The Event, Part 1

Thursday 11/7/2019: Emergency Room & ICU

So November 7th, 2019, was the day I could have died three different ways before breakfast.

It started out like an ordinary Thursday, with the feeding the cats and the dog and the drinking the coffee and the checking the emails and the working on the book and all that stuff. But then around 8:45am, while I was using the, ah, facilities*, I had a sudden, severe attack of vertigo. Not the head rush kind of vertigo where you’re a little dizzy for a few seconds after standing up quickly, but a kind of room-darkening, can’t straighten up, somebody’s-squeezing-you-in-a-giant-fist vertigo that I’ve never experienced before and hope to never experience again. This lasted for what seemed like a few minutes, though it may have been a few seconds. After it ended I was left with a cold sweat and a strange new sort of ache across the back of my head and into my shoulders. Denial not being just a river in Egypt, the first thing I thought was:

Me: “Maybe I’ll skip the Bowflex today.”

I progressed from there to thinking that maybe I should make an appointment with my doctor to thinking maybe I should call 911, just in case something really bad was happening**. I went into the bedroom to let the dog out into the backyard and then got dressed, because of course I couldn’t call 911 while I was in my robe and pajamas. (Pro tip: Don’t do this. This is silly. Whatever you’re wearing, the paramedics will have seen it before, and when you get to the hospital they’re just going to undress you anyway.) Then I went to get the phone from the kitchen, which, as has since been pointed out to me several times, was not the nearest phone to where I was. But it is the phone I use most often. So that’s the one I went to. (What can I say? I obviously wasn’t thinking very clearly at this point.)

On the way to the kitchen I suddenly got a severe headache in the top of my head, as if someone had dropped an anvil on me. It’s funny when it happens to Wile E. Coyote, less so when it happens to you. I still managed to make it to the phone, but I couldn’t seem to get it to dial 911. So obviously the phone was defective. I then proceeded to the living room to get a different phone which would, presumably, work better.

Not long after that, I woke up on the living room floor with the phone next to me, in the approximately 18 inch gap between the sofa and the extremely hard, heavy, and pointy-cornered coffee table.

Upon waking up I discovered that I had vomited on the sofa and the nice clean clothes I had put on for 911 (told you getting dressed was silly). It was now 9:13am according to the clock on the mantel. So the three ways I could have already been dead at this point were:

• I could have just not woken up.
• I could have cracked my skull on the coffee table.
• I could have aspirated the vomit after throwing up while unconscious.

Miraculously, none of that had happened. I managed to pick up the phone, which still didn’t seem to me to be working properly, even though it was. I didn’t realize I had successfully dialed 911 until I heard a faint tinny voice frantically saying “Hello? Hello?” Remembering that I needed to hold the phone to my ear and mouth instead of carrying it around like a banana, I managed to give 911 my address and followed their instructions to unlock the front door, get my cell phone, and put away the pets—well, one pet, anyway; I found Chaplin and got him into the cat room. Lulu was still out back, and I couldn’t find Charlee. That was all right, though, as there was zero chance Charlee would come out from under the sofa or wherever she was hiding while strange people were in the house. Such as paramedics.

Said paramedics arrived before I was even finished talking to the 911 dispatcher. I went out to meet them but they steered me back into the house for a brief chat and evaluation. I described what had happened and they asked a few questions. I only really recall one of them.

Paramedic: “Did you throw up?”
Me: “I think so, but I don’t remember.”
Paramedic: “Well, it smells like you did.”

Since I had in fact thrown up on myself, that smell followed me around for a while.

At this point the paramedics walked me down to the ambulance and off we went. Within a few minutes my phone rang; a neighbor had seen the ambulance and alerted our friends around the corner and one of them was calling to check on me. I didn’t manage to pick up the call, but I did manage to call them back from the ambulance. (Technology!) We had a brief conversation that went something like this:

Friend #1: “Are you okay?”
Me: “I’m with the paramedics.”
Friend #1: “Are. You. Okay.”
Me: “They said my vitals are good.”
Friend #1: “All right. Do you need me to call anyone?”
Me: “Can you call Lulu into the house? She’s out in the yard.”
Friend #1: “All right. Can I call anyone else?”
Me: “Can you call Lulu into the house?”
Friend #1 (pause): “Okay.”

Needless to say my friend also called my wife. Good judgment there.

After this my recollections of Thursday get kind of murky. I don’t think I opened my eyes for more than a minute for the entire rest of the day, and I only remember bits and pieces of events and conversations, like this:

Me (to paramedic in ambulance): “I hate to make a fuss.”

If the paramedic answered me, I don’t remember it. I did wake up briefly when we got to the hospital and I was unloaded from the ambulance; I remember seeing the sign for Emergency. Some time later I realized I was actually in the emergency room and people were talking to me, or trying to. I managed to answer one question from a doctor:

Doctor: “Have you ever had anything like this before?”
Me: “I had an anxiety attack once.”
Doctor: “This isn’t that.”

I remember hearing someone say that my wife had arrived, and I remember hearing the doctor tell her that I was very sick and not stable to transport. I have been informed that I told the ER doctor that this wasn’t the worst headache I’d ever had. (I am prepared to revise that statement.) I have also been informed that I apparently really, really had to pee. I vaguely recall being given one of those urinals you can use in bed, but I didn’t have much luck with it and eventually they had to catheterize me, and according to my wife they had to do it in a hurry because I kept trying to get out of bed to go find the bathroom, and obviously nobody was going to let that happen. (They would have catheterized me eventually anyway, given what was going on, but the rushed nature of the insertion came back to bite me, as you will see later.)

At some point someone said or I had heard enough discussion to figure out that I had a ruptured cerebral aneurysm. Much later, I discovered, from reading the ER notes in my hospital file—which I had to pick up so it could be entered into the system at my primary care clinic—that I had been graded a three on a subarachnoid hemorrhage evaluation scale. The notes don’t specify which scale was used but I suspect it was the Hunt and Hess grading system, which I found online during one of my many searches on all the new terminology I learned over the course of last November. This scale includes both evaluation criteria and a rough estimate of the patient’s chances of survival:

Spoiler alert: I survived. Most of that day is pretty much a big grey smear across my memory, though; I don’t remember being catheterized, or all the blood work they drew, or being taken for CAT scans, or being admitted to the hospital and brought to ICU. But that’s probably for the best.

* Toilets: Killing people basically since they were invented.
** It was.