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tags: story andrea piccolo kat butler operating room doug ford anesthesia awareness



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I went on a strange, unexpected adventure. During COVID times. But without a passport and without air travel, of course. I am not a politician, or part of the 1%, after all. My adventure started fast, and ended even quicker, and involved blood, and pain, and a cast of characters who were mostly heroes, but with some villains sprinkled in. And some regular people. Plus a nutter or two. (The nutters aren't central to my story, but they add some color. A lot of color.) However, this was no stage show. This was very real. This was harrowing. And by the end, after being in Mount Sinai Hospital in downtown Toronto for three days and two nights, inspiring, and humbling. But most of all -- for me -- it was a wonderful and insightful reprieve from the monotony of being locked down in Canada's biggest city.

By the end of it, I had made hundreds of mental snapshots, met an astounding number of interesting characters, and gained an even greater appreciation for the talented team of people saving and improving lives in our healthcare system. Our wonderful, hard-working, healthcare system, that is shared by everyone, not just the politicians and 1%-ers. In a whirlwind, I was witness to black magic performed by men, women, and trans people in blue scrubs, who in quick order removed a mysterious organ from my body and sent me on my way, seemingly unremarkably. But it was remarkable. Which is why I am writing this down, while it is fresh in my mind. I can't believe what just happened. And it really did just happen; this sentence is being written 2 days after getting home. Now I want to reflect on things, to share as much as I can, to highlight some real heroes... and to note a couple places where improvements can be made at Mount Sinai.

Let me start at the Big Show. At this point, I have been through the Emergency Room (ER), admitted into the hospital, diagnosed, and am at last in the Operating Room (OR). I make it through the ER and into the OR in just over 24 hours. My diagnosis is appendicitis. The solution: remove the offending organ, the appendix. This seems like some serious overkill in modern times, but even in 2021 it turns out that is the standard treatment. If you live in a wealthy country, anyway. Appendix flares up? Yank it out. It's not like it is your heart or lungs; humans appear to do just fine without it. (Usually. More on that in a future chapter.)

In any case, when an appendix is inflamed, for whatever reason, you can try to treat it with antibiotics alone, but the outcome is often poor. And going the antibiotic route can just end up delaying an inevitable operation. So, I have chosen to go the surgical route; I signed the consent forms the night before. Fortunately for me, my case is deemed uncomplicated, and the goal is to do a procedure "keyhole style", with just 3 small incisions. If all goes well, this laparoscopic approach should lead to less risk and a faster recovery. ("Laparoscopic" just means they use a laparoscope, which is a small camera.)

I am on an operating table, flat on my back. I am nervous as hell. On high alert. I have not eaten anything for over 24 hours, nor have I had a drink. An IV has been providing my hydration for some time. I am sleep deprived. Previously I was feeling pain and nausea in waves, but at this moment I am too hyper-alert for pain or nausea. I am scared; people die in situations like this. I am trying to be stoic; what happens is out my hands now. I have a mask over my nose and mouth, giving me some sort of gas, and my right arm has an IV in it, filling me with some sort of chemical cocktail. It is bright. And there are people in blue scrubs all around me. I recognize some of them, and some are new to me.

There are a lot of women here. More women than men, I think. I like that. The woman leading my surgery is Dr. Andrea Piccolo. That is her real name. You can google her. I know I did, after I met her, which was earlier in the day. She made me feel comfortable in our meeting, and googling her after helped a bunch, too. She is good. And going into this critical event, what I am calling the Big Show, I do feel I am among talented professionals who know what they are doing. That helps, big time. There was a chance due to more pressing emergencies, that my operation would be pushed later on in the day or evening, after Dr. Piccolo's shift was over, and be performed by someone I had not met. But I got lucky.

These are my thoughts on the operating table, about to go under. They were random and rapid fire, like shooting stars in different directions. I hope I don't die. That anaesthesiologist has beautiful blue eyes. But it is hard to hear her through the mask and screen she is wearing. Are they going to shave my big belly? Will I know when I am going to go out, and feel the drift, or will I just "shut off", like a light? "You're doing great, Matt," says a clear, reassuring voice. They are easy to hear and understand. That is Kat, talking from above my head. Kat Butler is their real name. And they are also an anaesthesiologist. I am not sure why there are two (or more?) anaesthesiologists needed? Hmmm... Is the tube, which I only just found out would soon be shoved down my throat, made of metal or soft plastic or what? (God forbid it doesn't go in properly. It can't have sharp edges, can it?) "Go to a happy place, Matt." That is me, overriding these random and often negative thoughts.

Boom!, I am at Red Frog Beach in Panama. Beautiful sand and water, and it really does have these neat little red frogs. With black speckles. They are poisonous, but so cool looking. Intrusive thought: Doug Ford's fat face. Ok, find your happy place, Matt. Intrusive thought, again, and it's a biggie: Christ, I hope I don't become alert during this whole thing. ("Anesthesia awareness" it is called. I read about it last year on wired.com or medium.com... or maybe it was the New York Times, online edition? I wish I did not read that article, in retrospect. In super rare cases you become aware of what is going on during the surgery, and sometimes can even feel what is going on, and you are paralyzed, and just have to endure it. It sounds like a hellish nightmare, but it is a real thing. Albeit incredibly rare.) But you know what is worse than thinking of "anesthesia awareness" right before you go under? This thought: Oh my God! I already have a huge pot belly. I am going to look absolutely ridiculous when they inflate my abdomen with carbon dioxide, which I know they will do. I googled it. I am 6'3" and hirsute. This is going to look freakish; cartoonish, even. My long, hairy limbs sprawled out on this too-small table, with a huge, humpty-dumpty inflated middle? (Especially if they shave my belly. They must shave my belly, right?) "Breathe in slowly... now push out strong." Kat again. They are right there with me. I love Kat. Thank you so much, Kat. You are amazing, Kat. You are so young and so confident. You have truly found your calling, Kat.

I first met Kat Butler 20 minutes ago, just outside the operating room. They had a bunch of stuff to explain to me about what was going to happen, like the tube down the throat thingy, and possibly some legal details which I paid no attention to whatsoever. They are tall and strong-looking and young. They had a hospital ID with an old picture of (what appeared to be) some small-town kid with a mullet. But this was no small-town kid with me in the flesh. They were grown up, and wise, and sensitive. And strong. And they lost the mullet. I felt their good, protective energy envelope me as soon as we met. They were so... engaging. And, for now, engaged with me. An instant ally. They made me feel like they knew this was a big, scary deal, and they had my back. They were watching over me, and looking out for me, wholly and completely. Kat, you are one of the heroes of my story. And I thank you. So much.

My thoughts continue, rapid fire. Some good, some bad. Some driven by Kat, some driven by my own inner voice, and some just out of the blue (aided by powerful meds and stress, no doubt). When something I don't like pops up, I try to push it away. I need to find my happy place. I keep circling back to Red Frog Beach, it's my go-to, with those little speckled frogs, and then, when I need it most, my wife's beautiful face pops into my head. And then my daughter. I love you, Beth. I love you, Clementine. "Please let this go smoothly," I think to myself. Boom, I am out. It is just like a light getting shut off.

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This writing above is one chapter from the long form article "3 Days and 2 Nights".
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