Other photos

Here are some other photos of staff and pictures from my room that I did not place within the text of my hospital experience.

Addio Giuseppe

Addio Giuseppe

Una volta che, quando ho svegliato brevemente nella rianimazione, ci fossero altri due pazienti là. Uno era un giovane di circa 23 anni e sono stato detto che ha fatto un aneurysm del cervello causare dagli stessi per della leucemia che Fran ucciso. Sono stato ricordato a leucemia crudele ed improvvisa del ché assassino può essere.

Parecchie altre volte, poichè ho lottato verso la coscienza, mi ricordo vedere in primo luogo la sua madre, allora il suo padre ed allora il suo amico di ragazza che fa una pausa la sua base, sempre con almeno i due personale dell'ospedale. Stavano comunicando tranquillamente e brevemente con lui, ad esempio loro buoni byes. Avévano portato alcune delle sue cose favorite per porre sulla sua base, compreso un calcio Jersey firmata con affetto a lui da Luca Toni, precedente percussore per Palermo, che ha acceso a Firenze ed ora giocano nel Bundeslegge per Baviera Monaco di Baviera, così come fissare per la squadra nazionale italiana.

Una parete della stanza di rianimazione era tutte le finestre ed ai membri e gli amici di famiglia non permessi entrare nella stanza potrebbero passare vicino ed esaminare loro amato. I suoi altri parenti erano là varie volte ed una volta che la sua sorella provata per aprire la finestra e per arrampicarsi nella stanza essere più vicino lui. Sono soltanto spiacente là non ero stanza e capacità permettere che tutti ottengano vicini per un ultimo arrivederci.

Mi ricordo particolarmente una volta quando un uomo anziano era vicino diritto la finestra aperta. Stava dicendo ad alta voce tranquillamente: “Giuseppe, sveglia. Giuseppe, sono io, nonno di tuo. Sveglia, Giuseppe, sveglia, sonno io. Giuseppe.„

“Giuseppe, sveglia. Giuseppe, è me, il vostro nonno. Svegli, Giuseppe, svegli. È me. Giuseppe.„

Più successivamente ho svegliato e guardato il medico denominare la data di morte ed ho guardato le cinque persone delle persone unire le mani nella breve preghiera e con le rotture nei loro occhi, stacco le macchine mediche dalle coperture che avévano accluso lo spirito del Giuseppe.

Il mio cuore esce alla sua famiglia ed il più specialmente al suo grande padre, di cui gli echi morbidi e pieghevoli di voce in mie orecchie e porta a rotture ai miei occhi.

Addio Giuseppe. Bravo di era del Tu.

The Road to Recovery

All roads must have a start. I suppose this one started sometime in February, 2998, when I broke a couple of ribs. I have had broken ribs before. No big thing, just a few months of pain and everything is alright, and there is not a lot that doctors can do about it.

So I went on my merry way to Amsterdam, Chicago, San Francisco, Chicago, Amsterdam, Israel, Cologne, Palermo, Munich, Frankfurt, Lamperthiem, Viernhiem, Munich, home. That was just to cover the two months of pain.

But the pain lingered a bit, and I felt things moving around, so when I got back to Amsterdam, I discovered that when I breathed, my left lung bulged out of my rib cage. This seemed like something to get help for.

Of course I called my good friend Dr. Gasperi Marinello here, and he took me to the hospital, where I got x rays, and then told me to go the next morning to Ospedialiera Il V Cervello the next morning, emergency room.

The folks at the emergency room were not sure I needed to be there, but the triage nurse did code me as green. Red would mean take care of now of they will die now. Yellow would mean take care of soon (after the reds) as they may die soon. Green means that I could be taken care of after the coffee break. White would have meant that I had no reason to be wasting their time, and as a penalty for going to the emergency room just to get a free band aid or aspirin, I would be charged 25 Euros.

With the small cups of coffee folks drink around here, I was able to be seen by a doctor in about fifteen minutes. I think that is less time than it takes to get a copy made of your health insurance card in most US emergency rooms. The medical staff checked me out, and sent me up to thoracic surgery for a consult. That is what Gasperi had expected.

I was met by Dr. Sergio Playa, who indeed speaks English. He had never seen anything like my problem, so he went to get the chief surgeon, who is a few years younger than I am. Dr. Regio had only seen it once before. He called the rest of the staff in to show them this wonderful ballooning chest. When caposalla (head nurse - administrator) Sgr. Randazzo came in, he said: 'Do you speak English?' When I told him that I did, he frowned and said 'I don't'. Just what I needed, a man with a warped sense of humor almost as bad as mine.

They upgraded me to yellow, arranged to have me admitted to their care, and set up a CAT scan (TAC in Italian), some blood tests, and on and on.

Dr. Regio asked that I wait until the end of the summer for the surgery, as there would be less chance of infection during less hot weather. He also wanted me to lose some weight. I met with him on September 1st, and we scheduled my admission for surgery on September 8th, and he told me I would be kept in hospital until such time as I was able to care for myself at home.

Bright and early on Monday morning, my friend Angelo came to Sciacca, picked me up, and took me to the hospital, staying with me until I was settled in. The team decided that I should have the surgery on Wednesday morning, so I had a day and a half of liesure. I did get some more tests, and met with the anesthesiologist who would be caring for me.

My room had four beds, and they were all filled when I got there. Two of the occupants were released during the morning, and I and another man were given our beds. They were busy. They had a lot to do. The staff took time to answer our questions and calm our nerves.

When lunch came, it was not delicious, but the father of one of my room mates came in with a large dish of pasta al forno, and he made sure I had some. He kept trying to give me more of his wife's wonderful cooking during my stay, however I tried to maintain Dr. Regio's diet for me.

On Wednesday afternoon, I was trundled off to surgery, where Dr. Regio spent two hours getting my ribs where they belonged, tieing up a new netting with silk thread, and closing me up. He found that not only were my lungs coming through the hole in the rib cage, but also part of my diaphram and my spleen. Good fun.

From surgery, I was taken to reanimation, which is sort of like an intensive care unit. They wanted to bring me around slowly to ease any pressure on my heart, and I ended up staying in ranimation for two days. Then it was back up to the ward, where judicious use of morphine and other medicines kept me pretty much free of pain, and helped me begin the healing process. I did have some problems with low blood oxygen levels, constipation, and a low grade fever, but all were satisfactorily taken care of.

Because of my snoring, Dr. Regio arranged a consult with a cardialogist, and we agreed (even my room mates ) that I probably have sleep apnea, and while there is a machine I could wear at night to quiet me down, probably more important is that I lose weight, which I will try to do. We will meet again in six months to look at progress.

Finally, on Saturday, September 20th, Angelo came and got me and took me home. Paolo and Ignatzia fed me (too well), made Angelo feel at home with them, Dr. Marinello stopped by and made arrangements for me to have oxygen in my bed room if I needed it, and two American friends of friends arrived to begin their week stay in the apartment next to mine. They helped pick up the oxygen with me.

So that is the dull story. There are a lot of emotional components to what went on, and those will be covered in the next posts, including my views of The Italian Health Care System, Hospital Parrots, Il Doctore, Davida, Gieuseppe, my reading list, help from my friends, and whatever else I think of.

I do want to thank everyone at the hospital for the excellent care I revieced.

Italian Health Care

I have been trying to decide which of the emotional issues regarding my hospitalization I wanted to write about first, or wanted the reader to view first. Of course there is a lot of interpersonal stuff, but I have decided for that to wait until after I deal with some bureaucratic issues, that are highly emotionally charged to me right now, as my country of birth, the country I first and still loved, prepares for an election.

This is how it seemed to work. I needed a specific kind of surgery. Instead of going into a general sort of hospital, where the surgery could have been done, I was sent to a hospital that included in its menu of services a specialized unit dealing with problems like mine. It is one of four such hospitals in Palermo, and one of ten in Sicily.

The thoracic surgery department is staffed by six doctors, a caposalla (head nurse - administrator) twelve nurses, and four auxiliary personnel. There were also some students from the University of Palermo, studying for thoracic specialization. Each of them had specialized training to be a part of the team, and a team they indeed were. They all felt that by working together they could take the technical aspects of medicine to the next step, and together they could work to be healers.

I was not there for any staff interviews, but I will tell you that in the interview process, somehow they were able to determine the ability to be a part of the team, along (of course) with technical expertise, and along with caring about patients. The staff as a whole reminded me of teaching at its very best, when I was with a team of teachers who shared a common vision, and for whom the consumers were most important.

Beyond that, the chief surgeon, Dr. Regeo, networked his team with the other teams in the hosptial. In one case, he wanted another doctor to look at something he was concerned about with me, and called consult. The other Dr. was there to consult within an hour. They did this not because they needed the businesss, and not because they would get payed more, but because they wanted what was best for the patient. When a room mate needed a special consult, and the best person for that consult was in Rome, they did not settle for second best, but made an appointment and got their patient a plane ticket to go see the man in Rome.

Because my case was unusual, Dr. Regio, who was the only one who had ever seen a case like it, did the surgery himself. The other surgeons watched, except the one who was making the video to be used in teaching at the University of Palermo. The whole team used it as a training experience.

Of course the hospital was clean and orderly. The needs of patients were met, always. One might take issue that the bathroom did not have soap or toilet paper, but that is the norm in Italy. Hospital bathrooms are not supposed to have toilet paper or soap, that is something the patient is supposed to bring. They also bring their own TVs to watch, and their own books to read. I knew this going in, so I brought in a lot of books, and more than enough toilet paper and soap, although I knew that I could ask a room mate to help out if I was caught short. I have heard complaints about Italian rest rooms not having toilet paper from Americans, I used to complain, and now I just realize that it is simply the norm here.

I will say that the ceiling could have been in better repair, but as I lay in bed looking at it, I decided that is was really paintings showing what was wrong with the patients. Neat graphic displays.

So, I think I got good care. I was in hospital for twelve days. The reason it was so long is that I live alone, and they would not send me home until I could take care of myself. True, I could hire someone to take care of me, but as long as I lived alone, hiring someone or not, they would not send me home unless I could take care of myself.

I was in reanimation, which is sort of like an intensive care unit, for two nights. I always had at least one nurse or doctor by my side when I was in reanimation, as did anyone else who was there.

The billing office, which operates out of an office smaller than the one I had in the Fulton School District, helped me get my health care card, so they would not have to bill my US insurance. Besides, they said, I would probably have to pay something if I used my US insurance. Because I am a resident of Italy, I was covered by the Italian Health Care System.

The total cost of my stay, including meals and medication, but not including toilet paper, ended up being zero out of pocket. No insurance claims, no billing office at the end, no disputes about what care I got and did not get. Nothing. No cost. It is simply a part of living in Italy.

But was it quality care. Would someone who knew the system use it? Well, the person in the bed next to mine was a noted cardiologist in Sicily, and it is the system he chooses to use. It probably has something to do with the fact that Italy is ranked number two in health care in the world by the World Health Organization of the UN.

Some of my friends in America, and some of my friends at the Sigonella Naval Air Station here, indeed a friend of mine in Germany, all wondered if I should have gone to the states to get the operation. I will admit that I myself had some misgivings. But no more. I am glad I stayed, and I am glad that now I no longer need to have second thoughts about staying here for the long term because of health care.

All the reasons the US gives for not providing universal, free health care for all of its residents is baloney. There is no reason it should not be done. I am embarrassed almost to tears as I think about how poorly my birth country treats its own citizens. It is a shame, a terrible, life costing, depressing shame.

Italy certainly has fewer resources per resident than the US. It is a matter of how the resources are spent. Well done, Italy. BRAVO.

BRAVO

Papagallo

While I was still getting some morphine,but was back in my room on the ward, they removed my catheter. I really was pretty happy about that, but there were enough tubes bringing things in and taking things out of my body, and I was still woozy enough from the morphine, that I knew there was no chance I would make it to the bathroom. I asked the nurse what I should do about this, and he told me to pee in the papagallo.

Now, for you Spanish and Italian students, you know that a papagallo is just their word for a parrot. I thought I had heard wrong. I could not imagine peeing into a parrot. I mean, look at the beak on the one above. Would you pee on him, leaving yourself exposed, so to speak. But maybe it was just the morphine talking.

I asked again what I should do if I needed to pee. Again, with a little annoyance, the nurse told me to pee in the papagallo. Okay, time to play along. I looked all over the room, but nary a bird did I see, certainly not a parrot who might be willing to let me pee in him. I told the nurse that I did not see any parrots, indeed, I did not see any birds. He pointed to the floor next to my bed and said: 'Right there'.

I looked. There was nothing there. My next bed over room mate started to chuckle. I told the nurse I saw nothing, and he looked, and ran out of the room, coming back carrying one of those little plastic devices that men can pee in when they are in bed. So I learned a new, apparently unofficial Italian word. I was relieved that I did not have to worry about any large, sharp beaked, angry wet birds soming after me.

But I need to tell you, I still have images of such birds in my mind, and I think I will forever think of the parrot as the mascot of Ospediale Il V Cervello.

Davida

One of the first room mates I met in the hosptial, and indeed the only one who was in the room with me from start to finish, was Davida, a fourteen year old wonder boy. He was there to have some fairly non life threatening problems taken care of, although the work to be done was important, and he had to have a lot of tests to get ready for his operation. Each test required recuperation time, so he was in the hospital for a good long stretch. He was also the glue that held the room together, indeed, from the patient perspective, he may have been the glue that held all sixteen patients together and gave them a good frame of mind.

Davida was like my favorite junior high school student - the smart one who could get along with adults and a wide variety of kids. He was always positive, always smiling, always helpful. The child of Giuseppe and Laura, he was obviously the product of wonderful Sicilian style parenting. He was always going here and there, carrying the drainage jug from his lungs by his side, seeing if anyone needed anything. He could tilt my bed up or down if I needed it, and even was seemingly happy to empty my parrot.

With all of this, he had some insecurities, but he did not like to show them,. He was happy that his father would spend the night by his side in a folding down chair. After his operation, when his father was asleep, he asked me to come over and just hold his hand for a while until he could go to sleep.

My first hospital meal was nothing to write home about, but Giuseppe had brought in a huge tray of pasta al forno that Laura had made. He insisted that I have some, and my goodness was it good. No matter how much I wanted more, I was able to convince myself to try to stay on my diet. I am amazed that Davida is so thin, with such a good cook as a mother.

He had what we hope will be his final operation two days before I left the hospital. I was happy that he was just getting up and around, and seemed to be doing well, before I had to leave.

When he gets back to school, he will be studying information technology, so watch out computer whizz's, there is another good one coming up.

Bravo Davida, tu e grande.

Il Dottore

When I came back from reanimation, there was a new person in the bed next to mine. I found out over time that he was one of the leading cardiac surgeons in Sicily, and had been retired for a little while. His face reminded me a bit of my friend Carl's.


His wife was with him most of the time, and slept on a folding chair in the room at night in case he needed anything. When his children came to visit, I found out that I had a mutual acquaintance with one of Il Dottore's sons.

They were always friendly with me, and after Franca warmed up to me a little, and got used to the idea that my pronunciation was not always perfect, she did whatever she could do to help me as well.

Often she would just sit with Il Dottore and they would talk softly to each other in Sicilian. It was the first time I had heard Sicilian spoken that way, usually it is the language of arguements, or of confusing and loud stage shows. The beautiful sweet tones of the language came out as they were talking to each other.

Il Dottore became a friend as I recovered. It was he who first understood the problem of the parrot, and we were able to laugh about that. We also talked about Cava de Cusa, the old mines where parts what would become the ruins of Selinunte were mined, the site where the workers walked off the job, leaving their tools behind, when they saw the size of an approaching Punic invasionary naval force.

Unfortunately, the thoracic surgery unit was not able to help Il Dottore, so he was sent home to await a flight to see another sort of specialist in Rome. His condition worsened while he was waiting for news, and he and his family decided he would rather wait at home.

He is a good man, and he will be facing a tough fight, and my thoughts are with he and his family.

Auguri, tanti auguri Dottore e Amico Mio. e in Bocca a lupa.

A Little Help from my friends

I heard from a lot of people when I was in the hospital. This was especially comforting as I was coming out of reanimation and confined in myh bed, not able, or really willing to move. I want to thank the people who helped keep my spirits up, particularly during the dark times. My friends from Palermo - Angelo and Franci, Giusi Vitale and Melito Polito, Franco Tranchina and Giusi Cerlito, Ernesto. I even saw all of them doing the perp walk behind the windows in reanimation. And Gabriella and Fabrizzio Ricotta came all the way from Sciacca for a visit. There was never a day that I did not have at least one visitor, and Giusi Viatale even arranged for a volunteer to come and visit to make sure I did not need anything.

Paolo Ficalora and Ignatzia Marchese called at least once every day to make sure I was alright. Nadja and Petra and Gene from Germany all called. Toto Grisafi and Anna Catenzarro from Sciacca, and Monica, and Pascale from Sciacca, kept my phone going with their caring thoughts. And of course Gasperi Marinello, who not only called me, but also talked with the doctors, and then talked to me to make sure I understood everything. My friends from the Sigonella Naval Air Station.

Michael, Carl, and Mike from the states, often.

Of course Jon and Jess, always taking the time to be with me by phone, always comforting me, always able to chat a little, even if the business next door was burning down.

Some times I was too tired to stay on the phone for very long. Some calls I may not remember because of the pain, or the morphine, or the tiredness.

I just want you all to know that you were a great help to me.

I am humbled at having such wonderful people caring in my life.

Strange Things that happened

Once, when the medical staff in reanimation were working on Giuseppe, Forman turned around and said: 'Okay, House, it is your call.' I looked over and Dr. House was not there. Then part of my mind said that it was not real, and that I should open my eyes. So I did. It was not real. I realized then how powerful morphine is.

Speaking of being in reanimation, I remember at one point waking up and feeling fairly lucid, and being aware that I was in reanimation, and then the lucidity started to slip. I decided that the reanimation must be working to re animate some of the old Disney cartoons, and that was why I was sometimes acting so, um, Goofy. So even when I was out of it, at least I had my puns.

I stopped by reanimation before I left the hospital, because I wanted to see what it looked like, if my memory had changed it at all. I remembered a large, cavernous room, with high ceilings, and room for three beds, each one having tons of neat electrical medical looking machinery. When I stopped back, I found out it was a small room, with barely space for three beds, although each did have tons of equipment. I think the morphine helped it grow.

More than once I would decide that since I could not sleep, I might as well read in bed. I would pick up the book I was reading, or start a new one, and get about thirty pages in, and decide that it was not the book I expected it to be. Part of me told myself that I was not reading, but I knew I was. So part of me said that I should feel with my fingers, to see if I was holding a book. I was not. Then that part of me told me to open my eyes. No book. It passed the time for me, I guess, until I could start on the books I had brought with me to read.

Hospital Reading

It was almost like a vacation, I got so much reading done. Here is what I read while I was there.

No Pictures in my Grave by Susan Caperna Lloyd.
The King of the Vagabounds, Baroque Cycle 2 by Neal Stephenson
The Eight by Katherine Neville
Thunderstruck by Eric Larson
Anansi Boys by Neil Gaiman
With Their Backs to the World by Asne Seierstad
Controcorrente by Julian Barnes
Il Famoso Caso de Sciacca by Francesco Savasta

And of course Tutti Sport and Giornale de Sicilia when Davida's father brought them in.

Addio Giuseppe

Once, when I woke briefly in reanimation, there were two other patients there. One was a young man of about 23 years old, and I was told that he had a brain aneurysm caused by the same for of leukemia that killed Fran. I was reminded of what a cruel and sudden killer leukemia can be.

Several other times, as I struggled toward consciousness, I remember having seen first his mother, then his father, and then his girl friend standing by his bed, always with at least two hospital personnel. They were talking quietly and briefly to him, saying their good byes. They had brought some of his favorite things to lay on his bed, including a soccer jersey signed with affection to him by Luca Toni, former striker for Palermo, who went on to Florence, and now plays in the Bundeslegge for Bayern Munich, as well as staring for the Italian national team.

One wall of the reanimation room was all windows, and family members and friends not allowed to enter the room could pass by and look at their loved one. His other relatives were there several times, and once his sister tried to open the window and climb into the room to be closer to him. I am only sorry there was not room and ability to allow all to get close for a last good bye.

I remember particularly once when an old man was standing near the open window. He was quietly calling out: 'Giuseppe, sveglia. Giuseppe, sono io, tuo nonno. Sveglia, Giuseppe, sveglia, sonno io. Giuseppe.'

'Giuseppe, wake up. Giuseppe, it is me, your grandfather. Wake up, Giuseppe, wake up. It is me. Giuseppe.'

Later I woke up and watched the doctor call the time of death, and watched the five staff persons join hands in brief prayer, and with tears in their eyes, detach the medical machines from the shell that had enclosed Giuseppe's spirit.

My heart goes out to his family, and most particularly to his grand father, whose soft, pliant voice echos in my ears, and brings tears to my eyes.

Addio Giuseppe. Tu era bravo.

Closed Port

The fishing waters off Sciacca have been closed for two weeks, and they will be closed for another two weeks to try to allow the fish population to regenerate. This will happen in all of the Italian fishing waters, one at a time. For now, the people of Sciacca get their fresh fish either from a neighboring fishing port, or from one of the amateur fishermen who are still allowed to go out and fish. They have not taken advantage of the situation to try to catch more fish, but just do their normal Sunday morning fishing, selling their excess catch at the dock.

It is strange to look outside over the waters in the middle of the night and not see the fishing boats leaving port. Often I have seen as many as twenty boats heading out at three in the morning. Now there are none leaving at that hour, and only few fishermen ignoring the ban and trying to catch calamari and octopus late at night with their special boats with the huge lights. So far they have apprently been ignored by the authorities, who have indeed stepped up patrols during the day, and also have helicopters patrolling the zone around Sciacca.

Sciacca is reportedly the second largest commercial fishing port in Sicily, and Mazara del Vallo, which is about forty five minute drive from here, is not only the largest in Sicily, but the largest in Italy. I am hopeful that closing the waters as they have done, along with stricter enforcement against catching hatchlings for novelame in the spring, will keep the waters healthy and the fishing industry will be able to continue to thrive. My friend Klaus says that much of the water near Greece has been overfished for so long there are almost no fish left there. Sad indeed.

Good or bad, the fishermen do not get a vacation. The dry dock is full of boats being repaired, and the wharf is full of fishermen tending their nets, making permanent the quick temporary fixes they have done all year. The boats are being cleaned inside and out, the motors tuned, and all is being made ready for the season re-opening.

NUTS

You may remember the post of the couple who have a mill that shells almonds. Well, I just got involved with the step prior to the shelling of almonds.

My neighbors Totò and Anna were working away on their terrace the other day. It seems Totò had just finished picking the almonds from his four almond trees that he has on his small farm near Caltebellotta. He and his son Vincenzo had gathered the almonds, and it took them two days to get them all.

They then bring them down in large bags, and let them dry out for a while. Then they take the soft covering of the almond and discard it, leaving the almond in the shell for the next step of the process. It was nice sitting with them on their terrace pulling off the fuzzy soft shells. The shells go onto the ground to provide potassium for the soil, and are raked up in the spring. The almonds are taken into town and sold.

The four trees produced probably a bit over 100 pounds of almonds, and I have no idea what that would sell for in town. I do know that it did provide quality time for Totò and Ann, and sometimes Vincenzo to sit and talk about the days events, their dreams for the future, and just to spend time silently together.

It took me back to summer in Mendon Center when the neighbor farmer asked my brother and I to clean a large bag of kidney beans. We gladly did it, as we were to be paid for our labor, and we sat out under the box elder tree in our yard and took off the coverings, cleaned out the stones and clumps of dirt, and rebagged the clean kidney beans. When the farmer picked up the finished product, he overpayed us, but said he did not want any more done. My father told us that he had asked us to do the work, because his own son, while complaining of being bored with the summer, refused to join the family during this special time of mindless work and important talk, and he wanted to use my brother and I as an example for him. Apparently the cleaned beans were worth much more on the market than the fresh harvested beans.

Anyway, it was good to be a part of the process, and to spend the time with Anna and Totò. Maybe next time I will pick the almonds, and will do it right. Fran and I picked almonds once on Paolo's farm, but we also picked them off the ground, and found the almonds from the ground were wormy, and we could not easily separate them. Oh well. It still made for another fine memory.