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Surgical notes: If I’m talking, I’m still alive

The day before surgery, we met again with Dr. Patel. He explained there were a few actual risks to discuss, such as the chance of my being paralyzed, though this was rare.

Patient intake area at Northwestern Memorial Hospital.
Navigating the maze of medical care while keeping your humanity intact can be a challenge for patient and hospital alike. The intake desk at Northwestern Memorial Hospital’s Center for Comprehensive Orthopaedic and Spine Care.
Neil Steinberg | Chicago Sun-Times

This is Part 2 of my Spine Surgery Summer Series. If you missed Monday’s column, you should start there.

The nurse’s urgency startled me.

“Do you think it’s OK to wait until Tuesday?” I said.

“If your condition deteriorates before then, call me,” she said. That was not the answer I expected.

My hands had been numb for months, so my doctor ordered up an MRI. It showed severe stenosis: narrowing of the spinal vertebrae, compressing the spinal cord within, damaging it. The first surgeon I saw had suggested operating right away. Now, I was seeking the famed second opinion.

My wife insisted on attending. She wanted another adult in the room — besides the doctor.

Dr. Alpesh Patel was a revelation. I assumed he’d merely endorse the first doc’s suggestion. Instead, Dr. Patel gazed at the MRI and called the go-in-the-front-and-pluck-out-the-bone-spur strategy “dangerous.” Doing that, he explained, also might yank out a chunk of spinal cord. The hole would then leak spinal fluid and couldn’t be repaired, leading to meningitis and — I’m not sure if he said this or I just added it, mentally — death.

Dr. Patel took a long time explaining what was going on — if Dr. Bone Joint took 10 minutes, he took 40. As if I were an actual human facing a complicated and terrifying situation, and not just the latest sack of defective meat delivered to his doorstep by the health care conveyor belt. He contemplated the MRI, musing, “Hmm, I’m not sure WHAT is the best thing to do here.” He ordered a CT scan to get a better look.

Doctors love to radiate certainty. But suddenly the first diagnosis felt like a clerk at Macy’s giving me the once-over and announcing I’m a 38 Regular. Being initially uncertain — Go through the back? The front? Both? — struck me as a sign that Dr. Patel was actually evaluating the situation instead of just pulling a procedure off the rack and hoping it fit me. My wife watched saucer-eyed — she later insisted it was worth my having surgery just to see Dr. Patel in action.

She didn’t really say that; I tend to convey difficult experiences through glib lines. Nor did Dr. Patel actually leap up, sweep the stuff off his desk, then push me down on the desktop and start to scrub up, the image I used to communicate his sense of urgency. What he actually said was, “I’ll clear a spot on my schedule next week.”

With two different recommendations: go through the front and pluck, or go through the back and crack, I considered seeking a third opinion. Then I made a gut executive decision: This guy knows what he is doing. I’ll sink or swim with him.

It was 1:30 p.m., which to me meant one thing: lunch. “Are you insane?” my wife said. We instead began arranging and attending pre-op interviews, trekking from clerk to anesthesiologist to nurse practitioner.

When we arrived for my 6:15 p.m. CT-scan, the receptionist encapsulated my entire experience at Northwestern in seven words. She glanced at my chart, then at me, and said: “Looks like YOU had a full day.”

I could have hugged her. I must have really needed someone to see me, to recognize that here is a person yanked from ordinary life, drop-kicked into this medical maze, with no guarantee of when, how or if he’ll get out.

We had a week to wait. Some friends responded with great kindness — my college roommate and his wife drove from Naperville so she could lay her hands upon my neck and invoke the healing power of Jesus Christ. Not a ritual I’d typically condone. But I decided to view it as an act of friendship, and besides, I’d take all the help I could get.

Others, well, not so much. “After spinal surgery, you’re never the same,” one informed me. Another warned my wife, incorrectly, that I might go blind.

The day before surgery, we met again with Dr. Patel. He explained there were a few actual risks to discuss, such as the chance of my being paralyzed, though this was rare.

How rare?” I asked.

It’s never happened to any of his patients, he said.

“Then you’re due,” I replied. I’m proud of that. I wielded my personality throughout the process like a protective shield. The folks at Northwestern took it well. No one ever said, “Will you please just shut up?” which at times must have required true professionalism and restraint.

Coming Friday: The operation.