The ER

I was puking blood.

The good thing about being locked up for three years is I never got sick. But three weeks ago I went out four nights in a row. Two of those were outdoors. One was indoors, but there was a high ceiling and I was relatively alone. Another was at a restaurant sparsely attended. But after that outdoor gig at the Hollywood Bowl I went backstage and got in a long conversation with Jacob Collier and his team. This is what I do best, relate to artists. If I was a businessman I'd be rich, but I am not. I don't know how to get along like a bro, I don't know how to charge. But if you want to talk concepts, feelings, I'm your man. And a real artist specializes in those. And it was Jacob and his right hand guy from MIT and his manager Adam and a management team member from England and we were having a very fruitful conversation about AI and the possibilities. Jacob was talking about triggering, using AI to create music. It's all blue sky, there are legal issues, but instead of being defensive, saying no first, artists look forward, see every innovation as an interesting challenge, an opportunity.

So Jacob had just flown in from Asia. As had two of the aforementioned team members. And I think I got something from them. Because traveling musicians, they're sick all the time. I don't want to blame them, stuff happens, but everybody else I was with over those four nights is totally fine, and for three weeks now I've had a cough.

Hmm... No sore throat. No jag where I couldn't stop coughing. And then...

I'd just left my car for a hike in the mountains, this was Friday night, and my chest felt rough, scratchy. And I didn't have a beverage with me, but there was a water fountain about ten minutes ahead and I figured I'd stop there and partake and ultimately clear my throat.

But the cough wouldn't go away. So I decided to expectorate, you know, to clear the passageway.

And when I spit on the ground... I saw blood.

Not that thin stuff, you know, saliva with a bit of a tint. This was splotchy, and a deep crimson color.

But that was just once. My throat was clear now, right?

Well, I kept on coughing and expectorating and the same thing happened. Splotches of blood. Big ones.

This was after I'd turned around. After I'd Googled and found out coughing up blood was evidence of an infection, maybe pneumonia. I needed some expertise.

So I called my doctor and when I got to the part where you page him, I realized I'd better go home first, in case I needed to write something down, and that was only twenty minutes away, so there I went. And when I got home I paged my doctor, who got back to me right away. Yes, that's the attention I get. And I'm paying a hundred cents on the dollar. My internist went off insurance years ago, and then he stopped taking Medicare, but this was the guy who found my leukemia and...it's worth every penny.

So he called me back instantly, I described my symptoms, and he asked me what I thought.

I said I thought I should probably take an antibiotic.

He wasn't so sure. He thought I needed to be seen. He thought I shouldn't be cavalier about this.

Now the weird thing about turning seventy, and that is the age I am, even though I feel about fifty years younger, is you realize you're gonna die. You can fight aging, but you're never going to win the battle. You can lie to yourself, get plastic surgery, hang with young 'uns, lie about your age, but inside you can see the end coming. And it's very weird, because so much of what used to have meaning no longer does. And that's exacerbated by the Internet era, where everything is Balkanized, where there really is no chart and you're not sure where you really stand. You're alone. Even worse, your contemporaries, so many of them have already retired, they've retreated, they're living a life of leisure. And they're focused on their grandkids. I've got no kids, never mind grandkids, and there's still so much I want to accomplish, but time is running out. Christine McVie didn't even make eighty. And Robbie Robertson just barely did. And then there was that guy who went to the hospital, they found out he had pneumonia, and right thereafter he died.

I didn't want that to be me. But it could be.

So my internist gave me two options. I could go to Sollis or the ER.

Sollis? I'd never heard of it. What it is is concierge ER. They see you immediately, they triage the situation, get you additional treatment if you need it, get a bed for you in the hospital. And my doctor thought I might need that, a bed in the hospital, or oxygen, he was scared by my cough.

But you've got to join Sollis. But my doctor said the first visit could count. He wasn't sure of the cost, he thought it was five grand. Turns out it's six grand. And that was just too rich for my blood. And this was the first time I wished I had more money. Made more money. Because when it comes to your health, you don't want any limits, you want the best and you want it now. As the Eagles sang, the doctor says he's coming, but you've got to pay in cash. It's good to have that cash.

But if I might need to be admitted to the hospital anyway, why not start off at the hospital? My doctor recommended St. John's, which is in Santa Monica.

So I shaved and showered. On one hand time was of the essence, on another if I was stinky and...

I was planning to go alone. Because the ER can be interminable. But Felice insisted on coming with me. Which I felt guilty about, but like I just said, she insisted.

And in case you haven't been to the ER recently, they prioritize. If you come in profusely bleeding, or if you come in an ambulance after being in a car accident, they see you right away. But if time isn't of the absolute essence, if your condition is not life and death, you may continue to be bumped down, it could take hours to be seen.

But it didn't seem that busy in the waiting room. And no one looked incredibly sick. Then again, after about an hour someone came in with suitcases, and another with oxygen, so I read my book and did the Saturday "Times" puzzle on my phone. I never do it, I don't have the patience and I'm not good at it, but I astounded myself by actually filling up about thirty percent. Well, maybe twenty five percent.

And then they called me in.

After three hours.

And now I had to give my spiel. I like to make it detailed but short. You want to give all the information, clearly, with nothing extraneous. And you've got to talk about extenuating circumstances, like I'm immune-compromised, because I got a Rituxan infusion for my pemphigus and it wiped out all my B-cells. This is another reason my doctor wanted me to go to the ER.

But I'd be lying if I didn't tell you that as soon as I was lying on the bed, talking to the doctor, I felt like I wasn't entitled, that what I had was no big deal. Then again, I'd already put in three hours.

Did you know they've got a portable x-ray machine now? They wheel it up to your bed, shoot pictures, and you wait for the results. They said it would be at least an hour, but the analysis came in about thirty minutes later. It said:

"IMPRESSION: No definite acute process. A small amount of left lower lobe pneumonia cannot be completely excluded, exam limited by portable technique."

So now we needed to do a CT scan.

Now when you're lying there, it's like you don't exist. It's like a club of doctors and nurses and they all hang in this office in the middle and they're having a rollicking good time and even if you yell, they usually don't hear you. And I didn't want to be pushy, but I'd been holding it in for hours, I needed to pee.

So when one of the maintenance people went by, I told them and they got a nurse and I was disconnected from the wires and I went to the bathroom and...

Now I've seen worse at port-a-potties. At airports. But this was a hospital. Go to In-N-Out and they're cleaning the toilets regularly. Even in the gas stations you fill up at in the desert. This is their calling card. But at the hospital?

Since I was disconnected and up, I figured I'd give #2 a try. But there was no way.

So I walked around the building, looking for another lavatory, and eventually I found one and I'd like to tell you it was clean, it wasn't, but it was cleaner, so I did my business and on my way back, I poked my head into the bullpen, the office, and they freaked out! I just wanted to know when I was going to get my CT scan. It was 2:30 in the morning already. The two people in the beds next to me were close to death, at least they looked that way. They were now asleep. Both very aged. No one seemed to be worried about them. But me?

And I'm thinking I'm young, but I'm aged too, just not that aged.

So I go back to my bed and within half an hour they came and started rolling me around, on the way to the picture room. And this is when I really started to feel weird, like I wanted to get out of there.

What I didn't mention is I've had the negative experience a number of times. You know, what is a routine test is not. And the doctor looks grave and they start to take action and your head spins and you settle into passivity, being wheeled around the hospital is part of the experience, you almost enjoy it. But in this case, I wanted to jump up and leave, I didn't want to be considered sick. But I'd invested so much.

So they took the pictures and I started to wait again.

I had the scan just before 3 A.M., and then it was 4, and then it was approaching 5... I was getting itchy. But like I said, I'd invested so much time.

Now I forgot to mention, that those results that came in early... I got them on my phone. It's really pretty amazing. St. John's is a Providence hospital, but UCLA and Cedars have these apps too. You get the results as soon as they're in, oftentimes before the doctor sees you, and this can be scary. But the CT scan was not showing up.

And then, at 4:55 AM, the ER doctor came to consult with me. The CT scan had shown nothing... Well, it did show calcification of the heart, but I already knew that. Rust never sleeps. You're fighting deterioration 24/7. Go to the doctor, face the music, accept the process, or be ignorant and die.

So...

It could be pneumonia. Or it could be bronchitis. You can cough up blood with bronchitis. But just to be sure I should take an antibiotic.

And after eight hours at St. John's, we got in the car and left. At 5 A.M. Thankfully before the sun came up. Because if you're a late night person you know there's nothing so depressing as the sun coming up, you want to lay your head down before that happens.

And I got to be about a quarter to six and...

I wanted to forget the whole damn thing. Make like it didn't happen. Because otherwise I'd get angry and frustrated and there was no upside to that.

And I woke up to e-mail from my internist asking for a report, the data had not shown up for him.

I told him I was going to take a Z-pak.

He told me if the cough persisted there were things he could prescribe. Steroids... There were about four.

And then I decided I was not going to leave the house. Screw hiking, I was wiping the decks clean. Because it's like Covid, not such a big deal if you're young, but if you're old, it's a really big deal. What seems minor could kill you. We always think we'll bounce back, but that's not always true.

And now I'll hear from those people telling me Covid is serious, and coming back. As if I live in a rat hole and know nothing. And this will lead to the antivaxxers, which I completely don't understand. Did you ever get into a discussion with these people? They start citing facts that are easily disprovable online. If you paid attention you know that the mRNA vaccines were not new, they'd been created over years, it's just now they had a use, for Covid. But I keep hearing people telling me they were rushed. That it was too new. And then about all the people who died. Well I know plenty of people who died, but they didn't get vaccinated. Which way do you want to have it? I've got to ask you, do you feel lucky, punk?

And believe me, when you're in the hospital dying you'll want everything they can throw at you. You won't be calling your healer, your naturopath, you'll want some of those western drugs. Oh no, Big Pharma is the enemy! And doctors just want to run up the bill!

Of course Big Pharma is flawed. And there are stories of doctors over-prescribing on a regular basis, doing unnecessary surgery. But do you throw the baby out with the bathwater?

I'm not arguing with you. It's your choice. Do what you want. But know your odds of a long happy life are better if you go to the doctor, get the tests, get the immunizations. Then again, statistics tell us the wealthier live longer, because they get better health care.

Bingo.

This is one area where you don't want to skimp. Then again, maybe you don't have enough money to get the best care. That's another feature of America, everybody's on their own.

And I've got to tell you, at five in the morning Sollis looked pretty good. I still couldn't rationalize it, I mean when was the last time I was in the ER? But maybe next time it will be more serious.

So I'm laying low, my cough is a bit better. But who knows?

I certainly don't, but I don't want to chase the dragon, I don't want to test the limits, I don't want to burn the candle on both ends. Because when you're older it can catch up with you.

Then again, thinking about it Friday night, I decided I cannot become gun-shy, I cannot stop doing things for fear I might get hurt. If you're not living life to the fullest, why live?

And the weirdest thing is as I was getting ready to go to the hospital, scared, I realized if I did die, I'd lived a good life. Maybe I'd die before my time, but how much could I complain? Then again, my father died at seventy, from the Big C. I wonder what was going through his mind?

I'm now at that age. Both of my parents are gone. Which means I'm next.

When it's going to happen I am not sure. But I want to do my best to push it as far into the future as possible.

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