Surgery Monday: A Sister’s Tale

by Francine on August 19, 2014

“Surgery Monday” said the caption on the selfie my brother sent.  There he was, laying in a hospital bed, my younger (69) brother who hadn’t even retired yet. The selfie came as a text message addressed to me and a bunch of other phone numbers I didn’t recognize. What??? What happened? My heart jumped and my stomach churned. I used my yogic breathing techniques to get hold of myself because I was driving. Our father had dropped dead of a heart attack many years ago. Clearly Bradley  hadn’t done that. But why was he in the hospital. He is my only brother. My mind flashed back to how bad our mother had felt when her own younger brother died. She was never the same after that, and she told us she was very lonely for him.

I pulled into a gas station to find out what was happening, and set the gas pump going. Always productive and efficient, I was driving home from a ribbon cutting ceremony for the new inner city STEM school whose board I had joined when I saw the selfie. Yes, I was stressed out all of a sudden, but I wasn’t going to pass up an opportunity to fill the car up while I was here.

Just the very fact of the selfie was odd. My brother is, in his own words, an “old cow” who prefers to talk on the phone rather than text. He prefers Dunkin Donuts to Starbucks, and he derides me for communicating only online He’ll do Facebook, but only to make snarky political comments to me and his  kids. Revealing something serious through a selfie was very unlike him.

I read down through all the messages from others: “I thought the cardio said it was okay.” “What happened?”  “What the hell!!!! Can I call you?”

It was something all these people knew something about, but I knew nothing. Boom.

My brother and I grew up in New York City. After college, I got married to the first Jewish guy I could and moved out of town with him to Upstate Medical Center in Syracuse. It was up to my brother, three years younger, to be home with  my parents when our dad collapsed on the night of the big New York City blackout and died in our living room. He saw it. I didn’t. He tried to run out to get help. I didn’t. In fact, at the end of that year, I picked up and moved further away —  to Arizona.

My brother and I, who had never been close as kids because of the difference in our ages, now weren’t even close geographically.  I had two kids and went through a string of careers, divorces, and relationships. He became a highly regarded commercial photographer and traveled the world with assistants, apprentices, women, and Quaaludes. We didn’t fight or anything; we just never  saw each other. In fact, I never saw much of ANY of my family.

And then I went to visit my mother in Florida to introduce her to my fifth and final husband, and found out she had Alzheimer’s. My husband-to-be, a physician, diagnosed her at the front door when she opened it to greet us dressed “to the nines,” but without a skirt. My brother and I convened after that, and he admitted he had been flying down to Florida to see her regularly and was aware of her condition. But by this time, he had a wife and child and another on the way and was still on the road all the time. He couldn’t do any more for her.

So I moved her to Arizona.

My brother couldn’t believe I would do that, even as I couldn’t believe he had been caring for her all along without even telling me. He figured I couldn’t do it because I was too far away. And too selfish.  That’s how little we knew about each other, about who each of us really were. It’s like we stopped knowing each other as kids; he was the pesky little kid who interrupted my parties, and I was the selfish older sister who left home.

And now here he was in the hospital. He had been very overweight most of his life, and had decided to go on a weight loss program.  To get on the program, he had to take a stress test. That’s where they discovered he had two arteries that were 90% blocked and put him right in the hospital without passing go. The surgery was the following Monday. Five days away.

Intellectually, I could have predicted this. When we ate together, he consumed mounds of foods I had given up years ago: meat, mayonnaise, pickles, hot dogs, dessert, almost anything. He inhaled it while I ate my salads and fish or later, not even fish. I bitched at him, his kids bitched at him, and his answer was always  “I like to eat.”

And now I might lose him!!!! It made me realize how much I loved him, what a good and honest and admirable man he was, quitting the glamorous photography career to become a 6th grade teacher and coach Little League, being the father of the year for his two kids born later in life, sacrificing everything for them once he decided to have them. Taking care of our mother without burdening me.

And it also made me realize how much time we had wasted, leading our separate lives and thinking we had nothing in common.

After my stomach calmed down, I sprung into action. I called him, his girlfriend, and my niece and nephew. I offered to do anything I could to help. I sat by the phone waiting for the results of the surgery, scared to death he would die on the table, also afraid he wouldn’t come out of the anesthesia with all of his faculties.

I was FREAKED OUT!!! I could not imagine Brad not being in my world, even if we were typically 2500 miles apart and much of our communication consisted of him posting his  political views on the Facebook walls of my Arizona friends.

I did something I’ve never done ever. I asked my Facebook friends to pray for my brother. I never pray. I don’t even believe in God. But I somehow believe in the power of prayer for the people who do believe, and I also wasn’t going to overlook anything that might help.

The surgery was moved up to Friday afternoon. Oy, I thought. A Friday afternoon surgery. A tired doctor anxious for the weekend,  a skeleton staff of rented nurses at the hospital on Saturday and Sunday. Way too many opportunities for mistakes in this American health care system I’m so cynical about lately.

Guess what? More than a hundred people commented on my wall, prayed for my brother, and despite all my misgivings, everything went as routinely as they always tell you it will — the same “they” who sometimes give you staph infections, non-nutritious food, and nurses who don’t speak your language. He couldn’t keep up with the tsunami of well-wishers. His surgery was a success.

He comes out tonight. I am resigned to the fact that he’s not going to become a vegan. He says they told him the grafts are good for twenty-five years, and he feels like he dodged a bullet. The lesson he learned is different from the one I would have learned: his is, “get that stress test.” He says it saved his life.

And the one I learned?  I learned again to be grateful. Whatever works. I finally know how I feel about my brother.





Sometimes it is necessary to revisit the past in order to see whether mankind has actually progressed. Lost in the day-to-day struggles, we lose sight of the long view. Especially with regard to American health care, which I view with more than a modicum of cynicism these days because as a Medicare patient I am the target of every doctor and hospital under the sun trying to sell me something that will prevent something I do not yet have, treat something I don’t think needs treatment, or test me for something I haven’t even conceptualized.

Why? Because they can. Because the technology exists and Medicare will pay for it, and doctors and hospitals need to survive. The business of medicine is big business. In the last week, I have narrowly escaped spending $8500 for dental work on teeth that don’t yet hurt, and whatever Medicare will allow for a colonoscopy I do not need. This despite the fact that I can’t get a blood test that might actually tell me something I want to know. It’s the reimbursement, stupid.

So I watched the first episode of “The Knick” tonight, and found it therapeutic for exactly the reasons described above. American health care might be bad now, but at the turn of the 20th century it was probably worse. Or maybe not.

If you haven’t seen “The Knick” yet, it’s a ten-part series about a New York city hospital and its chief surgeon just at a moment of great change. Electrification is coming to the city, along with  boatloads of immigrants with tuberculosis and other diseases.  “The Knick” stars Clive Owen as a man who, besides being an incredible surgeon, is a cocaine addict with collapsed veins. Every episode is directed by Stephen Soderberg, so we’re in for a real thrill.

For reasons known only to me, I found “The Knick’s” revelations comforting. After all, many doctors are addicted to painkillers today, and it’s good to know that’s part of a long time-honored tradition. It’s also good to know that hospitals were running deficits because of uncompensated care as early as a century ago. I would hate to think my own generations fucked up something that used to work by overlaying insurance and its accompanying cost structure over an idyllic relationship between patient and doctor.

The first episode begins with a Caesarean section  performed publicly, with much fanfare,  for other physicians. It fails miserably; both the patient and the baby die. But we are meant to feel good, because  we know that now Caesarean sections are so routine they can be performed purely for the convenience of either the mother or the doctor. Just think! Only a century since something once worthy of witnessing in an amphitheatre has devolved to  simply a scheduling issue. Surely this is progress.

I’ll not ruin your enjoyment with spoilers, but the stage is set for contemplation of where we’ve come from and where we are now. Some things are obvious: the horse-drawn carriage is on its last legs, so to speak, and the hospital is being electrified. But others are not so obviously changed for the better: do our doctors still take their professions so seriously that failure to save a life is grounds for hara-kiri? Do we still have hospitals supported by wealthy families who want to help people? And what of the competition among physicians for honors at the hospital?

To me, “The Knick” is a complex meditation on health care, technology and progress, if such a concept really exists. Have we truly graduated from the dark ages in medicine to somewhere better? Or have we merely replaced one form of ignorant barbarism for another?  The first episode of this series was so good that I intend to stay tuned.



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