To my family, friends, & fans:
Those of you who have been receiving this free monthly newsletter for years know that if it isn’t received the first ten days of the month then I am either waiting to time it with a big announcement or something unexpected happened. Sometimes it might be something humorous—like back in March when home repairs forced me, my wife (Kim) and our 20-year-old son (Branden), to move in with my sister for two weeks where my wife’s laptop proceeded to torture me, refusing to allow me to write the newsletter or anything else.
The word “torture” is apropos for the September 2022 situation. When things like this happen (it seems like I have had to endure my fair share of late), I try to get the play by play down on paper while the emotions are still running hot. That’s where the best writing is found, but definitely not the best insight—insight defined here as one’s attempt to substantiate why things happen, i.e., everything happens for a reason. From a medical standpoint this is true—what happened to me happened because of a past surgical procedure. To read anything more into it can be a dangerous thing because I/we tend to use it to justify my/our actions (yes, my inner voice is speaking to yours right now).
But there is more to this story, and even as I type these thoughts onto the page, I am still not sure how much I can reveal. Best I table that for after you’ve read what follows—here’s what happened:
(The original version of this email was sent to family and friends on September 7. It has been edited.)
SUBJECT: To Hell and Back
ALL: It’s been a rough week.
As many of you know, our daughter, Kelsey and her beau, Av Shin (pronounced Av-Sheeeen),recently became engaged. I cannot see a better match for my little blonde juggernaut who—upon her arrival during the Superbowl in late January 1994—immediately rose to superstar status (her birth being one of the few things my father, Lawrence didn’t videotape—no worries, I got it.)
Dad passed away about 13 years ago, but he would have approved of Av Shin—who checks off every box in my “Suitor Qualification List” (better known as SQUIRRELS). And my daughter certainly dated her fair share of nuts over the years, my least favorite being the prize who introduced himself with, “Hey bro.”
Av Shin’s sisters generously volunteered to host a Get to Know the In-Laws Engagement Party and the date (9/4/22 at 8 p.m.) and location (NYC) was selected. My wife, son Branden, and I would fly to NYC from Florida on 9/3/22, attend the party the next evening, and then drive south for our annual pilgrimage with our friends, Art & Trish at a beach house in Bethany Beach, Delaware. The beach house represents 30+ years of generosity from Bob Pasquale, Art’s first boss and eventual partner who hired the Widener Law Student and got his U. of Delaware roommate as a player-to-be-named later in the attorney softball LEAGUE (see “Ringer”) For the record, rumors are true that Bob’s youngest son was the first to ask Kelsey to marry him (he was 8, she was 5) proving once more that Michael remains the true brains of that loving syndicate.
It’s also true that I wasn’t crazy about flying to and staying in NYC. Parkinson’s (17 years in) doesn’t lend itself well with long gateways and crowded streets. But Kim was ready—purchasing security passes, arranging wheelchairs to and from the airport gates, and purchasing a walker with a built-in seat so I would always have a place to rest. And it all worked … right up until the night of our first get together.
SATURDAY NIGHT 7 p.m. to 8 p.m.
We had to walk two long blocks uphill from our hotel to Kelsey and Av Shin’s apartment building. Aided by my new walker, I had attacked the hill (going slow is actually harder as it throws off my gait) and I noticed my stomach felt slightly sore from the effort. By eight p.m., our group (Kelsey, Av Shin, Kim, Branden, Art, and myself, along with Kim’s favorite cousin Connie and Connie’s husband, Gerald) were seated in a 5-star restaurant, ready for a great meal. By the time we left the pain in my stomach had doubled.
We took Ubers back to our hotel, with Kelsey dropping off Pepto Bismol and ginger ale. Neither helped, the pain getting worse.
Back around 2010, I had experienced a similar ache in my stomach, only not in the middle, more lower left. I waited a day and finally went to the ER in West Palm Beach. A CAT scan revealed a diverticuli had perforated in my colon and was leaking waste into my body. Emergency surgery was called for, nurses rushing around prepping me in what felt like a nightmare, having never undergone major or minor surgery at the time. An ER doctor told me that the surgeon would make three small holes in my lower belly and basically repair the damage arthroscopically. Didn’t sound too bad.
Foolish twit. They wheeled me into the OR which was packed with doctors, nurses, and med students. A fierce-looking black man introduced himself as Dr. Chidambaram. “Mr. Alten, do you know what we’re about to do?” I repeated the ER doc’s info. “No, Mr. Alten. You are leaking poisons into your body, and it is very serious. I am going to cut open your waist, clean up as best as we can, then sew you up. When you wake up, you will be wearing a colostomy bag.”
WTF? Two hours ago, I was at home …now this?
“Any questions?”
“Is there any good news?”
“Yes. The good news is I am going to save your life.”
And he did.
I stayed in the hospital seven long days, the first six without eating or fluids, the pain handled only through Dilaudid, a clear elixir that could knock me out in seconds. I wore a colostomy bag 4 months before it was (thankfully) reversed, but the hole kept having problems healing and Dr. C (my new friend) had to operate again to clean it out.
Why is that story relevant?
By 11:30 p.m. the pain in my gut had crossed into a new threshold and I told Kim that I had to go to the hospital ER. Kelsey and her beau picked us up and just before midnight of the day of our daughter’s big engagement party, I was taken to the ER at NY Presbyterian hospital. There were only a few other patients and we were placed in an ER exam room with two empty beds. For the next two hours I was put through many tests and an IV drip, along with a syringe in my I.V. of my old friend, Dilaudid, the drug that had gotten me through emergency surgery. The 3 a.m. pain on Sunday was far worse, overwhelming Dilaudid, which did diddly-squat.
A surgeon (Dr. Anton G. Kelly) came by around 3:30 a.m. and told us the not-so-good news: “Scar tissue from the last surgery is causing your colon (small intestines) to twist and that is causing blockage. Three possible scenarios; If twisted but not torn and we can remove the scar tissue, there’s a chance it could return to normal. Or it could be too late and the organ partially died—which means a colostomy bag and rough future. And if it tore open or is dead …
“Oh … one last thing: I saw a spot on the CAT scan of your right kidney … I’m pretty sure it’s cancer. But it’s early and we can treat it after we get you through this.”
I could have gotten upset, I could have reacted … but all there was at that moment was pain … and yes, it was still getting worse as my colon twisted around in my gut like a coiling snake.
Surgery was scheduled for 7 a.m.—the soonest they could assemble a team and operate. It was 3:45 a.m. and the pain continued to increase. (For those wondering about the PD, I was sure to keep the meds going—the last thing I needed was to be immobile).
At 4 a.m., things went from bad to surreally bizarre …
Kim is my rock and soulmate and as tough as they come. But by 4 a.m. she was physically and emotionally exhausted; we had been up early to fly to NYC—and she was angry … This was supposed to be a joyous occasion—she and Kelsey had spent months looking for the perfect dress—making sure all of us were ready. Now her husband of 30 years was in an ER facing the unthinkable, the party in 13 hours which—barring a miracle she’d miss. Exhausted, she laid down to sleep in the vacant bed … the other ER rooms were all vacant.
Enter a new nurse, complete with her own reasons for being angry. “Ma’am, the beds are for patients only, you must get up.”
“Where do I sit?” There were no chairs anywhere.
“I don’t care, but you cannot sit there.”
My wife had done nothing wrong, and no other nurses had said a thing to her since we had arrived four hours earlier. Her husband was in agony—was she supposed to stand next to me until surgery?
But there are times even when you are 100% right when it is best not to poke the bear.
I was in the restroom. When I emerged, the bear had been joined by two police officers. It was NYC at 4 a.m. in an ER—a zero tolerance situation and it was clear to me that my loving spouse was not going to back down.
The handcuffs were less than 10 seconds away as I stepped in between them. “Officers … I want to apologize. My wife is exhausted from traveling all day, and I am in horrible pain. Please … if you allow me I will put her in an Uber and send her back to our hotel to rest …” at least that was what I thought I had said. According to my wife, I threw her under the bus and then backed over her a few more times.
Well, being under the bus is a lot better than being in a jail cell …
NOTE TO SELF: Never attempt to use logic in an emotional firestorm … stupid man. Also, try not to wear a Philadelphia Eagles shirt and matching shorts while in an ER in NYC.
Thankfully, the two police officers left without arresting my wife. A staff member offered me a blanket—no chair for Kim. She sat in my walker until we decided it was best for her to go back to the hotel and get a few hours of sleep before the 7 a.m. surgery.
5 a.m.: The surgeon returned to work a tube up a nostril and down my throat. He described what would happen: “I’ll open your belly with a vertical incision. We’ll remove all of your small intestine and lay it out on a table. We’ll untwist it and check for holes. Then we’ll cut out the scar tissue, check to see if the organ is still working and then replace your insides.”
6 a.m.: I have experienced different types of pain in my 63 years, from severe migraines and convulsive vomiting to second degree burns … and of course the post-surgery gut pain from the emergency surgery years ago. But I have never ever felt or imagined the level of pain that hit me at 6 a.m. … and somehow ticked up!
My stomach muscles were rigid and locked in a muscular convulsion that simply refused to ease up—even after three straight IV shots of Dilaudid. I couldn’t lie flat, curl up, sit up, or stand for more than 5 straight seconds. I begged God to give me strength. I called out to the nurses’ station for more drugs.
By 7 a.m., the pain had hit a threshold so high that I could not have felt any different if it was still rising—I was in Hell—Hell being a non-stop insane agony and there is no difference in burning at 300 degrees versus 325 degrees.
Can pain kill you? In retrospect, I suppose it could have stopped my heart at some point—but my heart was strong, and I wasn’t thinking, I was drowning. I hurt too much to move or to NOT move. I knew only one thing could end the agony—I needed to make it into surgery where the anesthesia would knock me out and I would awaken pain-free.
I locked onto that thought and did something taught to me as a Water Safety Instructor when I was a teen … SURVIVAL FLOAT. If too far from shore to swim, and too weak to tread water—tuck your knees, take a shallow inhale, face in the water and exhale, lift face and shallow breath, lower face and exhale …
Saying “please God” on each exhale, I rocked and held on, lost at sea, experiencing every painful torturous freaking stabbing, twisting seizure of my small intestines, my stomach muscles clenched over my now bulging gut as I did the “survival float”—just breathe and float.
I was groaning when Kim returned to the ER at 7 a.m. She told me surgery had been pushed back to 8 a.m.
Ughhhh.
For the next 3,600 seconds she watched me writhe in agony. At 8:20 they came for me. Kim attempted a kiss, but I hurt way too much.
The ride to the OR took two minutes. When I arrived, the nurse asked if I had to pee. I said, “no” but felt a slight twinge and figured I better try. So I shoved a urinal under my gown and stood before a half dozen doctors and nurses and finally said screw it … just stick the catheter in. I don’t know how much time passed after I laid back down on the table—I am guessing mere seconds—but at some point, I blacked out after just more than 8 hours of arriving in the ER a lifetime of pain ago.
When my eyes opened, I was a little lost. I was in a large room. A kind nurse (one of many) said, “Steve, you are in recovery. Everything went perfectly. The small intestine was not damaged and the scar tissue was removed.
I closed my eyes. What about the cancer? Oh, that’s something else … You were in pain … you were drowning in it, but you refused to drown …
