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Point of View

Change, change, change
By Willem Lange

I can summon up that face yet, though I saw it 54 years ago for only a few seconds: A middle-aged nurse with a white, starched uniform; a green snood covering her hair; rimless bifocals; her mouth pursed and eyes narrowed in disapproval as she shook her head and muttered something about the worthlessness of "young people these days."

She was cleaning up a mess that I had made in my hospital bed. I felt awful about it, but I was simply unable to heed her order to "Clean this up yourself!"

Half a century's progress in the sciences and arts that contribute to a successful hospital stay had made an amazing difference.
Illustration by Suzanne DeJohn

Unmentionable: So I felt awful. But what'd they expect? They'd put me to sleep for an operation (tonsils and adenoids) with an ether enema, which had produced the two expected effects. I suppose if I'd been a toddler, she'd have lifted one ankle up in the air and pitched right in. But I was 14, and . . . well, you really had to live during the first half of the 20th century to appreciate how far we've come from considering our bodies and their functions to be unmentionable.

By contrast, my experience with surgery earlier this year was like a trip through the Tunnel of Love. Half a century's progress in all the sciences and arts that contribute to a successful hospital stay had made an amazing difference. Everybody I had anything to do with was terrific: committed to his or her job, happy to be doing it, and apparently devoted to making me feel better about what was happening right then and to knowing better how to handle what would come next.

Clearly, there's been a successful wedding of technology and people considerations. There's no way an institution the size of Dartmouth- Hitchcock could keep things straight without major-league computers and wizards to run them. By the same token, anyone who deals with the customers—not just nurses and doctors, but housekeepers, transporters, and maintenance workers, too—all of them act as if they're delighted to have had you drop in to get your problems mitigated, if not solved. I almost wanted to stay an extra day.

Atmosphere: The atmosphere has brightened in other ways, too. Used to be, they shut you off solid food almost a day before you had to show up. Something to do with the dangers of general anesthesia, I guess. Now you can eat till midnight the night before and drink juice or coffee before you present yourself at dawn. And every desk I came to, they were expecting me.

Sitting in the little curtain-shrouded room where I doffed my duds and switched into a horrid hospital gown (that's one of the things that hasn't changed over the years), was like old home week. One of my wife's former kitchen-design clients checked me in; the surgeon, whom I'd known years ago as a Dartmouth undergrad, showed up to ask if I had any questions; the anesthesiologist was a guy who sits a couple of pews behind us in church; and a semiretired orthopaedic surgeon who worked on me 30 years ago stopped in to chat.

After we'd agreed on the method of anesthesia, the anesthesiologist placed something damp and warm—it felt like a baby wipe that had been in the microwave for maybe 10 seconds—near the base of my spine. That's the last thing I remember until a few hours later, when a person dressed in blue wheeled my bed through many automatic doors to Room 326.

The next four days, like any hospital recuperation, were a running gunfight between the desire to lie still in order to avoid pain and the need to get moving in order to restore mobility. When I had my knees replaced seven years ago it was "up and at 'em"—take up thy crutches and walk! This time, there were constant cautions about the danger of overloading my beautiful new ball-and-socket too early or of bending it inappropriately. You dislocate that thing or tear a muscle, everyone warned, and you'll have to baby it forever.

Advice and rules: It's hard to internalize all that advice right away, so naturally I forgot—once. The evening after the operation, I rose from the lounge chair in my room to get into bed and dropped something on the floor. I'd been given an aluminum picker-upper with a claw on the end. I tried to use that but dropped it, too. So while the bystanders screamed, "Stop!" I ignored four rules: (1) Don't bend more than 70 degrees from the plane of your legs; (2) Don't reach below your knee; (3) Don't reach down and across your body so that you stretch the new joint; (4) When lifting, keep your toes and your belly button pointed in the same direction. Without going into further detail, I can assure you I'll never forget those rules again!

Other than that incident and its aftermath, it was a lovely four days. The nurses were great. One heard me grousing that my TV remote changed the channels in only one direction. A few minutes later, with a conspiratorial wink, she slipped me a different one that went both ways and, I discovered, even controlled my roommate's TV! Martha Ussler, a dynamic physical therapist whom everybody calls "Martha the Unforgettable," hovered around me like a horsefly till I swore I'd faithfully execute every exercise she prescribed, and no more. The night nurses pretended to believe me when I said I could shower at 5:00 a.m. with no problem, then hung around to dry off and put back to bed the inevitable quivering wreck that resulted.

The whole experience was fascinating. How I wish that that longago nurse in Albany Children's Hospital could have seen it. She'd be amazed that the "young people" had made such progress in medical technology . . . and in medical care.

"Point of View" provides a personal perspective on some issue in medicine. Lange is a carpenter in Etna, N.H.; the author of six books about rural life; a commentator on Vermont Public Radio; and a columnist for the Valley News, in which this essay first ran.

If you would like to offer any feedback about this article, we would welcome getting your comments at DartMed@Dartmouth.edu.

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