I got to the hospital by 8:25, and Gary was in sheer pain. I called the nurse; she called Doctors. They were on rounds. He's howling. The nurses page the doctors repeatedly. Apparently, all they get is a "we're on our way." He looks at me with white eyes and says "help me."
Mom calls at a bad time - the nurse answers and hans the phone to me Me-Ma wants to talk to him. He can say nothing truly coherant. She asks him if he's in pain. "Yes," he manages to say. She gets me on the phone and tells me I've got to get a doctor there right now. I'm doing all I can.
After I threatened to call 9-11 and get him moved to a public hospital or get some emergency service somehow, the doctors show up around 11. They tell me that the moaning and howling is because of his ecephalopathy. Patients in his condition do this, according to them, and it's not necessarily indicative of pain. He can't really communicate with me, except that he's in pain. I feel truly powerless. They take blood to check his ammonia levels.
At noon, Dr. Wheeler returns and says his levels aren't that high. I ask her if she thinks he's really in pain (he's been howling for hours now). She says she's not sure. She decides that they need to tap him to reduce the pressure. I finally meet Dr. Orloff and she assures me that they will be able to stabilize him and we'll return to SA on an ambulance flight. I need to have hospice arranged.
At 2PM, they decide to tap him. It takes almost an hour to find the right people and set up for the proceedure. They're going to do it in his room. I can't stand to see this, and Emmitt comes in to watch and give me blow-by-blow reports while I sit in a wheelchair in the hallway. In fact, it's the one I brought Gary up in yesterday. For some reason, I fix on that and roll the chair around and down the halls. They remove almost 7 liters of fluid from Gary's abdomen. Dr. Wheeler says a sample needs to be tested to see if there's an infection.
After the tap, he seems truly restful. So comfortable. I just sit and watch him sleep for a good long while. Relief.
But by 4PM, he's awake and now he's hallucinating. They move a porto-potti next to his bed because he's messed himself. I can tell it's full of blood, but the nurse thinks it's just hemmeroids. It's everywhere. On the floor. In the bed. The nurses try to clean him up and make him comfortable again.
He doesn't make much sense at all to me, and even less to the Doctors and Nurses attending him. A lot of the time, what he's talking about isn't that crazy, it's just that you have to know him to understand. He is fascinated by my hands. He holds them, open and closes my fingers, plays with my ring and watch with a look of almost astonishment. He plays with my hair and messes with my hands some more as if they are unique mechanical objects. Finally, he says "Kiss my hand and tell me goodbye. You should leave now." He repeats this over and over, until finally, I decide I should go. I kiss his hand and tell him I love him. My presence in his room seems to do nothing but agitate him.
By 7PM, I'm in the car. I don't know where to go or what to do. I go to Starbuck's and get a coffee and I wander around Barnes and Noble. I buy the Kubler-Ross book on dying, because I know I've got to steel myself. I don't really know what to expect, but It's happening. I call back to the hospital, and they say he's stable. Me and Mom go back and forth with Pam, the nurse, who says he's sleeping. I've left my cell phone number with them, and I'm exhausted.
I call Nell around 8PM and talk to her about encephalopathy and hospice. She's going to see what she can do to arrange for our arrival. I check back with the nurse at 9PM. I've talked with everyone, and no one really knows what to tell me. Finally, I try to sleep for a bit. It seems that as soon as I lie down, I get a call on my cell from Dr. Wheeler. They're going to move him to ICU and they need us to make some decisions. They're decisions I shouldn't make, but Mom and Me-Ma have had enough, I think. I can do this myself. I should get back to the hospital. It's midnight. I call Joe and decide to get back there before I call Mom.