4
April 2015
It takes me centuries to get dressed. I pause for eons in front of the mirror as I try to remember why I’m bothering to brush my hair. I blink, and when I open my eyes time has passed, enough for new universes to be born, enough for the sun to have burned out, imploded, the world gone. Somehow I am clothed, am downstairs, am ready to go. I blink and I’m in a cab, lying down in the backseat, jostled, gauging the route by how many turns I feel the car making. Blink again and I am sitting up, credit card in hand, confounded by the payment machine. Blink again and I am outside the hospital, upright, wincing in the sun. Blink again and I am upstairs, in the neuro-ophthalmology department, sitting in a chair, confronted by a form. So many boxes, so many lines, so many questions. Name, birthday, address, insurance. I write what I can remember and find a corner of the waiting area. I lie down.
Blink and I am called by a nurse. Weighed, measured. Asked why I’m there. Blood pressure high. I apologize, “My arm gets claustrophobic,” I say to the nurse. She regards me with an eyebrow. Blink and I am back in the waiting area, on the floor, the nubby carpet thin and rough. There are people sitting all around me, in chairs, like they’re supposed to, but I don’t care. My eyes are closed. I can’t see them looking at me, wondering why on earth a person would be so rude as to lie on the floor.
Blink and I am summoned by a doctor, who seems bemused as I rise out of the depths, emerging from the waiting room floor. I’m escorted to a room with an eye doctor chair, and I ask if it can be adjusted to be flat, just for a little while, but maybe he doesn’t hear me. I curl up on the base of the chair, lying sideways, an awkward fetal position.
Blink and the real doctor comes in. He is a colleague of my husband’s; I have encountered him for years at social events, informal pool parties and fancy dinners where I play the part of doctor-wife and make small talk while supervising my children or pretending to be a person who eats fancy dinners all the time. I have talked to him about books, about his idea for a book he wants to write. I have met his family. He knows me as a person who can sit up and have conversations. And so he is concerned to see me struggling to not slide off the chair, to watch me struggle to make sense of his questions, to witness me in pain attempting to sit up for his exam. He doesn’t know about the divorce yet, none of Gil’s colleagues do. He asks after Gil, who is away at a conference. I tell him Gil is fine, that he’s away at a conference.
He asks what’s going on, and I tell him what I know so far: that I had a terrible flu, and then a headache that wouldn’t go away; that I was given antibiotics for a suspected sinus infection, but the headache persisted. That it improves a little when I lie down, but being upright for more than five minutes brings the headache to full force, and having to be upright for more than an hour, even if I’m just sitting, not moving, basically wrecks me. Can’t think clearly. So much pain.
He tells me what he suspects, based on the MRI, based on his exam. This is spontaneous intracranial hypotension, otherwise known as a spontaneous CSF leak, possibly located in my ethmoid sinus, at least according to what the radiologist saw on my MRI. Had I coughed when I had the flu? Right. Well, that could have caused a tear, or some sort of rupture. And this spot in my ethmoid sinus could be allowing cerebrospinal fluid to escape. “So what you’re saying is, this is all in my head,” I joke, but he answers me seriously, telling me that it’s possible the suspicious area seen on the MRI could just be a totally normal thing for me, the way my anatomy has always been, and the leak could be someplace else, not in my head at all. But that’s why he wants me to consult with an ENT, who is the only doctor at the hospital who deals with CSF leaks. He will evaluate me and look at my scans and maybe order more, and then we’ll go from there. If it’s really that area in the ethmoid sinus that’s causing the leak, he says the ENT can go in through my nose and get to my brain and place some sort of mesh over the leaky spot to patch things up.
“The other thing we can do,” he tells me, “is kind of a ‘voodoo’ procedure. It’s called a blood patch. No one really knows how it works, but it sometimes works for these things. It’s like having an epidural—you had an epidural with your kids, right? It’s like that, but you get injected with your own blood.”
This sounds horrible, so I just nod and close my eyes and sink down in the chair. I blink and there are residents in the room now, doctors in training who don’t know me but know my husband. The doctor is concerned. He tells me he is considering admitting me to the hospital for the weekend, he’s never seen me like this. He asks me, “Do you want to be admitted? It’s your call.” I don’t know how to answer this. It seems like such an imposition. And what about the kids? “If I
