Wednesday, May 27, 2015

Notes from a Bulgarian Hospital

It was a routine play. I was guarding a taller guy. When I reacted early to block his shot and he jumped into me, his shoulder hit me square in the nose. I immediately knew it was broken—not because of the pain or a cracking sound—but precisely because I felt nothing except for the release of blood from deep inside my nostrils.
I don’t know how the basketball ended up in my hands, but I threw it straight into the wall, pissed off that my face just got smashed at the end of a nothing game on a nothing play.
There was silence on the court.
I sat down on the bleachers and that’s when the blood started gushing. It was all over my shirt and hands.
“Lay down to stop the blood!” one guy said.
“Yeah, lay on your back,” another concerned Bulgarian told me. 
I did what they said and felt that everything would be okay because this kind of thing happened sometimes in the game of basketball.
Of course, most of the guys were gathered around, asking: “Are you OK?”
I’m not dying, but I’m far from OK!
I was only lying on my back for a few seconds when I felt what I thought was mucous gathering in the back of my throat. I was about to swallow it when I realized it wasn’t viscous enough to be mucous and it was collecting too fast. I started to choke.
I jerked to my side and coughed out a mouthful of blood.
I almost choked on my own fucking blood!
It felt scary.
It looked pretty bad too.
There were already two pools of blood on the gym floor.
One of the guys brought me a tissue. I thanked him and pressed it to my nose.   
“Hey,” one Bulgarian guy said, “Are your teeth okay?”
“Yeah, they’re fine,” I said.
“You are lucky to not lose the teeth,” he said in a thick accent.
I let out as much of a laugh as I could. “That’s funny,” I said. “I’ve heard that one before.”
I had.
Seven years ago I got in a surfing accident and the side of my face, near my left eye, was cut open. The gash needed ten stitches. And when people saw the damage a lot of them told me: “You’re lucky you didn’t get it in the eye. You could’ve lost an eyeball.” I guess when things are looking bad we say all kinds of things so that people don’t feel so shitty.

After a few minutes, the bleeding from my nose had slowed.
Another basketball player in the group offered to drive me to the hospital.
I walked out of the gym all right, but was spitting out blood as I went.
I was on my way to a Bulgarian hospital for the first time.
Tokuda hospital is known as one of the better ones in Sofia. Despite the language barrier, I got registered and was attended to without much delay. Blood had dried and darkened on my hands and face so I went to the bathroom to wash it off. I tried not to look at myself in the mirror too much—just enough to wipe my face and see how crooked my nose was.
Soon after, my face was X-rayed and they sent me down a stark, Soviet-style hallway.
I sat down in an empty waiting room for only a few minutes before Nurse Dimitrova brought me inside. She pointed me to a medical chair. She spoke a decent amount of English but didn’t waste time on niceties.
“Can you breathe through your nose?” she asked.
“No,” I said. It was all swollen and stuffed up.
Without any warning or brief description of the next procedure, she grabbed some thin, metallic pliers and opened up my nose. It didn’t hurt as much as one might suspect. What hurt like a medieval torture technique was when she shoved a thin metal pipe so far up my nose that it felt like she was hitting my brain. The thing had a trigger and she was using it to suck out the blood that had collected deep inside my nostrils. My body jerked and I griped the handles on the chair. It was an eerie, unearthly pain.
She removed the thing as hastily as she’d thrust it in.
She grabbed the pliers again to open up my nose and check inside.
She used a similar, seven-inch, steel tool to shove a wet gauze pad so far up into my nostril that it felt like it was in my throat. The liquid the pad was soaked with started dripping down the back of my throat. It was acrid and made me choke. Without a word, she did the same thing again—and then twice to my other nostril. The probing and stabbing didn’t hurt as much the second time because the bad part of the break wasn’t on that side, but the bitter metallic taste multiplied and made me choke even more.
I had to spit into a napkin in my hand.
It was mostly blood.
Nurse Dimitrova walked to a nearby sink and I began to feel faint.
I looked around the room and it started to go dark, though my eyes were wide open. I could see all the blood vessels from the back of my eye sockets. I told her I was about to faint or pass out, but I could barely hear my own voice. What I did hear sounded like a distant, muted voice in an echo chamber. I suddenly felt cold and clammy.
What the fuck was going on!?
Nurse Dimitrova guided me to a nearby table and laid me down.
She put a cold towel on my forehead. It was the first gentle thing she had done.
I regained normal functioning of my sight and hearing within a minute or two.
I rested there while she looked at my X-rays.
My nose was clearly broken on the upper bridge. But because it was almost midnight, no doctors were around. The nurse told me I’d have to come back the next morning at 8:30am to get my nose re-set.
She asked me to sit up and she pulled out the skinny, seven inch pliers and tweezers again.
I wanted to beg— Not again! Please!—but I didn’t say a word.  
She opened up my nostrils and pulled out the wet bloody cloths, one at a time, as I writhed in discomfort—though I must admit the abrupt removal felt better than the abrupt insertion.
I left the hospital with the bleeding stopped and the ability to breathe out of my nose, but couldn’t imagine how my nose “re-setting” would go down.
I didn’t want to go back there.

That night I couldn’t fall asleep because I couldn’t stop imagining that Clockwork Orange hospital—that same room—the next morning.  I kept replaying the recent events: coughing up a few shot glasses full of blood, long steel instruments being thrust deep into my nostrils, choking on medicated soaked gauze pads, momentarily losing most of my vision and hearing. I could only sleep in short spurts and, as I lay supine in the darkness, I became unaware if my nightmares were conscious or unconscious ones.

The next morning my girlfriend and I took a taxi to Tokuda.
Thankfully, she could communicate everything in Bulgarian, so I could make my one and only request very clear: Anesthesia! Please, tell them to drug me up—big time. I want to be unconscious.
Well, they didn’t exactly knock me out.
After two hours of waiting, we met the doctor—a fairly young guy wearing a surgical mask and cap. He led me to a light blue medical chair. He talked to my girlfriend, not to me, so I assumed he spoke no English. Then he turned to me:
“This will feel a bit uncomfortable,” he said in English.
He took those all-too-familiar stainless steel pliers and opened my nostrils one at a time. He took a good look in there before he stuck a small nozzle just inside my nose and sprayed some liquid anesthetic. It rolled down the back of my throat and tasted disgusting. But it wasn’t all that bad. I was just glad he hadn’t shoved the thing all the way up into my frontal lobe.  And good news: I could already feel the numbing effect.
It’s gonna’ work! I won’t feel a thing—or at least not much.
I was told to go back to the waiting room to wait for ten minutes so the anesthesia would be fully absorbed.
Things were looking up until I was called back in by the doctor.
“OK, so we now make an adjustment to your nose,” he said.
“How?” I asked.
“By hand,” he said, holding back a full grimace, but the sentiment was clear. “I will push it back and it will hurt.”
Mother fucker.
“But first we put this inside in case of bleeding.”
He picked up the pliers and the stainless steel tool with the wet gauze attached at the end.
No, goddamn it. Not again.
The doctor could see the fear in my eyes.
 “It will be uncomfortable,” he confirmed.
And so it went, just as the night before: Like my brain was being stabbed with a metal skewer—twice on each side. The suffocating feeling of the gauze. The acrid dripping in the back of my throat. The choking and coughing.
While I tried to shake off the pain and my gag reflexes, two other doctors come to look at my nose. One of them touched it gently and said, “Don’t worry. I’m just checking.”
I know this trick, asshole. You say it’s just a practice run; that you’re not doing anything yet, and then—when I least expect it—you’re gonna’ grasp and snap that thing back into place and it’s gonna’ hurt like hell. 
The guy pulled his hand away and nodded to the other doctor.
The first doctor who spoke English returned and stood straight in front of me.
“I will push here,” he said and pointed to his own nose, “...and then it will be straight. No problem.”
“Got it,” I said.
“It will hurt.”
“I understand.”
“Don’t you want to see the X-rays?” I asked.
He shook his head in that ambiguous Bulgarian way that could mean ‘yes’ or ‘no.’
“Not necessary,” he said.
I took a deep breath.
The doctor positioned himself on my left and widened his stance a bit.
I closed my eyes and felt his thumb press down on the upper bridge of my nose as if he were trying his hardest to push a thumbtack into cement. I let out a dog-like growl—the product of an agonizing yell that must have been muted somewhere between my diaphragm and the bulging veins in my neck. It was an excruciating five seconds.  

When it was over, I caught my breath. I was sweating.
A squatty nurse with acne scars appeared in front of me and patted my head with a cold wet cloth.
Kak si?”
Dobre,” I said. Good. It was all I knew how to say in Bulgarian and the worst of it was over. It had to be.
Wait, the gauze pads are still inside.
The doctor held the skinny, stainless steel, seven-inch pliers in one hand and the long tweezers in the other.
He opened up my nostrils and pulled them out, one at a time. I writhed in discomfort more than pain, since the thumbtack bone re-setting had just adjusted my entire pain threshold.

Two other doctors and a nurse took turns looking at my nose. One of them got a pencil and they took turns lining it up with the bridge of my nose, judging their work. Did I pass the pencil test? They conferred and declared it straight.
While the doctor who spoke the best English taped up my nose, I smiled inside because 1) I couldn’t smile on the outside because it hurt to smile, and 2) I knew that the worst of it was behind me.
It had to be.

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