John O'keefe Bypass 2020

1 Stroke July 26, 2017 I’m beginning to feel a numbing on the right side of my face along my jawline as if I have just received a gentle injection of Novocain. I am quite overwrought. My friend Elizabeth is driving me up Van Ness Avenue. I am going to have an angiogram. I was supposed to have it in the afternoon, but the doctor says I can have it two hours earlier if I get there by 10 a.m. The driving in San Francisco has gotten nuttier since the Trump takeover, and the hysteria of tail-end-rush-hour dawdlers is cramming Van Ness Avenue like plaque. The car will take a left on California Street in two blocks, then up the hill and we will be there. I can decide then if I will tell them about my stroke. By the time we enter the garage, the numbness in my right jaw has turned into paralysis. I can’t smile. I had something like this ten years ago but I don’t remember the results of the test. I was taking boxing at the time and out of nowhere my left arm became paralyzed and I couldn’t speak for about ten minutes. I had an ultrasound taken. It was expensive because I had no insurance. I paid for it out of pocket and put it out of my mind. After my silent heart attack, the cardiologist found that old ultrasound in my file and it revealed that I had had a great deal of plaque even then and that I had probably had a TIA, a transient ischemic attack, a mini stroke. But that was then and this is now, and in this now, I am entering the garage of the California Pacific Medical Center on Clay and Webster. Insanely, I am thinking that the twilight anesthesia they will give me for the angiogram might not only calm me but reverse the stroke and I will be able to go home. Elizabeth has found a parking space. It’s a tight squeeze, so I get out. There is a cracking of automotive glass. A protruding unmarked ledge above the parking space has knocked the back window out. 2 Elizabeth is calm. She says she will take care of it while I am having the procedure. I am feeling quite terrible about it all, and the numbness is continuing to drive itself into my bones. I hesitate and steady myself. I try to talk, but my voice is slurring so I stop. Elizabeth drops me off at the door. She is going to seek the garage attendant. She will catch up with me as soon as she reports the damage. I try to find the waiting room for the angiogram. The hospital is large, and as I tend to I get lost easily, and I do get lost. There is a room called “Cardiology,” but it isn’t the lab waiting room. I am getting a bit shaky. The right side of my face is sagging. Running beneath my consciousness like a highway at great speed are the words “I’m having a stroke!” I don’t want to draw undue attention for I don’t want to stay in the hospital. I am asking one of the receptionists where the angiogram waiting room is. She can’t understand me; she is conferring with another receptionist. A big hot tear the size of a bluebottle fly has dropped from my right eye and splashed on a new patient form. The first receptionist is coming toward me. She is looking concerned. I’m thinking that she won’t turn me in. This is the cardio unit: people with paralyzed faces must come here all the time. She is saying words, but I don’t understand them. I don’t want to think about not being able to understand them; might mean that yet another part of my brain is shutting down. Am I going to scream? I watch the direction of her index finger. It points to a place down the hall. I am nodding my head instead of speaking because my mouth is falling off. I don’t want people in the white suits to get me. Somehow, I am in the hall under a sign that says “Laboratory.” There is another word with it, but I can’t make it out. What is that word? I need to find someplace to sit down. *** Things are skipping now. I am in a waiting room. Someone is calling my name. A nurse in blue scrubs appears in a doorway. I am following her. My face is falling. I’m trying to hold it up. 3 I’m going to go to one of those rooms with the gurneys and the thin clothes with the open back. The nurse is asking me to change. Act normal. Think of my body, the same one I have had for all these years. It has come from familiar places, like Iowa and maple trees. A teenager has kissed it, and someone has said hello to it. Its name is John. Yes, slip the pants off even though it is icy in here. I can hear a man through the curtains. He is going to have an angiogram through his groin, so he has to stay overnight because he might bleed out. If mine goes through my arm it will not be as bloody. Is it dangerous? It is dangerous. Bleed to death. Stroke. I have a stroke right now, but do not to tell anyone, no. She is asking me to lie back. She is shaving my groin. She is shaving all the pubic hair from my groin! I wanna make a joke about it but I don’t feel very jokey. My curtained-off room is getting crowded. There is a nurse and the electric shaver. Half an inch away on the other side of the curtain is a family of four: two mothers and a brother and a man lying on a silver platter. He’s getting shaved too. He’ll get a wire in his heart, one way or another. He’ll get the radioactive dye. Both of us are going to the cold room and the x-ray machine … I have watched the angiogram procedure for hours and know what they are going to do. Now some men in white coats are in the little curtained-off room. They are hoisting my body onto a gurney. Now we are going. When am I going to get the drug, the Versed? They are rolling me into the room—the room of the operation—and it is cold. There are people in shower caps. They are wearing heavy aprons. That’s because of the x-ray machine. There are computers overhead. They are wheeling me beneath them. I Googled the angiographic surgeon. She is quite attractive and speaks Russian. Her name is Lauran Ryder, which isn’t a Russian name. She’s married, no doubt. I am waiting to see when she enters. It is all quite theatrical, this medical hegemony. 4 There she is! She is wrapped up tightly in a number of garments and seems to have goggles over her eyes. There is a certain swagger about her movements as if her very actions spell life and death. She reminds me of a pirate. She glances toward me but I am supine and can’t quite get a good look at her. I must resemble something in a butcher shop rather than a coffee bar. And now it is beginning. The twilight anesthesia is being injected. I am waiting for the discontinuity of consciousness. I am feeling it; I am also feeling the numbness on the right side of my face. Carelessness is saturating my anxiety. I will worry about the “oh-my-gods” of my stroke after the “procedure.” Right now, there is this slithering hiss of blood moving through my heart. I am trying to see the screen. I want to see the dye squirt into my heart like I saw in the YouTube videos. I am warned not to move. Oh yes, they are putting this into my body, “my” body. I guess the anesthesia is working. The operating room creates its own intoxication. It is an operating room, but it could be a butcher shop with a slight shift in thinking. I also know that they have put an IV in my wrist, but I forget when they do it. That is a part of the shock. I am wondering what it is like to have a lethal injection … if it is like this, distant, abstract. The X-ray monitor is moving over me like a square white cat. It is “purring” and it is nosey. It wants to look inside of me. It is staying near my heart, sniffing it, rolling over it a few inches away, then moving again. I like it. It reminds me of an alien. I take comfort that an alien and not a human has such access to my vital parts. Yes, the anesthesia is working. The procedure is almost done. I understand why they call the anesthesia “twilight.” It smudges consciousness. I can feel myself “forgetting.” I am forgetting that the operation is closing down. I can feel the coolness of oxygen in my nostrils. They have put some oxygen apparatus on my face. The possibility of a stroke is dawning on me as they wheel me out of the operating room. The doctor is nodding.

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