Yesterday was TERRIBLE and you know I am not one for hyperbole or negativity.
“Mark broke his neck,” I texted a friend. Then when I called her, she was crying. “Why are you crying?” I blurted out. “I’m so worried about you,” she choked out. I on the other hand was completely emotionally shut down, so, you know, fine. That’s how I get through trauma. I go deep into my brain bunker until the bullets stop flying, and then I emerge and deal with the dust and carnage.
There will be a lot of dust and carnage from this one.
The night before, Mark went to use the bathroom. I heard a crash and found him lying on the tile, facial abrasions bleeding, nose bleeding. He struggled to stand. I had to use all my strength to pull him up and help him onto the toilet and then back to bed. This is not why I took him into the ER, although any head injury would be a fair reason to get Mark checked. The next morning, he was at his cognitive baseline so I felt he was okay. We went to the ER because after a spat of morning vomiting, the skin inside his forehead burr hole opened up and started bleeding. This being an outside-world breach into the intracranial world of Mark, I freaked. Internally. Externally, I calmly said we should get this checked out. In turn, he calmly insisted on eating ramen before going to the ER.
The ER. Normally, I can handle the ER just fine. I settle in, knowing it will be a long haul. I had remembered snacks and a phone charger. We drove in during morning rush hour. I had formulated a plan for efficient delivery of information to the first medical people we encountered. I thought I did a good job. And they did a good job of relatively quickly giving Mark an EKG, CT, chest x-ray, bloodwork. The attending was attentive and kind when she came in and said, “I have some bad news.” Mark had fractured his C3 in the fall. They needed to put him in a neck brace and make a plan.
Mark and I were shocked. There’s a lot on my list of worries and things to watch with Mark. Paralysis was not one of them. As Mark settled into bed with his new neck brace, I googled C3 fractures. Aka “Hangman’s Fracture” as these are the bones that snap during a hanging execution. I shut down my phone and looked away from the Google.
Our ER experience was all downhill from there. 15 hours later, they never did make a plan. We didn’t see any doctors for hours and hours. They did more tests, and more tests, and more tests. Many CT scans. An MRI. More x-rays. All day, I had gotten inconsistent tiny snippets from the nurses. “They” think he’ll be discharged. They think he can be in bed without the neck brace. Oh now they think he has to have it on! He can eat. Oh now he can’t eat! He can walk to the bathroom. Don’t let him get out of bed! Mark was quite patient, as was I. For the first 12 hours. After that, not so much. He pulled off monitoring equipment. He asked me repeatedly to leave.
What’s that movie from the 70s or 80s where the mom freaks out at the nurses because her daughter with cancer isn’t getting the treatment she needs? That’s me. That’s what I became. It started slow. I ramped up requests. Specifically asking to see the ER doctor, the attending, the resident, the neurosurgery residents. It ended up with me in the hallway, staring at the residents in the fishbowl, and imploring them to find someone to talk to us about what was happening. Was he going to be admitted? Why were they ordering all the tests? What were the results? How do I take care of him. What is the plan.
I could read the test results on the hospital system app as they were uploaded to Mark’s medical record. I can’t understand all the jargon, but I could glean that his fracture was stable. No blood vessel involvement, no spinal cord involvement. Bloodwork consistent with last week’s. CT and MRI unchanged from last week’s.
I finally reached the point where I decided that his case must be boring enough that it didn’t matter. That’s how bad our experience was, that I got to a place where I decided to take the guy with the broken neck home rather than continue with this ER debacle. I grabbed his hand, at 12:20am, and said, let’s go home. I put him in a wheelchair. I tapped on the window of the unit fishbowl to get the resident’s attention. He came rushing out. “They’re thinking about admitting him now, did someone tell you?” For god’s sake. NO. No one had told us. I don’t even know if that is true. I rolled Mark to the foyer and went to get the car out of valet. When I came back, the resident was there. “Does he still have his IV in?” Oh yes, whoops. We had totally forgotten. A nurse came out and removed it.
When we got home at 1am, Mark sat on the couch and immediately took off his brace. I lost my mind. I said all the things that you’d expect after a day of next-level stress. I told him he was being selfish, and stubborn, and risking paralysis. As unproductive as it can be to argue with Mark, thankfully something I said took root and he put the brace back on.
I texted my nurse friend Carolyn this morning, and she came over to give Mark a good nurse talking-to. He sat silently and listened to her explanations of how to take care of his abrasions, his burr hole wound, his fractured neck. Keep the brace on, 24/7, and possibly for many weeks, she urged. Who knows where he sorted it all into his brain. It at least helped me to know what to do. Hopefully it helped Mark know what to do. And not do.
I’ve followed up today with the PCP (already had a telehealth visit) and neurosurgery (crickets). I put a call into the patient advocate line at the hospital to discuss what happened in the ER yesterday. Mark is on the couch, neck brace on, and I am now watching him like a hawk. Like a better hawk. Is that an eagle? He CANNOT fall again.
My back is killing me. My fall down the steps, trying to get Mark off the bathroom floor, sitting in an ER folding chair for 15 hours, the stress of it all.
Where is the balance for this? Friends, I will find it. I will. For now, I am fried.