Thursday, February 21, 2008

Getting it Together

September 2007

Once I was out of the ICU, and the various hallucinatory drugs had largely washed out of my system, the real work of recovery began. While I did not realize it at the time (it really did not hit me how long this was going to take until the day I was discharged from the hospital), this work was going to absorb a significant amount of my time for the foreseeable future.

To a large extent, bombings are no different than any other medical crisis. All of a sudden one finds oneself juggling medical appointments and paperwork. As time consuming, unpleasant, frustrating, irritating and often painful as it was, this also provided me with an opportunity to take back control of my life. I asked the questions. I made the phone calls. I made the arrangements. For someone whose life has been literally blown up, a single, successful phone call to put on a hold on a bank account or convincing a doctor to check out this or that can be profoundly satisfying. There is nothing nicer than feeling as if you are in charge of your life when it has just been proven, beyond all reasonable doubt, that you are anything but in charge of your life.

True, most aspects of medical care are anything but empowering. Being constantly subjected to the application of copious quantities of varied drops, slimy creams and ointments and gauze bandages and surgical tape to what seemed to be my entire body was not the sort of thing that made me feel like A Woman In Control. (At times I found myself thinking that was covered with enough gauze to clothe an entire third world village; whether this description became more apt if the village assumed to be starving, and thus thinner and easier to clothe can be avoided as being in appallingly poor taste). In addition to bandages, slime and drops, there were also the requisite thermometers, IV drips, blood pressure tests and pills that must by necessity must be administered at 11:00 PM, just when I had finally fallen asleep. This, of course, did wonders for sleeping patterns already whacked out by five nights in the ICU. Once the nightmares tapered off, I spent countless nighttime hours lying in bed, unable to read, write or go off and do something, bored out of my mind, holding my teddy bear and fantasizing about actually getting my hands on some dental floss and flossing my teeth.

So, it was not the day-to-day medical care that empowered. Rather, it was my interactions with certain medical care providers, namely, with my doctors. In some ways, this is counterintuitive. Doctors make pronouncements. Doctors tell you what is possible and what is not. Doctors shuffle you off to other departments. I spent a fair amount of time loaded into a chair and being ferried from department to department to have this and that prodded, poked and checked. Doctors (and in particular Israeli doctors) often do not bother to explain things, do not appreciate questions and expect be listened to, and obeyed.

But it was the very intransigence of Israeli doctors which did the trick. I would ask the doctors to explain what they were looking for in English, so my father, also a physician, could understand and promptly hit the unsuspecting doctor with a barrage of detailed questions. I myself asked questions, and demanded answers. If the answers were too complex, I insisted on, and received, answers in layman's terms. I got into the habit of tracking all of the medical questions that popped into my brain in a notebook. Each time the doctors came by on their rounds, I would hit them with the list and demand answers. To a man, they hated me. I did not care. Questions were power. Knowledge was power. Asking questions and extracting solid, understandable answers out of people not particularly inclined to provide them meant I was not a helpless, powerless cripple.

Doctors were part of my medical crisis experience from the day one. The "paperwork" angle only kicked in at the beginning of my second week in the hospital. By this time, I could read letters about ¼ inch high, so long as I held the page close to my left eye and gave it time to focus. This was good enough for me. I announced to my (probably somewhat amused) father that my first week had been something along the lines of a vacation and that now it was time to get serious.

My hospital bed became my command center. Every morning I drew up a daily to-do list: call this organization; ask National Insurance about my rights; ask my social worker to clarify something. My father, who is at least as anal as I am in such matters, helped me to compile data. In the afternoon before my father flew back to the States, we sat in the café of the hospital (good coffee) and drew up lists of useful information organized by function: names and phone numbers of all of my doctors, names and numbers of non-medical contact people, names and numbers of aid organizations and what each was useful for. Back in the ward, the nurses dictated to me detailed instructions for taking care of each of my injuries. I filed everything away into a binder that would become my 'Bombing Bible'.

At least during this period, all of this proved to be very therapeutic. Again, this may seem counterintuitive, in particular as I was still a very new immigrant with no experience whatsoever with the Israeli medical system, National Insurance or bombings. (They covered a lot of very useful subjects at Ulpan Etzion, right down to "how to argue" and "how to complain". Unfortunately, we never got around to bombings). Here as well-the challenge did the trick. The process of proving to myself that I could handle this situation, blind or no and clueless new immigrant or no, allowed me to feel competent, confident and in control.

Item by item, question by question, I started to pull my life back together. Bombing or no, vision or no, I was not helpless. Things were going to get better. I was in charge now and I had decided: I was going to be okay.

It sounds really, really hokey, I know. But hey, it worked.


Baila said...

I just can't imagine it. Being new is so hard--learning stupid things like how to pay the bills and where to get a decent haircut. But navigating the medical system after being blown up???? The government should extend your zechuyot for 20 years for that!

Gila said...

I was very lucky--Bituach Leumi hooked me up with a fantastic volunteer who got me through the first few weeks AND I had a marvellous social worker who really looked after me and walked me through stuff.

Anonymous said...

It doesn't sound hokey at all! I did all the same things as you when our first child was in the Neonatal Intensive Care Unit. I had my big binder with notes and printouts, and researched every new piece of information online. I'd ask for English terminology so that I could look things up, and I always came prepared with questions and opinions. It got to a point that whenever the department head would provide us with new information, he'd stop in the middle, turn to me and say, "the name in English is X, and you can find out more about this on such and such a website".

Creating my catalog of information allowed me to feel that I had a lot more power, and "knowledge is power" became my motto at the time.

I found that doctors who were more professional and felt more secure about themselves tended to be a lot more accepting with regard to my proactive role, and I've changed my own doctors whenever I've felt that my proactivity wasn't appreciated or respected.

Unknown said...

The recently (a few years ago) enacted "patients' rights law" requires doctors in Israel to explain everythin to their patients.
It may seem odd, but bedside manner is not taught in medical school. So either you've got it or you don't. If one is so minded and receptive, a young doctor can learn a lot from a mentor as to how to approach patients and relate to them (as opposed to lecturing them).
Other than that, it takes some time for an oleh to get used to the gruff Israeli manner.

Mia said...

I thought that's what you are supposed to do... have a binder with all of your medical stuff, history, perscriptions and so on.
I had these when I was in the hopital and had them out when the doctors came for thier rounds. Some of doctors even went through them.
I shlep them with me to followup appointments and the doctors and nurses love them.

Mia said...

I was wondering where you went when you were discharged from the hospital. Being by yourself in the country, and not having family to help you adjust.
Did you go back to the apartment you lived in before?
I think about you being new in the country, and having all the Bituach Leumi and other bureaucracy to deal with in addition to looking after yourself.
What did you do?

Gila said...

I stayed with friends for about four days after I was released from the hospital. As for everything else, I will get to that but the cliff notes version goes like: lots of help, support and phone calls from Liat Biton, my Bituach Leumi social worker, Hadara Bogot, my Bituach Leumi volunteer and Barbara Jacobson, the hospital social worker. They really were invaluable for the first couple weeks when I was trying to figure out what to do and how to do it.