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A Stone of Contention

Bascom, Tim

AJN The American Journal of Nursing: February 2010 - Volume 110 - Issue 2 - p 72
doi: 10.1097/01.NAJ.0000368067.70050.e9
Reflections

Competence and bedside manner don't always go hand in hand.

Competence and bedside manner don't always go hand in hand.

Tim Bascom is a visiting assistant professor in the English department at Drake University, Des Moines, IA.

Contact author: timothy.bascom@drake.edu. Reflections is coordinated by Madeleine Mysko, MA, RN: mmysko@comcast.net. Illustration by Hana Císařová.

Figure. I

Figure. I

At the hospital, when the emergency medical technician (EMT) eases me into a lying position on the gurney, I curl up, clenching like a possum around the spiked ball of pain in my right flank.

"You need to breathe," says the EMT.

Cathy says, "He had kidney stones once. Could that be the problem?"

Breathe in through the nose, I think. Now out through the mouth. Or is it the other way? My hazy memories of Lamaze are no help.

The EMT looms back into view. "We called urology. They said Dr. Mercer is available."

Cathy and I stare at each other in distress. The EMT adds, "Not your top choice, eh? I tell you what, I'll check with the office once more."

I am already panicking. After going to Dr. Mercer for a vasectomy, I found myself walking bowlegged. I had developed an infected prostate accompanied by a burning bladder and aching testicles. After two months of antibiotics, I was still subject to painful relapses, yet Dr. Mercer was as comforting as a rodeo clown.

"I can barely walk," I explained to him.

"Just think, no more babies," he shot back.

"But I mean I hurt down there all the time."

"Heck of a thing, eh. Can't live with 'em, can't live without 'em."

Suing was not my style. However, I had written him a good-riddance letter, making it clear that I not only found his remarks inappropriate, I also suspected him of incompetence.

The EMT leans over me, shaking his head. "I'm afraid you're out of luck, buddy. It's either Mercer or another hospital."

"Look," he adds, "for what it's worth, I've worked with the guy. I know how difficult he is. But if he has to operate, he's good."

Cathy looks at me with worried eyes.

"Alright," I find myself whispering.

When the EMT comes back, he is chuckling: "You should have heard Mercer. He kept asking 'Are you sure we're talking about the same guy?'"

For the next hour I lie on a frigid X-ray table, being turned onto my cramped sides. The pain eases, and I wonder if a kidney stone has worked itself loose or if the Demerol has finally kicked in. Then Dr. Mercer strolls in, working a wad of gum and lifting dark aviator glasses to his forehead.

"Howdy pardner. How you doin"?"

"I've had better days," I say.

He nods. "I can see why. You've got a stone in there the size of a watermelon seed."

"Is it moving? Because the pain's improved."

He shakes his head. "You're leaking."

"Leaking?"

"It's like anything with pressure. Something has to give. In your case, the ureter popped. No pressure, no pain. You're fine for now, but after 24 hours, you're gonna be miserable. The bowels will shut down. A hundred years ago, I don't know. . . ."

I try to assimilate this not-so-subtle hint. "So what do you recommend?"

"Well, if I was your brother, I'd say let's scope it and take that stone out."

I study his face closely. "And if you were my brother," I reply, "I guess I'd tell you to go ahead."

Did I just say that? What if he screws up? What if, subconsciously, he wants to screw up?

"I know we've had our differences," I add, "but I hope we can put that behind us."

"No problem, pardner." He stops at the door, lowering his sunglasses onto the bridge of his nose. "But I want you to know I'm good at this scoping stuff. Damn good."

As they strap my legs apart, I am ready to go under. The anesthesiologist says he is starting the anesthesia. I wonder why I am still alert enough to respond.

Suddenly, though, I'm staring up at a bowl of bright white light, and my throat feels like someone put a blow-dryer down it. I cough.

"Breathe through nose," says a disembodied woman.

"Have they started?" I croak.

"All over," says the woman. "So happy for you. Stone gone."

This voice is oddly familiar. The thin brows, too, when she leans in closer, pushing back black bangs.

"God is so good, don't you think?" she says. She begins to sing softly: "God is so good. God is so good."

Then it comes to me. This is the same recovery nurse who brought our son out of anesthesia when he had ear tube surgery. This is the woman who jostled him in her arms like she was mixing pancake batter in a Tupperware container, who insisted "baby need stimulus," dancing away from me as Luke reached and screamed. I had to pry him out of her hands; he was so traumatized that, months later, he howled when he heard someone with a similar accent.

Helplessness is a strange thing, I think, as this nurse putters around me, checking my IV and humming. Would I have ever turned to these two people if not forced?

She begins to sing again—"God is so good." I know that song from junior high. It is the sort of sentimental campfire tune that makes me roll my eyes, but now it seems strangely right. I feel so good lying here—set free from the tearing pain and the old resentments—that I could almost sing along. If it weren't for my dried-out throat, I would.

© 2010 Lippincott Williams & Wilkins, Inc.