Shifting away from the melodrama...

I figure that the surgery-related posts have given us all enough dreariness for now; it is time to catch up on a couple of episodes that will hopefully take the maudlins away.

First, by popular request, the business over the dishy Deputy Ambassador. Goody!

One of the simple pleasures to emerge during the Korea years has been membership at the British Embassy pub. It has been a little slice of home in a foreign land: packed with Brits, good beer, and familiar accents. It runs simply: every Friday night, the bar is open to members and guests. Embassy staff serve the drinks, while expats and some locals crowd in for the company and conversation. I've struck up several good friendships there- it is where I first met the couple who Annie will be moving in with next week, for example- and the people have been as kind and concerned about my health and its physical impact as they have needed to be- and being British, have promptly found ways to help me laugh at it. My membership has initiated participation in related mischief such as the Robert Burns Dinner in January and the St Andrew's Ball in November. Both events are brilliant - whiskey and kilts, with poetry in the former and Scottish Country Dancing in the latter. I am good at poetry. I am less good at dancing.

Last January, a gaggle of friends and I toddled along to the Burns dinner, and my (I flatter myself) gift for pithy rhyme resulted in our table winning the poetry competition. The prize for this included tickets to the next society event, the Muckleshunter, which I was unable to attend. Instead, I was given a ticket to the Ball, to be held next Saturday night.

This Ball originated in a different era in Seoul. The St Andrews Society was made up of ex-pats- mainly Scots- none of whom was of the ilk to retire early from a knees-up, and this Ball was a serious knees-up. Formal attire, sixteen or so different dances, food of a Scottish flavour- including haggis- and more whiskey than the human imagination could conceive. There was still a curfew in the city at that time, and the party-goers figured that the best way to beat the law was simply to keep playing until the next morning, serving breakfast before departing for home. The curfew has disappeared, but the pattern remains: eat, play, drink and dance the whole evening away.

It is a great night out. While I am not generally happy to stay up all night, I have managed it- the biggest issue for me remains the dancing. I have no memory for dance patterns, and this is ALL about remembering when to cast off or set or which partner stands on which side and gets swung round... Honestly, it is a debacle. I can barely manage to coordinate myself during aerobics- add another seven couples into the mix, high heels and a long dress. Farce. I think people may pay the ticket price just to watch.

So, when the posters went up and friends started committing to go, it was clear that some pre-Ball practice would be required. The dances were all laid out on the website, but friend Alex and I determined to attend one of the official practices at the Embassy. One Wednesday afternoon, we toddled onto the bus and headed for Seoul.

The Embassy grounds are in the City Hall region of town, one of those interesting enclaves where stepping five paces off the main drag makes one feel like the city is somewhere else altogether. We passed through the guard gate without incident, and headed down into the basement of the long grey building that houses the various departments of the diplomatic services. The crowd had already gathered, dotted here and there with familiar faces: the Head of the British School, a few teachers, several acquaintances from the pub, and the Deputy Ambassador.

Time for an aside: I have no interest whatsoever in this man: would not, could not, do not. Important to say this from the outset, however briefly. I won't belabour the point, beyond insisting that it is true. However, he is quite startlingly attractive, in a Greg Wise/public schoolboy sort of way. He is attractive enough that, despite aforementioned total lack of interest, he renders one babbling and blushing, much as an unexpected encounter with Johnny Depp or Clive Owen- or indeed, Greg Wise- would do. I see him occasionally around the pub and its environs, and he is unfailingly gentlemanly and pleasant, making no reference at all to my inability to string together more that four monosyllabic wanna-be words in response to his greeting.

This night at dance practice, he was there. Alex and I took to the floor for the first reel. She, dance professional that she is, was quickly counting off the steps and learning the routines. I, on the other hand, was trying not to fall over, crash into the walls, or step on the feet of the people in the set on the other side of the room. Graceful, not.

My energy levels at the time were still at a low ebb, this being a few months ago while I was in the middle of my second round of chemotherapy,  and Alex was prepared for me to need to sit out most of the dances. That was okay. Her goal was to run through as much as possible to get the steps into her head so that she could teach them to the rest of us. After the second interval, I was ready for a break, and asked to be excused. My place in the set was immediately- instantly, in fact- appropriated by a young man who had been hovering on the edges of the room for about half an hour. He leapt forward so rapidly that I could have been forgiven for thinking he'd been muttering incantations against me from the sidelines, wishing me ill so that he could step into my space. He was clearly very happy to partner Alex.

Alex was, as always, kindess itself to the young man. He was a familiar face to me, but conversation with him had always been limited because of... well... trying to remain generous here... his being highly focused on his work, shall we say? Soooooo very focused. Poor man. He was also very interested in the lovely Alex, and refused to leave her side for the rest of the evening, even when I had recovered enough to take my place back in the dance. He would not be shifted, despite my loud attempts to rescue her from his determined clutches. Alex, a painful plea for help in her eyes, found herself with him in a group that contained several hard-core Scottish country dancers; a few converts to the form who were bossy, pushy and irritable with any new additions to the set, and who were impatiently shouting at the unfortunates who missed a step or headed in the wrong direction. I was well out of it, and did not mind sitting quietly on the side, pretending to count off the steps and learn the moves as I watched.

I was startled suddenly by a figure blocking my view of the dance floor. It was the dishy Deputy Ambassador:

DDA: Excuse me,
P: (scarlet) Blurgh?
DDA: My dance partner has to leave now. I wonder if I might trouble you for the next dance?
P: Bleegle, furshwollup.
DDA: That's lovely. Thank you so much. I will be back as soon as I have waved her off.
P: Ack, pleck-wipple blem.

At least, that's what I think I said.

I struggled in vain to find something to say that made me sound less moronic when he returned. In. Vain. He came back from helping his partner on with her coat and saying goodbye, reached out his hand in a 'Nobody puts Patti in the corner' gesture, and led me to the set of in the corner of the room, where I was welcomed by a simply lovely group of people who were accomplished enough in the moves of the Posties' Jig to guide me gracefully through its overs and unders and arounds and throughs and swings for the next fifteen minutes. All this, with dance partner encouraging and smiling and generously ignoring my total incoherence. Not the belle of the Ball, no. But definitely no bad. Nooooo, sir.  

And as I glanced over at Alex's set, I saw one of the cranky experts push his partner into the correct space with a scowl, nearly knocking Alex over in the process. She caught my eye and mouthed, 'I hate you.'

Grinned so hard I darn near broke my face off, and swirled away.

When the worst was over...

That Wednesday of the second surgery- wretched, wretched.

I have referred in an earlier post to an elephant in the room. At the time, it was Annie and how she was responding to this whole episode. She remains well; an astonishing young woman, who thrives and sparkles and looks forward to conquering her own universe one day, despite schoolwork woes and the caddish behaviour of a young man or two.

Many readers who have known me longest will know that there is another elephant- one that has been around longer than even the teen, and considering what you know of my upbringing, I’m a little surprised that no one has asked after it.

I was born on a Sunday, almost exactly 45 years ago. The next Sunday, I was in church. I was raised in the kind of household where one missed church only if one was dead or dying- and even dead, there was at least one more service to get to before six feet of soil prevented further attendance. While my folks never actively insisted that it be so, I recall the faith of my childhood to be predominantly based on rules and fear. There were a lot of ‘thou shalt nots’, which seemed to include a fairly arbitrary collection of things that increased as I grew older and discovered boys. I remember the fear most clearly, however. My youth rallies and camps were the sort liberally sprinkled with films about the end times and encroaching Armageddon, designed to scare the Hell out of us. I was generally convinced that the four horsemen of the Apocalypse knew where I  lived, and were likely to come clomping up Union Street at any time, with a vendetta up their sleeves with my name on it. Eventually I out-grew the fear, about the time I realised that I was basically a liberal, and that if there was a God, He probably didn’t actively have it in for a skinny nine-year old way down on the South Shore of Nova Scotia. The fish He was frying were probably bigger. He also probably had a far better sense of humour than people gave Him credit for, as was evidenced by the ridiculousness of most of those people so devoid of humour. Relinquishing the fear made me sleep much easier at night. It did not require me to relinquish faith.

I do not intend to bang drums or blow trumpets about faith here. It was never my style, not really, despite the frequent sanctimony of my youth, and my attendance at obscure little denomintional colleges, where I learned much about just how ridiculous the humourless people are, and showed an early inclination for seeking out comrades most likely to bang their heads repeatedly against the status quo. My faith has been consistently quiet. A big, quiet elephant.

And this last twelve months, it has been rocked to the core, as quiet and inoffensive as it has tried to be. Trust and love have been given and squandered. Loneliness and ill health have arrived; at times they have been overwhelming. ‘Nuff sed. It was what it was.

I will not rail here now- though I have many times, off piste and on. You are all likely to know the code: who ‘Cosmos’ is, and who I rant and rave at when I shake my futile fist at the skies. You might also know what I have come to think of Grace, in its many quiet guises.

When I was teaching GCSE English, I used to teach a poem called ‘Blessing’ by Imtiaz Dharker- deceptive and uplifting, but only momentarily- about the bursting of a water pipe in the middle of a slum in India. Fleeting relief arrives, and is greeted with dancing. Just one short line sticks in my head now as I think of the first night after the hysterectomy, as I lay aching on that slab of a bed:


‘the voice of a kindly god.’

I have hurled a thousand prayers at the sky in this last year, and I won’t list any of them here. The sky has frequently remained silent, as is its wont. But Grace has many new guises- the nurse dancing into the room, singing my name and brandishing an unrequested ice pack for my head; my mother’s hands rubbing cream into my swollen feet, colleagues helping my brother get into mischief while he was here, the same brother understanding the love I bear him through our years of easy silence. Grace also arrived during the long night after that awful second surgery, disguised as a simple text message from a tender soul who was listening out, miles away. Say what you will, it sounded like the voice of a kindly god when I read it:

Sleep, sweet girl. I am here.

This is not to say that I thought a god was speaking. Just that I felt then, during the worst of it, that there was someone standing vigil. It mattered.

Tonight I sit here in the flat on my own, pondering the next steps. I have been back to the hospital for my post-op check, you see, and while people were basically pleased by the outcome of the surgery and are (apparently) rather impressed by my powers of recuperation- {Yes, Maggie, I did don my wooly tights and discharge myself two days after the hysterectomy, and am planning a separate entry to cover the oddities of that last morning in hospital, drainage tube removal and an eyebrow-raising exchange with my surgeon}- while they were basically pleased, it turns out that some cancer cells remain. They lurk and simmer, waiting the first chance they get to turn into something seething and nasty. So, having had advice from the first hospital that was, in my disappointed state, rather unfathomable: (‘You mean I’m not done yet???’) I sought a second opinion from another. They agreed with the surgeon from the first- I need to have more surgery, and to have more tissue removed. When this will happen, I do not yet know. I need to go back and discuss it again with the professionals.

I am weary, disgruntled and a little depressed again. It would have pleased me immensely to have been able to draw a line underneath the whole episode. I have things to do, universes to conquer, new prospects to explore and adventures to embark upon! I look well, feel better and more positive overall than I have since arriving in Korea. However, the saga seems set to continue further.

So, the girl heaves a deep breath, adjusts the seat belt, and heads again into the ring. She’s ain’t done, but neither is she dead yet. She’s still here, mixing her metaphors.

And in her corner: kindly voices.

Surgery Number Two- Subdivision A

It has taken two and a half weeks to reach this stage of the tale, not because of deliberate heel-dragging, but because there have been so many other things crowding the front of the stage, so to speak. Since the hysterectomy, I've had the recovery time in hospital- upon which more shall follow- the return home, Bert's last few days in Korea, Annie's trip to Mongolia, my staged return to work, the remainder of Mum's visit, band rehearsals and a performance, a trip to Seoul for Parent-Teacher conferences, several visitors, the one week check-up and pathology report... Girl's been awfully busy!

The details of the final days in hospital must be processed, however, and so we pick up where we left off: the preamble of the hysterectomy. You will recall that the operation was deemed medically necessary because I had thickening of the uterine wall (which was discussed no further by the surgeon, who packed me off to the gynecologist immediately) and a seven centimetre myoma on the uterus (discovered by said gynecologist with the light sabre) that might or might not be cancerous, and because the breast tumour was caused by hormones; if I wanted to remain tumour free, I needed to become uterus and ovary-free. You will also recall that the operation had been cancelled once by the insurance company because it was NOT deemed medically necessary, postponed once because the hospital did not have my blood, and prepared for twice because two of the departments involved in my case don't speak to each other, even though they are housed in the same suite of rooms and their reception staff share a desk.

Well, now that we're all on the same page, let us proceed:

When day dawned on the Wednesday, I was still a bit phased by yet another night spent with constant interruptions from nurses and trips to the restroom. The operation was scheduled to take place earlier in the day than the lumpectomy had been, so there was much less preamble. I did get a visit from the surgeon on his early rounds, however, minions in tow. He lifted the dressing from the wound for the first time to have a look at the incision, which I also examined with great interest. The wound started about an inch and a quarter to the right of my nipple. It curved up and around the areola and back down, cutting across a section of it before finishing in a flourish two inches on the left of the nipple. The whole incision was about four inches long in total, and was held together by tape rather than stitches. Above the whole area was the most glorious purple and yellow bruising, angry and swollen. 'Very good,' the surgeon said after a brief glance. He taped the dressing back and left me to fiddle with the velcro fastening on the hospital-issue bra. (I hope to return to this marvelous contraption later- a wonder!)

So all seeming well with one operation, we continued to get ready for the second. A nurse arrived with a clean set of surgery-wear and helped me into it. Another giggled into the room to take blood- this time from my leg, which seemed odd. A third, straight-talking and efficient, arrived to give me the jab in the backside (and again, slapping the area firmly really hid the fact that she was stabbing me with a very painful shot- how canny! Try it yourself next time!). Next, a trainee arrived to insert the catheter, deemed necessary for this operation where it had not been for the first. The point was that I was basically not to move after the operation for about twenty-four hours, so the midnight excursions to the bathroom were halted, as was the line-dancing down the corridor. Shame. After about a quarter of an hour, her supervisor arrived to check the work, tutted disapprovingly, removed the first attempt and did it over again herself. Yes, try to think of something more pleasant than having a catheter tube inserted twice, and you'll not have to try hard. However, compared to the nasty fluid that dealt with the rest of the necessary evacuations, and the needles, probes and scans of the previous few days, it was a walk in the park.

All this completed, I was once again fetched away by porters and crowded onto the service elevator with half a dozen other coughing/gasping/pale n' wan masked figures, and rolled away towards the operating theatre. This was in a different room from the last surgery. In fact, while I was in the operation, my whole case was going to be shifted into the gynecology department, requiring Mum and Bert to pack up our things and get them moved to a new room on a different floor. I would be oblivious, of course.

The room was more spacious and chilly than the one I had been in two days previously. There may have been as many people, but there seemed less bustle, less haste. This may have been just an impression. I was already feeling a bit groggier this time, due to the needle having been administered slightly earlier. Still, the eyes that appeared above me registered:

PoE2: Hello, again!
P: Hello- how are you?
PoE2: (Placing the mask over my face) Errr- fine. I am anesthetist! I was in operation Monday!
P: Lovely to se...

There were no dreams this time. There was no irritating song repeating itself in my head, nor absent seams of thought stretching across my sleep. When I woke again to the sound of my name being shouted repeatedly in my ear, it was all roaring. Everything was roaring. The air conditioners, the swirling figures in the recovery room, the tension across my shoulders, the uncontrollable shaking, the cramps, the emptiness, the feeling of having been scoured. I was aware that my eyes were open only because I could see my hands quivering in front of them. I knew my ears were functioning because I could hear my own whimpers and moans and woundedness. This was not a gentle awakening. There was no smug satisfaction or acerbic observations to be made about the others in the room, nor was there any awareness of the cabinets or clipboards or colours around me. I can describe nothing of my surroundings. Everything was inside, everything roared. The figure that approached and asked if I was cold barely registered. I must have said yes because a wide tube was slid between my blankets and warm air began to surround me. It did not stop the shaking.

I cannot tell you whether what I was feeling was pain. It felt lesser than pain, but as visceral. I felt savaged.

Someone must have come and removed me from recovery, but I recall nothing of the journey to the new room where my mother was waiting. I know that I arrived, because through a haze the nurses transferred me from one bed to the other, four little hustling figures shifting my moaning, shivering mass in a tangle of wires and tubes and soiled hospital cotton. The bed was lowered flat, and I was laid across it, shaking, crying, keening. I was vaguely aware that Mum was somewhere in the room, vaguely aware that she would be finding this distressing. There was nothing to be done. Absolute helplessness.

The nurses continued their ministrations: business-like, inscrutable. The wires and tubes were assembled and my modesty covered. A painkiller was added to my IV, and then an additional bottle was attached, a small plastic orb with a blue button pressed into my right hand. I was whisperingly informed that this was more pain relief and that I should push the button when I needed to. The nurse demonstrated. The fluid burned as it entered my arm, but the edges of the pain became less distinct. I was told to be still, that I was not to sit up at all, but that I could move onto my side if I needed to. I was told that my back would hurt. I cannot tell you what else I was told. Gradually, slowly, the blurs began to take shape and the world started to include the rest of the room.

I was never so glad to have my mother with me.

The Lumpectomy, etc

Annie and Bert arrived from home during the final preparations for the surgery: assorted tube adjustments and changings of garb and needles in the backside (Did you know that when the nurse slaps you repeatedly while giving this injection, it hurts less??), and the worried-but-hiding-it-very-well teen hovered with me for the last few quiet minutes before the bed upon which I was to ride to the operating room arrived in a flurry of porters. A crowded service elevator ride later, and I was wheeled in to a bright green, icy cold room with high ceilings and powerful lighting. It felt like there were dozens of people there, all in surgical scrubs in a colour range designed to indicate their role in what was to follow, with faces covered by masks presumably to prevent me from seeing that they all were sixth graders on a field trip from the local middle school. I was left briefly in the centre of this room while the bustle continued around me. Strange, that. All the action spun and circled like a Disney dance routine; the bed in the middle and its occupant oddly detached from it all.

A pair of eyes leaned over me from my left.

PoE: Patree-cha?
P: Hello! How are you?
PoE: Err. Fine. Do you know what operation you are having now?
P: I am having a tumour removed from my LEFT breast.

This was not the first time that I had been asked to confirm what procedure I was there for. While I knew that it was part of the process, and designed to avoid any mishaps (like you know, doing a hysterectomy or something ridiculous) I was mindful that some people didn’t actually seem to know why I was there for certain themselves. I was happy to continually remind them. Another pair of eyes, this time from above:

PoE2: I am anesthetist for surgery.
P: Happy to meet you.
PoE2: I am putting mask on you and you will be asleep in count of ten.
P: Wanna bet.....?

And then I woke up.

It wasn’t just like that, actually. I do vaguely recall a sense of dreaming: wide, rambling dreams without edges, the song ‘What Does the Fox Say?’ running through my head- curses to Annie for last song syndrome- and then a very loud voice repeating my name, very close to my right ear. THAT’S what woke me.

The recovery room was slightly warmer than the operating theatre. My bed was one in a line of about eight, all occupied by people in varying stages of consciousness, all surrounded by another swirling mass of masks and scrubs and clipboards. A large, metallic cabinet was against the wall just to the side of a long desk. From it, nurses operated a rotating system of removing and replacing blankets that would be stretched over the recovering patients briefly, then whisked away when the beds were rolled out. I was absently aware of increasing clarity; the cabinet became more defined, the noises of the bustle more distinct. There was heavy bandaging over my breast, my throat was so sore and raw that my tongue also ached. Swallowing made me wish I could go back under. Checked my toes- they worked. So, too, did my fingers. All was well so far. There was a dull ache in the breast, and I nervously ran my hand lightly over it. I could not feel much, but there was definitely still something there. This was a relief, as it had been made abundantly clear to me that if something horrid were discovered when they opened me up, it might well just be lobbed off. Highly unlikely, considering the extent of the examinations I had undergone beforehand, but one never knows what will happen when the mask descends.

I lay there for several minutes testing my limbs and digits, feeling very proud of myself for being more alert than everyone around me, before a bustling nurse decided I was cooked enough and rolled me out to a waiting porter, who returned me to my room where my tense family was waiting.

In truth, I don’t know how tense they actually were. While I’d been under, the three of them had wandered over to the MacDonalds across the road, where Bert and Annie had somehow managed to make Mum steal a couple of plastic glasses, the account of which proved far more amusing to the two masterminds than to their glasses mule. While I was having the hysterectomy two days later, Mother quietly went back across the street and returned the glasses. Bert returned himself later and stole two others. My family and other criminals.

They were all lolling about in my room, being just so typically LONG. You’d never know any one of them was worried about anything unless you were fluent in mockery and derision, and Bert and Annie were playing around with their anxiety like a comedy duo. What people would have thought if they’d understood them, I don’t know.  Even Mum joined in, despite being a Johnston and generally above such shenanigans. Every one of them was being a smart ass and and most of it was at my expense. Other than a few jibes about the nurses refusing to let me drink anything and the soreness of my throat, the details will remain hidden in the post-anesthetic fog for now; I will wait for Annie’s next ingrown toenail to have my revenge.

The little marvel had, however, managed to sort out the internet connection for me, so within minutes I had logged into my bank account so that I could make her school tuition payment. This is when the surgeon walked in, accompanied by his intern-shaped minions. He stopped in his tracks:

S: You’re working???
P: No, no- oops, bugger, no- I’m just- hang on, let me press ‘send’- wait, almost...

To be honest, though, considering how smug he was months earlier when he told me that a Korean woman would be back at work in two weeks, I don’t actually mind overmuch him thinking that I was working half an hour after leaving the recovery room.

His smug just kept coming. He informed me that he’d removed what remained of the tumour and some surrounding tissue and it looked like all the cancer cells were gone; we would need to wait for the pathology report to be sure, but he was pretty confident. He also told me that I could drink some water whenever I wanted (‘Go, mother! Go now! Get water!’) and that I could also go get some dinner when I felt like it, as I had missed the afternoon meal. This was all good news. I must confess, that I was most excited about being able to drink. The intubation process had left me in a bit of a bad way.

Mum and I wandered downstairs later on to the cafeteria to get some Bimbap- the sizzling stone bowl kind that is my absolute favourite. Eating was painful, and not just because of the inevitable mouth burn one gets from shoveling the scorching, charred, nutty deliciousness into one’s mouth- seriously, go the hospital just to get this; it’s fabulous- but also because of the sore throat. Mum was a bit taken aback by the raw egg resting on top of the food- another surprise that wasn’t bad, just surprising. We toddled back upstairs afterwards, and settled in.

Well, settled might be a bit ambitious. That first night was a constant swirl of visits and noise. The nurses obviously came in regularly. They could not do so without turning on a couple of lights, and they inevitably came in to take my blood pressure and temperature before returning to their cart to pick up odds and sods that they reckoned I needed. Mother was astonished that they would just walk away and leave the cart unattended. I was astonished that anyone would get any sleep at all in there. It was a bit frustrating how often the nurse would press the button on the automated inflation what-cha-ma-callit and then wander off, letting it blow up and squeeze my battered arm painfully and then deflate entirely before she returned and had to repeat the process to get the reading. The record for this was four times.

In the morning, my throat was still sore, but recovery was pretty rapid. There was a steady stream of nurses and doctors, all followed closely by smatterings of young med students- kindergarteners, all- checking wounds and temperatures and blood pressures.  I was feeling very well, in all honesty reaching the ‘Am I really so ill that I couldn’t be at work?’ stage by about three in the afternoon. My mother sighed heavily at this.

She was doing well. I was not an ideal patient, in that I needed very little done for me. She occupied herself by writing in her notebook and chatting and occasionally recounting the view over the parking lot behind the hospital:

M: Patricia, you wouldn’t believe this!
P: I bet I would. I’ve seen the driving here.
M: That guy just backed into an empty parking space, with no other cars around him!
P: Sounds about right.
M: And there’s another one- he’s pulling into a space next to another car- but there are three empty ones on the other- WHOA!!! He just hit the other car!! He’s just driving off!! He’s... he’s... he’s moving to the next row and parking!
P: It gets really fun on the streets next to convenience stores.
M: (turning to stare at me, aghast) This is the Korean Air parking lot. Those guys could be pilots? They fly PLANES??
P: Well, probably not all of them.

She would wander down to the basement level to pick up some food or cough drops for me from time to time, and was quickly coming to terms with the comings and goings of the nurses and cleaners. We were impressed by the nurses, who were unfailingly perky and bubbly as they came in to administer potions and needles. It occurred to us that they were, in fact, bizarrely cheerful- most of them would just start laughing openly at me as soon as they came through the door.

Towards the end of the working day, I was visited by Hyungji and a high school freshman, whose task it was to see that I understood the procedure that would be taking place the next morning. I was led into a small office, and before I was properly assembled in the seat in from of the desk, my mother was summoned to join me. Neither one of us is entirely sure why, even now. The doctor adjusted a video camera- apparently, all these meetings were meant to be recorded, presumably to avoid litigation later- and began to outline what would happen in the operating room and beyond. There would be four incisions made: one at my navel, another at the top of my pubic bone and one on either side of my abdomen. There would be a tube inserted, and my belly would be inflated. Then, all sorts of funky cameras and knives would start rolling and flashing around in there. (My words, not hers). A few quick snips, and the whole bally mess- ovaries, uterus, myoma, all, would be removed vaginally (Sorry- should I have issued a user warning here?? Wait till I describe the removal of the drainage tube!). There would be a few dissolvable stitches on my cervix, and one in each of the incisions.

Tidy.

Unless there was a problem.
They reserved the right to change track in the middle of the operation and slice me wide open. If it proved difficult to remove things vaginally, they would just go in from the front. The recovery implications were huge: no lifting, no driving, no return to work for weeks, no exercise, no sex for three months (she kept repeating this last- I don’t know if it was because I had an especially libidinous look about me, or if it was because she saw me cringing - ‘Kid! My MOTHER is sitting next to me!!’) constant rest, yadda, yadda. Clearly I did NOT want to have this procedure done abdominally. I agreed to all, signed all, shuffled out and away.

I had asked that no one visit on the days of the operations, so my first company came that day in the form of my department from school, who clambered in all lively and bearing gifts of ice cream and juice. The description of the parking lot antics was met with sage nods. They were followed by Phavana and Aruna, who was keen to show me pictures of her not-quite-done-yet baby brother, due to arrive in December.

As the evening moved on and the company began to disperse, the preparations for the hysterectomy began. The dreaded box containing the nightmare powder and mixing flask arrived, amid many shivers and whimpers from me and sympathetic strokes and giggles from the nurse. Once more, I shall not describe the outcome. Feel free to let your imaginations run wild.


Coming up - Surgery # 2

Shenanigans, Part 3- And the action picks up...

So the evening passed, as did many other horrors. Throughout the night, the workings of the hospital continued: blood pressure checks and IV bag changes and discovering the limits of my mother's hearing aids. It will always astonish me that she is unable to hear regular conversation without the volume turned to maximum- and sometimes not then- yet a few keystrokes of messaging- SILENT keystrokes of messaging- on my iPhone at two in the morning will send her sitting bolt-upright on the sofa, with a startled 'What do you need?'

Dawn broke and the chain of events began to speed up towards the surgery, scheduled for just after lunch. I had been told that there would be a few more procedures coming, including a scan, an ultrasound and a mammogram to further confirm the location and current status of the tumour. This process started at about ten to eight, with the arrival of a spotty, universal-teen porter. You know the sort: gangly and languid and texting carelessly on his phone as he guided me to the service elevator. He was wearing a face mask, as so many people here do. I have become increasingly grateful for this over the last few months- hospitals are full of sick people, and there is no habit of covering up one's mouth when one coughs. I suspect that the masks are meant to prevent the wearer being infected, rather than consideration of others, but I do not mind.

The whipper-snapper gossiped aimlessly with a chum as we went down to the Radiation Department. It was early, and there were few people around in the corridors. The first familiar face was that of the friendly (and slightly dishy) technician who had given me the first radioactive jabs about a thousand years ago, near the beginning of this process. He was still as cheerful and slightly bewildered as before, and greeted me amiably. The other nurse, also one I had encountered before, came along shortly thereafter and dashed back and forth between me and another couple of customers before coming back and guiding me to the room where the scan would take place. I had been in this room twice before, and both occasions had resulted in strange blisters on my lips and foggy, indecipherable photos of assorted body parts- the sort through which my surgeon apparently identifies me.

The nurse talked me through what would happen next. Her English was limited, but perfectly adequate- she would be injecting a substance directly into my breast, as close to the spot of the tumour's origin as could be managed. This would hurt. Quite a lot. She then would spend five minutes rubbing this substance into the area, making sure that it would be nicely slooshed and spread about in there. (She did not say 'slooshed'. That would have been far more than just adequate- it would have been rather brilliant.) I do appreciate the candour of the people I have encountered in the hospital. It is easier and more affirming to be told the truth straight away- one can not only prepare oneself, but one also is not made to feel like a big baby when the procedure doesn't actually just sting or pinch or burn a bit- but when it bloody HURTS. 

She was right. It hurt. When the first biopsy was taken way back in May, the technician paid me the courtesy of anesthetising the area. That was the only time anyone has given me anything to reduce the discomfort of the procedures. Not even a congratulatory lollipop. The insertion of the needle into a space already bashed about by the growth of the cancer was pretty flipping wretched, in truth. The rubbing afterwards was less sharp and invasive; however it smeared the pain around, sharing and squashing it through the rest of the breast. I still wince at the thought.

Eventually, the rubbing stopped, and she stepped away for the machine to do its noisy and mysterious business. Within about twenty minutes, I was being helped down from the table, my IV trolley being rearranged around me, and my feet being slid back into my slippers. Thanking the technicians and bowing, I headed for the door.

On the other side stood Hyungji, ashen-faced, and one of the young doctors who had visited me the night before. I could not recall which procedure he'd spoken to me about- there really were so many. Something was clearly amiss. Before I could get out my usual 'Hyungji! How are you?', she was speaking:

H: Patricia, there is a problem with the surgery.
P: Uuuhhh, go ooon....
H: The hysterectomy is cancelled because there is no blood- you have a rare blood type.
P: Yes, I know I do- they told me last night that there was a problem with the blood. But they kept getting me ready for surgery, so I thought it was sorted out.
H: No, they do not have the blood.
P: Then why have they continued to get me ready for the operation?
H: Because they don't need blood for the breast surgery, they need it for the hysterectomy. The preparation is because the breast surgery was not cancelled.
P: And no one told the people operating on my breast that the hysterectomy could not go ahead?
H: I am so sorry. This is terrible.
P: So, what exactly are they telling you?
H: They want you to check out and come back and do it all Wednesday, when they can get blood.

Now, reader, I have been able to maintain pretty good humour through my dealings with the hospital and its staff, despite language barriers and culture-butting and the bizarre nature of non-socialised health care. I have managed, despite fear and uncertainty, a determination to ensure that dealing with me is as easy and good-natured a process as possible. I know that it can't be easy, taking a non-Korean speaker through this whole business. They have a tough job, and do not need me to make it tougher through bad humour or rudeness. However, I had just emerged - LITERALLY AND ACTUALLY just emerged- from a procedure so painful I made it through whistling the whole first verse of 'If I Only Had A Brain' while trying not to cry, hot on the heels of a night spent dashing back and forth to the bathroom for purposes that cannot ever be shared in polite company, in a room with a mother who leaped out of her skin with every shift or shimmer, frightened that I had fallen out of bed or garrotted myself on the IV tubes. My patience had worn thin. Dangerously.

P: Haaaaang on. They want me to check out of the hospital and return in two days?
H: Yes. And they will do both operations on Wednesday instead.
P: Because THEY did not get the blood that they needed in time for my operation?
H: (Blushing) I am so sorry...
P: No, no. You do not have to be sorry. I just want to be clear. They KNEW last night that they did not have blood, and they STILL prepared me for surgery through the night and this morning, and they want me now to go home?
H: It should not have happened.
P: Well, quite clearly! So, if I am to be sent home, will the insurance company need to authorise the procedures again? They will not want to pay for anything twice- who will pay for the night in the hospital room if I am to check out now?
H: Well, the room will have to be paid for...
P: Yes, it will. But clearly NOT by me. How much would that cost?
H: (quiet voice) About two million won.
P: Two thousand dollars. No. This is not my doing. I will not be paying that bill. And what about the test I have just had? Presumably they will not need to do that again Wednesday...
H: (Speaking quickly to the doctor, and looking stricken) They would need to do that test again.
P: Hyungji, that procedure was terrible! I am expected to go through that twice because the hospital made a mistake? What about the rest of the preparations? What about the things I had to drink last night to get ready? I would have to do that again??
H: Yes.
P: And who picks up the bill for that?
H: (silence, lips pursed, head bowed)
P: Hyungji, you asked me months ago, at the very beginning of this whole process when I was first diagnosed, WHY Westerners go home when they fall ill here. THIS is why. THIS is what they are afraid of.

She was deeply apologetic, of course. I was left with a choice. I could go ahead with the lumpectomy as planned and delay the hysterectomy until Wednesday ('And are you SURE they will have blood??' 'Yes, they will have blood.'), or I could go home and come back two days later. (And have the hospital try and give me a bill that I could not afford and would not pay, meaning that they would be unlikely to treat me at all if I returned.)

Rock, I'd like to introduce to you Hard Place. Hard Place, this is Rock.

There was really only one choice, as my mother and I discussed a few moments later: to have the breast surgery, and then do the hysterectomy two days later. At least something would be accomplished, and the charge for the room would not be wasted.

What was the learning? Well, first of all, that my doctors would really only talk to each other to confirm arrangements, not to consult on my case. Each one of them- highly trained and skilled and specialised- was treating my illness and their treatment of it as three separate events: the breast surgery, the hysterectomy and the cancer treatment. I had some evidence of this beforehand, of course, when there was some debate about whether I would be having a total or partial hysterectomy, for example. However, the fact that I would be getting prepped for one surgery when it was impossible for the other to proceed- well, I was speechless. No, not exactly speechless. I had plenty to say. But this we learn: that is the way things are done. For any one of them to question decisions made by any other of them - or even to double check some of the details- would be insulting. I do not think they were risking my health particularly; I do not deny their skill or expertise in any way. They are all exceptional. But Lord, Lord. One conversation and a modicum of different thinking would have made a big impact, and would have saved me from having to drink two gallons of vitriol again on Tuesday night.

I called Hyungji and told her that I would go ahead with the lumpectomy. She informed me that she would let the insurance company know that there would be a change in date for the hysterectomy.

H: Oh, and by the way...
P: Yes?
H: I spoke to the people at the blood bank and they said that they did have blood for you yesterday, but that there was a car accident emergency last night and they needed to use the Rhesus Negative blood for that patient.
P: Thank you, Hyungji.

Do I believe this? Does it matter?

Preparations for the lumpectomy continued now that the decision was made. The remaining tests, I was told, would include the insertion of some wires, an ultrasound, and a final mammogram. The wires sounded like something new and fun.

The same spotty teenager came and fetched me down to the women's cancer ward. It was a bit like old home week, seeing the receptionists and technicians there. I feel like we all go way back, now, and the loss of hair and addition of iv and trolley only heightened the regret of our interactions drawing to a close.

Well, not really. They've been absolutely lovely, but I really don't think that any of us expect to regret me never returning there.

The technician led me into the ultrasound room. Here, I had been subjected to the first invasive tests five months before, carrying on with the girls about the 'Snap!' of the biopsy gun. We had also talked about Italian vacations and practised our vocabulary together. This day, it was all business. They were going to help the surgeon locate the tumour remnants precisely by inserting a wire into the centre of the mass area.

P: (bleakly) Eerrrrrrrrr.... a wire, you say?
Techie: Yes. We will put needle in first and then insert wire through needle. It will hurt.
P: Terrific.

The levels of pain I've experienced over the last few months have grossly exceeded anything I had previously known. Many women cite childbirth as their most painful experience, but I do not. Annie was born by a wonderfully medicated Caesarean section, having been stuck so nicely in the breech pike position that had she decided to turn they'd have felt it in Aberdeen. I elected for the operation- wisely, I still think, as it turned out to be the most pleasant part of the whole 40 weeks- and was awake throughout. They gave me an epidural and I was doped up nicely enough that I was able to communicate cheerily with the anesthetist:

A: Make sure you tell me if you feel any pain at all, and I'll give you more anesthetic.
P: It's weird- it doesn't really feel like pain...
A: What does it feel like?
P: Well, you know when you pull the meat off a chicken bone?
A: More anesthetic!!

I was far less pleasant to Annie's dad:

P: Why are you stroking my forehead?
R: I'm trying to be comforting.
P: Do I look like I need comforting?
R: Perhaps not.
P: YOU might need comforting. Shall I stroke YOUR forehead?
R: No, that's fine.

Ok, I may have made some of that last bit up. Some. I was a little tense, though, that much is sure.

There were no epidurals offered here, though I did suggest it to the junior doctor on Tuesday night, when she was talking through the hysterectomy with me. (When I say junior, I mean that she MAY have been eight and a half.) She was pretty clear- they wanted me completely knocked out for the operation. In the meantime, I was sailing without the rigging throughout everything other than the surgery itself. (And I have not forgotten the root canal, not for one moment.)

I was brusquely arranged on the table by the ultrasound machine, and propped up on the wedge so that my left side was raised. The area around my nipple was cleaned and disinfected and deodorised, and the doo-hickey (what IS that thing called?) passed over it. Then, while one technician held the doo-hickey (See? Impossible to take this description seriously while I am calling the equipment a 'doo-hickey'!) the other deftly slid a thick needle about two inches into my breast, an inch or so directly above the nipple and at something like 45 degrees deep into the tissue. Those of you currently expressing astonishment that a needle could reach such depth in that bijou little bosom, kiss my elbow. It bloody hurt!

The needle was wide enough to accommodate a gossamer-thin wire, which the technician slid into place, guided by the image on the ultra-sound screen. She was cautious not to move the needle much, for which I was thankful. The wire itself made barely any impact at all, and once the needle was removed, I was left with just the strange sensation of something light and flimsy being suspended from my skin. This was quickly taped up, and I was bustled outside by the shorter, less chatty of the two women. After a brief sojourn in the waiting room, I was swept up by her again and taken over to a room across the corridor where the mammogram machine stood waiting patiently.

The technician's face, already business-like, now became set and grim. She had always been the less chatty of the two technicians, and it was obvious that she was far less confident in her English than her colleague. However, she'd been preparing both her explanation of what was about to happen, and some words to help with any questions I might have. In this room, two more wires were to be inserted into the tumour area- during the mammogram. I felt slightly sick. She gave me a deeply sympathetic pout, stroked my arm quickly and comfortingly, and helped me out of my pyjama top.

The procedure was similar to that of the ultrasound room. This time, however, it started with the familiar awkwardness and discomfort of the mammogram. Three different positions, three fairly forceful jostlings into place between the plates of the breast, three switches thrown and clampings, three snapping images before the clamping plates were released- twice. The technician then left the room. I was still suspended on tip-toe with my left breast uncomfortably pinned between the plates. The room was cold, my skin was clammy, I had a wire sticking out of my breast, and I had been abandoned. I doubt that it really was for long. It did not matter. I rested my head on the cold metal of the machine, and shuddered. Just all rather over-whelming.

I'd like to say that was the worst of it. However, the door opened again, and the technician returned with a young man- another Middle Schooler in a labcoat. I cannot tell you if he said a word to me. The two of them approached and manouevred a small rolling table into place next to the machine. On the table were two needles and two more gossamer wires.

I tried not to cry out, honestly I did. Having had so much said or intimated about the forbearance of Korean women, I did not want to let down the side and make a fuss. It was badbad, though, and I admit to whimpering occasionally, sucking air through my teeth in a hiss like a rattlesnake, and- bizarrely- whistling like the Scarecrow when the cries drew too close. Who knew that The Wizard of Oz would provide my pain barrier tune? The technicians once more cleaned and disinfected my breast. The first needle was pressed firmly into the tissue on the opposite side of the first wire, again deep into the flesh and at an angle. Once it was in place, the young man moved behind the protective screen and began staring at the monitor behind it. He came back out and adjusted the needle, carefully forcing it deeper before sliding one of the wires into place. Then the plates were tightened again.

P: (whistling) I'd unravel any riddle, for any individ'le, in trouble or in pain...

The machine snapped, the clamps released. Patricia moaned.

The young woman stepped out from behind the screen and came over to re-adjust me. The clamps were spun round and I was manipulated back up onto my tiptoes while she kneaded and molded the reluctant (and increasingly vulnerable-looking, now that it had a great ugly needle sticking out of it) breast into the new position and once again tightened the plates. She stroked my arm again while the young man emerged once more and picked up the other needle. The sounds she made- Lord, the universality of crooning! I have made the same sounds to Annie; my mother and grandmother have made them to me. The tenderness of understanding helplessness, and the noise that it produces- I may not have been able to comprehend more than fifteen words this woman was able to use with me, but I understood the tone of her compassion.

The clamps tightened further and the needle was once again pressed unrelentingly into my breast, deep, deep. My whistling resumed as the lad pushed it into position, changed the angle slightly, pushed it again. The woman stroked my arm, crooning the whole time. They both disappeared behind the screen again and stared at the monitor grimly before again coming out and re-adjusting the needle deeper before checking one more time, sliding in the last wire, and snapping the image. The clamps did not release this time. They were kept in place until the sympathetic technician was beside me again, helping me move away from the plates without stumbling or knocking the needles.

No new needles were inserted this time- just a final change of position, a final tip-toed posture, a final cool hand moving my head to face away from the machine, a final gentle stroke of my arm. The last image was taken after much consultation behind the screen. Then both technicians returned, and the woman continued to soothe me (... my head all full of stuffin') while the needles were removed, leaving the wires in my breast at wild angles. Then the plates were finally released, and I was helped to peel myself down while the young man cleared away the blood that now was smeared across them.

I was tidied up a bit and the wires taped behind a gauze pad out of the way before I was shown to the door with a final sympathetic bow and smile. I somehow found myself in the corridor outside the women's cancer centre once more, and while I am not entirely sure how it was that I managed to get back upstairs to the twelfth floor and to my room, I know that is where I ended up. I know this because when the bed that was to convey me into the operating room arrived twenty minutes later, I was up there waiting for it.


Coming up: In, out, shake it all about

Surgery and Even MORE Shenanigans... with the surgery, this time!

We finished off the first installment with the trip to the hospital late Sunday afternoon to check in. Connie Kim had volunteered to come with us, as things would just be more straightforward with a Korean speaker along. As usual, Connie is a hero. She was a little taken aback by the amount of luggage we had with us, having no real clear idea about what would be required, and informed me knowledgeably that there would be no need of a suitcase for me, as I would be wearing whatever the hospital told me to, actually.

Dropping us on the curb, Connie supervised the unloading of the (evidently excessive) baggage, and drove off to park. The trip had been the first daylight journey for Mum and Bert, who were especially interested in his first round of the 'Spot the strange translation' game'; always fun around the 'Fine is Fine' factory. There was the usual press of traffic, over-crowded apartment blocks thrust into the side of hills, impossible buildings (restaurant shaped like a Georgian-era British warship, Taj Mahal replica, etc) and taxi drivers asserting their own special passive aggressive kind of authority on the roads. The bustle of the hospital in this first encounter was no less unsettling for my easy-going Maritime family. Annie, in contrast, strode around with the purpose and flippancy of youth; however, I remember what home is like, and know well that this building may be among the largest my mother has ever been in, let alone had to negotiate her way around while under duress- and it is all in Korea.

There was a minor dispute at the check-in counter over the amount we were going to have to pay for a single room (The insurance company would cover the cost of a double- I knew that a single would be better for Mum especially, so intended to make up the difference in price myself- well worth it, too, as long as it was the $40 Hyungji had told me, and not the $200 the clerk was informing me from the other side of the desk) Connie helped iron out the wrinkles of the encounter, and accompanied us up to the twelfth floor.

The room was basic, considering what I would have been paying without insurance. A small washroom, a few cupboards, a sofa and a bed. It had a good view of the parking lot behind the Korean Air building, which would prove to be a source of great interest to Mum, and was comfortable enough. People would come and go through it at all hours, only occasionally knocking.

We had been there only a few minutes when the onslaught of health care professionals began to arrive. Blood pressure and temperature were taken first- these would be monitored closely throughout my stay. A 'Save Lt arm' (sic) sign was put over my bed, giving warning that all procedures were to be done to my right arm only- I needed to draw this sign to someone's attention at least once a day. Other nurses and technicians came and went, drawing (a simply ridiculous amount of) blood, and dropping off a set of hospital pyjamas. Very cottony and very comfortable, as it happens. A twelve-year old doctor came in and began to describe the lumpectomy preparation. I would be given dinner, and then should eat nothing after nine o'clock. Water only, then, until midnight.

An early aside about dinner. The answer to the question 'Do you want the Korean menu or the Western one?' is ALWAYS and emphatically 'Korean!' This was wise advice from my friend Maggie, who after her hospital stay last year let me know that there were few illnesses as bad as the hospital's take on a grilled cheese sandwich. Even if you think you can't stomach stewed pork and squash for breakfast, resist the urge to try the scrambled eggs. Breakfast food is a wholly Western convention, remember, and most parts of the world believe- quite correctly, as it happens- that food is basically food, and does not need to be limited to certain times of the day.) In my experience, we usually only remember this in the West when there are leftover ribs and pizza from the takeaway of the night before.

Back to the topic: shortly after the departure of the first health-care Middle Schooler, dinner arrived. I picked at it; nothing wrong there, but I don't tend to eat alot of rice. I planned to walk downstairs with the family to show them the workings of some of the restaurants in the basement, where they would likely be needing to buy food while I was incarcerated... errrr... incapacitated. I had just pushed the half-cleared tray to one side when another Seventh Grader walked in, all be-labcoated and purposeful. This one, in grim and slightly panicked tones, notified me that there was a problem with the surgery.

P: Again??
SG: (Clearly anxious) Yes, I am sorry. You have rare blood type.
P: (Long, tense pause) I have a rare blood type?
SG: Yes. Very rare in Korea. We do not have blood. Need to get blood from blood bank.
P: (Volume rising slightly) Hang on. I have been coming to the hospital every three weeks since June. Every single time I come, my blood is taken. You are telling me that you are only NOW realising that I have a rare blood type???

Connie was still there, helpfully transmitting a bit of my (deep and increasing) frustration.

SG: (Via Connie) The blood is needed for hysterectomy, not for the operation on the breast. Therefore, the gynecologist did not realise that you had a rare blood type.
P: And it never occurred to anyone to check??
SG: Blood bank does not have Rhesus O Negative blood.
P: (Pointing at mother, who had been sitting dumbfounded throughout this exchange) This woman has my blood type. My brother is here, and so is my daughter. THEY both have my blood type; (which  may suddenly be sounding slightly less rare, I'm sure you will agree) I'm pretty sure that they'll let you have a few pints!
SG: (Aghast) No, no, we can't use their blood!
P: But why? They are here, they are able to solve the problem-
(Mother is already reaching for her blood donor card- she regularly donates at home)
SG: (And I may have imagined her tone, here, the one that made it sound like I was a moron for suggesting something so outrageous as getting THREE family members to make a quick donation to the Patti cause) The blood cannot just go from one person straight to another.

I sputtered a bit here- absolutely not what I was suggesting to the condescending little... eeerrr... highly trained and skilled professional.

SG:  It must go through treatment...

I let the child trail off at this point, because it was clear that I had encountered one of those nonsensical moments when I knew that the system is totally unaccustomed to change or side-ways thought. It would have made PERFECT sense to me to have my three willing donors willingly donate - just so that there is some extra blood in the bank for the next poor Rhesus Negative sod who happened to happen along, even if I wasn't able to use it myself. There are bound to be a thousand different sets of screening in place anyway before they will use it in the operating room, so what difference does it really REALLY make whether or not the donors have just flown in? Furthermore, within minutes of hearing that the O Neg situation had reared its bloody head, I had a flurry of emails from people at work who ALSO had this astonishingly rare blood type, arms extended and sleeves rolled up; these colleagues had also, of course, gone through the same extensive screening programme that everyone who comes to work in Korea undergoes, including full HIV and STD tests. Why, if the hospital is catering so much for internationals (And they are, and honestly, I think that there has been a simply FABULOUS job done in so many ways) WHY are they not regularly lining up at schools like mine, pestering the faculty for a pint of the Best? And finally, if it comes down to it, how the hell long does it take for a few pints of blood to go through the filters and processes necessary to be fit for human consumption? When one of those pints belongs to my MOTHER? Ghandi was more prone to wild living than my mother- if she's got anything funky in her blood, I should probably try to get it in mine as well.

These are questions that remain unanswered. My frustration may have been evident.

The Seventh Grader left with a tiny flea in her ear and the hint that there was still a mad hunt afoot to track down some blood in time for the surgery. This implication may have been geared to placate me somewhat.

Connie, bless her, made her excuses shortly after this extraordinary exchange, and headed home to her boys. She had not been out of the room more than fifteen minutes when we were interrupted yet again by a slip of a thing with a box and a drinking bottle in her hand.  As with the others, she was nervous and a little apologetic about using her English. She indicated the leftovers on the tray behind her and told me that the kitchen was officially closed, so to speak- that I was not permitted to eat anything else. This was several hours before the deadline that I had been given earlier, which was baffling. She also said that I needed to consume the contents of the packages in the box before nine o'clock, and then could have nothing at all. This was so dramatically different from my earlier instructions, that we called Connie, who confirmed that I had not misunderstood through the haze of my rare blood type. (!!) She also explained the contents of the packages. In short- and please, realise that we are entering henceforth the realm of hospitalese, when some of the descriptions of processes and procedures may come uncomfortably close to a few boundaries- this was to flush me out.
I was to mix each package, along with its accompanying sachet of electrolytes, with 500 millilitres of water, and drink it before nine pm. It was about 6:30. Two litres of fluid with the sole function of ensuring that anything inside my innards was... well... out.

And gentle reader, it was awful. At the risk of causing a copyright war with Ms Rowling, remember the scene in the Half Blood Prince where Dumbledore needed to retrieve a Horcrux by emptying out a receptacle of fluid that stole his wits and burned his insides?

I think I know what that stuff was.

It was thick and foul-smelling, the cheery lemon logos on the front of the box only serving to point out how LITTLE the contents resembled anything remotely citrus-flavoured. I am fairly sure that I was supposed to sip it: impossible. The only way I could get it down was to hold my nose and chug half a container at a time, then spend the next twenty minutes working up the wherewithal to do it again. Every once in a while I would peek into the box, incredulous that there were still remaining packages. The hours I spent consuming that vile viscosity rank amongst the worst experiences of this whole episode, and believe me, I have had some pretty unpleasant procedures over the last few months. I shall describe more of them soon. That liquid, though- shudder. And not the good kind.

Believe me on this, too: no one here wants to know what drinking that liquid did to me.

Next installment:
Do You Really Want to Hurt Me?

Surgery and other Shenanigans- Part 1

Despite my best intentions, I didn't write a single post while I was in hospital. There were constant issues with the wifi, and well- I think I can safely claim that there were a few distractions to be getting on with. General updates could be managed on the FB wall; it is not really a forum I am comfortable with under normal circumstances, but until I could get a few hours of uninterrupted typing time- without blood pressure checks and needles and visitors and nurses and twelve-year old surgeons- it sufficed. The intention was always to come back and work through the whole process. It will take a few entries to manage, so if you've been following developments with any kind of interest, keep an eye out over the next few days for more. There is no way of covering all the events in one post, so I'll divide things up.

Where to start... hmmmm.

The arrival of Mum and Bert on Monday marked the beginning of intense preparations for the hospital stay. I have found myself wishing that they had been able to come when I was well, and when I had time off to show them around properly. This frenetic scramble to make sure they have met folks and ventured out to the supermarket or to attempt public transport- it just would have been lovely had it been at a slower pace, letting them explore properly and ask their questions and become more relaxed before being thrust into the colosseum. However, there wasn't really anything else to be done about it, and now that they both know that the trip is manageable, perhaps they'll come back.

My friend Tamarisk volunteered to come out with me to pick them up. You've all met Tamarisk here before; she's the one who discusses the Karma of car parking and clubs me in the head when I've just had chemo. No, we shall not let her forget that. We headed to the airport after school with an eye on a Macdonald's cheeseburger, knowing that we were likely to be early. I do like these rituals! We were sitting comfortably at one of the impossibly small tables, sharing our French fries and noting the incongruity of sitting next to a performance stage with three tuxedo-clad tenors belting out arias next to us. Incheon airport is the sort of place where one can, apparently, hang out even without a ticket to ride. We have friends who have done it. There are bars and shops and a cinema and an ice rink: it is, evidently, a great evening out. Welcome to Korea. And precisely so, since it is at the airport.

Having located the gate, we waited while the flow of arrivals sputtered and spurted through the sliding double doors. There was a brief game of 'How long have THEY been on a plane?' (Especially with a group of four of five men who were so pungent that I could only hope they were traveling together) and 'Spot the Hagwon teacher', before we landed on 'I bet you can find my family without me telling you who they are.' There were a couple of wide misses before I said, 'Look for me, twice. One as a man, the other in thirty years.' My meaning became obvious when Mum and Bert made a beeline for me. There's no mistaking any of us for anyone else. Bert even was wearing his hair at a similar length. It was like high school, when we had about a year of having the same perm and the same jacket. Cars would stop in the street so that drivers could stare, open-mouthed, at the resemblance we bore to each other.

Family collected, we wended our way back down to Tam's car and headed for home. Mum was pretty subdued in the back, exhaustion and dead hearing aid batteries working their magic. Bert was more animated, and eager to ask all the learn-everything-you'll-ever-need-to-know-about-living-in-Korea-in-the-next-fifteen-minutes questions. We covered, as one would: utilities bills, subway behaviours, adventures on escalators, mopeds, taxi drivers, truck drivers, car drivers, bus drivers... Bert was astonished at the new-and-differentness of it all. Tamarisk was in full descriptive flow, barely taking time to breathe:

T: Yes, and when you get on the public bus, the stops and starts can be really dangerous. If you have to go all the way to the back, don't sit in the middle, or the driver will shoot you...
Pause. LONG pause, while she attempts a quick breath and ends up fighting off a cough.
B: Gasp!
P: (barking with laughter)
T: (leaping abruptly back into the sentence) ...to the front of the bus when they slam on the brakes.
P: They don't actually SHOOT you for sitting in the middle, Bert.
B: It did seem pretty extreme...

And so, we were home.

Once we were all sorted out and fed back at the flat, Mum turned in early. Bert was pretty wired, so we went for a stroll around the block to help him settle and so that I could make sure he was orientated. Once he got it, both of them would be ok, as he has a pretty good sense of direction. Not a great sense of how violent the bus drivers are likely to be, but he can find his way home easily enough. He was, as we all tend to be the first few weeks we are here, amazed to see small children out playing by themselves long after dark, even more amazed to see some of them just coming home from their academies, impressed by all the products readily available in the market ('Oreos? Really?') equally astonished by the things he'd never seen before, also in the market ('Ready-peeled quails' eggs? Really?') and a bit over-whelmed by the number of coffee shops in the immediate vicinity of the apartment.

The next few days were dedicated to getting prepared for my absence from work and getting my two guests acclimatised. I think that Mum was basically relieved to see that I was as well as I have been (though she did keep looking at me rather sharply, as if searching for evidence that I was simply putting on the appearance of rude health) and Bert was basically relieved not to be trapped on a plane any longer. I took them over to the school a couple of times for short tours and to make a few introductions, and would then come home in the evening to traipse into town for food. Bert was especially keen to be adventurous with his meals: mandu was a hit, as was Korean barbeque, steamed pork and mung bean pancakes. Mum appreciated the presence of the rice and the forks, which were delivered knowingly by the waiters upon request. It was all unusual, but when she was able to cross-reference it with things that were familiar ('Mum, the fried mandu are like egg rolls, but with meat in them') then it became easier. I think the noise of some of the restaurants, the bustle, the lack of English, the simplicity of the food, the spiciness of some of the dishes, the lack of salt- all were elements of an experience that was entirely and utterly new; all seen through the shadow of fear and jet lag. She did very well. 

Thursday's agenda was slightly different, in that it held the Exploratory Fair at school. Those of you who are somewhere that is else, this event happens at the beginning of each new quarter, and it essentially an opportunity for teachers to advertise their new extra-curricular clubs to the students before the sign-up session the next week. When I was organising Exploratories, I got into the practice of fronting the Fair, and no one ever really got round to telling me that I wasn't doing it any longer. It was nice to have Mum and Bert in the audience, though it did allow Bert the chance to poke fun for the rest of the week at the tumble-weed jokes that occasionally surfaced (I mean, come on- the kids don't speak much English, and I've still got chemo brain!)

The next day's plan was to toddle into Seoul after school to spend the weekend with Annie. I finished up work and came back to the flat, laden with flowers and best wishes from school, and we gathered ourselves together to make the trek into the city. It was to be our first excursion on public transport, and I was keen not to have to do any of it at the height of rush hour traffic. Getting things organised with three people is, however, more complicated than with just one, so it was about 4:30 before we were really nearing readiness.

Then my phone rang. On the other end was Hyungji, the liaison person from the international clinic. She seldom calls, but I wasn't surprised to hear from her, considering how close we were to my admission to the hospital. However:

H: Hi, Patricia, it is Hyungji from Inha University Hospital.
P: Hi, Hyungji! How are you?
H: Errrr, fine. I am calling because there is a problem with your surgery Monday.
P: A problem?
H: Yes. But I am leaving work soon so I need you to do something for me.
P: (eyebrows beginning to draw dangerously together) What is the problem?
H: It is the insurance company. We sent the information to them about the surgery but they will not pre-authorise it.
P: Say that again??
H: The information was sent to them yesterday and we just got a message back saying that it is not pre-authorised.
P: Wait- the information was sent YESTERDAY? We have had the surgery date for over a week now. Why was it sent yesterday?
H: Well, my colleague was supposed to send it and she didn't do it until...
P: (beyond caring much about the rudeness of the interruption) And they've just said no??
H: Oh, sorry, no. They have pre-authorised the lumpectomy, but not the hysterectomy.
P: But why? The gynecologist and the oncologist both ordered the hysterectomy.
H: The message says why has no other treatment been tried on the myoma, and have you had myoma before?
P: But the myoma isn't the only reason why I need the hysterectomy- the oncologist says that the breast cancer was caused by hormones, and she wants there to be no more hormones.
H: Ah, yes. But I am going home now for the weekend; could you call the insurance company and talk to them about it?
P: Grrrrrrrr.....

So the journey was set on hold for a few minutes while the patient started wrangling with the insurers about whether or not the treatment ordered by the healthcare professionals was medically necessary. This wrangling continued, in varying degrees, for the entire weekend. The conversation with Hyungji may paint her in a slightly less-than-positive light, but she did make regular check-ins throughout the process with information that had not been forwarded to me by the company, despite the sound of the crying baby in the background. At one point, she did suggest that I just go ahead with the hysterectomy myself, and try to recoup the cost later from the insurers. How much would that cost? I asked. About $8000, she said. Errrrr, no, I'll wait to see if the authorisation comes through, I think.

I was aware throughout the process that I needed to keep close check on my responses to the delay and uncertainty. Maintaining calm in the face of everything meant that others were forced to also be calm. If I'd acted concerned or over-anxious, I think that it would have made things more difficult for Mum and Annie, especially. I sometimes caught one or the other looking at me, as if thinking that I was hiding something from them about how I was feeling. Well this time I was. I remain baffled that healthcare can be as complicated as it is. I am grateful for it and certainly appreciate the rapidity of all my treatment here, but it is still baffling. The situation was only finally resolved on Sunday afternoon about three hours before I was due to check in to the hospital, when I received an email from the insurers saying that they had spoken to my oncologist and decided to amend their decision. Hey, thanks!

Apart from the debate over whether or not the doctors were just randomly making up procedures for me to have performed, the weekend passed nicely once we got into the city. The travel in was a bit gruesome, as the delay in departure put us on a couple of trains that nobody wants to subject one's increasingly elderly mother to. If you've ever traveled here, you'll know the ones I mean- rush hour at Seoul Station sometimes involves being crammed so tightly in that your feet are practically lifted from the floor of the compartment. Mum maintained good humour throughout, though. I was rather proud of her.

Bert went to the Rocky Horror Picture Show with Annie on Friday night- how fabulous having a child old enough to show her uncle the sights of Itaewon at night! They had a great time; Annie needed to be reminded to watch the show and not get too hung up on how the stage design was managed- theatre geek, eye roll- and Bert dealt well with the incongruity of a Western cultural landmark (???) being staged in the middle of Seoul. Saturday I took them over to City Hall to show them the palaces, where we happened upon one of the changing of the guard ceremonies, and then up to Insadon. Both were interested in picking up some souvenirs. There were some interesting moments: Bert bought some tea at a tiny hole-in-the-wall shop that allowed us to test the wares almost endlessly, and we were shadowed by a group of over-toned, over-tanned Abercrombie and Fitch male models in jeans and red jackets, all shirtless and coiffed. I found myself disapproving, sternly.

My careful calm was momentarily shaken by the presence of a large brass band on the subway on the way home. (Really, people- in an echo chamber like that??) but quickly restored once we were on the train back to Itaewon. Sunday morning I picked up a few necessities from base and we headed back to Songdo in a taxi, taking Ann with us so that she could join us for the hospital check-in later that afternoon.

And thus ends installment one! More to follow.