:

  Posted by user ACLSurvivor at 7:13 p.m.

  Thanks for posting this. I actually had the same procedure about a year ago but all I remember was just being knocked out cold and waking up in the hospital with no idea what had happened except it felt like an elephant sat on my leg. Now I finally know what they were doing, thanks to you!

  Posted by user Ms_Edison at 9:11 p.m.

  You deserve a Pulitzer for combat reporting, Carla. Leave it to you to stay on the job even as you’re going into the operating room. We’re all wishing you a quick recovery here at the Kourier!

  Posted by user SoccerGirl#17 at 10:17 p.m.

  We smashed Mumsford in girls’ soccer in your honor, Carla! Get well soon!!!!

  DINNER WITH FRIENDS

  Posted by user JERRY on November 20 at 10:00 p.m.

  My mom pulled into the driveway early this evening and saw me walking Smitty and shouted, “Jerry, we’re having company for dinner. Put Smitty away.”

  Smitty is our golden retriever, and he’s very friendly, so I couldn’t imagine why I had to put him away. He likes children—he even likes the mailman. I walked closer to the car to see who our mysterious guest was. I saw dark blond hair, and then the person sitting next to Mom turned and I recognized my fearless fellow blogger.

  I was surprised to see Carla, but it made perfect sense. She must have been referred to the Wellness Clinic after her knee operation. Mom doesn’t usually bring her new patients home for dinner, but I knew she had been reading Carla’s blogs and was a fan.

  “Hi, Carla,” I called. “Glad you survived the operation. I hope my mom isn’t killing you with rehab.”

  “She tried her best today,” Carla told me. “She made me scream so loud I had to bite a pillow.
”

  “The first few weeks are the hardest,” Mom assured her. “I have to bend the knee to get the full range of motion back. Then it gets easier. Do you need help getting out?”

  “Might as well learn to do things myself,” Carla said, and hoisted herself out of the car. I saw her wince—her knee was wrapped in a protective bandage and clearly very tender. She tugged some crutches out after her, and in a second was balancing precariously on the sidewalk, studying our house and then glancing warily at Smitty, who wanted to make friends by leaping all over her. “No offense, but get that humongous mutt away from me.”

  “He’s no mutt and he’s friendly,” I assured her, keeping a tight leash on Smitty.

  “Too friendly and too big. I’m a cat girl, anyway.”

  Smitty bounded at her, and I pulled him back. “You shouldn’t have said that. I think you hurt his feelings.”

  “Jer, get him into the house before he knocks her over,” Mom commanded.

  I tugged Smitty inside, and the smart dog knew what was coming, so that I had to practically drag him down the stairs into the basement. “Sorry, old fellow,” I told him. “You’re dining alone tonight.” I gave him some food and water and left the light on for him, but he followed me back up the stairs whining and pleading. I told him to chill out, locked him in, and turned to see Carla hobbling through our front door on her crutches.

  “You’re pretty handy on those,” I told her.

  “Sarcasm is the last thing I need right now,” she said, looking around at the inside of our house. “Why don’t you just call me Tripod or Long John Silver and get it over with.”