THE ER PART II by Nora Logan

Recently my platonic life-partner Layla sent me a recording she took when I was in the Emergency Room. I started to write a post about the ER in 2016, just a few days before I was hospitalized for rejection, a lot of which I used for my previous post The ER Part I. As I slipped into acute liver rejection, my recovery morphed into relapse and the course of things dramatically shifted. I've often looked at the draft of these posts and even opened them, stared blankly and moved on. I think having as serious a set back as I did made it all but impossible to talk about the ER in a pithy way (as originally intended). Because the narrative changed, I no longer had my neat little bookends for the chapters in my story. Here's the one in which I enter the ER, here's the one in which I have the transplant, here's the one where I emerge from the hospital triumphant, never to darken its doorstep again. That setback taught me that I could land back in hospital at any given time, such is the nature of being a transplant recipient. But it's also the nature of being human. I could break my toe and have to go in and I could go in to have a hernia removed as a result of muscle mass around my scar. For me to wrap my head round those variables is what I had to eventually come to terms with. But then, I couldn't possibly imagine going over ‘The First 24 Hours' at a moment when I was again in a prison of my medical history. 

When I listened to the recording, it all came rushing back like when you are trying to dive into a pool but you actually do a belly flop and it hurts like hell. You know that being-bitch-slapped-by-the-water feeling? If you're anything like me (which maybe/hopefully you are decidedly not), it's a feeling of 'ugh I never want to experience that again but maybe I should try it just one more time to be sure'. The first 24 hours in a hospital, especially when you enter said hospital with a mystery illness are at once eventful and mind-numbingly boring. Just the conversation from the recording goes on for quite a while. I've transcribed some of it here to give you a sense of the many, many, many conversations I had with doctors who were trying to figure out what was wrong with me and save my life (and to avoid transplant). I've made mention of these conversations at length on this blog, and I am sharing it here as an example that when doctors are trying to get to the bottom of something, you best believe questions will be asked over and over and over. In my experience, doctors do not like a head-scratcher - like most human beings, they like to have a definitive, scientific explanation for something. Anyone who has been through any sort of serious medical experience (or even not-so-serious) know about these questions, and they get old fast. I can see it now in a new light: doctors are detectives and all they have as evidence is blood-work and answers from patients (who happen to also be the most unreliable sources in the world). Turns out they weren't trying to torture me for the sake of it! 

Despite the tenderness I now feel towards the medical team who were deciphering my blood tests and often unreliable responses, bear in mind that I was asked these questions repeatedly over a 2 week period. From an unimaginably large multitude of medical professionals. I don't know how I didn't lose my shit more often. 

Doctor: You know..warbled..little bit higher than I would like so I do want to keep you here to figure it out I fully anticipate figuring out what it is. So I don't want you to worry about that. [She's referring to my liver enzyme levels, which would continue to shoot through the roof.]

Me: Ok

So the question is what is it? There is a whole gamut of things that the liver could have problems with. Virus, clot, other types of infections, autoimmune disorders, there's like tons and tons of different things. So then the other question is teasing out what it is and what do we do for it? Ok? That's going to include probably a thousand blood tests. The ultrasound which we have to take a look at. There's going to be even more blood tests. 

Me: This is my mother. 

Doctor: Nice to meet you.

Mama: Nice to meet you.

So again, a thousand blood tests. Some of them come back quickly, some of them do not. So we're going to have to figure out what they are. The ultrasound, which I wait for that to be read by the radiologist, ok? [sic]

Me: Ok

Doctor: If we really need to, I can always do a liver biopsy. I have like 15,000 tests I can do so, now, what is easiest and what is going on for you? To start we'll do the liver tests, the blood tests. So you should anticipate getting a lot of bloods drawn today. So we'll be like vampires, we're just going to take and take and take.

Inside I thought: 15,000 tests?!!?!?! What the shit is she talking about??!!! Instead I said:

Me: I love it. 

I told you I was charming. First rule of ER: charm them. Make them love you. Be in acute liver failure.

Doctor: So we're going to try and get, hopefully, ideally if I can just get it from a liver blood test, then we're done and I can just get the answer for you. If not we do other tests, not a big deal. So my turn to ask you questions if you don't mind. I heard you went to Indonesia. 

Is that a question though, really, doctor?

Me: Yes. 

Doctor: Fantastic. Why'd you go? 

Me: I used to live there for 2 years and my best friend still lives there and my godson lives there and I have never met him so I went to meet him. 

Doctor: Oh, nice. 

Me: Yeah, it was great. 

Doctor: How long were you there for? 

Me: I was there for two weeks. 

Doctor: And when'd you get back? 

Me: On the 14th, I got back on the 14th, I left on the 13th of July. 

Doctor: Now, before you left, any problems? 

Me: Yep, on the 10th...

Doctor: Before you left from the US, before even going there.

Me: Oh, no. 

Doctor: Healthy girl. 

Me: No. Super healthy

Ok Nora, chill.

Doctor: Anything at all? 

Me: I was like working out all the time, feeling great [I mean, she doesn't need to know how great you are at exercising, Nora]. I had had a shoulder surgery but that was you know...

Doctor: Where'd you have your shoulder surgery? 

Me: I had a labrum repair. 

Doctor: Here in New York? 

Me: Oh, where did I have it? At Langone. 

Example of hilarious doctor patient misunderstanding here.

Doctor: Now, I'm gonna guess they checked blood tests before that procedure because almost always we do. 

Me: Yeah, it was last year, yeah, I think they did. 

Doctor: Did anyone tell you anything was wrong? What'd you do, just like do some crazy...

Me: Yeah I had multiple dislocations over ten years so...

Doctor: Oy ok, so you had some procedures. Got it, ok. Since then you were doing ok? 

Me: Uh, yes.

Doctor: And no problems with the anesthesia?

Me: No.

Doctor: Were you taking any pain medicines for the...?

Me: Yes, throughout the time I was recovering, I would say what like probably two months? I was taking the codeine and percoset. 

Doctor: And in 2 months you haven't been taking that afterwards? 

Me: No, it was last year. 

Doctor: Right, so 2 months after that, so like the past 9, 10 months you haven't been taking anything? Not even..

Me: No, I took Aleve, yeah, I took Aleve for quite a while because I ended up getting a pinched nerve from being in the sling.

Doctor: Got it. 

Me: So I probably took Aleve longer than I should have. 

Doctor: So Aleve but no Tylenol? 

Me: No, I don't like Tylenol. So I never really take Tylenol. 

Doctor: So when was the last time you took anything over the counter? Including Aleve? Not counting, like we're still talking about before you left to Indonesia. 

Me: Before I left? 

Doctor: Yeah. 

Me: I may have taken an Aleve or two in like the couple of weeks leading up. 

Doctor: But like one or two, not like everyday with a bunch? 

Me: No, no, no. 

Doctor: Ok. So you left feeling great, happy to see your godson and then I heard you got sick there. 

On and on and on the merry-go-round it went. 

The way it started was this. I went to work in the morning. I had an ultrasound scheduled at Beth Israel for 12pm. My mother met me there, and I went in for the ultrasound. Whilst I was waiting, I called my insurance and checked which hospitals were in my network. It was between Weill Cornell Presbyterian and St. Luke's. My mother looked at me and said: 'We have to get you to the fucking hospital. No more of this waiting around.' The upside for Weill Cornell was that we were already on the East Side (at Union Square) and both my mother and other family members had been there already for procedures and surgeries. The upside for St. Luke's was that it was closer to my parent's house. We decided that didn't matter, really, and chose Cornell. Thank god we did. No shade to St. Luke's, but I had no idea I'd be needing a liver transplant at this point, and I was going to one of the best hospitals in the world specifically for liver transplant. 

After the people at Beth Israel told us we would have to wait 48 hours for the results, we hailed a cab and told the guy where to go and to go quickly. We called my dad. We got to the ER. I sat in the waiting room chair and firemen in full fireman regalia passed by. A volunteer handed sandwiches out. I tried to take a bite of a tuna one and nearly threw up all over the linoleum floors. They called me in for testing behind the plexiglass. The got me a bed. We marveled at how *relatively* quickly they got me admitted. We weren't in any sort of state to fully understand the reason for swift action: bitch was yellow and getting yellower, and they didn't see me leaving anytime soon. And I haven't, really. I still go back to that hospital once a month, with pleasure (and sometimes complaint due to it's wildly inconvenient location).


So I wrote a long email to all my friends and family (who are also most of my blog readers, so you're welcome and I'm sorry?) That was almost, radically, a week ago and I haven't really had the time to put my mind round a proper post what-with people coming in my room every five minutes (PAs, doctors, nurses, nurse's aids, whole teams of doctors together, plumbers, cleaners, visiting friends and family and one very special guest who is here to be by my side (although conveniently for me she's left to have lunch in the big city and go to a 'baby conference', no idea what that is, all I'm imagining is a lot of baby clothes and different brands of stretch mark cream). We've had a LOT of chats to get in. You can check out the whole story of how Claire came to be here on my Instagram account: as well as Claire's I even have my own hashtag on her insta. Which is jokes. Just to give you some context: in the span of time it took me to write that paragraph, my nurse came in to take me off of a Magnesium drip I was on on my IV, a nurse's aid came to take my vitals and then my mother and my auntie walked in to say hi. Because my mother is now also a patient in the room next to me, because that makes perfect sense in the story of our lives and is a totally normal thing to happen. Not freaked out at all by it. At allll. More on that later. 

Claire and I having fun together on phones, eating ice lollies, bonding deeply.

Claire and I having fun together on phones, eating ice lollies, bonding deeply.

A couple of the aforementioned friends suggested I post the email on my blog to elucidate how real and true to form this blog is (and how I just luuurve 2 write). But I do want you guys to know it's real and I mean every word and what could be more intimate than sharing with you an email I sent to my entire family and friends about the state of my health? I daresay: not much besides naked photos and this is not that sort of blog and I am a classy lady, so get your mind out of the gutter. Herewith, an email dispatch from last Wednesday about what exactly is going on here at New York Presbyterian Cornell, or as I affectionally call it, Club Cornell. A lot more has happened since this email, and I'll try to keep up when I can. 

Looking totally radioactive and kinda gross. Hospital stays are not good for your usually pleasing aesthetics.

Looking totally radioactive and kinda gross. Hospital stays are not good for your usually pleasing aesthetics.

I've put in photos for you, dear readers, for your personal enjoyment. I don't put photos in personal emails (most of the time).

Dear friends and loved ones,

A lot of you have been asking for updates and info (and some haven't!), so rather than texting all of you individually I thought I might update you together via email since I am feeling up to it this week and so you have a clearer view of what's going on (on that bcc flex so it doesn't turn in to one giant thread, you're welcome). I love being in touch with all of you but I want you to also understand what's going on medically. You could also read my blog (shameless self promotion here) as I'm trying to post there when I can. Hospital is a full time job though so will post and email when I feel I can! For now here's some concrete information I received today from my doctors. I realise it's difficult to be far away (or even in the same city) and try to conceptualize, especially when I am sometimes vague or feeling crap and not able to give a clear view of the situation.

Card courtesy of

Card courtesy of

So I've been in and out of hospital since the beginning of April as you all know and I'm experiencing Acute Liver Rejection, which sounds worse than it is, even though I guess it's pretty bad. The strange part of it being that it occurred at such a late date in my recovery (usually happens in the first 1-3 months). My young, robust immune system is attacking my new liver and recognizing it as a foreign entity. So I'm doing a doozy of a drug called thymo globulin in the form of an infusion which started out as 14 hours and has now gone down to 9 a day, and I am being monitored closely in order to make sure I don't experience the myriad side effects associated with this medication. The latest news is that my doctors didn't round until 2pm today which is irksome because I had big plans for the day and was going to try to walk down York Avenue like a civilian. And since they wake me up at 530 am to weigh me and take vitals, you can imagine how impatient I was by 2pm. But I did get to see my main Hepatologist, and he's always a barrel of laughs (he actually is!), certainly a character. He wears bowties and great cologne. As I predicted this morning, which Tom Logan can attest to, the first thing he commented on were the Himalayan Salt Lamps I have in here and he said he has one too in his kitchen but is not sure their healing powers are strong enough for me at the current moment (dude obviously hasn't been to the Himalayas). 

Photo I took in the Himalayas in 2005 after a 3-day trek. One of the hardest things EVER that I did with Pema, who you can read about  here  and Zein (see pic of her beautiful face below and who will certainly be featuring heavily in this blog in the future).

Photo I took in the Himalayas in 2005 after a 3-day trek. One of the hardest things EVER that I did with Pema, who you can read about here and Zein (see pic of her beautiful face below and who will certainly be featuring heavily in this blog in the future).

There is still no discharge date in place, but I'm hoping that by the weekend I'll be able to be in my own bed and Dr. Brown said that that is a distinct possibility. Here's hoping. [ED. Note: this did NOT happen, I am still here. It's Tuesday]. I'm going to have to do the full 10 doses of the infusion of thymo globulin (they were originally thinking 7 doses). I'm still waiting to be hooked up for the 9th one today. They are not that happy with my liver enzyme levels right now, or my bilirubin count but also very confident they can fix it. Possible liver biopsy scheduled for Friday (going for Guinness Book of World records of most liver biopsies in one month obvs [Ed. Note: Apparently I would not make that record, for which I count my blessings] and then if the numbers are still not that good they may still let me go home and then put me on another immunosuppressant that I don't remember the name of but sounds like a character from Harry Potter.  I told my doctor that and he said he hasn't read Harry Potter which was honestly the most surprising thing about our conversation. Although I heard him say just before he came in to the PAs to order the biopsy outside my door, so pretty sure it's a done deal and they're sparing me the details/trying to be vague. It's vague city over here sometimes. I won't have to be in hospital for that which is the main thing and then the numbers will hopefully continue to trend down. The biopsy will determine more accurately whether I'm still in acute liver rejection, which is harder to figure out just going off the numbers. He's committed to getting me better and is the best in the liver biz so I am confident he knows what he's doing. It's unfortunate that I haven't responded better to the treatment but trying to take it a day at a time and focussing on having a positive outcome. It was upsetting news to hear, but I am rolling with it since I have no choice but to surrender. He is still surprised that things don't look better on paper, but paper doesn't mean absolutely everything (except to the doctors). 

About to get a chest X-Ray. My lungs are soooo cute.

About to get a chest X-Ray. My lungs are soooo cute.

So that's the latest: more of the same. I love you all and thank you for everything and all the support and well wishes (and food!!) thus far. All of it keeps me going! Morale is up and down, as is to be expected in the hospital when you're chained to a metal pole for much of the day. My appetite is also up and down but I'm eating 3 square meals of food I get people to smuggle in for me so that's a HUGE win. And getting loads of amazing visitors. And running into old doctor and nurse and cleaner friends, which is so nice. I also promised and insisted on throwing them a Christmas party last year when I was on very heavy pain medication which never came together (surprising, I know) and avoiding the subject :) :) :) I've also listened to Lemonade 4000 times, and it hasn't got old yet so that's good. Meanwhile my darling Claire is arriving tonight to help take care of me for 10 days, hang out with me and help support my parents -- I'm so excited! And they just walked in with the thymo so it's time for me to shut the hell up and get outta here (aka take a nap).

All my love,

Nora xxx

Ol' Bazbags. One of the 'amazing visitors' mentioned in the email.

Ol' Bazbags. One of the 'amazing visitors' mentioned in the email.

Claire the day after she arrived, basking in Club Cornell's glow.

Claire the day after she arrived, basking in Club Cornell's glow.

Zein and Hana, more visitors also looking and being really cute.

Zein and Hana, more visitors also looking and being really cute.

So that's me done for today: on my 34th day in hospital over the past two months, I'm feeling alive and I do feel like discharge is around the corner. More to come when I'm not having the entire hospital come in and out of my room taking blood, vitals, telling me the score etc. round the clock, amazing food being delivered by friends and family, and other friends coming to visit and distracting me from the task at hand. Plus the small matter of a minor addiction to Instagram and Snapchat. Which is to say, probably never.