Friday, April 28, 2017

Behind The Wall: My Local BioContamination Ward

Physical Therapy is code for the bio-contamination/isolation unit at my local hospital. 

Though the sixteen to twenty physicians whom I know, personally, saw me there, and spoke to me as they attended patients, not one has ever admitted that this place, called, "the tank", exists, nor that this recollection is anything but a flight of fancy.

The unit called the tank is located underground, and is accessed from the hospital building via a network of tunnels. 

The tank is located behind this local business...


...and is accessed via this gate which leads to another set of gates. The tank is connected to the hospital by a large and complex network of tunnels. The hospital, which is not pictured here, sits to the right of this area. The tunnel network termimates in the clinic pictured below...

The complex of tunnels terminates in the hospital, on one end, and this clinic on another. They were designed to provide the physicians of this clinic access to the hospital when emergencies required them, and time would be of the essence.

Methicillen Resistant Staph Aureus, commonly called "MRSA", is the quiet epidemic visiting the elderly, the infirmed, people with compromised immune systems, and those whom are simply unlucky enough to be in contact with a person whom has it, and may not be aware...

The conclusions of the physicians whom oversaw the tank hold that MRSA is no longer only contracted in hospitals, but is out in the community.

The goal of this entry is not to provoke emotional responses, but to inform the public as to the very real, and very necessary means that the local, state, and federal authorities have undertaken to quarrentine patients and reduce the risk of epidemic.

The following narrative occured between June 30, and October 11, 2010.

I have lupus, and was born with asthma, and health has always been something that I know could just vanish completely for me, at any time. As a result, I have become what my local ER and in-patient docs and staff refer to as a "frequent flyer". 

Beginning in 2007, my health took a very potentially lethal series of increasingly frightening turns for the worse, including a number of medically-induced comas, countless code-blue ressuscitations, and long periods of recovery at home. On more than a half a dozen occasions, my family was contacted and told to come in and say their goodbyes...only to see me edge back into life...

By 2010, these in and out of hospital cycles were a regular part of my everyday life. So were the huge bills. So, when I was offered a job by my buddy Jim, whom needed somebody to paint a bunch of mobile homes he was refurbishing to create a mobile home park, I jumped at the chance. Needing the cash, and feeling lucky for his concessions to my preferences to work at night because of the scorching Alabama sun, and the lack of electricity in these mobile homes, I was completely thrilled about this project. I love both fine art painting, as well as interior/exterior house painting, and was thoroughly excited about this opportunity. 

So I accepted the offer and moved in. After a couple of days, I was just beginning to get into a smoothe routine, and just beginning to enjoy myself...
That was when the A/C unit inside the main house, and the dryer we used, just suddenly fried. We spent days in the heat, nights working in it, and due to the heat, the act of doing laundary had to be followed immediately with hanging them out to dry, otherwise the clothes soured rather quickly. We had to invent a clothesline system. Gradually it evolved from porch rails, to a crazy thrown together rig made from trees and ropes...looking back, it was completely ridiculous. 

Due to Lupus, my periods of time out in the direct sunlight had to be extremely limited, and sometimes I could tell when I had been in it a bit too long, as any number of nasal sores appeared, lesions on my skin, rashes, and extreme pain inside my entire body.

Jim was a former Marine, and really quite a lovable asshole, and if my pace slowed, or he would see me fumbling with my lesions, he would throw things, berate me, and remind me that I am being reimbursed more than market price, so that any such attempts which could increase my deterioration gave him the right to do what he needed to in order to protect his investment. 

On the tenth day of the laundary difficulties, I was going to the edge of the wood a quarter mile away on the west end of the property, which was yet another sustained exposure to sunlight to which I felt compelled to expose myself...
As I walked, I noticed the emergence of a rash on the back of my shoulders, and as the sun burnt down upon my back, and the music of Led Zeppelin's "Kashmir" played inside my head, I simply attributed it to Lupus, (SEL, in case you were informed, and wondering) and I resolved not to say a word to Jim. After all, he had just paid me a thousand dollars, and my rent was free, and I had the usage of a vehicle: too sweet of a deal to risk his sudden upbraiding should I forget and scratch it and he see it, and "for my own good", let me go.

That Thursday evening I was able to conceal it, and Friday, as well. But on Saturday, I began to notice that I was now wheezing, and my inhaler was not able to provide any relief. As Sunday evening approached, I decided that it might be best to go on to the emergency room, and get sterile medications (IV meds), and attempt to intervene prior-to what I was familiar with, which usually begin with pneumonia type emergencies, making me deathly ill, and the er docs speeches about, "What the hell made you think you should just wait?!?!"

The er wasn't very busy. As anyone familiar with er's could tell you: there are some nights when there is just nobody there to be examined. If the hours of 10-midnight aren't busy on a Sunday, then the after church crowd in Bible-belt Alabama must be healthy, and generally a slow shift endures till 7:00 am, when first shift takes over. If you're being seen in these conditions, your level of care seems to be friendlier, and much more expedient.

I hadn't been there long, when the doc pulled the curtain back, and asked, "How are you, Mr Drummond?" I recognised the excellent Dr Miliner, whom had been on the recieving end of more than one occasion of my extreme temper loss, and my loud disapproval. He had been so kind about it. As I explained my situation, he asked, "So...wanna tell me about this rash on your back?"
"It's lupus,"
"Sure about that?"
"Yeah..." I answered. 
"Well, as much as we want to get you on out of here, I gotta cover my bases. I will get you a drip of some antibiotics and solumedrol: but I am going to order labs, and so don't wander off before the results come back, would you?"
As this had been a thing I did from time to time, I agreed to stay put.

About an hour after the lab, the in-patient liason doctor, Dr Bruner, knocked on the door, and I was all, "C'mon! You've got to have the wrong room..."
"Drummond?" she asked, looking down at her clipboard?
"What's this about?" I asked, because her appearance in your er room, at least in those days, means that you are going to be admitted. 

I was not planning on this...
She explained, "Your initial labs indicated that this rash (gloved-hand rubbing the area to identify and distinguish it from lesions that were from lupus) may be MRSA. 

My jaw literally hit the floor. I had done this very same thing a hundred times before. Normally, the only time I am admitted is by ambulance in the early hours...and the thought of Jim, his constant insistances that I should hurry up because this or that contractor needs this painting to be done...and I requested that they run the test again. She agreed, and an hour later, she showed up with the admit paperwork.

On Monday morning, the IM contract doctor over my case came in, and told me that I shouldn't make any plans to leave, anytime soon...

Here is some advice, you can take or leave it, but when you are an in-patient, and the doc says you will go home the next day, if labs are not drawn in the middle of the night or very early the next morning, you are not going home. If they are showing up day and night, be prepared for a lengthy stay. 

And this is what was happening until Wednesday morning. On that day, the IM contract doc showed up, and said, "Your case is going to be considered a false-positive for MRSA, due to the fact you had four positive cultures, and five negative cultures, and those were all since Monday. The antigen, the organism that MRSA is, therefore, can not be in your body. As a precaution, we are running another series tonight, and if it, too, is negative, you can leave tomorrow!"

I was ecstatic. I had lied to Jim about the diagnosis, because straight-up, in whatever sort of "for my own good" fashion, he would've fired me over the phone, so I was patting myself on the back for having played that well. Also, I did have his truck.

The labs must've come back negative, because I was discharged, and I went home the very next afternoon. 

In one of those in-patient happy accidents, on day two I actually ran into my guitarist, who'd taken his mom to the er on the evening after I was admitted, and we just happened to step out (I snuk off the unit) simultaneously to smoke, he extended an invite for that weekend 4th of July cookout his dad always held. And I went, and had a great time.

Upon my return to Jim's on July 4th evening, he took very ill very quickly, and this resulted in my defying his orders and calling 9-11. As he arrived in Birmingham at the hospital, he suffered a stroke. He would survive, however, I never saw him again after that night.

For two weeks I managed to pay all the bills at Jim's, and fielded worried calls from his yankee family, even welcoming his son whom drove down from Michigan to visit his dad, and tried to continue where I had left off with the painting.

And though I drove Jim's son to the hospital in Birmingham to visit his dad, Jim requested I remain outside of the room. I took it to be family stuff, and was not at all offended. 

The next day Jim's son and his uncle had made family plans to be together all day, and he awoke early and left. I woke up at the same time, and at first, everything was ok.

By 10 am I was sneezing. By noon, I was coughing. But by 1:00 pm I was dying. I struggled to breathe, and was becoming so weak so quickly that by 1:30, I could no longer walk. I was afraid to call an ambulance for myself due to concern for Jim's two beautiful dogs, and fear that they would starve or die of thirst if I left.

By 3:00 pm it couldn't wait. I called a mutual friend, and asked him to keep an eye on the property until Jim's son returned. I then called 9-11. 

After many, many trips in the back of ambulances, one grows accustomed to the rythm of their operational procedures: they take your vital signs, while asking what meds you are on, they get i d, and generally explain their actions. And though ambulance crews are people, and people are diverse, different, and unique, what goes on in ambulances generally follows a similar pattern.  
But when something is severely wrong, they do not laugh, they do not smile, and they make no small talk. This was one of those rides.

I laid in the er room bed, struggling to breathe,  seeing faces of staff members whom I had known for years, and the concern on those faces conveyed the message in ways words cannot: I was dying. And they were going to do everything  that they could to help me,  but they could only do so much...

I was still not sure what was wrong, and was operating under the presumption that lupus had inflammed my lungs, and due to the sheer number of arterial, painful sticks deep into the underside of my wrist, which detect the amount of oxygen or acids in your blood, and Dr Habtemarkos's sad frown as she overruled my begging not to be induced into a coma, I did realize that this could be it for the old Kevster...

So, I requested a shot of Ativan, after having been overruled for the coma reflected upon the heart monitor as a pulse of nearly 170, Dr Habtemarkos smiled for the first time that day in my presence, and she said, "I think we can do better than that..."

The nurse brought a syringe that was dark blue, and had two little globes dangling off of the end of it opposite the needle. One was pink, and the other, blue. And she said, "Dr H has ordered this for you, it is Bupenorpherine."

It was soooo awesome. It made me wet my pants. As the surgical team administered Prophynol to aenethsitize me, I blew the plastic out of my mouth, and said to the anesthesiologist, "That shot made me wet my pants...!"
"Sometimes, that happens!" he replied. 

"Well, I think we should....

Black. Shapes. Silence. Relief. Terror.
Three and one half weeks....

"...clean it UP..."

I sat up to find Chris, or so he introduced himself....and he was a dick. He argued, refused to let me stand, all he did do right was another one of those awesome shots...otherwise he was truly not cool.

It is then that for the first time I heard the code word, "Physical Therapy." Chris told me that I was not nearly ready for discharge. And despite my demands to speak to my doctor, he refused, saying that she had written orders for me to go to physical therapy. 

Later, I discovered that she had actually discharged me to the tank. And that this was a well-worn path for unfortunates such as I.
Unaware at that time, however, I wanted to be allowed up to walk around. Chris kept cockblocking, and I was getting mad...

See, back then I smoked. I have since quit, but it was commonplace for me to, after being heplocked, (when your IV lines are blocked off and you're able to walk around without a IV stand) to sneak out and smoke. Normally after a coma, I am not restrained by some dude this way, and it made me very angry. I repeatedly tried to get up, and go outside. Each time the dude checked me, getting angrier, and angrier. At one point, Chris physically restrained me from doing so, and finally, in his exasperation, he picks up his walkie talkie and says, "I need to get Drummond over there, now!"
"Over where?" I demanded? 
"Told you, already. Physical Therapy!" he growled.

He wheeled me outside bruskly, and put me into the back of a very out-of-date old van type ambulance, and I was like, "But the physical therapy department is on the first floor of the hospital...what, are you....driving me to the front entrance?"
He replied, "The Physical Therapy department I am taking you to is not in this hospital..."
And he drove us out, into something that I sensed cannot be right....

The van snaked around the front of my dad's family's local headquarters, a place I am familiar with, and I happen to know it is a high level security zone. Armed guards patrol back there. But Chris got out of the van, and used keys! He opened the gate with keys! And he got back into the driver's seat, and pulled into the security zone, then got back out, and locked the gate behind us. He went through one more set of gates this way, and then backed down a ramp and engaged the emergency brake. Leaving the van running, he quickly whipped the gurney, with me strapped to it, into a subterranean world that I never knew was back there. This was scary, all the way around. We are on a facility with my last name on the sign, but I never have seen this before. One of my cousins built this facility, but I have never seen this part, before. And this was extremely bad.

As Chris entered the facility, I made a mental note of the security, which is the highest level I have ever seen in a medical facility. I have been on military installations which weren't this well-designed.

In order to enter, Chris, whom seemed to me to be around six feet tall, had to stand on his tiptoes, and another staff member inside the tank had to also stand on his, and simultaneously, they turned both sets of keys. Then, we were still not inside, but we were inside a vestibule, then Chris re-locked the door we had just come through. At that time, he spoke through an intercom system, and said, "Hi, it's Chris, and one Kevin Drummond."

Presently the door buzzed unlocked, and a male nurse in dark blue scrubs (they resembled Webloes, cub scouts, without neckerchiefs) recieved us into the facility, saying, "Drummond is going to 31."

While checking in, I noticed a very small lady, whom apparently was on staff, standing next to my bed. She just stood there, stood there, and stood there.. She looked, to me, anyway, to be too old to be a RN. I started looking for the tables and portable steps that physical therapists use all the time, and there was nothing of the kind.
It was then I think it finally hit me: this was not actually Physical Therapy. 

When the doctor came through the door I had never seen him before, which, at this hospital, at least, was highly unusual. 

"My name is (we will call him Dr T V) and (another had joined him) this is (Dr E B). We have taken over IM (the company whom holds the contract for internal medicine admits when the patient's doc doesn't have hospital privelages).
He continued, "This is an isolation ward, and you are here to recieve the best possible care we can give you. You were diagnosed with MRSA, and that is the sole diagnosis we handle in this ward."

"How long will I be here?" I asked.
"I cannot say, yet. Let us run labs, get your meds going, and we will discuss it, later, Ok?"
See, I know the physician blow-off when I hear it, and asked, again, "Why have I been taken from the hospital?" 
"Because you are too sick to be in the hospital over there. We need you here, where we can keep a much closer eye on you..." he said. And, from his tone, I realized he was not going to tell me that I could leave, or much of anything else, for a very long time.

The lady who had been standing there went to the nurses station, and came back with an armload of meds. I tried to talk to her. What I could get her to talk about, her job, she said very little. Turns out I was right, she was too old to be working, and was a volounteer. 

The floor plan of the tank was like an open horse shoe, and the opening was paralell to the side of the facilities out of which physicians magically appeared now and then, and vanished back into, now and then. The escape artist in me bode my time, and waited until the nurses' desk was unattended, and the cameras were not being monitored, and tried to examine the route we used to enter. I learned that there would be no way out that way, so I tried the side not visible from my cubicle, from which the mysteriously appearing docs came and went. 

Each time that I escaped I was easily recaptured, the fourth and final time (in the tank) Dr TV came out of the office as they strapped me to a gurney, and asked, "Do you know who I am?"
"You are Dr T V!" I replied. And he nodded in approval.
(Pointing at his buddy)"Do you know who this is?"
"Dr E B!" I said. Again, he nodded, in approval.
"Do you know where you are...?"
"The hospital?" I answered, like...I really wasn't sure...

And he shook his head in a furtive and disapproving "nope".
For some reason that horrified me.

Later, Dr TV appeared at the door of my room, and said, "In this facility are mainly elderly people, sick people, like you are now. There are thirty one other cubicles in this facility, just like the one that you're in right now. And each of them has someone who is very sick in it. Not all of them are going to make it out of here alive....do you understand what I am telling you?"

"Yeah, I think so." I said.
But I really did not understand, not at all. I thought he was telling me, "Next time you escape, be quieter, old and sick people are complaining." But what he was really saying was, "You might not survive this, guy..."

I could continue the narrative, but the purpose was  really only to help people understand that yes, these docs are CDC (their names don't appear ANYWHERE as licensed physicians) and that the CDC does engage in this kind of thing nationwide. I was told that MRSA is everywhere, now, and there are a few things that I could do to prevent my ever coming back to the tank.
  • Bathe once daily. Thoroughly and diligently.
  • Wash your hands after being out in public, especially when handling things that children may have handled. Children are more at risk for exposure, but due to stronger immune systems, they are less at risk of contracting the disease.
  • Do not go out of the house when you're sick. When you're sick, your immune system is already compromised, so going into an area, such as a grocery store, and bumping into someone whom has MRSA places your liklihood of catching it very high.
Dr TV said that observing these basic things would lower my risk by 90%.

I spent a very long time trying to locate either of those docs, TV and EB, to no avail. I even made a formal request for my in-patient records from the hospital for the day when Dr TV had acquiesced and taken me, via the tunnels, to the ward I was most familiar with in the hospital. The reason this was signifigant is, according to a friend whom works there, I assaulted Dr TV with a chair while on that ward that day, and the hospital called a "code white", which involves law-enforcement. But there is not one record of that, or Drs EB or TV. And they were never the heads of the company whom ran the IM contract. I even kept one of the prescriptions that Dr TV wrote for my discharge, only throwing it out a year ago, having come to accept that most people do not believe me, or just do not care.

After a number of years, I have come to realize that nobody, not even members of my family, is going to admit that this ward exists. Once, when I had to get a state ID, the examiner acknowledged that the tank exists. She is the one who told me that there are quite a few of them, dozens, in this state alone. But she was the only one whom ever acknowledged that MRSA has evolved more quickly, and far more devastatingly, than anyone is telling us.

1 comment:

  1. If you know of a familiar tale, or of a Physical Therapy ward like this one, please contact me. I would love to find other survivors.

    ReplyDelete

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