Surgical Tourist

I’m counting ceiling tiles. Flat on my back on my hospital bed, I’ve been wheeled by a Belgian nurse into a hallway that serves as a pre-op staging area for Jan Palfijn hospital in Gent, Belgium. I’ve been waiting over an hour. It’s now 11 a.m., Central European Time. At one point, a line of six patients hugged the right-hand side of the hallway. Others have come and gone, yet here I lie.

This isn’t my first time going through this. I’m getting increasingly nervous, as I remember very clearly what lies ahead. The last time, they gave me a shot in the right hip to relax me before I had my left hip resurfaced. Now, no shot, no pill, just me wide awake in the hall, counting ceiling tiles.

The ceiling tiles look the same as they would anywhere, suspended in the air in their industrial metal grid. They’re twice as long as wide, the long side running with the hall, as does my bed. I’m parked against a window, as my side of the hall is lined with windows, but it’s a cold, grey day outside and the windows face an interior courtyard of the hospital.

For that matter, this hospital could be anywhere. Because of my proximity to the surgical suites, I’m now in the air-conditioned part of the hospital, safe with the cool air behind double metal doors that seal me off from the world outside. It’s just as sterile and impersonal as you would imagine in any hospital.

A very efficient Belgian nurse is playing traffic cop in the hallway, all the while arranging patients, starting IV’s and occasionally speaking fluent Dutch or French into her cellphone. Although I’ve been here longer than anyone else, we’ve made no connection and I get no special treatment. She also speaks English, as I found when I told her my doctor wanted blood pulled for a metal ions test when she started my IV. She used the cell phone to confirm this with someone, found the right set of tubes for the job, then grudgingly complied.

After a sleepless night, December 17, 2008 began at 6:30 a.m. when my watch alarm chimed. I got up, brushed my teeth, shaved and got into the shower with 3 tubes of Betadine. It was my duty to repeat the shower I had taken late last night, scrubbing myself thoroughly from head to toe with betadine. Unfortunately, this time the water turned freezing cold while I was still lathered in the reddish-yellow foam. I had no choice but to suffer through the rinse cycle, and it was the first indication of the direction my day was heading.

At 7 a.m., my wife Roslyn and I were downstairs in the lobby of the Villa Cento Passi, home of the ANCA Clinic and rehabilitation facility for people with new metal and ceramic hips. Jared Manders, 7 days post-op and looking well, was waiting for us. We had never met, but I knew Jared from the Yahoo! Surfacehippy Group; we had a couple of phone conversations before making our respective ways for Belgium. I shook hands with Jared, then went down the steps into the darkness where Hugo Contino was waiting with the van to take us to the hospital.

In the van we met Marian White and her husband Robin. Marian was third on today’s schedule of 5 hip surgeries; I was second, on the schedule at 10 a.m. Hugo speaks perfect English and I knew him well from my two previous visits to Gent.

Shortly before my first hip resurfacing, Hugo had retired from the surgical team and the position that translates from Dutch as “leg-turner;” he was the person who handled the dislocation of the hip during the surgery, and evidently he had been quite the expert. During the short drive through the dark streets of Gent to Jan Palfijn hospital, I made a lame attempt at humor, telling him that I wanted him to come out of retirement to “turn” my leg. He laughed and said he was much too busy running the Villa these days. Little did I know how important that request would have become.

We arrived at the hospital and went to the reception area. I pulled a ticket numbered C023 and waited with Roslyn to be called to the check-in desk. The process was fairly painless as they had already received my wire transfer of 5600 EUR, covering all the hospital costs. We were in the room by 7:30 a.m., which was a disappointment, as I had requested a semi-private room and this one had four beds. As I was the first to arrive, I took a bed by the window and quickly unpacked the few essentials I had brought with me. I pulled out my journal to occupy myself by capturing my thoughts, and sat on the bed to while away the time till they came to get me for the surgery.

After making sure I was settled in, Ros went downstairs to the gift shop and returned with a stuffed donkey, which I immediately named Hoti… Donkey Hoti. Another omen, tilting at windmills. Ros also bought me a beautiful, multi-colored card of a dog with butterflies, one of which has landed on his nose. Ros always knows how to lift my spirits at exactly the right time.

The day had dawned, but it wasn’t a pretty day. Outside wasn’t much of a vista, but being by the window had saved me during my last visit, but that was during the summer and an unbelievably hot stretch of ninety degree days. At one point, I saw Marian and Robin power walking along the paths in front of the hospital. I admired the way she continued to push herself to be in top shape right up to the very last moment before the surgery. She had mentioned in the van that the surgery before mine was supposed to be a difficult one, so I wasn’t surprised when a nurse told me I wouldn’t be going to pre-op for a while.

When 9:30 a.m. rolled around, I decided it was time to get ready, so I undressed and put on the hospital gown, which incidentally, is unceremoniously taken away when you are bathed by two nurses the morning following surgery – it’s very important to bring one’s own bedclothes. Last time, I had made the mistake of not bringing my own washcloth and towels.

At 10:00 a.m., the time originally scheduled for my surgery, a nurse came for me and rolled the bed down the hall, turned the bed left, then right and we passed through the double metal doors to pre-op purgatory.

As 11:30 a.m. approaches, I am alone in the hallway, still counting ceiling tiles. My intuitive alarms are going off: what am I doing here; do I really want to go through with this; did I really wait long enough; why don’t I just get off the bed and walk away? They’ve given me too long to think and I’m not really sure anymore. But I’ve come too far, physically and mentally; no one travels 5000 miles for surgery and then walks away minutes from the goal; besides Dr De Smet had told me it was time.

While I’m battling my internal dialog, the traffic cop gets a call on her cell phone, comes over, checks my wristband, releases the brake on the bed and we’re off to the end of the hallway. Where the hall ends, we’re met by Bart De Roest, the surgical nurse, who takes the bed, turns to the right through another set of doors and we start passing the surgical suites.

At the end of this corridor, I receive another omen. The room is still being prepared for my surgery. Bart apologizes and pushes my bed out of the way into a supply closet. I spend the next five minutes auditing the supplies used to clean and prepare the operating theaters.

Eventually, Bart reappears and as he’s rolling me the last few feet to the operating room, I remind him that he owes me an article on resurfacing surgical technique that he had promised me. He smiles and tells me he’ll email the article to me that evening. He squeezes my hand and turns away to finish his preparations.

It’s unbelievably cold in the operating room, literally like having been rolled into a walk-in freezer. Then, it’s time to help with the transfer to the operating table. The anesthetist and his aide are on my left side, and another couple of gowned people begin exposing my right leg. I resist the impulse to let my teeth start chattering. The anesthetist makes a few last checks and injects the sleepy drugs into the IV line.

I look over at Bart and then I’m gone…

Saturday, I spent several hours picking out fonts and a Word template, as a prelude (or possibly procrastination) to throwing myself headlong into the actual writing of Surgical Tourist.

I know, it should be enough just to grab the word processor and start typing away, but over the years, I’ve become used to formatting my documents as I go. Now, a Word document looks naked if it’s not dressed up in a suitable style sheet and pretty fonts – the things a template controls.

I started out by simply thinking that I would just go into Word, 2007 select a new document and apply a template. But my installation of Word was devoid of templates, and suddenly I was on the net in Office Online looking at hundreds of templates, some Microsoft, many from “the community.”

I thought surely there must be multiple templates out there formatted especially for this type of project; someone who has got it in their head to just sit down and write a book. Yuck! Template after template I had to download to open in Word, only to be disappointed again.

So, off to Google I go and start looking for templates indexed by that trusty friend. Disappointment again. All I could find was a bunch of templates that people want to sell you that don’t look any better than the free ones Microsoft had to offer.

Finally, I dropped back to an old favorite from Microsoft, a “Professional” template for a report on the fictional Blue Yonder Airlines. I’ve used it several times before and like the basic look-and-feel. I end up back where I could have been hours ago!

But my palette has become more refined over the years, and I need to dress up the style sheet and fonts that come with Blue Yonder. My next shock is the entirely new and different representation of style sheets in the Word 2007 ribbon. Now, I’m way out of my comfort zone; I spent years learning to use Word and this version has completely changed the landscape. I’m having trouble finding the most basic commands to reformat the style sheet.

On to the fonts! The Blue Yonder template comes with a style sheet that uses Verdana for the headings and Tahoma for the text. I wanted something with more punch than Verdana for headings, so I went looking for help. I remembered I had really liked the look of an eBook I had recently purchased from Rockable Press, called "Twitter Up Your Business," so I pulled up the file and looked at it. Google led me to find that Rockable Press is a brand owned by Envato, which was co-founded by Collis Ta'eed. A Google search for Collis Ta'eed and Rockable Press led me to a wonderful blog posting on another of his sites tutsplus.com, called "Creating a Rockstar Brand, Logo & Styleguide in Illustrator."

 http://vector.tutsplus.com/tutorials/designing/creating-a-rockstar-brand-logo-styleguide-in-illustrator/

The Rockable Press style guide uses Rockwell for headings and Helvetica for text. Based on Collis being a graphic designer and the requisite shots at Microsoft, they are Mac people, and there are differences between the fonts offered on Windows and Mac computers (not to mention the Linux crowd). But Rockwell is a very nice font, suitable for big, bold type and it just looks good on the screen.

But the mention of Helvetica (which was known as Swiss when I first encountered it) led me to question the difference between Helvetica on the Mac and Arial on Windows. I found a nice article on the differences here: http://ilovetypography.com/2007/10/06/arial-versus-helvetica/. Having read that, I'm a little more able to discern the (subtle) differences between the two. (I suppose I may be a geek, but I'm not a typeface geek, at least not yet!)

In my Word style sheet I replaced Verdana with Rockwell and liked the result. What I didn't like was the Tahoma left over in my body text. I think Arial is a bit overused and I wanted something different, but Tahoma looked too tall and narrow for my eye. That realization led me to this blog: http://urlgreyhot.com/personal/weblog/arial_tahoma_and_verdana, where Arial, Tahoma and Verdana were compared. Supposedly, the width of the characters in Verdana make them look better on a computer screen.

Verdana, Verdana… where did I see that used recently. Damn! That's the font I just replaced in the Blue Yonder style sheet with Rockwell. Well, how about I just replace Tahoma with Verdana in the style sheet, and let's see what we have.

I like it. Rockwell for the headings and Verdana for the text. I've got a style sheet for Surgical Tourist that I believe I can live with for the long, long time this project is going to take.

 Special thanks to Collis Ta'eed. The Rockable Press books are also very instructive and informative.

And, by the way, I just changed this font to Verdana. 

Last night, I decided to try out Mindjet MindManager while we were watching the election returns from Massachusetts. MindManager has a template called “Writing Project,” so I decided to try it. The template had many of the pieces I was looking for to create the outline for Surgical Tourist, so off I went…

For those not familiar with mind mapping, I’ve pasted in an image of the current mind map. Mind mapping lends itself to free associative, non-linear, visual brainstorming. I’ve used the concept before in creative projects, my favorite medium being colored pencils on 11” x 17” paper. To tell the truth, I’m not completely enamored with the idea of using a computer to generate a mind map; this interface loses all of the tactile sense of working on paper.

Here is the gist of the outline, so far:

Dedications – to my father and wife

About the Author

Foreword – Don’t tell him yet, but I hope to get my surgeon, Dr Koen De Smet to write this

Prologue – Just before my 2nd hip resurfacing

1. The Initial Diagnosis and the events that led me there
2. My search for answers and alternatives
3. History of Total Hip Replacement and Hip Resurfacing
4. Using the Internet for information: activejoints.com and Surfacehippy
5. My journey through the medical establishment
6. Finding Dr De Smet
7. Preparing for the journey and the surgery
8. First Surgery
9. First Recovery
10. The 2nd hip fails
11. Second Surgery
12. Second Recovery

Epilogue

Bibliography

Appendices