My Version of Hell Has Just Been Upgraded

No, my previous version of being chained to a theater seat in Branson, Missouri and forced to watch an eternal looping version of Riverdance was just too lame…

Now I have the perfect version of Hell: an emergency room experience in Puerto Rico!

[WARNING: INAPPROPRIATE LANGUAGE & TOO MUCH INFORMATION SPOILER ALERT!]

So, I’m on vacation in Puerto Rico. My wife and I are visiting her family. I am taking every opportunity to paint as much as I can. Everything is going great until…

The Boys get a little cramped in their surroundings. I mean so cramped that I begin to walk like a cowboy who has been in the saddle too long. They’re giving me a lot of pain as well. Was it that episode in the Miami Airport? Our flight from Jacksonville on American Airlines pulled into Gate 60 on Christmas Day. What we thought was going to be an easy travel day was shared by thousands of others who thought themselves savvy as well. The airport was overwhelmed. And some bright soul decided to shut down the Miami Airport Train. We had to walk from Gate 60 to Gate 22 for our connection to San Juan. The Gate information was given to us by an American Airlines representative as we exited the plane but when we got to Gate 22, the sign said, “San Salvador”.

“Oh, the San Juan flight was changed to Gate 36,” another American Airlines representative told us. “A lot of backtracking for us,” I frowned at Vicky. We crammed much of our stuff into legal-sized carry-on luggage so, our stuff was heavy. All of the courtesy shuttles were full – and – going the wrong way. It was a long haul to Gate 36…

Once in our hotel room in Dorado, Puerto Rico, Vicky’s Fitbit was ready to pop the Champagne and throw confetti. “It’s telling me I extraordinarily accomplished my daily mileage goals,” she beamed.

Maybe all of that walking and carrying heavy baggage was the cause of the pain in my groin. Or was I experiencing a hernia? By Monday – three days later – The Boys were quite swollen and the pain was worse. It was difficult to bend over and getting in and out of a bed, chair or a car was quite a chore.

I figured I could endure the pain for the duration of my Puerto Rican vacation. I would go to the doctor as soon as I landed in Florida. I even called to give them a heads up and make an appointment for the Monday after I arrived home. Mr. Leedy, you are so efficient!

“Because there could be several serious things going on, you need to go immediately to the nearest urgent care facility in Puerto Rico,” the nurse on the other end told me, “I know this is the last thing you want to hear but you really need to have your condition checked out. This is very serious.”

Yes, it was the last thing I wanted to hear. I called a good friend who had experienced a hernia before: “If that thing ruptures, you’ll really be in trouble…go see a doctor!” As if those two calls weren’t enough, I called another friend for a third opinion. He echoed the first two calls. But I probably wasn’t convinced until he called me back ten minutes later: “I’m really worried about you…promise me you’ll go see a doctor and now.” The urgency in his voice closed the deal.

Vicky was on her way back from visiting her sister in the hospital in San Juan. I fixed a drink and sat on the balcony of our hotel room and watched the late afternoon light settling into dusk along the beautiful northern coast of Puerto Rico. My vacation is fucked I thought…

Vicky arrived and I fixed her a drink. We sat on the balcony and enjoyed the view. “Don’t get too comfortable,” I told her. She looked at me with a puzzled I’m-not-going-anywhere-after-today look. “As if one hospital was not enough, I need you to take me to the emergency room.” She knew I was not in good shape. “Do you want to go tomorrow morning?”

“No, I need to go now – after we finish our drinks.”

Dorado had a hospital nearby but Vicky’s brother, Carlos, told us there was a fairly new hospital in Manatí. We made the 30-minute drive west. We arrived at the hospital sometime between 5:30 pm and 6:00pm.

The emergency room was packed. Many of the people had brought cell phone chargers and found outlets to plug them in. This subtle observation proved later to be a bad sign. While Vicky parked the car, I practiced my hospital Spanish on the hospital attendants and did quite well. First there was a security guy in the waiting room who asked what my problem was. He told me to wait until my name was called. Then I was buzzed into an office beyond the waiting room. When it came to describing my condition to the young woman behind the desk, there was a brief moment of panic when I realized the only word I knew for testicles was “cojones” – or appropriately and gutterly translated as balls. Right at the moment when I needed to send the word out of my mouth, my memory snapped to in a timely manner: “testiculos!”

She told me to go back out and wait in the original waiting room. I asked her how long it would be. Not long – she told me – there are four people in front of you. They will call your name.

Several hours later, Vicky asked: “Are you sure she said cuatro (4) and not cuarenta (40) ?  A few security guys came through to talk to the one behind the desk. They all wore black suits, skinny black ties and donned wireless headsets with the twirly phone cord headed into the ear. “These guys were trying for the Secret Service look but failed miserably,” I remarked,”they look like undertakers.” I imagined the Hospital Security Guard Union got together to figure out ways to upgrade their image; the light blue shirt and dark blue trousers with hat & badge was just too 20th Century.

Finally my name was called. I was led into a doctor’s office. Only I later learned she was not a doctor. She spoke perfect English and asked why I decided to visit the Emergency Room. I told my story then she asked where I was from. “My daughter goes to school at The University of Florida.” Thinking that it would drastically help my cause, I said, “Go Gators!” I got no mileage out of that other than a smile. But the good news was I was well on my way to getting diagnosed and getting out of there. So I thought…

“You can take a seat back in the waiting room and you will be called back in to see a doctor.” I asked her how long it would take. She was brutally honest but didn’t shock me with what she really thought: “Face it, it is Christmas, we are understaffed and there are a lot of patients in here tonight; the ambulances are quite busy and they take priority – those patients go to the top of the list. It will probably be a while.”

Vicky & I waited in the waiting room. My phone was dying. I thought about asking someone to let me borrow their charger but then thought there was really no one to call. A woman behind us was playing some silly game on her cell phone and it made a strange, annoying noise. “Is that woman playing with her dentures?” I asked Vicky, “that rattling noise is driving me crazy.” I brought a book to read but my attention span was nowhere to be found. The overhead TV was on and thankfully not tuned into a Spanish telenovela. It was the History Channel and there was some program on warfare and how life, in general, sucked during medieval times. I read the subtitles in Spanish and learned a few new words like la peste bubonic, el cólera, decapitar, and impalar.

I had a lot of nervous energy. Perhaps that was why I could not concentrate to read? I then saw that people were wearing sweaters & jackets in the hospital waiting room. My nervous energy was actually me shivering from the cold. It had to be 52 degrees in that waiting room! Despite wearing only shorts and short sleeves, I am definitely not a cold-natured person and I was freezing my ass off.

“José López Quiñones, Puerta número 4″….”María Martínez Ramos, Puerta número 3″…”Omar Enrique Vargas, Puerta número 1…”

The names were spoken from behind a glass partition. No loudspeaker. No numbers on a screen. I feared I would not hear mine. The waiting was stressful. The names were not called very often, and when they were called, it was never anything close to mine. Hours passed and my patience was waning. Vicky & I shifted positions, leaned our heads on one another and tried to place ourselves anywhere but this God awful waiting room. “I think it would have been more fun dying of a slow death than coming here, ” I said to Vicky.

Finally. They called my name. I barely heard it but immediately felt as though I had won the lottery. We were buzzed back into the hospital and led to the pediatrics ward. Oh shit, I thought, they have me confused with some child. We went into a room and met the doctor. He asked me why I was here at the emergency room. Never mind I already told this to three people, I listed all of my symptoms. The doctor was a nice fella who understood and spoke English but preferred to communicate in Spanish. What I didn’t understand Vicky translated. He asked me about swelling in my testicles: “Son grandes!” I answered with a smile.

The doctor told me he would do a blood test, urinalysis and sonogram to determine what was wrong. As I was ready to head to the lab, he told us to go back into the waiting room and they would call us when they were ready. I was still freezing. “Is there anyway to get a blanket? I am very cold,” I asked. He left the room and returned a few minutes later with a sheet and a very satisfied, Samaritan look on his face. A sheet? Really? I wrapped it around me as we went back out into the waiting room.

There were really no bad cases of doom in the waiting room other than one guy who looked like he was in really bad pain. It seemed most people had a small entourage with them – after all, every activity in Puerto Rico is usually a family affair. The more the merrier I thought: the family members decrease the actual number of patients in the room. There were familiar faces from my hours in there and not so familiar faces as well. What I really wanted to do was conduct a poll to get an idea who was ahead of me and who came in after me. I could stand up and say, “Damas y caballeros, I am conducting a poll. If you were here before this gringo walked in [pointing to myself], please raise your left hand; if you noticed this gringo after you walked in, please raise your right hand; and if you have no recollection, raise both hands.” I abandoned the idea as I figured the non-patients would also participate and confuse matters even worse. Then I slowly went around the room visually and tried to recall each face as best I could. It was no use. I had no idea…

Robert’s Handy Hints When Visiting
an Emergency Room in Puerto Rico:
It is imperative to contact a friend or family member and have them call you in one or two weeks if they do not hear from you. Always make dinner reservations at a nearby restaurant. If your dining time exceeds three hours, be sure to check in at the emergency room to see if your name has been called. If your injury is severe, ask for takeout. Be sure and bring a good mountaineering jacket and wool socks & wool hat to combat the cold. If you have space, bring a polar rated sleeping bag. Bring snacks, canned goods, freeze-dried meals, fresh fruit and a case of bottled water. Write down the number of all local pizza delivery companies before arriving. Charcoal & gas grills are not allowed but do bring a microwave oven – it will come in handy. Blankets, sheets and pillows are necessities and remember the folding lawn chairs for extra family members. If you have children, stock up on extra diapers and bring toys that make a lot of noise. Portable Bluetooth speakers are a great idea so you can share your music with other patients. Make sure your mobile phone is fully charged and bring your charger with you. When you first walk into the waiting room, take a photo of everyone in there so you will know who is ahead of you and who is not. Cancel your newspaper subscriptions, hold your mail and update your will. And please – make arrangements for your pets as you will not be home for several days or weeks.

This next wait was painfully slow. The frequency of names called dropped. The arrivals of ambulances also dropped off but then I imagined so did the number of hospital staff on duty. The waits were beginning to feel like twisted versions of Groundhog Day. More hours passed.

“OK,” I told Vicky in my I-Have-a-Plan voice, “if they don’t call my name in ten minutes, I am getting up and walking out of here. I am tired of this shit! I don’t care about the consequences…I cannot wait any longer. This is killing me!”

Vicky said she would ask the security guy if they had already called my name. “It’s not going to do any good,” I warned. She did and moments later:

“Robert Leedy, Puerta numero 9.”

But it was only another, smaller waiting room for lab work. There were many familiar faces. People were coughing and hacking and I could almost see the germs floating  in the air. “We’ll be very lucky if we aren’t deadly sick in a few days,” I told Vicky. It reminded me of the flight from Miami to San Juan and the tiny aisle seat that I had. I mentioned to Vicky when we landed: “Time to double down on the Airborne – I think every person boarding that flight touched me with the exception of Rows 1 – 7.”

More waiting. My name was called once again. I was led into a lab where they took blood and gave me materials for a urinalysis. This procedure was a little less sophisticated than the recent ones I had done in Florida. I was given a small plastic cup and an even smaller test tube. The idea was pee in the cup and pour urine into the test tube. It was impossible not to spill pee on your hands as you aimed for the tiny test tube opening. I washed my hands and wondered what percentage of people didn’t wash their hands. Back into the germ-filled waiting room. As I handed the test tube to the technician, I asked,”I guess I come back tomorrow for the results?” I was thrilled to be able to go out into the warm, tropical air and head home for a long, deep, sleep. “No! It will be ready in two hours, you can wait in the waiting room.” Suppressing a scream, I went back in and told Vicky the bad news.

One of the chronic coughers in the germ room was a crazy-looking woman who had that raspy, years-of-smoking voice.  She was in the corner on a respiratory therapy machine of some sort. A nurse closed a small curtain around her then I heard these dreadful moans and whimpering. My God, what are they doing to that poor woman? I wondered. Did they stick a needle into her lungs or something? The woman eventually got up and walked around the waiting room. She was talking and laughing to herself in her scary, raspy voice. There was another hacking, raspy-smoker-voiced woman who looked just as crazy and just as contagious. It appeared they were buddies. Both enjoyed talking to themselves. I learned the original’s name was Amarylis. She looked around the room while she mumbled to herself. I think she was looking to make eye contact. I avoided her gaze at as best I could.

I cannot begin to describe how miserable I was as a result of the freezing temperatures in that hospital. It added to the stress of waiting. “When I get out of this hospital, I am not going into another air-conditioned room or building on the island as long as I am here,” I complained to Vicky. This got me thinking about Puerto Ricans. It used to be that islanders were not so dependent on air-conditioning. Homes and buildings were open to the breezes and though it could get hot, the heat never really was a problem. When we lived in Puerto Rico, the only air-conditioning we had in our home was in the bedrooms, usually a small window unit. And we didn’t always use it. Actually it was more of a noise barrier – a source for white noise to keep the distracting noises out. I noticed on this trip that Puerto Ricans seemed more dependent on air-conditioning and I frequently found myself very cold. This was especially true in this nightmare of a hospital.

I shivered in my little sheet. I was like Linus and his blanket. I actually took the sheet home with me when I was discharged from the hospital. Vicky fussed at me: “WHY do you want to take that with you?” “It’s my hospital souvenir…I’m quite attached to it…it’s kind of like my own Wilson, the volleyball.”

They called me to the lab where they performed a sonogram. A pretty young technician in a dimly lit – and warm – room instructed me on how to lay things out (I won’t go into detail here.)

“I have only one request.”

“And what is that,” she smiled.

“Can you at least warm the lotion?”

[Laughing:] “Oh yes, we always do.”

I restrained my sense of humor by not asking a sexist question like, “So, can you put on some Bryan Ferry or something?”

She began the sonogram. I thought it was going to hurt but she was very gentle and it was almost like a massage. I almost fell asleep. It was the most enjoyable part of my stay in Emergency-Room-From-Hell.

Back again for more waiting. It was probably 1:30 am Tuesday morning by now. The waiting got more and more dreadful. Amaryllis was pacing back and forth across the room mumbling to herself. I yawned every two minutes. Yeah, go ahead and take a gulp of that good clean air… 

Several hours passed. Vicky had the brilliant idea of standing outside the consulting doctor’s office and assaulting him with questions about my lab results anytime he opened the door. It worked. I believe it jumped us up the list and we went inside and sat down for the consultation.

It turns out I did not have a hernia – I had a severe urinary infection. “You were smart to come in when you did,” the doctor told me, “left unchecked, this could cause a multitude of problems for you.” He prescribed several IV’s of antibiotics and then informed me that I would be in the hospital for 10 days.

“Como se dice ‘Plan B’? No way, I need to leave here as soon as possible! I have an appointment in the States with my doctor as soon as I get back.”

Vicky & the doctor continued in Spanish. I was too tired to follow. I felt like I was being hoodwinked.

The doctor wanted me to stay in the hospital for several more hours – long enough for more IV’s and a consultation by an urologist at 8:00 am. I had a vision of myself running down the hospital hallway with my IV stand in tow and screaming, “THEY’RE NOT GOING TO BREAK ME! THEY’RE NOT GOING TO BREAK ME!”

I was led to a tiny, curtain enclosed hospital room with a small bed with no blankets nor pillows. They hooked me up to an IV while Vicky made herself comfortable in a reclining chair. Poor Vicky…what a trooper she was to hang in all of this time…and she was in hospitals all day long! I finally had a bed as simple as it was. I was butted up to a curtain. I felt a movement…someone was shuffling their weight in a bed on the other side of the curtain. I heard familiar moans then the unforgettable raspy voice. I whispered to Vicky: “That fucking crazy lady is in a bed right next to mine…” We laughed and for the first time I almost saw light at the end of the tunnel.

I lay back in bed and watched the flurry of hospital employees coming and going. From my vantage point with the curtain open, I could see just about the entire room. It looked like a set for a play with left and right stage exits. In the center and who I picked out as the head nurse  was a large but attractive woman with braided blonde hair and hazel eyes. She had a strange but beautiful complexion – almost Naples Yellow in color – that complemented her hair and eyes. Definitely  from the center of the island. She was very stoic and seemed to have a command over anyone who encountered her. She reminded me of Wagner’s Brünnhilde. Her attention remained fixed on her computer screen except when greeting fellow employees or taking a doughnut from the box someone brought for the late night shift. I could not get over her eyes and at some points when I looked over at her, she seemed almost like a lioness.

The people watching was fun. A young man caught my attention. He had the weirdest hair-do I have ever seen: It was very short – even shaved a bit – on the sides and then quite long in the front. With, I’m sure, a lot of hairspray, the long part swooped up to a height of 4 or 5 inches then tapered to the back of his head where it blended in with the very short part. His hair looked like the officer’s hat for a German U-Boat Commander. Donald Trump has nothing on this guy…

I kept my eye on the box (or should I say, ‘case’) of doughnuts. I tried to track who ate the most but soon lost interest.

It was amazing the number of hospital employees staring into computer screens. What were they doing? Were they scheming on how to keep hundreds of patients trapped within these walls forever? Would I ever get out of here?

Then there was a sigh in my ear – and a bit of crying. My goodness, this woman is practically on top of me. Amaryllis let out a fart or two and I tried my best to return the gift but realized farts on demand were not as easy as they were in my adolescent days. Amaryllis continued to sigh and moan while shifting her weight in the bed. Every time she moved, it rocked me a bit. She finally stopped talking to herself and nodded off.

Vicky was out as well. The hospital employees in their ski jackets and fur coats on top of their scrubs morphed into a blur. I shivered myself to sleep and dreamed of laying on a spot of beach sand warmed by the Caribbean sun.

The night passed slowly as I seemed to come in and out of  bad dreams. The humming of the activities of hospital staff and patients now sounded like a medieval market with smells of rotting vegetables and sour meat that I realized was pig shit. A shawm and a hurdy-gurdy provided the soundtrack for my Hieronymus Bosch descent-into-Hell nightmare. Amaryllis was breathing heavy and caressing my torso through the curtain. Her face was within inches of mine. She said something unintelligible as she smiled to reveal black, rotting teeth. Before I could react, a wet, gray tongue thrust past a few missing ones into my shocked and unprepared mouth.

The cold air never allowed me to fall into deep sleep and the entire night felt like a series of slipping in and out of consciousness. In addition to the horrible dream of Amaryllis I had continual dreams of tasks that could never be completed or questions that could never be answered. I was in some sort of limbo. It was a true nightmare, indeed.

I awoke the next morning to Vicky and a nurse scrambling to mop up a lot of liquid that was below my bed. Oh shit, my IV leaked and I will have to stay here for another one! It turned out to be some sort of liquid that Amaryllis spilled and it leaked over to my side. Yeah, some voodoo elixir to do me in!

“I’m starving,” I told Vicky, “I’m ready for Eggs Benedict, fresh orange juice and a stiff drink.”

Vicky called her brother Carlos to bring some much needed items. Carlos & Scott arrived with blankets, fresh fruit, water, a United Airlines Business Class doc kit and an iPhone charger.

With the blanket, I now could sleep. The urologist was still several hours away (the time was moved up to 10 or 11) and I did just that. Right before I nodded off, a nurse came in and introduced himself as Maldonado. He asked if I needed anything.

To Maldonado (in my get-by Spanish): “Nice to meet you, Maldonado…Hey! It’s hot in here! Is the air-conditioning not working?”

Maldonado looked confused but willing to help.

“He’s only kidding,” Vicky interjected, “get used to his humor.”

To Maldonado (in English): “Hey man, this is worse than waterboarding,” I said pointing to the air-conditioning vent above me.

[Laughing]: “Voy a ver a lo que puedo hacer.”

To Maldonado: “Si quieres comprar cuadros, llámame.” I handed him a business card. He laughed again.

The urologist finally showed up. He was assuming I was spending the full ten days in the hospital. “No way,” I told him, “I need to get back.” He insisted I see a doctor as soon as I return to the States. He  stood up, closed the curtain all the way and took a look at The Boys. For a brief moment, I felt like Al Capone. “Smithsonian material?” I asked the doctor. “Definitely. But we really would like to keep them here in Puerto Rico.” He  spoke again about the importance of taking my antibiotics and calling if anything started to change for the worse over the next few days.

“I guess I can release you now.”

I hadn’t heard such sweet words in a long time.

It had been over 18 hours in the emergency room. Vicky & I were famished. We stopped in Dorado and ate comida criolla for lunch. Back in the hotel room, I was getting ready to spend a few hours on the beach. I fell asleep on the bed and went into a deep somber completely free of Amaryllis and any medieval monsters.

As terrible as it sounds, I still received good care in the hospital. The doctors and nurses were good – only the idea of patient management really sucked. As usual, my sense of humor pulled me through this bad episode. I certainly am not warning anyone to avoid a Puerto Rican emergency room – I am warning that you need to allow time, take pillows & blankets, dress warmly, have a little food and water on hand and bring something to help you pass the time. There is no avoiding a lengthy visit.

Sure, I might sound like a whiny gringo. In the States, we get used to doing things quickly and efficiently and get cranky if things don’t go smoothly. It’s definitely a cultural difference. I even had a laugh at Vicky when we first checked into our hotel. The room was a bit moldy and the air-conditioning was not working. We asked for another room and thirty minutes later when nothing had been done, she went on a rampage. Though Puerto Rican, I guess her time living in the States had adjusted her patience. “You’ve got too much gringa blood in your veins,” I kidded her that evening, “you need to let it drain out.” A walk on the beach the next morning solved that. I also think when she found out breakfast was included, her attitude adjusted. Back home and working with an ongoing construction mess in the house, Vicky made the observation: “Well, the US is not that smooth and efficient; one need not look any further than the construction industry,” she declared, shaking her head. Yep. You got that right, for sure.

We went on to fully enjoy our vacation time in Puerto Rico. I was able to get a lot of painting done and we had a fabulous New Year’s Eve celebration at Carlos and Scott’s oceanfront condo.

Back home in the States, The Boys are calming down, I saw my doctor and I am on the mend. Vicky & I are already planning our next trip to the island!

“Calle del Sol” by Robert Leedy, watercolor on paper (hand•book trav•e•logue series sketchbook), 10 1/2″ x 16 1/2″

[UPDATE: I just returned from the Mayo Clinic where I had a follow up sonogram. I have to say it was nowhere near as good  as the one in Puerto Rico:

1. The guy performing it was not quite as cute as the girl in Puerto Rico.
2. The room was  a lot brighter – not as conducive for relaxing.
3. The lotion was cooler.
4. The guy didn’t have much of a sense of humor.
5. He was a little less gentle on The Boys.

So, I wonder if Yelp does reviews of testicular sonograms? Should I submit one?