Friday, April 4, 2014

31 March 2014

Start of the day, what would Harpo do?

This morning, at 8:20 AM, the nurse came in with the usual eighteen pill assortment and my Copaxone injection. She was all bright and cheery, bubbling with enthusiasm and making inquisitive small talk using the royal “we”. Bustling about full of efficient movement that gave the impression of great purpose to her behavior. She reports to work at 6 AM, so I imagine that she has been up and awake for a couple of hours by now, at least.

I, on the other hand, was awakened by her officious entry and incessant verbal barrage. I sleep with a CPAP machine which is connected to me with a long hose attached to a mask that is held tight to my face with a harness that fits around my head. The machine is designed to keep a constant airflow moving through my nose, keeping my airway open. Thus stopping sleep apnea of the obstructive type from happening. I have used a CPAP since 1984, by now it is very familiar, like an old friend. One thing I have learned is that speaking while the machine is on, mask affixed, is very difficult. Once the mouth is open air proceedes to enter the nose and then rush out the mouth, giving a very breathy quality to the voice. There is no resonance coming from the chest. Because the design is to keep the airway open, certain sounds are impossible to effect, like forming an “N”. Thank you, becomes thag you. Verbal communication is not the forte of a CPAP machine.

My waking procedure has a methodic approach. First find the bed controller to raise the head portion of the bed so I can reach the on/off button to stop the CPAP machine. Then I have remove one clasp that attaches the harness to the mask so I can remove the mask from my face. Then I have to remove the harness from behind my head so I can set the mask/ harness assembly aside. At this point, like a butterfly emerging from its chrysalis, I am free. Like that butterfly, I am not yet ready to fly. I have to wipe the sleep crumbs from my eyes, take in my surroundings and determine where I am (sadly I am in the same ol' place – again, still). Sometimes I am awakened during a dream. When that happens I have to also decide how I want to respond, which reality am I in, what works here and what does not, in other words having determined where I am, I need to figure the game plan for the interaction protocol in this reality. ( I have some really wild dreams sometimes). Normally this all unwinds fairly quickly, a few seconds to half a minute. But when someone is jabbering non directive, meaningless apothegms I have to factor that in too.

What do you mean saying, “How am I this morning?” That rising tone of inflection implies a question. Are you really asking me this? Do you really need an answer, or is this another one of those mindless colloquialisms that I should answer truthfully with sufficient thought, or equally mindlessly with “OK” or “Fine”. Is it not obvious to you that I am still waking up? Do you wake up in this manner, with someone fully awake babbling inanities at your bedside, armed with stomach upsetting pills and a needle they are going to stick in you? I need some time here to come fully awake and to participate completely with this diurnal world and its strange ways. The behavior being exhibited in front of me, now, is another one of those strange ways. Does everything that happens between us have to go through the mouth? Is everything in the waking world constantly reduced to words?

I could extend my fist with my thumb erect, pointing toward the ceiling in the universal affirmation sign. But I'm not feeling so affirmative just yet, I just woke up, if you care to recall. I suppose that I could pass my open hand, palm facing down, in a back and forth horizontal fashion, signalling so-so. But some people, nurses especially, like to play junior social worker. Such a neutral expression is often an invitation for more talking, more requests for further information, more explanations as to why I would feel like that, and the felt sensation that I have to defend my feelings as if they were not the “approved” way to be on this particular morning. I was just sleeping a few moments ago. I haven't been up for hours by now like you. I haven't had any breakfast yet either. I'll bet you even had some coffee too. Real coffee, not the lukewarm decaff the facility pushes on us. And maybe real eggs of substance, not the anemic egg white substitute we get here. I'll wager that you have even made hundreds of personal choices already by the time you come in to my room to force me into your world. There is so much that I could tell you, about good quality food, making meaningful choices that have some bearing on the direction of my life, but you don't have any time for that. You have other medications to dispense to many other residents. They must stretch endlessly down the hall.Thankfully, unlike yesterday's nurse, you refrain from staying and watching me until I take all of my pills and probing for some kind of way to understand me.

Soon the nurse leaves and the incessant stream of verbal barrage leaves along with her. This nurse closes the door when she leaves, unlike most of the other nurses. Alone with my thoughts I look at the little plastic cup and the eighteen pills of various colors and sizes. The task is clear, I have to begin taking those pills on an empty stomach. Soon the breakfast will arrive and my medication is spread out on the table where the tray is to be placed. The unspoken and the spoken expectations have begun. I am without thought or care launched into another day of the same stuff. I smirk as I wonder what would Harpo Marx do? Given the overwhelming odds against him to be like everyone else, what would Harpo do?

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