The Two Kinds of Decay

The Sikh

My first central line was implanted in the middle of the night. I needed apheresis right away, and my arm veins were finally blown. That’s a clinical term. They had scarred and narrowed. I still have my tracks. I should have been given a central line earlier, but every apheresis session was declared the last one I’d ever need, so it was a while before anyone noticed it was time to get serious.

Central lines flow through a catheter into a large vein, usually the vena cava. Central lines can deliver more toxic fluids that would irritate smaller veins, and they have room to contain multiple lumens, and they can deliver fluids faster, as the heart distributes them immediately.

My hematologist asked me if I wanted my parents there while it was implanted, and though I’d never have thought of bothering them in the middle of the night, I thought he was telling me that getting a central line was something that one’s parents were supposed to be there for, so I said sure. And so my parents came to watch me get my first central line implanted.

My hematologist might have thought I’d wanted my parents there to help me feel less fearful, but I didn’t know enough about the procedure to feel fearful. Yet I was old enough to have known that watching their child have vascular surgery isn’t something parents should do.

I didn’t have to watch. I was on my back, and the Sikh doctor, who attached his surgical mask behind his head with a bent paper clip, as the tops of his ears were tucked under his white turban, jabbed away at my subclavian vein.

I’d been told I’d be injected with lidocaine, and that a needle would be stuck into my subclavian vein at a point just below my collarbone, and that while the needle was in the vein, a tube would be threaded over it and pushed down, through my skin, and through the hole in the vein, and deep into the vein, over the needle, and that the tube would be taped (and later sewn) to my skin, and that the needle would then be withdrawn, leaving the tube in place.

What if I’d been told someone would be standing over me, massaging my collarbone, while I lay blindfolded? That’s something I would have tolerated. And up to the point that the lidocaine began to wear off, that’s almost what it felt like.

If the procedure had lasted only a couple of minutes, I might have been all right.

But the doctor flubbed the procedure. He kept getting the needle in, but he couldn’t jam the tube over it. The entry angle was too sharp.

So the lidocaine began to wear off, and the doctor kept telling the interns and the surgery residents exactly what the trouble was, and he became frustrated when he couldn’t get the tube into me, and tried another, thinner tube, and sweated onto me, and stunk up the entire room with his frustration.

He tried again and again to jam the tube into my vein. Every now and then he had to stop and apply pressure, as I was bleeding. At one point I thought I felt a jet of blood spurt into my chest cavity, and that’s when I lost my composure.

Months later, after his hair had gone from steel gray to white, my father told me it had looked like a horror movie.