A Day and A Night in the ER

 Welp, it's happened again. After waiting longer than I should have, I called the advice nurse about my increasingly uncomfortable condition. She said I needed to be "seen" within the next four hours; I should go to Urgent Care or the ER. Mkay? The nearest Urgent Care run by my HMO was 47 miles away. There is a Primary Care run by another outfit in my little town, and as it happens they take my insurance, so I've been able to go there for immediate care, but not this time. They wouldn't be able to see me for at least 24 hours. Low on staff, high on patients. Mkay? 

So the choice was the Urgent Care way out there. They could see me in a couple of hours.

I got there and was informed they were running behind, but they'd get to me as quickly as they could. It was only about an hour later (c. Noon) when I was called in to the examining room. BP and temp were OK; I was alert, coherent, ambulatory -- with some difficulty. Described symptoms and problems.

"Dude, you need to go to the ER, stat."

Oh fuck. I hate the ER. Nothing but turmoil, stress and strain, lack of care, waiting and waiting and waiting while the place fills up with more and more suffering, disease, madness and pain. What is the point. 

The nearest ER as it happened was another 15 miles or so away, and the Urgent Care said they would call over and let them know I was coming, and they said it would probably be less of a wait there because they would probably have fewer patients.

Mkay. We get to this ER, and truth was there were hardly any patients in the waiting room. Five, maybe six. Most had already been triaged. Some had been seen and were waiting for test results.

It was calm. Very little obvious suffering. Quite a few people came in while I was waiting for triage (c. 30 min). Nearly all were members of one family there to see their relative who was being treated inside. They were allowed in two by two. 

Triage was straightforward, and I was told to wait in the lobby. They'd see me inside as soon as they could. 

More patients came in while I waited. More visitors came to see the one special patient as well as other patients in treatment. Some of those who arrived were in really bad shape. Extreme pain, unable to walk, one couldn't even sit and her wheelchair ride was torture for her. Some appeared to be having strokes or heart attacks. 

And believe it or not, all of those I saw in serious distress were treated promptly and compassionately by the very young staff, none were left to linger unattended. Some were treated directly in the lobby, others were wheeled or ushered into the ER treatment areas, but none were neglected.

This was astonishing. I have never been in an ER where staff did not neglect the patients, ignored their suffering, even disparaged those who sought treatment. I have never been in an ER where prompt treatment of severe conditions was the rule. I have been in ERs where staff had no interest in or consideration of patients waiting, and where patients died while waiting without any care at all. The cynicism and contempt for patients in some ERs I've been in has been off the charts, and it's happened so often, in so many different ERs in California and New Mexico, I took it for granted as just the culture of these places. It's outrageous, but there you are.

This was an entirely different situation altogether. I didn't need immediate treatment, though I would have appreciated the pain medication I eventually received had it been administered while I waited. I got an xray within an hour of arrival, but had to wait to be "seen." My distress was minimal compared to some of the patients who sought care, and everyone who needed immediate care received it compassionately. Those of us who had to wait mostly did so with equanimity; so many others were in much worse shape than we were.

After about 5 hours waiting in the lobby, I was called in to the treatment area and assigned a room where I was introduced to the nurse and CNP who would be treating me. Both were kind and positive. As it turned out, the nursing staff would have a shift change in an hour, but the CNP stayed with me throughout. 

Treatment would take just about 8 hours.  During that time, I received a CT scan, pain medication, Ringer's lactate, anti-nausea and anti-inflammatory medication, and two different treatments for the condition I was there for. Neither was fully effective while I was there, but I was discharged with a prescription for another medication to take if the ER treatments didn't work within the next 6 hours or so.

When I read the after visit summary, I noticed that the CNP had missed a finding on the CT scan -- I had a hernia -- which which was probably a contributory or precipitating cause of the problems that sent me to the ER. Oh. I suspected the hernia, and I pointed out the odd swelling and pain in my groin, but it was not recognized by me or anyone else for what it was at the time. The CNP said it was "gas". And I saw on the CT scan report that there was considerable build up of "gas." But missing a hernia with obvious symptoms (I realized later) was odd. 

The treatments that were administered in the ER did work effectively the next day at home, so that part of the problem was taken care of, thankfully. The hernia has not been addressed yet, though the swelling and pain are not as severe.

It seems to me, I've had this condition before -- a hernia, that is -- and after several weeks, it self-repaired. We'll see. It's not fun, but it's bearable. Primarily it limits my movement. 

What I can say about the overall experience in the ER this time is that it was worlds better than any ER I've been in (for myself or on behalf of others). Even though part of my problem was missed by the staff, or perhaps not missed but dismissed as not that important, I was treated with consideration and respect, was given needed medications and treatment, was tested and imaged to a fare-thee-well, and discharged with explicit instructions and medication prescriptions with orders to return promptly to the ER if none of it worked.

Well, it did work, and I'm grateful.

Now to deal with the hernia... 🤪

The Need to Understand...

I watched a biggish part of the funeral ceremonies and cremation of Thich Nhat Hanh in Hue, Vietnam, (what meaning that has for someone like me) over the Plum Village livestream, and yes, it was moving. The turnout to honor him was amazing, in the tens of thousands, and the ceremonies themselves harked back to a prior age in Vietnam, before the wars that destroyed so much of the country and its people. What once there was will never be again, but still...

I found that so many people were seeking to "understand" the man and his writing. Understand as in "take possession of..." Having ownership over. Now I understand that desire; I shared it myself for many years, and then like with so many other things, I let go of it. No, I don't need to understand, and I don't need to own or possess the thinking and/or spirit of fine people like Thich Nhat Hanh. Others do.

When I was chatting with my Dharma teacher during sesshin, I found that I couldn't say his name quite right. It kept coming out "Trick Not Han..." I couldn't explain it, and truthfully, I was embarrassed, as my Dharma teacher was befriended by him at one of his retreats at Plum Village, and she has always considered him her Root Teacher. So here I come, can't even say his name right, oh well.

I go back before his advent in the US, not long before, but earlier in the course of Zen in America. And we talked about that a bit. About Suzuki Roshi. Richard Baker. SFZC before Tassajara and before Green Gulch. Before even the City Temple. 

Before all the money and fame and... controversy. Well no. There was controversy at Sokoji from the moment Suzuki Roshi started attracting young American white folks (mostly male initially) to Zen study and practice. Sokoji was primarily a Japanese-American (Issei and Nissei) Buddhist temple -- open to all of course, but still -- serving a reconstituted post-war Japanese-American community in San Francisco when Suzuki Roshi (not yet a roshi at that point) arrived from Japan in 1958 or so, at the height of the beatnik era, to lead the small but devoted congregation.

The attraction of Zen and Buddhism to the Beats was already well established thanks to the poetry of Allen Ginsberg and Gary Snyder and the novels of William Burroughs and Jack Kerouac among others.

I think Snyder was in Japan in the late fifties studying at one of the Rinzai Zen temples where he had taken vows as a monk. I think he learned and spoke Japanese before he left for Japan. Kerouac writes poignantly about Snyder's departure in The Dharma Bums. Snyder's influence, in other words, was indirect at the time Suzuki Roshi established himself in San Francisco. But he'd already spurred many others to study and practice. 

Kerouac certainly influenced me in the mid-sixties when I read three of his novels: The Dharma Bums, Desolation Angels, and Big Sur. Snyder's influence at that time was non-existent on me; I tried to get into Ginsberg, but it was a no-go. His poetry from Howl and beyond was raved over, but to me, there was nothing there. Perhaps that was the point.

Kerouac on the other hand was deep and rich and he wrote like I thought. His travels took him to many places I had been and knew well. I would only much later read On the Road, and I would discover how closely our travels paralleled one another all over the country. It's kind of eerie. And today we live in a little rural area of New Mexico that I'm all but certain he and Neal Cassidy not only visited but stayed in for a while during one of their cross-country treks.

I don't call Kerouac a Root Teacher; he's more like a door-opener which can be just as powerful. Without that open door, I'm not at all sure I would have discovered what's on the other side.

Suzuki Roshi, though, is still a very strong Root Teaching influence on me. Richard Baker -- his right hand in San Francisco -- had a different kind of influence, actually more like Kerouac's as a door opener. Baker Roshi, as he's called now, acted as a guide and encourager. Give it a try. Keep going. 

I keep thinking that I met them both, sometime after 1965, but realistically, I couldn't have. Somehow, though, I feel there must have been some kind of face-to-face contact or contact with their image. 

And thinking back, it was probably at the Midnight Movies in the later '60s where I'll bet I saw a number of Suzuki Roshi's lectures on film. Baker-Roshi was there, so he was probably in the films, too. And one of the strongest recollections I have is of the appearance of the interior of the Sokoji Temple while zazen was taking place. I have since seen it on film (a YouTube of a KQED documentary of San Francisco Zen Center made, I believe, in 1968) and it is exactly as I remember it. Ergo, I likely saw that film, and it was most probably at the Midnight Movies rather than on television as I wasn't living in the Bay Area and didn't have access to KQED programming.

But I can't be sure.

Which is all right. None of it really matters all that much, does it? If my memory is faulty, so be it. 😉

We don't really have to understand so much, do we? We don't have to have possession. Ownership. 

Let it be just out of reach. 

Feeling the Cold

 Yes.

We've been having overnight temperatures well below zero for days now. This is not unheard of, but it is unusual around here. And we're feeling it. I am certainly, but Ms. Che may be feeling it even more than I am. 

Our house is not well insulated, so the cold penetrates. The floors tend to be very cold, and some rooms get frighteningly cold, so we don't heat them. I was thinking about some neighbors who only heat one room in their house during the winter, and we're not actually that different. 

This winter, because of the extended cold spell, we've got some frozen pipes. The hot water line to the bathroom froze the first overnight below zero. Then the line to the toilet froze the next overnight, so there's no hot water and no water to the toilet still. The toilet would be OK -- we could fill the tank with a bucket -- except for the fact that the second night of below zero temps showed that the sewer line is backed up, perhaps from root invasion, but I thought at first that it was frozen too. Now, it shouldn't do that, but given how cold it's been and how long the super-cold has lasted, maybe it did? We haven't seen above freezing temperatures since last week. So...?

That means we have to find somewhere else to pee and poop until the plumbers can come, and that's not going to happen before Monday. So the most convenient place for us at the moment is the truck stop up at the interstate, maybe three-four miles or so. Not at neighbors'? Uh, no. They're dealing with their own issues.

This is the longest extended period of cold we've experienced since we've lived here. I know other parts of the country have had it worse, and I'm not complaining. But it is clarifying.

Given all the other issues we've been facing of late, the fact of the cold just goes to show how fragile the conveniences we take for granted -- like water and flushing toilets and well, cat food (which has become very hard to find around here) -- really are. 

If something happens, like an extended cold spell, or the electricity goes out for a long time (the longest we've experienced is 8 hours during the summer), or the gas stops flowing, or human food shortages show up more than they already have, what actually are we going to do?

We've taken modest preparatory steps, but it's hard to anticipate just what might or might not transpire. 

Over the last couple of years of the Covid pandemic, we've been getting used to not doing or having a lot of things that we once did. The whole population has been conditioned, if you will, to doing without and adapting behaviors to whatever new reality arises. We're so used to it, we hardly notice anymore.

Now we are seeing some of "what else" lies in store.

Be well. Stay sane!