Into the hospital ...

A Memoir
By Hilding Lindquist
Copyright © 2002 by Hilding Lindquist

Hilding Lindquist

Fairbanks Memorial Hospital
Fairbanks, Alaska

Looking back, if I had boarded the 10:45 A.M. Warbelow Air mail plane to Central, Alaska from Fairbanks on Friday, July 26,2002, for the Miners Picnic the next day, I probably would not be sitting at my computer today writing this journal entry for my website. That morning I came as close to dying as I care to think about, thank you, all because of my stubborn denial of what had been happening in my body.

Even as I checked in my bags for the flight, I was in the last stages of acute renal failure due to my own misguided diagnosis of my illness over the past year. I thought my now chronic fatigue was caused by my lungs giving out on me after thirty years of heavy smoking, even though I had quit in 1985. Talk about denial! I chose to believe that what was happening to me was something I could deal with later. For the moment I had a Miners Picnic to go to in Central and a cabin to finish when I got back to Fairbanks. Retirement benefits would kick in August 1. Being sick would wait for winter.

Over the course of my deteriorating health, my friends had grown concerned about me and I had relented enough to get a physical examination. I had it at the Interior Neighborhood Health Clinic in Fairbanks on Monday, four days before I was to go to Central. If it had been left entirely up to me, I would have put the exam off until the end of summer, if I would have had it at all.

I had been planning my trip to Central for the Miners Picnic since attending the same picnic the previous year. It would be my fourth consecutive annual trip for the event. My other regular visit to Central, 127 miles up the Steese Highway, is during the Yukon Quest each February. The Quest is a thousand-plus mile sled dog race between Fairbanks, Alaska, and Whitehorse, Yukon Territory, Canada. The starting point alternates yearly.

I go to Central during the Quest to watch the mushers and their dogs pass through the 101 Mile and Crabbs Corner checkpoints. Crabb's Corner is (now "was") in Central. The checkpoint at 101 Mile is in a cabin 26 miles south on the east side of the Steese Highway.

Memorial Day, Fourth of July, and Labor Day have also often found me there over the past few years. And any time in winter is a perfect occasion for heading up the Steese Highway into the incredible sub-Arctic wilderness surrounding the Yukon River. Central is where I go to marinate my soul. It is my mecca, a place for immersing myself in a social milieu that transcends the manipulative materialism and cut-throat competition of America's large urban communities where I spend so much of my time. Friday's trip to Central was something I wanted to do. If the flight had been cancelled, I would have driven up. I had my heart set on going, and planned to write an article about my trip when I returned and submit it to The Heartland, the local newspaper's Sunday magazine.

By the time Friday morning rolled around I was ready to go. I had packed the night before so I wouldn't have to get up too early, and I was taking advantage of being able to sleep in when my neighbor came by my cabin in the Goldstream hills and woke me well before my alarm was set to go off. "Gus, are you in there?" I tried to ignore her. She just raised the sound of her voice and repeated herself, "Gus, are you in there?" Wearily I realized that my car was parked in the driveway and she would know that I was home. Much to my now everlasting chagrin I responded with obvious annoyance, "Yes, what is it?"

"Dr. Todd called last night," she said. "He's trying to get a hold of you. I came by but you weren't here. He wants you to call him as soon as possible."

I muttered to myself, "Oh for goodness sake, what is it now!," as edited for a family newspaper, and then thought for a moment. I controlled my response to her as much as I could without shouting something stupid. In my mind she had wakened me for no good reason, but she was my friend and she had gotten up and gone out of her way to deliver the message. Still my annoyance clearly came through as I replied, "It's o.k. I know what it's about and I've taken care of it." At least, that is what I believed at the time.

"Well, he said it was urgent that you get in touch with him. I brought my cell phone with me so you can call him." She knew I didn't have a phone in my cabin.

"It's not urgent," I replied. "I've taken care of it. He just didn't get my message."

"But he said it was urgent for you to call."

"Go home and let me get back to sleep. I'll call him later and straighten it out." I didn't even thank her for coming by.

You see, I thought I knew what it was all about. The evening before when Dr. Chris Todd from the clinic called, I was supposed to have picked up some medication and instructions for a CT scan that was originally scheduled for that Friday. The original appointment had been made during my physical examination on Monday prior to checking with me. Dr. Leif Thompson, a resident doctor on the clinic staff for the summer had made the routine part of the examination first and then called Dr. Todd in for further consultation. They decided I should have additional tests as soon as possible and the clinic staff made the appointment for me at Fairbanks Memorial Hospital for the CT Scan on Friday, the first available time. As I was leaving the clinic I asked the staff if I could change it to Tuesday when I was supposed to be back from Central. They agreed and after I left the clinic, I called the hospital and switched dates. So when my friend let me know that Dr. Todd wanted me to call him, I simply assumed that he had been out of the loop on my changing the appointment, and that I just needed to explain that I was going to the Miners Picnic and that would be that. I hoped I hadn't screwed up his schedule, but I had called in and changed the dates like I was told I could do. It was someone else's fault that he didn't get the message. I'd call later and straighten everyone out.

Annoyed with whomever it was that hadn't passed the message to Dr. Todd, I cut it as close as I could. I called him at the clinic from the Warbelow Air terminal after I had checked in for the flight. I had debated in my mind whether to call him from Fairbanks or after I got to Central. I was inclined to wait until I got to Central to call. In my mind, that would have been time enough to straighten out what I still thought was a simple miscommunication about a change in schedule. Then another friend who drove me to the airport asked me to check for a message on my voice mail before I took off. He had given my phone number to a realtor as a backup number in case he couldn't be reached. As long as I had to go to the phone and check for messages, and with plenty of time before the flight left, I decided to call Dr. Todd.

Little did I know then that in making that decision, I saved my life. If it hadn't been for a friend and a doctor who cared enough to go out of their way to contact me plus the fortuitous good fortune of being asked to check for messages for another friend, I wouldn't be writing this story. Dr. Todd knew that I knew my friend who woke me up that Friday morning and her husband, and he took the time to alert them when he couldn't get in touch with me Thursday evening. When she couldn't reach me the night before, she got up early and brought the message to me that morning. My driver asked for a simple favor.

Needless to say, Dr, Todd was not calling about my having switched appointment dates.

After the initial exchange of greetings he simply said, "I want you to go to the hospital." There I am, standing in the Warbelow Air terminal, my bags already checked in, and my doctor tells me he wants me to go to the hospital, now. Believe me, I did not want to listen to what he had to tell me. He explained that some troubling signs had shown up in my blood tests. My kidneys were shutting down and it looked like I was retaining a lot of urine - little did I yet know how much that would be. My response was, "Can't this wait until Tuesday when I get back?"

"Every doctor I know of," he said, "would say you should have been in the hospital yesterday. Normal Creatinine levels are one, people go on dialysis at five, you're approaching twelve. You need to be in the hospital."

At this point a simple but important human factor kicked into gear. I trusted Dr. Todd. We had met a couple of years back when I had a physical examination at the clinic and my PSA level came back high from the blood test. PSA is the acronym for prostate-specific antigen, a substance in our blood produced by the prostate gland that may be increased in amount if we have prostate cancer. There are other factors involved in determining an individual's PSA level, but it is a key indicator for discovering prostate cancer. Further physical examination of my prostate found that I indeed had an enlarged prostate gland. Combined with the high PSA, I needed a biopsy taken to test for cancer. Dr. Todd explained the uncertainties I was facing and the choices for treatment I would have if the biopsy proved positive. He wasn't afraid to admit he didn't know everything about the disease, and that nobody did. This intelligent, open honesty and lack of arrogance in his "bedside manner" dispelled in his case my general fear of medical treatment and distrust of medical professionals. Still I didn't really listen to him then, and though he sent me to a urologist for followup — and I went ... once — when the biopsy came back negative, I went on my merry way of denial and self-diagnosis. But the basic trust had been established with Dr. Todd — combined with the chagrin I was beginning to feel as it simultaneously dawned on me that this was happening because I had not gone back to the urologist when I should have — now served me well and I listened and followed instructions this time. I retrieved my bag and had my friend drive me to Fairbanks Memorial Hospital to be admitted.

In the warm friendly cocoon of the hospital's Two South ward a group of concerned and caring nurses drained five liters of urine from me over the next twenty-four hours. My prostate had grown large enough to block my bladder to the point that it had swollen into a huge liquid-filled balloon causing my kidneys to fail. Five liters of urine is an astonishing amount. That's two-and-a-half two-liter bottles of fluid. It's a Guinness Book of Records quantity. How could I have not known something was awfully wrong with me? Dr. Kenneth Starks, one of the physicians at the hospital, explained simply that it's amazing how the human body will adapt to adverse conditions gradually changing over time in order to survive.

During the course of the past year my abdomen had become enlarged and distended. Approaching sixty-four years of age, I thought I was simply becoming an old man with a potbelly. I urinated frequently in small amounts, but I thought this was "simply" due to my enlarged prostate. Dr. Tanja Britton, an Anchorage physician who filled in for Dr. Todd when he was away, asked me if I had felt any pain or discomfort during the period I was accumulating the five liters of urine in a swelling bladder. My reply was that I was noticing chronic fatigue but that I attributed it to developing emphysema. There is no getting aroundthe fact that I was in a classic state of denial within which I would have died if my friends had not intervened.

Fast forward to Friday. August 16, three weeks later and I have been out of the hospital for a little over a week. That afternoon at the hospital's outpatient surgery center Dr. Dave Brenner, my urologist, put a tube into my abdomen to my bladder to keep it drained. As I write this, I also have tubes coming out of my two kidneys. Each tube has a urine collection bag attached. I'm redefining the meaning of bag man and readily adopting a youthful baggy wardrobe to hide my appendages. My Creatinine level is still well above six, and the dialysis trigger is five. Which means I'm looking at the possibility of kidney dialysis for the rest of my life. There's more. The latest biopsy of my prostate gland came back positive. I have prostate cancer. What else? Oh yes, Dr. Brenner says my prostate is as large as any he's ever seen or heard about. Actually, what he said was, "Gus, it's trophy size." I'm taking hormone therapy to shrink it back as much as possible while we wait for my kidneys to recover as much as possible before we decide what the next step will be. I've lost thirty pounds and my body looks like a skin-covered skeleton.

But you know what? I am alive and I am not afraid of dying. I have more energy than I have had in well over a year. I don't have the strength for lifting, but I have the stamina for living.

In getting here from where I was three weeks ago, I have learned the value of friends and family who care about me and whom I care about. Graced by their caring, and enveloped in a spirit of kindness and love, I know that I can face anything with dignity and serenity.

Beside Drs. Brenner, Britton, Starks, Thompson, and Todd, I have met other doctors, nurses, technicians, and support personnel in the medical community here in Fairbanks who have radically altered my attitude toward the medical profession from one of skepticism and mistrust to one of respect and trust. I wish I could name them all. The day before he put the tube in my belly, Dr. Brenner recommended the procedure. As we went through the discussion in an examining room at his office, I recognized my change in attitude. I had already been down the path of explanation and procedure with my doctors enough times to know that he was telling me what I needed to know to make an informed decision, and that I could ask him, or the others, anything. Along with the others, he had accompanied me away from death's doorstep and I knew

that they would do whatever they could for me medically. That is a profound trust, unthinkable for me before I went through this experience.

As I waited in the hospital's outpatient surgery center just before Dr. Brenner came to put the tube into my bladder, the nurse asked if I needed a Valium to relax. Her question triggered a moment of reflection about all that I had been through. I replied, "No, I'm in good hands."

Hilding Lindquist
Recuperating
Maplewood, New Jersey