Subarachnoid

“You’re awake,” a nurse’s aide said as she approached.

But I wasn’t fully — I was still half-submerged in a soupy blur of delirium. A red beacon had materialized only a few minutes earlier to lead me out of my fog like the taillight of a distant car. As my eyes and mind began to focus, I realized the red light was no larger than a sesame seed. It was attached to a wire and taped to my fingertip. I waved my hand slowly and followed the light with my eyes. The movement tugged at the tube of an IV inserted into my forearm. Another IV dangled from my other hand, apparently attached to nothing. Several wired electrodes were stuck to my skin, too, in what seemed like random places on my chest and stomach. I was naked under a hospital gown and had no idea how I got that way. The paper-thin bedsheets smelled of bleach, washed to the point of being nearly transparent. As I pulled them over me, the tape holding the light to my finger slid off, causing a monitor beside me to chirp. An array of brightly colored graphs and numbers glowed from the monitor like a finance show on cable TV. And just like the stock market, I had no idea what it all meant. Whether I should buy, hold, or sell.

The nurse’s aide placed a thermometer under my tongue and wrapped a blood pressure cuff around my bicep. “Do you know where you are?” she said.

I had a guess, but even without the assortment of tubes and wires stuck to my body, a sign on the wall gave it away: No Cellphones in the ICU

“I’ll let the doctor know you’re up. He’ll want to check on you.”

When the neurologist arrived, the first thing I noticed about him was his height. Towering and solid, like a football player. But the woman who followed behind him was taller still due to her sky-high pumps. Her shoes seemed so incongruous with making the rounds in a hospital that I half-expected her to be introduced as an actress researching a role rather than the doctor’s assistant, as she was.

“You had a subarachnoid brain hemorrhage,” the neurologist said, tapping his head. He did a few quick tests—asked me questions, had me touch my nose, move my feet, and so on. “You’re doing great.”

“How much do you remember?” the assistant asked.

“I remember the dentist’s chair,” I said.

“What do you mean?” She might’ve thought I still had one foot in a dream world. I wasn’t so sure either.

“I was getting a tooth fixed,” I explained, putting a finger to my cheek. “I was in the dentist’s chair.”

“Oh, interesting,” she said. “Maybe it caused your blood pressure to spike. Do you have a fear of the dentist?”

“I do, now.”

Shortly after they left, I discovered a good reason for the sign saying, “No cellphones in the ICU.” Because when I found my phone on the table beside me, I immediately used it to look up Subarachnoid Brain Hemorrhage.

I learned that it is bleeding between the brain and surrounding tissues where the cerebrospinal fluid circulates, providing a cushion that protects the brain. A hemorrhage in this space can cause a coma, paralysis, and even death. According to the webpage, nearly half of patients die due to various complications within the first 30 days. About a third of those who survive are left with lingering problems.

That’s as much as I read before deciding “no cell phones” was a good policy.

I put down my phone and returned my attention to the numbers and graphs on the monitor. I tried biofeedback to keep them all steady. “Stay calm,” I whispered. “Don’t let anxiety cause more trouble than it already has.”

My dentist is in New Jersey, and he had been recommended to me by my sister. Unfortunately, the office is inconveniently located an hour and a half south of my apartment in Brooklyn. To make the trip worthwhile, I liked to squeeze in a lunch visit with my mom and dad, who live in a retirement community about 20 minutes farther down the Garden State Parkway. However, since my appointment was scheduled for late afternoon, there wasn’t time for a lunch visit. So I planned to whiz down the Parkway, get my tooth fixed, and zip back home — although whiz and zip are aspirational adjectives for driving in and out of New York City. If anything can make my blood pressure spike, it’s the blood sport of commuter traffic.

The somewhat rushed dental visit was because I’d cracked a molar while eating — likely weakened from the habit of grinding my teeth like a rabid wolverine every night — and I was eager for the dentist to fix it. Getting a crown is a two-step procedure, and I was there for part two, which should have taken no more than twenty minutes. That’s not to say it was a comfortable twenty minutes. Being an upper molar, the dentist had me tilted so far back in the chair I was nearly upside down.

Everything went smoothly, however, and the dentist began his finishing touches — filing down high spots that could throw off my tooth alignment. “Your bite only needs to be off by a millimeter to give you a splitting headache,” he said.

Another five minutes, and he would have been done, but I had to ask him to stop because I was already getting a splitting headache. “I feel weird,” I said. It was the only word to describe the sensations creeping over me. “I need to sit up and test my blood glucose.”

The dentist knows I’m diabetic because I remind him at every visit. “Just raise your hand if you need a break,” he always says.

Testing my blood glucose is the first thing I do whenever I’m feeling off, and it is routine for me to interrupt something at an inopportune time. Although I wasn’t feeling the usual symptoms, there are no hard and fast rules. And since an insulin reaction can be life-threatening, it’s always best to rule it out. I pointed to the coat rack and asked a dental assistant if she would please find my test kit. My headache was worsening, and my left eye began to list inward.

After placing a fresh test strip into the handheld meter, I pricked my finger and squeezed a drop of blood onto it. It only takes a few seconds to get a reading. Still, it felt like a long time. As I waited, I dug out an emergency container of glucose tablets from my pants pocket. Usually, all it takes is three or four tablets to set me straight and although I hoped I wouldn’t have to use my brand-new tooth to chew them, I was prepared to do what I had to do.

“What’s your reading?” the dentist asked.

“It’s fine,” I said. “A little high. Nothing unusual, though.”

“What do you need?”

“I don’t know.”

If my blood glucose wasn’t the cause of my symptoms, what was? I tested again. Normal. Why did I feel so bizarre? “I need a minute,” I said, lying back in the chair.

A numbness, which already blanketed my cheek and gums from a Novocain injection, crept from my face down my neck, arms, and legs as if the Novocain was coursing through my entire body. “Is that possible?” I asked the dentist.

“No, that’s not something that happens,” he said, sounding as confused about what was going on as I was.

Without the slightest hint of nausea to warn me, I suddenly vomited all over the dental assistant standing beside me. I apologized and tried to sit up but could hardly move. My body felt numb and heavy, my left leg especially. A psychedelic swirl of neon crystals crisscrossed my vision as if the Novocain had been laced with LSD. “What’s happening?” I said out loud and then to myself, “Am I dying?” Who wants to die in a dentist’s chair? Who wants to die at all? I struggled to stay conscious, fearing that if I let go, I’d never come back. I thought about my wife, Deborah, who was home in Brooklyn. I didn’t want to leave her behind.

“Please call 911,” I said.

“They’re on the way.”

The dentist tried to give me oxygen, but tunnel vision was closing in, and the face mask felt like a coffin lid. I pushed him away.

“It’s pure oxygen,” he assured me.

Another assistant stood beside me and tenderly ran her hand through my hair to comfort me. “You’re going to be okay,” she said. It felt like a mother’s hug, and I almost believed her. That caress is my last clear memory.

By the time the EMTs arrived, I was delirious. I remember them putting me on a stretcher and rolling me into an ambulance, but only in vague, gray snippets. I remember one of them saying, “Hang in there, buddy. We’re going to take care of you.” And the other one asked, “Do you know your name? Do you know what year it is?” I don’t remember what my answers were. And gradually, like a series of heavy blankets placed over me one by one, the world grew darker and darker until it all turned black.

Meanwhile, a receptionist from the dentist’s office phoned Deborah, who was listed as my emergency contact. Unfortunately, the receptionist couldn’t offer her much info other than to let her know which hospital I’d been taken to. The hospital was only a mile from the dentist’s office, which was probably life-saving for me but meant a two-hour drive in rush hour traffic for Deborah. Not that it mattered since I had the car. So instead, Deborah called my mother and father, who rushed to the hospital as fast as they could (which, despite living relatively near to the hospital, wasn’t very fast considering they are both in their 80s and my mother uses a wheelchair.)

Nevertheless, my parents arrived at the hospital and stayed for a few hours. But I don’t recall seeing them. My dad later told me I seemed a little out of it but appeared functional. For example, I provided my insurance card when asked. And I performed another finger prick out of sheer force of habit. But I don’t remember any of it. I don’t recall getting a Ct scan. I don’t remember having a catheter snaked from my groin to my carotid artery. No memory of the dye squirting into my brain to diagnose the bleeding.

A day passed before I awoke, and aside from the low hum of anxiety, I felt surprisingly okay. I even thought I might get released the following day, if not sooner. After the neurologist and his assistant left, and after looking up Subarachnoid Brian Hemorrhage, I called Deborah. I don’t remember what we said to each other, but she later informed me that I wasn’t as clear-headed as I thought. She worried my apparent struggle to communicate might be a permanent fixture. I kept asking what day it was and whether my parents had been there. “I sort of remember seeing them,” I said, “but it might’ve been a dream.” She assured me they had both been there and that it was Friday — roughly 24 hours after what came to be called “the event.” She also told me that, after my mom and dad spent the afternoon with me, they went home, exhausted, only to both become ill themselves — food poisoning, it seemed, or maybe a stomach virus. Or perhaps the stress of wondering whether they had said goodbye to their son for the last time. Whatever it was, neither of my parents visited me again.

In exchange for gas money and a free lunch, Deborah arranged a ride to New Jersey from our friend Jason. Jason first drove Deborah to get my car, which was still in the parking lot of the dentist’s office, and then the two of them caravanned to the hospital. It was only sheer coincidence that Deborah had her driver’s license. She had never learned to drive as a teen and, having lived most of her adult life within walking distance of a New York City subway line, never had much need for a license. But about a month prior, she got it in her head to take lessons and finally acquired her license at forty-eight years old.

When Deborah and Jason arrived, my optimism about an early release was already waning. I had a dull headache, felt nauseated, and utterly beat up. Not to mention the looming anxiety that, at any moment, my brain might spring another leak. But I tried not to think about that. I was grateful to be alive. And grateful to see my wife enter the room.

“How are you feeling,” she said, handing me a mylar balloon and a stuffed bear from the hospital gift shop. She leaned down for a kiss.

“Watch the jug,” I said, pointing to a urine container on the bed rail.

I couldn’t help thinking back to my first extended hospital stay when I was diagnosed with diabetes nearly forty years earlier. But my urine was pale yellow this time, looking and smelling like run-of-the-mill piss rather than the sweet tree sap of a maple tree.

Deborah picked up the jug and mimed a sip.

“Don’t drink too much,” I said, “they’re keeping track of the quantity.”

We laughed, but it might have been a little much for Jason. He appeared antsy, and his eyes darted around the room. Maybe he was feeling claustrophobic in the cramped space of the ICU, or perhaps he was unsettled seeing his pale friend crumpled in a hospital bed. Who knows —hospitals can have a funny effect on people. Whatever it was, Jason didn’t stay long. He wished me well, thanked Deborah for lunch, and left the hospital to salvage what remained of his Saturday.

Deborah slid the piss jug down the bedrail toward my feet and pulled up a chair next to me. Then, reaching through the rail, she held my hand.

“I’m sorry,” I said.

 “For what? You didn’t do anything.”

“I know, but—”

“Be quiet.”