A Medical Meditation

Penny lays in her hospital bed listening to the cacophony of beeps emanating from the machines monitoring her vitals. She wears medium wash jeans and a plain white t-shirt - both slightly too large despite only buying them in the last few weeks. She is cold, chilled to the bone. It doesn’t matter that she has on her navy blue, puffy winter coat or a knit black hat, or that the nurses gave her two blankets straight out of a warmer. The cold is coming from the inside, her bones are made of ice. Her heart rate beeps along at 51 bpm and her blood pressure hovers around 80/48. Everything is just too low and slow. She knows she is slowly marching into oblivion, each day the readings falling lower.

Penny’s mother, Maria, sits beside her holding her bony hand and looking with concern into her pale face and sunken, tired eyes. “Why hasn’t the nurse been back yet? Your readings are so low, that can’t be normal, there has to be something they can do.”

“I’m sure they’ll be back as soon as they can. There’s a pandemic going on and I know they’re stretched to the max.”

Maria, a slight woman who looks younger than she is and can command any room despite her size, takes her hand away and turns her attention to her phone, texting furiously.

Penny stares at the ceiling tiles, listening again to the beeps. They sound like a meditation mantra, an electric om, small and shrill. Penny thinks about her life and the events that led to that moment. Usually an optimistic person that relishes the beauty in small things, she can’t help but think that maybe all life really is, is suffering. It has all been so hard and the last few years have felt catastrophic.

Two years before, Penny was with her grandmother at the end of her life as she bled out from an aortic aneurysm rupture. Nana didn’t look like herself anymore at all. She was a mummy from the Egyptian Museum in Cairo that had come back to life and was writhing in pain on the hospital bed. It struck Penny at the time how an animal in a similar position would be euthanized out of kindness, but we weren’t allowed the same option as a human being. Nana had lived a long life and had progressing dementia, so for ways to go, this was the better of the evils available. It was still hard to say goodbye nonetheless.

“Hi there, how are you doing?” Nurse Rachel says as she walks into the room.

“I guess I’m feeling a bit better,” Penny shrugs.

“You do look like you’ve got a bit more color in your face,” Maria interjects.

Nurse Rachel checks Penny’s vitals and says, “Sorry for the long wait, it’s been a crazy night for us here. COVID is starting to put a strain on everything. What’s been going on?”

Penny sighs and responds, “A few months ago, I started having weird reactions to foods. They thought it was dumping syndrome but I’m not sure about that. Now, I’m having reactions to every food and I think also the medication they gave me for dumping syndrome. I don’t know what to do. I can’t eat. I’ve lost a third of my body weight in the last couple of months. Doctors don’t know what’s wrong with me. I was struggling to eat lettuce and olive oil today.”

“She can’t keep going on like this, her blood pressure and heart rate just keep getting lower and she has new symptoms all the time. Tests all come back normal, but this isn’t normal,” Maria adds firmly.

“I’m so sorry to hear that you’ve been going through that. Let me talk to the doctor and see what they want to do,” Nurse Rachel says softly.

“Thank you, I really appreciate it,” says Penny. Nurse Rachel leaves and Penny returns to staring at the ceiling tiles.

She thinks about her Dad and wishes he was here but knows it’s best he’s not. In the months leading up to his suicide the year before, she had tried and failed to give him reasons to live. They were separated by oceans and there was no one who could help him if he didn’t want it. He had decided he didn’t want to grow old and deteriorate like his mother. He wanted to control the moment of his death. Leaving it to chance to him, felt like waiting for the ultimate, cosmic slap in the face. It wasn’t an option. He said he would choose a day when he was happy to be his last day and he stayed true to his word. He had no will or other estate plans and left messes across continents for someone else to clean up in his absence. That person became Penny.

The year that followed for Penny was a blur of work, helping her brother finish his dissertation, dealing with transcontinental debts and litigation, and generally, running herself into the ground. Beer, cigarettes, and coffee made up most of the bottom of Penny’s food pyramid and sleep wasn’t on the menu. Eventually, the storm seemed to die down. The debts and litigation were resolved. Her brother finished his dissertation. Then, Penny was just left with the sadness and the beer, cigarettes, and coffee. She realized that taking on all of this alone was her terribly self-destructive coping mechanism. If you’re doing everything, you don’t have time to feel anything. Penny tried investing time in good things. She went to visit family, bought a house, and got a dog. Penny had seen enough movies to know that this was the part where she and her family had become stronger together and as people after weathering this tragedy – all that was left was their happily ever after. A few months into this happily ever after, Penny started to get sick. At the same time a new virus emerged in China. Now, just months later, Penny lays in the hospital, skin and bone, unable to live safely in the world while a new virus sweeps the planet at terrifying speed.

A cheery, “Hi, I’m Dr. Madison and I’ll be taking care of you today,” breaks Penny out of her trance. “So, I hear that you’re having trouble eating? Can you tell me a little more about that?”

Penny prepares to tell her story again, “It’s kind of a long story but to keep it short, I’ve been having all kinds of reactions to foods and environmental things. They thought it was dumping syndrome but that doesn’t seem right. I am having reactions to all foods now and I think also to the medication they gave me. I don’t know what to do or eat. I have so many symptoms all the time, I just don’t know what to do.”

Dr. Madison responds softly, “I’m so sorry that’s been happening. It sounds like you’re a zebra. We’re not set up in the ER to figure out what your underlying issue is, but we can help you be more comfortable now. I’m going to order some labs. We will see what they say and go from there. I would say to discontinue the medication they gave you immediately.”

Maria lets out an exasperated sigh. “Everyone keeps passing the buck to the next doctor. We have no idea where to go next and it’s becoming impossible to get an appointment with the COVID lockdowns starting. She’s going to die before we get to the right doctor.” Maria fights back tears.

“Mom, it’s okay. We’ll find some other doctors,” Penny says trying to reassure her.

With a pained expression on her face, Dr. Madison says, “I would recommend seeing an immunologist or a rheumatologist next. This sounds like some kind of immune disorder. I’m sorry we can’t do more here. We just aren’t set up for that type of care.”

“I understand. Thank you for the recommendations,” Penny says to Dr. Madison. “See? There are other doctors to see and we’re going to do some lab work now to make sure I’m ok,” she says to Maria.

Dr. Madison smiles as she leaves the room, “I’ll send the nurse back in to get those labs going.”

Maria looks at Penny, “It’s just insane that no one knows what’s wrong. You can’t be the first person to have this happen. What do they expect you to do if you can’t eat?”

“Mom, it’s going to be okay. They’re all doing their best. We’ll keep seeing other doctors until we find the right one. I’m sure I can see them virtually and just get tests done in person.”

Maria shakes her head and scoffs, muttering to herself.

Nurse Rachel comes back into the room and takes some blood. She disconnects Penny from the IV and monitors so she can go to the bathroom for the urine test. “Ok, here’s your cup. After you’re done just put it in the steel collection box in the bathroom and come back here.”

“Ok, thank you,” Penny says as she slowly gets up and heads to the bathroom. She’s lightheaded but makes it to the bathroom without falling. She notices the beeps of other people’s heart rates as she walks past their rooms. In some rooms the beep is all there is, in others there’s whispering or nervous laughter. In the distance, screaming and crying. Hundreds of rubbery footsteps rapidly race around the ER tending to patients. Penny wonders how medical professionals handle the stress of their day-to-day. She finishes the test and heads back to her room.

Maria is scrolling on her phone. Penny climbs back into bed. Nurse Rachel reconnects her to the IV and monitors. Penny stares again at the ceiling tiles, her electric om in the background. She wishes life was like the movies. She knows she’d be living her happily ever after now if it was. The problem with the movies is that most of them are so black and white and have such pronounced starts, climaxes, and ends. That’s pretty disconnected from reality. It doesn’t even seem like the beginning and end of life are black and white. There’s disagreement the world over about when life starts, is it when we are born or before? It’s no different for death. Is death when a heart stops or when a brain stops or is it something else? There’s rarely a nice “the end” to let the audience or the body’s inhabitant know that life is over. Life has very few clear villains and heroes, most people have a little bit of both in them. Life events are rarely black and white, they’re gray. Penny pictures her life as a gray continuum, the shades lightening or darkening depending on what balance of good and bad is happening at the time.

Dr. Madison returns. “Okay, we’ve got your results. You are dehydrated, but everything else looks normal.”

“Dehydrated? How is that possible? She’s constantly drinking water. She was still thirsty while getting IV fluids,” Maria asks.

“I’m not sure, but we’ll give her some more fluids here and that should help. Let’s try a different medication to help you eat,” Dr. Madison says looking at Penny. “It’s called Zofran, it acts on the nerves in your digestive system, so let’s give it a shot and get you something to eat. Let’s do something simple, how’s milk?”

“Sounds good to me,” Penny responds.

“Great. Here’s the Zofran and someone will come by with milk soon.”

“Thank you,” Penny says to Dr. Madison as she leaves the room. She takes the Zofran.

“I hope this works,” Maria says to no one in particular before going back to her phone.

Penny returns to staring at the squiggles on the ceiling tiles. She focuses on the tiny high-pitched om again. If you can’t interact with your world at all anymore and need to live in a bubble, is life over then? Is that “the end?” As Penny had gotten sicker, she detached from reality more and more. The annoyances of life don’t bother her anymore. Life is simply about stopping the final curtain from falling. Old arguments don’t matter. Work stresses seem trivial.

Nurse Rachel walks in with a small carton of milk. “Here you go,” and quickly walks back out.

“Thank you,” Penny says. She slowly drinks the milk. Her heart rate rises, but otherwise she feels okay. It seems like a success. Maria smiles but looks at the monitor with a concerned face.

Penny is exhausted. She looks at the ceiling and listens to the beeping meditation mantra once more. Life is better than the movies, she thinks to herself. It’s so much richer and more complex. Our lives are made up of the equivalent of thousands of movies but the lack of absolutes in reality makes each one so much more interesting than anything from Hollywood. Our lives have every movie genre imaginable embedded in them. It’s beautiful chaos. Life isn’t all suffering, but suffering is a part of life. Without it joy and beauty wouldn’t be so bright, Penny thought. She had been so sad and in so much pain after losing her father that she couldn’t see the beauty around her anymore. Since she fell ill every tiny thing of beauty is extra vibrant – every flower, every laugh, every bite of food. Even suffering isn’t all bad. It can teach you and it can highlight the brightest colors of life.

Penny closed her eyes and pictured herself as part of the universe. She felt at peace among the stars.