“I can almost guarantee you it’s benign,” says the doctor at the British Embassy. “It’s in the wrong place, and it doesn’t feel like cancer… although one cannot say with absolute certainty, and a lump is a lump and ought to be removed. My advice would be to have it taken care of as soon as possible.”
This is both what I want to hear and what I do not want to hear. “In Poland?” I ask. “Or in Berlin, or Austria? Or in the States?”
“Certainly not in Poland. You might go to Berlin, of course, where you will find excellent hospitals and very competent surgeons. But who will care about you in Berlin? Berlin will be expensive, as will Vienna. I would go home to the States, have this done among your own people.”
“Right now, in the middle of the fall term? Could it wait until Christmas break, or perhaps until the term ends in early February?”
“No one will want to see you at Christmas, believe me. As for February—I would act as quickly as possible. Make yourself a bit of a holiday, a fortnight in the States on you insurance company.
“But this is only my advice. You do as you wish. I am merely saying what I would do. If you need a letter, for your insurance company or your university, I would be happy to write one. Just come back here and let me know.”
I thank the man, pay his nurse $30 in hard currency—cash, no checks, please—and walk out onto Fryderyka Chopina Street, heading vaguely toward the American Embassy where, for another $25 and half an hour spent filling out forms, I could get a second opinion. Or I might drive to Berlin, visit Gabriele for a few days, enjoy myself as best I can, and get a second opinion there. I could indeed fly to the U.S., although if I am going to take a vacation home, I’d really like to wait until February. Or I could wait and watch, measuring the size and the pain.
Or I could consult a doctor in Łódź, just for the advice.
“My uncle is a surgeon,” says Tom Bednarowicz upon hearing my story. “I can telephone him tonight and get you an appointment to see him tomorrow. He is very good, people have told me.”
Well now I’ve done it. I can insult Tom, his uncle, and the entire Polish medical establishment by declining his offer. I can visit Tom’s uncle, but I know the escalation of favors and gratitude in matters such as this: if his diagnosis confirms that of the British doctor and I then skip out to the States or Berlin, Tom has spent a favor for nothing, and I have seriously insulted his uncle and the entire Polish medical establishment. The bottom line is that if I agree to visit this man, I am virtually committed to surgery here in Łódź. Meanwhile, the phrase “certainly not in Poland” ricochets off the cushions of my skull.
The following morning, during a break between classes, I see Tom’s uncle, who most certainly concurs with his British colleague in Warsaw: this matter should be attended to immediately. He phones his colleague, Doc. Dr. Professor Jeromin, urologist at the Klinika M. Kopernika, who will see me immediately. Dr. Jeromin takes one look at the lump and schedules me for admission on Monday morning, surgery on Tuesday. “I can almost guarantee you this is benign,” he assures me in perfect English, “but a lump is a lump, and it will only cause you more discomfort if it is not removed immediately.”
Neither Michelle nor I sleep much on Sunday night, but by Monday morning I’ve convinced myself this will be a quick snip-and-stitch operation, something like a vasectomy, of which Dr. Jeromin is certainly more than capable. Probably this will be out-patient surgery—nothing to get anxious about. My major concerns are two: anesthesia and infection. I have an old fear of being put to sleep only to wake up dead. It’s never happened, but who knows about Polish anesthetists, how much training, experience, and equipment they have? Rafał Pniewski’s medical school education has been absolutely general: six weeks of bones, half a year of nerves, a course in blood diseases, two years later another course in viral infections. What if my anesthetist’s curriculum in anesthesia amounts to two months’ study and an exam passed back in 1985?
Maybe I can get by with a local.
As for infection, I have heard repeated tales of nurses wiping hypodermic needles on their slightly soiled aprons between injections. Not much to do here except to insist upon new needles.
At 8:00, accompanied by Michelle and Ewa Bednarowicz, I present myself at Klinika M. Kopernika, the second most modern hospital in Łódź, behind only the new maternity hospital, “the State’s monument to Polish Motherhood,” where none of our Institute women ever seem to have their babies. We are directed to a basement “Depository,” where I exchange civilian clothes for a pair of hospital-issue blue striped pajamas and a fork and a spoon. In the pajamas and my Nike airs—slippers are not hospital issue—I take the elevator to the fifth floor, where a nurse separates me from my support team and escorts me to a bed in room 538. I last see Michelle headed for the elevator, fighting tears: she has never been in a hospital herself, never known anyone to come to a hospital except to die, can think only of cancer and death. I stifle a cry: there’s nothing for it anyway.
Room 538 is small and semi-private: three beds, while other rooms in the ward contain eight or twelve. The window commands a broad view of the tram stop below, where I think I see Ewa and Michelle waiting for a number 2 or 11. In the distance, apartment complexes and the three huge smokestacks which dominate the Łódź skyline. My bed is narrow and iron, painted white. Steel springs. No crank, hand or electric, although the head end can be raised by means of a bar-and-notch mechanism similar to that on an aluminum lawn furniture. The spring sags, of course, and the mattress is not particularly thick, but the sheets are freshly laundered, as is the cover of the featherbed. The single wool blanket, though worn, is clean. I settle in with a copy of Annie Dillard’s Pilgrim at Tinker Creek to kill the Monday before surgery. Tuesday I’ll be groggy from anesthesia, but Wednesday I’ll recover, be out of here Thursday. A piece of poppyseed cake.
But Monday is not for rest. Dr. Jeromin has ordered a battery of pre-operation examinations, including a sonogram (American machine) and blood tests (with sterile needles). By Monday evening I am reassured about Polish medicine, at least insofar as it treats foreign patients. Tuesday when I am wheeled into the immaculate, if slightly old fashioned, operating room, I feel pretty confident. Aqua and white tile walls, fixtures I saw last in Mercy Crest Hospital, Springfield, Ohio, in the mid-1960s. For staff, Professor Dr. Jeromin, his assistant Prof. Dr. Marek Rozniecki (who specializes, I later discover, in sex-change operations), not one but two anesthetists, a veritable bevy of young Polish nurses, one lovelier than the other. “Let’s hear it for Polish hospitals,” I am thinking to myself as I drop off to sleep. “Especially the brunette.”
Polish hospitals are not much for ice when it comes to post-op recovery, I discover later Tuesday afternoon, lying alone in my bed back in 538. It sticks in my head that after my hernia operation (Springfield, Ohio, mid-1960s) there was plenty of ice, and ice helped reduce swelling and pain. No ice here. No water either for the cotton mouth. No ice, no water. No nothing, just me, my bed, a couple of roommates. No Michelle, and I could really use Michelle. No Michelle. Where Michelle? Ice. Water. Michelle.
Later that afternoon Michelle phones to describe her long, anxious vigil outside the operating room, waiting and waiting, catching finally just a glimpse of me on the way out, I still unconscious, a cloth sheet up around my chin, looking dead as a Thanksgiving turkey. It is a tearful conversation, and she is over pronto, with flowers. I grateful for her voice, although still too groggy for coherent conversation, or to notice much about the room, the hallway, my roommates. Hell, at least I woke up alive.
Wednesday brings a new me: hungry, alert, prowling the halls, restless, impatient with Annie Dillard, ready to get back to my flat, to my life, to my wife. The walls of the hallway are white on top of dirty yellow, the same thick cream color of my Skoda, the dominant color (with battleship gray and barf brown) of hallways at Bradley Polytechnical Institute when I taught there in the 1970s. At one end is a locked balcony overlooking scenic Łódź; at the other, the secretary’s office and the office of Dr. Jeromin. Nailed to the walls are faded color photographs of Wawel Castle, Gdańsk Shipyards, some Polish fortress I do not recognize, a marsh somewhere in eastern Poland, and the bastion of old town wall in Warsaw. Also two posters campaigning against the evils of alcohol, another illustrating varieties of edible and inedible mushrooms.
Half of the rooms along the hallway contain patients and beds. There are two sets of toilets, one filthier than the other, neither containing a shred of toilet paper, both littered with cigarette butts. Several lounges for nurses and staff, one meeting room where each morning at 7:00, below a four-color chart illustrating every possible dysfunction of the urinary system, the staff of Klinika Kopernika meets to review patients’ progress and the day’s schedule. Although meals come from some central kitchen in a lower level of the hospital, this hall contains a small kitchen with shelves, sink and stove. Always there is a pot of hot water here, from which patients can draw water for tea at any hour of the day or night. There is a small laundry room, where each morning sheets and surgical gowns are ironed by hand. And of course the nurses’ station, with a chart of room assignments and open shelves stocked with gauze pads, jars of this and that, glucose and, yes, copious supplies of sterile hypodermic needles.
Hygiene in this second finest of Łódź hospitals is not good, but not, except for the toilets, as bad as I had feared. Each morning a maid with a broom and bucket and mop cleans the floor with a combination of soap and alcohol. Most of the trash she removes, but some inevitably gets pressed into the cracks between linoleum tiles. Between clean-ups, a good deal of medical litter—blood-soaked gauze and bandages, cotton swabs, spilled urine samples—lies strewn on the floor: nurses giving blood tests or injections make a habit of leaving alcohol-soaked cotton swabs in the hands of patients as they hurry on to further duties. Most patients hold the cotton in place for a second or two, then drop it absentmindedly on the floor as they return to watching television or munching the goodies—chocolate, cakes, cookies, fruit—brought by visitors. There the cotton lies, or the gauze, until the cleaning lady maybe sweeps it up. I know why I am shot full of antibiotics four times a day.
My roommates are contrasting types. One is a young lad in his late teens, the New Poland incarnate. He has survived enough operations to tattoo a topographical map on his chest. On his portable television set he watches only Western programs: Dallas, Santa Barbara, Sesame Street, CNN News, MTV, a couple of spaghetti westerns. His English vocabulary amounts to “good morning” and “good evening,” but his wardrobe, which he changes daily, is all in English, including a sweatshirt which reads “STADIUM Major League Baseball ALL AROUND THE WORLD Baseball Team good game fine play.”
My other roommate is old enough to be my father, whom he in many respects resembles. His bed chart suggests he has been in this room a long while, with no results beyond a significant stabilization of body temperature. He is in considerable discomfort, although the first thing he did on my arrival was to assure me that the doctors in this people’s hospital are absolutely first rate and I have not a thing to worry about. Each evening he is visited by his two grandchildren, eight and twelve, with whom he speaks in the most leisurely and gentle manner. As soon as they leave, he evidences great pain, usually calling the nurse immediately for an injection. Each morning he throws up most of his breakfast. The rest of the time he grimaces from the bed, or pads up and down the hall with others in their striped or plaid cotton bathrobes.
Meals are the high point of most patients’ days, and a remnant of the Old Poland. A large cart is wheeled up to our end of the hall, and, beginning with room 538, dinner or supper or breakfast is ladled from 5- and 10-gallon buckets onto white plates and passed out to queuing patients. Rolls come in huge plastic laundry baskets, tea in a bucket. Butter is slab butter. Apples or tomatoes come in a basket. Patients receive their portions like bums at a soup kitchen, then retreat to their rooms to eat. After supper they wash their hospital-issue utensils in the sink, set their plates, with whatever food remains, on tables in the hallway to be collected sometime in the night by staff. Sometimes food remains there all night long, attracting small squadrons of large and lazy gnats.
The brightest element of the hospital is the staff: intelligent, articulate surgeons, both of whom interned in the States. And the nurses, Polish women, vivacious as ever, demure brunettes and fiery redheads, one tough sparkplug of a head nurse with flaming eyes and a full figure… and the uniforms, not so severe as in the States, low cut and loose enough to show a generous flash of breast each time a nurse bends low to extract blood or give an injection. And the patients, characters out of Polish literature, one with a cousin in Trenton, New Jersey, several with brothers in Chicago. One with a can of Noxema medicated cream sent by a relative in America, “Bardzo dobry, bardzo dobry,” he assures me.
And the nurse when I check out: “How many days shall we say you were here? How long would you like to be away from your work? Would two weeks be enough?”
A week after being discharged, I return for results of the biopsy: benign as expected. I bring a thank-you card with some cash for Dr. Jeromin, another for Dr. Rozniecki, a big bunch of flowers for the nurses. Bottles of cognac for the anesthetists and Tom’s uncle, who recommended me to Dr. Jeromin. Much discussion has gone into these gifts: none of us are too sure just what gratuities are in order, and we want the staff to think well of Americans, should somebody else one day need hospital services. By my standards, it is cheap enough, practically 1950s prices: $200 for five days in the hospital (Fulbright insurance, to my surprise, honors my claim, although I don’t charge them for the cognac or the flowers) with major surgery and a retinue of attendants and nurses and surgeons. When my daughter had a lump cut off her right wrist, out-patient surgery no less, the pirates in Peoria charged well over three times $200, of which the bandits at Blue Cross paid but a fifth. And when Jack Hickerson nicked his finger with a power saw, the bill ran to $4,000.
One week after surgery I am home again, and Michelle is happy, and I am entirely reassured, and ready to tell the story of an American patient, probably the only American patient in the past half century, at Klinika M. Kopernika in Łódź, Poland.