When Providence Says, “Not So Fast”
Imagine yourself as the lead character in the following absolutely true story:
On August 16, 2006, a retired Albuquerque city employee named Gary Hoffman was playing the nickel slots on a machine called Mystical Mermaid at a casino in New Mexico.
He pushes Spin. The wheels whirl. And then the clanging starts.
“I become ecstatic,” Hoffman says when he sees the amount of the jackpot—$1,597,244.10. Cheering erupts. Hoffman has his picture taken with the machine. He recalls a casino employee telling him, “Sit down. We don’t want you to have a heart attack. Have some water.”
In his first few minutes as a millionaire, the single man gets a marriage proposal. He had less than an hour to celebrate, though—or ponder how wonderful his life would be in his new circumstance.
He was asked to come to an executive conference room, presumably to discuss the logistics of the money transfer. But instead, a manager intimidatingly points his finger in Hoffman’s face and says, “You didn't win. We're not paying you any money. Do you understand what I'm telling you? You're not getting any money.”
In short order, a technician from the slot machine manufacturer arrived and cordoned off the unit. He reported the computer malfunctioned and displayed a jackpot amount that was more that the maximum the machine was meant to pay out. It was declared to be an “erroneous jackpot,” meaning the machine’s memory malfunctioned causing it to treat a losing spin as a winner.
Hoffman’s good luck was null and void. “I was a winner,” he said “and walked out empty handed.” Well, not quite. He was given two free dinner passes.
Of course, the victim of this devastating reversal of fortune sought legal recourse. A state District Court dismissed the lawsuit based on the sovereign immunity of the Native American reservation on which the casino was located.
The New Mexico Appeals Court upheld that decision. The state Supreme Court declined to hear the case, as did the U.S. Supreme Court in 2010. Game over.
I have my own version of a “Not So Fast” story, but the stakes were so much higher.
When Dennis was being intubated in the ER, I was asked to go back to the waiting room so as not to witness the horrifying procedure. Soon a doctor came out and sat next to me. She held my hand and said, “Your husband is in extremely critical condition. If he survives the next 24 hours we’ll have a better sense of a prognosis.”
He was moved to the ICU. He was still alive in the morning. For the next two weeks, while he was in a medically induced coma and on a ventilator, I barely left his side.
Organ failure was the immediate fear. Hour after hour I watched the drip of his Foley catheter. Teams of doctors came and went. After many days Dennis began to stir. His hands moved toward the breathing tube. His natural instinct, of course, was to pull it out.
Big mitts were put on his hands to thwart his attempts to relieve his discomfort. For two nights I stayed up trying to calm him and keep his hands away from his face. The alternative was for his hands to be tied to the bed rails, which only made him more irritated and desperate. It was unbearable to watch.
On the third afternoon, the husband of Dennis’s sister said he would relieve me for a spell. I could go home, shower, and take a short nap before another night shift. I agreed. “Don’t leave him, Bobby. Don’t leave him,” were my last words as I headed for the elevator.
About ten minutes into my much-needed sleep, the doorbell rang. It was Bobby. “There’s good news and bad news,” he told me.
“What’s the bad news?”
“Well, I went to the cafeteria to get a cup of coffee and when I got back there were lots of people and equipment around Dennis’ bed. He pulled the tube out and it was a Code Red.”
I was flabbergasted at his irresponsibility. Had he even told anyone that he was leaving the ward? There was a coffee pot station about ten feet from the curtain around Dennis’s bed, for God’s sake.
“And the good news?”
“They’re keeping the tube out because he seems to be able to breathe on his own now,” Bobby said. My anger settled with this hopeful turn.
By the time we got back to the hospital, the good news had evaporated. The doctor told me that he had to be re-intubated after all. “I’m sorry,” he said. “It’s a setback.”
Many more days passed until, finally, Dennis could breathe without assistance. When the tube came out his first words were, “I’d like a beverage.” Then he looked over to me and said, “I’m so sorry I put you through this.”
“It’s okay Dennis, everything is going to be okay now. Everything is fine. Just rest.”
Within 24 hours Dennis was sitting up and eating. Within 48 hours he was walking by himself and cracking wise. “How’s it going in there?” a nurse asked as she knocked on the bathroom door.” “Is your urination okay?” Above the sound of robust peeing, Dennis said, “It’s flowing like the River Jordan.”
I was told that Dennis’ brain scan revealed “three small infarctions.” “That means he had strokes,” the neurologist explained. “”But the deficits should be recoverable.”
In the next two days Dennis’ recovery was on the fast track. He was transferred to the Rehab unit and began physical therapy.
The following morning, one of the nurses looking over Dennis’ chart noticed that it was his 57th birthday. She ordered a cake to come with his lunch. Later in the day, my mother came to the hospital with a homemade cherry pie—her specialty that had become a tradition on his birthdays.
Dennis was scheduled to be home in two weeks. That would give us about a week to plan what kind of stuffing he wanted to make for the Thanksgiving turkey!
I felt as if I’d won the Powerball Lotto. I was simply giddy with amazement at our good fortune. The exhilaration verged on euphoria. The pure despair of just days before was gone, replaced with blissful gratitude.
The day after his birthday Dennis had a few visitors at the hospital while I took several hours to return to my office. Our dear friend Nancy called me that afternoon and reported how well Dennis was doing and how funny he was. She said, “I told him how proud he should be of you for getting him to the hospital so quickly in the ambulance… And he said, ‘Well, it’s not like Mary Ann drove it herself.’”
When I arrived later that evening, Dennis confirmed that he had a good day. But he was grouchy and frustrated when he couldn’t figure out how to log on to his laptop. I was surprised at his temper, but he’d been through so much. “Relax and take it slow,” I said as I zipped the computer into its case. “I’ll see you in the morning, early, babe.” We blew air kisses across the room and I left.
The next morning, before I got to Dennis’ room, a nurse intercepted me. “Mrs. Watson, your husband had a very bad night.” It was Fate asking me to accompany it to the executive conference room….
She told me that Dennis went missing. He had wandered away in his open-backed hospital gown without anyone seeing him. The hospital police found him at around 3:00 a.m. in the chapel. He told them he was looking for the gym because he wanted to workout.
When I walked into his room Dennis was wearing street clothes, but his shirt was mis-buttoned, and his sweater was inside out. He said he was packing up to go home. When I told him that wasn’t a good idea, he said menacingly, “What part of ‘It’s a Free Country’ don’t you understand?”
I went to get the nurse to explain to my husband that he wasn’t ready to leave the hospital. She came in the room and said sweetly that he needed to get back into bed. He responded just as sweetly that he would. When she left the room, he said to me a blood-curdling growl, “You Gestapo bitch.”
I knew something was desperately wrong. I asked for the doctor, but was told not to panic because Dennis was displaying the classic symptoms of ICU delirium, a condition that afflicts patients who have been under heavy sedation for a long stretch. So, I allowed myself to believe he would get better soon.
But it got worse by the hour. The next day Dennis was barely speaking and too unbalanced to walk by himself. By the following morning he spoke only in monosyllables and had lost all affect. An EEG was ordered to rule out non-convulsive seizures. As the electrodes were pasted to his head, he was barely conscious.
The testing offered no answers. By the time the electrodes were removed, he was in full-blown catatonia, a frightening stupor with odd posturing of his arms. Was it schizophrenia? Electric shock therapy was advised. I researched as much as I could before I signed the consent form. My hand trembled as I did.
A young psychiatry resident urged her colleagues to postpone the electric shock, however, until another MRI could be done. Dennis, though, was unable to follow commands or keep his arms still. This made the imaging impossible. What next?
A senior staff member urged the administration of something called an “Ativan Challenge.” Large doses of the drug given through an IV push had been known to bring catatonic patients back to consciousness. Again, I was asked to okay a procedure that scared the bejesus out of me. But what was the alternative?
It didn’t work. Dennis didn’t open his eyes and say, “Did the Red Wings finally win that last game?” The Ativan knocked him out totally. He stopped gesturing and his arms fell to his side. The only upside was that this motionlessness allowed for the MRI.
The information it provided was devastating. Large portions of the white matter of his brain, the myelin sheath, had fallen away, leaving his primary nervous system unable to function. The diagnosis was Delayed Post-Hypoxic Leukeoencephalopathy—a rare condition that affected a small fraction of people who had suffered a lack of oxygen.
It was a raffle that no one wanted to win. But Dennis’ ticket matched the one pulled out of the fishbowl of bad luck.
“He’s a total,” I heard one nurse aide say to another outside the hospital room door at shift change. It was her shorthand way of letting the incoming aide know she wasn’t going to have an easy night.
My intellectually brilliant and remarkably athletic husband now had a feeding tube in his stomach, was unable to urinate without being catheterized, was unaware when he messed his briefs, and would drool as his eyes darted randomly without focus.
I applied for Family Medical leave from my job. A doctor’s prognosis was part of the paperwork. To actually see the words “Might not recover at all” was like a gut punch. As if the higher court decided not to hear the case. I had to sit down and put my head between my knees to prevent fainting.
There was nothing more that could be done at the hospital. I was told that the “good news” was that myelin could regenerate. The “bad news” was that is was a horribly slow process and Dennis’ demyelination was severe.
“What do I do if he doesn’t get better?” I asked one of the neurologists. I remembered that Dennis once commented that he would never want to be like Ariel Sharon, the former Prime Minister of Israel who was kept alive in a coma for his final eight years.
The answer was offered without emotion. “If he stays in this condition he will eventually develop pneumonia and you will decline to have him treated with antibiotics and his life will end.”
Dennis was moved to a nearby nursing home…and in the middle of that long, dark night I wondered what the odds were that I would have to make that decision.