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.