ralph robert moore
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Copyright © 2001 by Ralph Robert Moore.
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"he may not remember this conversation afterwards"
october 27, 2001
This past Thursday, October 25, my phone rang around 8:30 A.M.
It was the receptionist from the specialist's office where I was scheduled to have bone tissue transplant surgery the next day for a back molar.
I recognized her cheerful voice.
"Mr. Moore, I'm calling to let you know that I'll be phoning in your prescription to the pharmacy you designated as soon as it opens at nine. You'll need to pick these up before your surgery tomorrow."
I knew I had to take a sedative, but I wasn't sure what else I was getting.
"Well, there's Peridex, which is a prescription-strength mouthwash, and Doxycyclin HYC, that's an antibiotic, Triazolam, which is the sedative you'll be taking half an hour before and maybe during the surgery, you'll be taking between two to four of those, depending on how it goes, and Hydrocodn/APAP, which is a pain killer you'll need to take afterwards."
I couldn't think of anything to say, my mind stuck on the casual ominousness of 'depending on how it goes' . "With all these pills inside me, I'll probably rattle."
"After I take all these pills, I'll probably rattle when I walk."
"What do you mean?"
Being in that position we all find ourselves in occasionally of having to explain a joke, and a fairly lame one at that, and knowing from past experience that each successive, even more elaborate explanation will even further diminish any possible pay-off of sincere laughter, I tried to think of some way to simply switch the subject, couldn't, but then she wound up rescuing me herself.
"Oh! And don't take the antibiotic on an empty stomach. It's a very powerful dosage. You'll throw up."
Triazolam, the sedative I'll be taking, is the generic form of Halcion.
This is from the information sheet the specialist gave me during my most recent visit:
"You will be given a prescription of four Triazolam tablets which you bring with you to the office the day of your surgery. DO NOT take any of this medication before arriving at the office. You will be asked to arrive at the office 30 minutes before your surgery. You will take one or two tablets when you arrive in the office and then stay in the waiting room until your scheduled surgical time. At that time, depending on your level of sedation, you may be asked to take another Triazolam tablet. During longer procedures, an additional Triazolam tablet may be given during surgery if indicated. Most people feel moderately sedated to very sleepy from this medication. If you take Triazolam, you will be required to have someone drive you to and from your appointment. Your driver will need to make sure you are settled at home before you are left alone. You may sleep for several hours after surgery and may remember very little of the day of the surgery. You must go directly home after surgery and must not do anything that requires judgment for the remainder of that day."
To me, that whole passage sounds a bit grim, with its tolling of 'may' throughout, its 'stay in the waiting room', 'depending on your level of sedation', 'make sure you are settled', and 'may remember very little', which elsewhere in this little pep talk is referred to as the 'retrograde amnesia' effects of Halcion (I would have preferred a 'simultaneous amnesia' effect, myself).
I normally write these Latelys on Friday and Saturday night, and post them that Saturday, but in this case I'm doing something slightly different. Everything above, and through this paragraph, has been written before my surgery, on Thursday the 25th. I'll complete this Lately tomorrow, Friday, the 26th, after the surgery. Which means that the surgery itself, my slight dread of it, the pain, retrograde amnesia, my rest at home, will all, through the magic of writing, have already occurred, rather than still be breathing in my face, as the next paragraph begins.
And here I am now, post-surgery in this paragraph, at eight o'clock Friday night, my operation now ten hours behind me.
As can be said about almost everything in life, the surgery wasn't as bad as I dreaded it would be.
I actually slept quite soundly Thursday night, waking up only at one point, because the cats were crowding me. I reached out in the darkness and petted the one closest to my face. I could tell by my fingers in his fur it was Rudo, our oldest cat, a black, long-haired mutt Persian.
Mary and I went through the usual morning routines, although with more sunlight in the windows, since we didn't need to leave today until eight o'clock. As I shaved, showered, pulled clothes off the hangers, there was a tightness in my stomach, trying not to think of the surgery.
Traffic was bad. As we raced around the cars on the sidestreets, it occurred to me that here I was, hurrying towards a place I didn't want to arrive at.
Once inside the oral surgeon's office, the receptionist asked to see the Halcion. It was in a small plastic vial the color of an orange cough drop, with a white lid. She uncapped it, tilted the vial to see the little white pills at the bottom. "Good, they gave you the right ones. A lot of times, they don't."
These were the sedatives I'd be taking to prepare me for the surgery. "Should I take some now?"
"No. The doctor wants to come out to talk to you first." She smiled at Mary and me.
We sat in the over-sized brown leather sofa, knees lifting. Talked quietly to each other.
About ten minutes after nine, the surgeon came out. Tall, white-haired, probably late fifties. White jacket and slacks, powder blue surgeon's mask loosened down to under his jaw. "How you feeling? Are you ready for this?"
He sat in the chair next to the sofa. "May I see the sedatives?"
I handed the orange vial to him.
He unscrewed it, looked inside. "Good. A lot of times, the pharmacy gives the wrong ones." He handed the opened vial back to me. "Have you ever taken sleeping pills before?"
"Are you a cheap drunk, or does it take a lot to get you stoned?"
"I usually have to spend some money."
He smiled. "Okay. What we'll do is, let's have you take two of the pills now, we'll wait half an hour to see the effect they have on you, and then we'll adjust the dosage, if necessary. You might fall asleep completely, or you may just get really drowsy. With these pills, you don't swallow them. Just place them under your tongue, and let them dissolve. I'll be back in about twenty minutes to check on you. Once the operation is over, you'll need to go straight home. Take one of the pain pills as soon as you get home, then another one every three or four hours after that." He turned to Mary. "It's good that you're here to hear this, because he may not remember this conversation afterwards."
He gave me another grin, and left.
His last words struck me. 'He may not remember this conversation afterwards.' That's the retrograde amnesia. I looked around the small waiting room, realized I wanted to remember this, because I was here with Mary. I turned to her. "What he said, about me maybe not remembering this afterwards? I want to remember every moment with you. But here's this one moment in our lives I'll maybe never recall afterwards."
"So, I just want to say to you, in this moment together maybe only you'll remember later, that I love you."
She touched my hair. "I love you." We kissed.
Mary put her hand on my knee. "Is there anything else about waiting out here you want me to remember for you?"
I thought about it. "Only that I told you I love you."
Mary and I talked some more, read our books. After a while, the receptionist slid open the frosted glass at her counter. "How you doin'?"
"Good, I guess."
The surgeon came back out. "Are you starting to feel the effects?"
"I feel a little woozy-headed."
"Your eyelids are droopy. That's good. We'll give you a few more minutes."
Mary showed me a map in the book she was reading on the ecological history of North America. Most of the middle of the United States was under shallow water at that point, a body known as the Bear Claw Sea.
I quoted a sentence from the biography in my lap. 'Reading his book is like going out into a thunderstorm.'
"Wow, that's great."
"Am I acting weird?"
She giggled. "Well, I don't know. Maybe a little."
"Do I look--"
"I've seen you stoned, of course, so I have some experience in how you looked then. Your pupils are dilated."
We both giggled on the sofa.
I was led back to the room where the surgery would take place.
The padded lounge I lay down on was tilted so my head was lower than my shoes. The surgeon looked into my eyes. "You still seem pretty alert. Let's have you take another half pill."
He gave me Novocain shots, into the soft red tendons connecting my upper and lower jaws on the right side. "You'll feel a little prick here. Actually, I know it's more than just a little prick. Let's let that take effect, and then I'll be back"
His assistant, a short, friendly, heavy-set Mexican woman, wrapped a wide, black blood pressure cuff around my left bicep. Throughout the operation, it occasionally swelled with air, like slow breathing, getting almost painfully tight around my arm, giving off a blood pressure reading that showed in bright red readouts on a machine wheeled in front of my feet.
The surgeon came back in. "Do you feel numbness in your tongue, and on the right side of your face?"
"Okay." He pulled out a much longer, larger needle. "I'm going to give you a second series of shots now, which are more powerful, and will keep that numbness lasting through the surgery."
He slanted the big needle around inside my mouth, sticking it into the gums at different points.
We waited a minute or two, him sitting on one side of my shoulders, the assistant on the other, both in high chairs.
He slipped a metal instrument into my mouth. "You're going to feel some pressure. If you feel any pain, raise your hand and wiggle it."
I didn't feel any pain.
"Did you feel any pain?"
"Okay, you're definitely numbed-up." He flipped the instrument in his fingers so that the other end went into my mouth, the original end suspended a half foot in front of my eyes. I could see the blooded blade. That end wagged as he drew inside my mouth again.
"Did you feel any pain?"
Once he had my gums around that molar peeled back to the jawbone, he used another instrument to start shaping the bone of the molar, to make it more receptive for the transplanted bone tissue. I could hear a rough, grating noise in both ears, but it wasn't at all painful.
He glanced down into my face as he pressed a cotton cloth around my molar, not letting me see the cloth as he withdrew it. "You know, you're right, you're not a cheap drunk. The amount of halcion I gave you, you should be knocked out or in a twilight state, but instead you're almost fully alert. Are you okay?"
"Yeah. I'm fine." In fact, I was very calm. Partly because I knew Mary was waiting for me, partly because the worse was over and I hadn't felt any real pain, and partly because I was anticipating writing all this down in my next Lately. Sometimes, documenting an event controls it, at least for the one documenting it.
After the bone around my jaw had been reshaped, he started applying the transplanted bone tissue to it. It didn't look like bone matter. It was a fine grit that, in his words, would serve as a scaffolding for my own, natural bone to grow on. The procedure, his assistant handing him a tool with a little bone tissue in it, he tamping it down against my molar, giving her the now-empty instrument back, her refilling it, was almost identical to getting an amalgam filling, where the dentist adds a little bit of amalgam at a time to a filling.
After he had all the bone tissue in place he stitched up the gum on both sides, using what looked like a long-nosed pair of pliers.
Once it was over, he asked me to stick my tongue out at him.
"Good. No blood at all."
He held my elbow, helping me back out to the waiting room. Mary stood up off the sofa, coming forward. I felt a little fuzzy-headed, but not much. My legs did feel tired though, causing me to sway slightly left and right.
"Stick your tongue out at me again."
"Great. I don't see any bleeding at all."
The three of us, Mary, me, and the doctor, went outside, the doctor holding onto my elbow, leading me over to the passenger side of our car.
I shook his hand, thanked him for his help.
When Mary and I got home, I staggered into the bedroom, pulled my clothes off with her help, got into bed. For the next few days I can only eat soft foods. Maybe it was psychological, but I felt ravenous. I had a glass of cold milk, a can of Lobster Bisque, a triangle of Brie, and several tablespoons of coffee ice cream.
Once it seemed I was all right, Mary went out and rented some videos for us. We started watching the first one, Town and Country. I fell asleep. As the closing credits rolled I woke up in confusion, and for the first five minutes thought my surgery was still ahead of me. It gradually dawned on me, as I lifted my head, reached for ice water, that in fact the surgery was over, a thing of the past.
Plus I hadn't had retrograde amnesia. I remembered telling Mary I loved her.
The picture below is me on drugs, taken once we got back home.
Don't I look really stupid?