Part II – Re-expansion of the lung may take several days with the chest tube left in place.
The second time my lung collapsed was one of the worst experiences of my life. I was sitting in on a round-table philosophy seminar, a sophomore in college, discussing The Consolation of Philosophy. Boethius, a Roman philosopher and politiciain, was in prison for crimes he did not commit. He was sentenced to die, and, perhaps understandibly, feeling very sorry for himself. His old master, Lady Philosophy, visits him and reproaches him for whining. “Why are you complaining that you you are down? Fortune goes up and down, but at least when she’s down she’s being honest?”He learns, through dialogue and poetry, to be grateful for trials, to trust in God for his happiness, and not to fear death.
In the middle of this class discussion, I felt that now-familiar phantom-cramping sensation just between my shoulder blade. Without wanting to make a scene, I calmly got up, put my shoes on, and walked to the student health center. Unfortunately, my plan backfired, for once word got back to my classmates that my lung had collapsed, without knowing the context, they were quite concerned. My friend Judah cried.
“Um, I’m having trouble breathing,” I said, searching for a way to get the attention of the front desk. (Normally I’m just there to pick up cough medicine or maybe a sugar-free lollypop.)
“Oh! Oh, OK. Um, come here, take a seat. Doctor!? Mr. Buhler here is having trouble breathing…”
I sat in the room with my shirt off, trying to explain to them that this was old-hat for me.
“No, it’s not life-threatening. No, I feel fine. Yes, I’d like to call my dad.”
“Hey dad, how’s it going? Oh, cool, I’m glad the website’s going well. Oh really? No I didn’t. Hey, guess what? My lung collapsed again.”
I needed a taxi to the emergency room. It was really a process of elimination. “Can I drive myself? Well, that might be dangerous. Can the student health workers drive me? No, they’re on the clock. Could my dad come pick me up? No, he is downtown on an appointment. Well, we could call an ambulance. OK, but can I bring my book?”
We ended up choosing the ambulance. Unfortunately no one communicated to them that the case was not urgent. They stormed in like the SWAT team on a lone terrorist, or like the CIA on an alien life form that was having trouble breathing. They hooked me up to a hundred machines, put me on a geurney, and rolled me out the door, through campus, to the awaiting van, which sat flashing next to a real live red fire truck. I waved like a princess on a New Year’s Day float to worried friends and faceless Looky-Lous. I called out, “Much ado about nothing, I assure you! Save me a seat at dinner!”
X-Rays confirmed that my left lung was indeed down to about 70%. “I want to put in a chest tube.” I don’t know how emergency room doctors make this kind of decision. Maybe they have an AMA approved coin they go into doctor-only conference rooms and flip. “Hippocrates or tails, call it in the air!”To me the X-rays looked the same as the last one. It was a small pneumothorax, which, according to Medicine.net, “… may get better on their own.” But the coin landed Hippocrates’-head down, and so he wanted to put in a chest tube.
The chest tube, designed by Dr. Henry J. Heimlich, of Maneuver fame, is a clever device: it lets air out, but not in. He first made it out of a ballpoint pen shaft and the finger from a rubber glove with the tip cut off. It was designed for soldiers whose lungs had suddenly (if not sponteneously) collapsed, because of a gunshot wound, an explosion, etc. There used to be a big one (half an inch) which goes in through your side, under your armpit, but now they have a small one (eight of an inch). I got the small one, straight through the front of the chest, about three inches above the nipple, at the point where you rest your hand during the National Anthem. It goes in through the ribs, into the chest cavity. “Re-expansion of the lung may take several days with the chest tube left in place.”
“Are you going to put him under?” my dad asked. He had finished his appointment and met me at the hospital.
“No, we’ll give him a general anesthetic and do the operation. It’s considered a minor surgery.”
“OK, Keith, I’ll be right here with you.”
We waited while the doctor took care of his other duties, and the nurse prepared me. I was feeling sorry for myself because my frail body had interrupted a great class discussion that was continuing on without me back on campus. I picked up my Consolation of Philosophy and re-read Lady Philosophy’s chastisement of Boethius, and, like a lover who listens to love songs on the radio and, for the first time, realizes they were written for him, I read the words spoken by the lovely lady to Boethius and realized they were written for me. I tried to be thankful for the trial, and trust in God for my happiness. The doctor came in with a large needle, and I set the book down.
“First we’ll hook you up to this IV and give you some Demoral. That will numb the pain and make your whole body relax.” Now, understand: Demoral is like Diet Heroine. I’m reminded of those cheesy cassette tapes my sisters used to listen to in the 80’s that were called things like, Bach, for Kids!” Or the short, cheesy “classic” books they prune down to nothing and market as, “War and Peace, for Kids!” I can easily picture the florescent-colored Demoral labels at the local pharmacy cheerfully displaying: Heroine, for Kids! Great taste, less filling…! You get the picture.
“This will make you sleepy,” he said. More accurate would have been, “This will make you hover in a state of perpetual twilight, neither waking nor sleeping, neither living nor dying, neither thinking nor not-thinking, but hovering, in time and out of time, forever and ever. But it will only last a moment.”
If I had to do it over again, (which there is an 80% chance I will), Demorall will not be a part of it. But this time, they hooked me up, and I waited for the knife…