Did I Say That Out Loud?

It wasn't until the anesthesiologist on call appeared at my bedside that I began to suspect something might be dangerously wrong with me. She was still in her bulky down coat, little flyaways of wispy hair escaping her ponytail, glasses beginning to fog after rushing inside from the cold. Maybe it was the fact that she was out of breath or the fact that she hadn't taken off her coat, or maybe it was because she was the first person since I had arrived at the hospital three hours earlier to use the words emergency surgery. She said it in a quiet, reassuring voice, but you can't change the meaning of a phrase like emergency surgery just by changing your tone.

After it was all over, a number of people said to me, "You must have been so scared!" I wasn't then, although now when I look down at the giant purple scar, I do feel the remnants of fear. But I feel something else too. By the time we all reach middle age, our bodies are dotted with scars. Most of mine have come from cartoonish mishaps: when I tripped in the kitchen and fell into the stove; when I collided with a branch on the running trail. Dumb but harmless things I did to myself as I pinballed through life. These scars make me feel idiotic, because they send the message You are a clumsy oaf. This big, new scar, though, sends a different message: Guess what, girl—you are mortal! And so this scar actually makes me feel…lucky.

The pain started on Thursday morning as a funny little humming in my back. It felt like I had tweaked some tiny, insignificant muscle between my shoulder blades that I'd never bothered to learn the name of, and so now it was going to make itself known. I had a breakfast meeting with a man I found vaguely annoying, so by the time I got to my office I had chalked the pain up to carrying a heavy backpack and having to listen to an irritating person in a crowded restaurant with mediocre food and service that was incomprehensibly slow for midtown Manhattan at nine a.m.

At lunch the back pain was still there. I walked over to the Whole Foods on the edge of Bryant Park, which has an enormous salad bar from which I always pick the wrong things. That day I got cold tortellini salad (like chewing on a sponge) and found a stool at the long counter. Next to me was a young pair, clearly coworkers. The man sat mostly silent as the woman complained about her job and the fact that a third (absent) coworker was leaving their company for something better. "I want a new job too!" she said, and I stole a glance at her, hoping she was at least interesting to look at to make up for the fact that everything coming out of her mouth was a twenty-something cliché. Alas, no. As the conversation became more predictable I tried to amuse myself by turning what she was saying into a little millennial haiku:

In all fairness, my irritation with the girl was probably caused by the back pain, which had begun to spread. Exactly seven seconds after I swallowed each bite of tortellini, I would get a stabbing pain in what I assumed, from its location, was my stomach. I tried pressing my fist beneath my rib cage after I swallowed, which had always worked on pregnancy-related heartburn. This did not help. I was reading on a Kindle as I ate, bent over with one hand in a fist at my stomach and the other holding the Kindle. Not only was this ineffective but it made me look deranged or like I was in the beginning stages of a stroke. Even with a mysterious little pain in my back and a mysterious big pain in my stomach, I still had enough pride that I didn't want to look like I was having a stroke in front of the whining millennial next to me.

As I walked the three blocks back to the office, I argued with myself about whether or not I should go home. But it was a mild early November day and standing up seemed to alleviate the pain. So I went back to work and harangued the office manager about ordering a standing desk for me since everyone knew that sitting was the new smoking and my back pain was all the data we needed to prove it.

When I got home that night, though, I began to suspect this was not a problem a standing desk could fix. The back pain was still there and the stomach pain was worse. Plus, I had chills. I lay on the sofa wrapped in blankets, my sidekick, our black Lab Jill, snoring on my calves, and decided to take the night off from parenting. Perfect Renata, our sons' longtime babysitter, stood in the doorway and stared at me with alarm. "This is not like you," she finally said.

The next morning was no better.

"You should call your doctor," said my son Owen as he headed out the door.

"I might," I lied. Calling the doctor on your first full day of being sick would violate the Just Wait and It Will Go Away approach to health problems that had gotten me to my sixth decade relatively intact. But I knew Owen would worry all day if I told him the truth.

Honestly, I had no idea what was wrong with me. I canceled my morning coffee date and my afternoon lunch date and told the office manager that I was staying home. I watched from the sofa as the dogs chased each other around the dining-room table, and Renata and my youngest son, Axel, and Axel's friend Manu came and went. It hurt to walk and it hurt to eat, so I lay there all day with my Kindle, reading and dozing, petting the dogs from time to time, feeling dependent and ridiculous and slightly sorry for myself as I waited for whatever this was to pass. At five p.m. my friend Nandini showed up at the door. Nandini is Manu's mom and—most relevant to this story—a doctor.

"Hey," I called from my fainting couch. "Can I ask you something?"

Nandini leaned in and peered at me with concern. "You don't look good," she said. "I think it might be your gallbladder." Aha! I wasn't fat, but I was fair and female and fertile (I mean, ish) and over forty, four of the five risk factors for gallstones, which for some reason I had memorized instead of memorizing the difference between jealousy and envy or who was president of the United States in 1905. Talking to Nandini emboldened me to call my own internist, who told me that if I didn't feel better in the morning, I should head to the emergency room. But which one? Because I live in suburban New York, there are about fifteen hospitals within twenty miles of my house, and if you believe the comments on the local moms' Facebook group, they're all great and they're all horrible. My doctor seemed unsure of which emergency room I should go to, which was definitely unsettling but, I suppose, a discussion for another time.

Just before my hospital adventure, my husband and I had begun watching the Showtime miniseries Escape at Dannemora. Starring Patricia Arquette, Paul Dano, and Benicio del Toro, it tells the real-life story of two inmates who, in 2015, broke out of the Clinton Correctional Facility in northern New York with the help of one of the prison employees. Arquette plays the accomplice, Tilly; she runs the prison sewing room when she's not giving del Toro's character blow jobs or presenting him with hacksaws hidden in ground beef so he can escape and take her to Mexico for the exciting life she has always deserved. "She is so self-destructive!" I would cry every time Tilly made a bad decision, which was about seven times per episode. There is something fascinating to me about self-destructive people, perhaps because I pride myself on being moderate and sensible. Regular life is complicated enough without hacksaws in the ground beef.

But people who work in an emergency department see self-destructive behavior everywhere they turn. Which might explain why, after he reviewed my CT scan, the ER doctor gave me a long look, scratched his chin, and asked, "Do you chew on chicken bones?" As I was soon to learn, there are people all over the world who intentionally swallow needles and glass and paper clips and other sharp or dangerous objects. So I suppose it made sense for him to wonder whether the problem in my stomach was self-inflicted; just because someone looks like a moderate and sensible woman doesn't mean she doesn't chew on chicken bones just to see what might happen.

"No," I said.

"Your scan shows a foreign body," he said. "It has perforated your stomach. Do you remember swallowing a fish bone?" This was a tricky question. I can usually recall nearly every single thing I've eaten for the past three days. But remembering everything I've swallowed, even by accident—a dog hair? a piece of tissue? a bit of wax along the edge of a sliver of Manchego?—is something else altogether.

"No," I said.

The ER doctor sighed, his shoulders drooping. "I am sending in the surgeon."

On the other side of the privacy curtain to my left was a man who seemed to be on eighty-seven medications; he was surrounded by family members who obsessively deliberated over which toppings to include on the pizza they were going to order later. I'm no doctor, but it didn't sound like there was much wrong with this guy, as he had strong, lucid opinions about pizza and kept telling everyone, in a loud voice, that he was about to get up and walk out to his car. Behind the curtain on my right was an elderly woman accompanied by her adult son, whose sneakered feet I could see if I leaned forward and peeked around. Two EMTs had wheeled the woman in, and the son announced with exasperation that this marked their fourth visit to the ER in a week. He desperately wanted his mother to be admitted to the hospital, which he repeated patiently to each new medical professional who approached. As he described her health history and medications, his mother mumbled in a low voice, the sound unvarying and unbroken, like a delivery truck idling at the curb. "She's talking to someone who isn't there," the son said to the nurse. "She's talking in her native tongue." All I could think was I hope to God one of my three sons is this good to me in a few decades when I start mumbling in my native tongue.

In a flurry, the surgeon appeared with an assistant by his side. Dr. Miguel Silva was an extremely kind, trim man with a clipped way of speaking and frank eyes that never looked away when you were talking. "How often do you eat fish?" he asked, pushing down on my abdomen.

"I don't know," I answered, flinching. "A couple of times a week?"

"When was the last time?"

"I had smoked salmon on Thursday," I said, remembering my breakfast with the annoying man and secretly hoping I could blame him for this entire hospital visit.

Dr. Silva shook his head. "That's not it." He repeated what the ER doctor had said, that a foreign body had perforated my stomach, in the back, hence the pain between my shoulder blades. "If you just had a hole in your stomach, we could give you antibiotics and it might heal itself. But"—he poked the index finger of one hand through two fingers of the other—"because you have a foreign body there, your stomach won't heal unless we remove it. I think I should do surgery on you this afternoon to remove whatever it is and put on a patch. We may have to take out a tiny piece of your stomach, but we'll try not to do that." He waited, staring down at me. "What would you like to do?"

My husband, who'd been with me this whole time, was sitting to my left, just behind the head of my bed. I twisted around and looked at him. He is not a medical professional and, as far as I know, has limited experience with foreign bodies. Still, I felt like I needed a second opinion from someone. "What do you think?" I asked.

His response was sensible, if lacking that supportive touch. "Don't look at me," he said.

I turned back to the surgeon. "What would happen if I waited?"

"Well," Dr. Silva said slowly, "you could get—"

Let's pause for a moment for a list of a few words you hope never to hear come out of a doctor's mouth:

• malignant
• obstruction
• tumor
• terminal
• mass
• quarantine
• intensive care
• MRSA
• staph
• complications

…and sepsis, which was the word Dr. Silva used next.

"I guess we should do the surgery," I said.

Weeks later, my husband told me that he admired how I'd handled myself in that emergency room. No crying. No wavering. All forward motion. In his eyes, I demonstrated immediate acceptance and resolve: This thing happened to me, there is a known fix, so let's get on with it. He wrongly attributed my quick decision-making to strength of character in the face of adversity. What he doesn't know about me, even after twenty-seven years of marriage, is that I rarely open the little door in my brain that allows the mismatched thought marbles rattling around in there to hurtle down the chute that leads to the section labeled CONSEQUENCES. If I did, maybe I would not have attempted to lighten the mood by saying to Dr. Silva, "Why do you look so unhappy?"

And maybe I would have understood exactly what he meant when he responded, "I wish I didn't have to do surgery on you."

After the visit with the wispy-haired anesthesiologist, I was wheeled out of the ER toward the operating room and finally got a look at the devoted son of the woman mumbling in the bed next door. I had so many questions for him! What language was his mother speaking? Did he write her medical history down and keep it in a card in his wallet or did he just know it all by heart? And how could he possibly take his mother to the emergency room four times in a week and still hold down a job? The son appeared to be in his thirties; he had a scarf around his neck and a backpack on the arm of his chair and very nice eyes that regarded me with a mixture of kindness and sympathy. I didn't think I could ask the nurses to let me stay for a chat, so as I rolled by I simply said, "Good luck."

"You too," he replied with a wan smile.