The events leading up to a summer in winter clothes 

By Rich Pagen, August 2005

I’ve felt like I’ve been in two places at once before, but never quite like this.  Here I am at home in Minneapolis reading reports on the web about myself on a research cruise off of western North America.  During the month of July, because of some crazy happenings, I did sort of manage to be in two places at once. 

For each of the last three years, I’ve spent four months out at sea on a ship, somewhere on the world’s oceans.  On July 2^nd, 2005, I left my home and my love Kristin in Minneapolis on a flight for Seattle, the taking off point for this year’s research cruise.  We were to be surveying seabirds and marine mammals off the west coast of the US, from the Canada border to the Mexico border, and out to 300 miles.  This was new territory for me, and the unknown always creates excitement and anticipation.

Unfortunately, experience dictates that all this change, all this moving around, and a bunch of new people all coming together can sometimes cause one or more of us to come down with something as we adjust to life in our new surroundings: the ship.  This time, it seemed, was my turn.  Even before we sailed on the 5^th of July, I could feel the body aches that warned of probable illness ahead.  But no matter, I would ride it out.

The California Current, flowing south from Alaskan waters, was COLD.  I knew it would be, and I had packed accordingly, but I really wasn’t quite prepared for it until we met.  It was grey and foggy and chilly, the alter ego of the Minnesota summer currently taking place at home.  And working three hours in a row up on deck in this cold, damp weather didn’t seem to sit well with feeling sick.  My symptoms of fever, chills, headache and night sweats only seemed to be exacerbated by the weather.  And of course, we were busy as could be with birds so I felt reluctant to take time off and stick Sophie and Peter (my very understanding and accommodating co-workers – did I mention intelligent and good-looking?) with even longer shifts up top.  So I took it one shift at a time.  But my body had other plans.  After three hours topside, no matter how many layers of clothes that I put on, my body just got chilled to the bone.  The inside of the ship was kept at a relatively cool temperature as well, so for a guy with the chills, there were few options to warm up.  Even my shower had the nasty habit of, more often than not, spurting out cold water rather than hot.  Not the kind of shower one dreams about when shivering.  Finally, after several days of this, I decided it was time to check the fever.  I’d gotten to the point where I was pretty useless as far as work was concerned, and things did not seem to be improving. 

When the fever topped out at 104.3^o F the next day, even I was pleased with the command’s decision to bring me ashore.  What I was not so excited about was overhearing one of the ship’s medics on the phone with the NOAA doctor onshore, who said they should get an IV going.  I’m not against IVs.  In fact, since I wasn’t getting many fluids down, it was probably the best idea around.  But these guys are officers and/or seamen first, medics second.  Overhearing the three medics go back and forth over who should perform this procedure was not surprising, but it was somewhat disconcerting.  But they got the IV going no problem and were very professional.  Two other words I overheard on that phone call which caused both Paul (the medic speaking to the doctor on the phone) and I some concern was “Tylenol suppository”.  I told Paul that I could take care of that one myself, if he didn’t have any objections.  He didn’t.

During the night, the ship had steamed towards shore and at sunrise we were sitting just off of Coos Bay, Oregon.  A small Coast Guard boat picked up Jim Cotton (my comrade, company, and chaperone – no wait, was I chaperoning him? J  Sorry Jim, couldn’t resist….) and myself and took us to a waiting ambulance at the dock.  The looks of horror on the faces of the medical personnel on the dock made me feel instantly better as it seemed that they were waiting to pick up someone who had arrived half dead.  But with my fever now somewhat lower, I was feeling considerably better.  The ambulance was bouncing all over the road on the way to the hospital, but this did nothing to deter the EMT in there with me; she skillfully and magically had the IV all in place in the wink of an eye, despite potholes and sharp turns.  Once in the ER, all went smoothly.  The goofy sarcastic doctor, who appeared as if he was going to be attending to me, ended up going off shift and was replaced by a man who seemed to be a much more solid character.  When the new doctor told me that they were going to do a spinal tap to check for spinal meningitis, all I could do was look over at Jim and say, “Is this really a good idea?”  He assured me it was, so onward we went.  I think the idea of a spinal tap turned out to be worse than the procedure itself.  Having the doctor tell me beforehand that he was only going to take “a couple tablespoons” did little to comfort me.  After about 15 minutes in the fetal position, it seemed the “couple tablespoons” had been siphoned off, and I was free to reflect on what had just occurred.  I sat completely still out of fear that moving around might very well cause more spinal fluid to come shooting out of my lower back.  Jim found this idea particularly amusing. 

            After a negative result for spinal meningitis, the doctor left me with his recommendation: “Your platelets are very low (68,000), so I don’t recommend going back out on a ship right away.  Head home and get checked out in a week or so.”  So I started making plans to do just that.  After a false start (we had to head back into the ER to find my lost rain pants), Jim and I rode with a joke-telling cab driver to the lovely Comfort Inn (perhaps you’ve heard of it?) where I got to spend $137 for a chance to lay flat on my back for 12 hours before boarding a plane for home.  Stepping off the plane in Minnesota was like arriving on another planet.  Goodbye cool coastal fog, hello 94^o F with 100% humidity.  And of course I had left the ship pretty much with a toothbrush and what I was wearing: long underwear, a fleece jacket, a warm hat, a black sweatshirt, and a pair of Carhartt pants.  Since most everything I own was packed away in storage, a trip to the thrift store for a pair of shorts and borrowing a t-shirt from Kristin’s brother Eric were the best options I had for temporarily adapting to the Midwestern summer.

Fast forward one week and several doctor visits later, and I found myself feeling fine and getting the go-ahead from my doctor that I was ready to return to the ship.  I couldn’t wait.  The ship picked me up in Santa Cruz after much finagling of their schedule, and back out we went.  About four days later, I found myself in disbelief.  There they were again, like old friends (?): the fever, the chills, the headache, the night sweats and finally, a symptom I had noticed before only slightly, a full feeling in my upper abdomen (what I would later find out was an enlarged spleen).  I had hoped to ride it out but when that “spleen” feeling got to be quite substantial AND the whites of my eyes appeared more red than white, I decided to take Karen (the cruise leader) up on her offer to drop me in Santa Cruz.  Back so soon.

            Sophie came with me as Hermie and the others shuttled us over to the harbor in the small boat.  Dawn Breese met us, took us up to Sophie’s to get her car, and off we went to the ER again (this time trading Jim Cotton’s thorough supervision for Sophie’s).  Getting in and out of her car felt like an all day affair, my belly so swollen that I felt like I was as close to experiencing pregnancy as I would probably ever get.  The hardest part of the whole thing was telling Sophie that she couldn’t make me laugh, as the movement of my diaphragm up and down was basically punching my enlarged spleen.  I didn’t know that this was what was going on at the time; all I knew was that Sophie’s and my usual “tears in the eyes, rolling on the floor, hysterical laughing” would have to wait.  But the day was filled with some pretty close calls at outright comic hysteria, a few of them with Kristin over the phone.  On more than one occasion, Kristin started to make me crack up, and I just had to pass the phone away to Sophie so I could gain control again before the spleen took a beating.

So there I was, in the emergency room in Santa Cruz, laying in a bed (gurney I guess they are officially called), with Sophie sitting next to me as my platelets hovered at a whopping 33,000.  The comedy started almost immediately.   After waiting for what seemed like hours with no visits from any of the hospital staff, a guy came in to take a blood sample; at about the same time, a woman came in to put in my IV – both of them prepping, eyeing their particular vein (each focusing on a different arm).  Now I’m not a wimp when it comes to needles (OK, maybe I am), but it soon became clear that these two characters were so into performing their respective tasks that they were oblivious to each other….and……..they were about to stick me in both my arms at the same time.  I couldn’t hold it in any longer – “Hey, do you guys mind if we do this one at a time?” came nervously out of my mouth.  So they did, and my near heart attack (or perhaps more likely, my fainting) was diffused. 

A few hours later, a chatty young woman came in to get another blood sample.  I had the bright idea of starting up a conversation with her.  “So how does one get into taking blood samples?” I asked.  It seemed like an appropriate question.  But then she goes on to tell me in much detail that she actually gets grossed out by blood in many situations “like if there is a huge puddle of it all over the floor, or if it’s horse blood.”  She tells me all of this (and Sophie can vouch for this) WHILE she is sticking me in the arm.  I almost lost it and then, after she left, I did lose it….. laughing…….

Then came the rectal exam.  “A rectal exam?” I inquired, just to make sure I had heard her right.  I had.  I definitely appreciated that they were being thorough, but I was blinded by the short term and didn’t really see why this was a pressing issue.  I guess it was.  Now, had I known what the NEXT test was going to be, I would have savored the rectal exam (OK, not really).  In fact, I was still in the mindset that the spinal tap from my short visit to Oregon with Jim a couple weeks earlier was going to hold onto the gold medal as the least enjoyable hospital exam on my tour of west coast hospitals.  Not so (this is where some of you may choose to stop reading).  It started out easy enough.  “OK, you’re going to need to drink these two bottles of barium sulphate for the CT Scan”, said the nurse (for those of you who, like me before this whole thing, don’t know what a CT scan is for, it’s so the doctors can look at all of your internal organs.  This is the test that told them that my spleen was enlarged).  The slurpee of barium was a white and chalky drink with no real flavor except for a hint of a bad aftertaste, and the two bottles together added up to a liter of this stuff that I was supposed to guzzle down in the next hour.  The last 15 minutes were a bit of a challenge (of course, I got a little behind because Sophie and I were gabbing), but all in all it wasn’t that bad.  I hadn’t eaten anything all day, so it did get my digestive tract up and running, and there was all sorts of gurgling and bubbling going on (this fact, it turns out, would be important later on).  It took awhile before someone came to collect me for the CT scan, and then in walked Dave (funny that his name seems to be the only one that I remember from that day in the ER, but there IS a reason he was so memorable).  So Dave comes in and says, “OK, did they tell you how this is going to work?”  “Nope,” I responded.  Dave’s follow up question was rather unexpected: “Did they tell you that we’re going to do a rectal insertion?” …………..”Excuse me?”………….Hmm……I seemed to have missed some important information somewhere along the line.  Well, Dave went on to give Sophie and me that missing information, and then some.  More than I would have ever imagined.  The rectal insertion part.....in summary......just the important parts…….ok, I’ll cut to the punch (now’s the part where you really might consider not reading any further)…….it would seem that the procedure entails having a tube put up your butt for the purpose of pumping yet another liter of barium sulphate into your digestive tract.  My new friend Dave neglected to mention the severe cramping one might experience if you happen to have gas from DRINKING a liter of barium sulphate not one hour earlier.  But I can vouch for it.  He also didn’t adequately describe what the two minutes while you are trying to hold in all this new barium sulphate would feel like.  Well, the best way I can think to describe it is you have the worst runs of your life, and the bathroom door is locked………for two minutes……. …….. A VERY LONG two minutes……..anyway, while all this is going on, they pump iodine into your arm and you get a horrible taste in your month…….meanwhile they are taking pictures of your internal organs.  Then it was over…..not sure which I liked less, the tube going in or the tube coming out.  This was all followed by what seemed like an eternity on the toilet, where all hell broke loose for twenty plus minutes.  Soon I was being rolled back down the hallway in my gurney (by Dave) into my room in the ER.  As soon as he left, I looked over at Sophie…….all I could say was,”Wow.”

There was a lot of waiting there in the ER, and soon it started getting late.  Finally, Sophie turned into a pumpkin and headed home, and I waited for them to move me up into my new home: the hospital wing.  This took forever, and when I finally arrived there, and met the nurse who was on duty, it was 11:30pm.  Everyone everywhere seemed to be sleeping except me, this nurse, and her assistant (who, judging by the fact that she was following the nurse around everywhere, seemed to be in training).  They were both very nice, but this nurse didn’t give off the vibe that she REALLY knew what she was doing, but yet she kept preaching to her trainee as if she wrote the book on nursing.  She was dramatically slow, and my whole check-in procedure took an hour.  As she finally finished typing in my information, she looked at my IV and said, “Oh, they didn’t need to put that extra extension on there – let’s go ahead and take that part off of there.”  In the process of her pulling off the tape to get that extension off, it seemed that my IV got messed up somehow.  She told her trainee that it must have been messed up from the ER (“Boy, it worked fine an hour ago in the ER,” I thought to myself.).  Looked like rather than go to sleep, I would have the distinct pleasure of getting another needle stuck in my arm.  As she spoke to her trainee about how SHE puts in an IV, she missed and it ended up taking her two attempts – the first one, based on what she told the trainee, was “a bad vein.”  Yep, my fault, sorry about that – my veins just have no discipline.  Good night……..finally.

It was a night of sweats, followed by a day of fever, followed by another night of sweats.  The following day, a new neighbor moved into the room next door, behind the very thin accordion wall dividing our rooms.  I could hear everything that was going on – he was in his 80’s, two of his daughters were there with him, he had pneumonia, AND, most striking, he was pretty confused.  In my early morning grog, I could hear the typical questions from the nurse, in a particularly loud voice, “SIR, DO YOU KNOW WHERE YOU ARE?”  “I’m at the beach,” he replied weakly.  Then one if the daughters would cut in: “NO DADDY, YOU ARE IN THE HOSPITAL.  YOU’RE SICK, REMEMBER?”  This went on and on.  Finally, he became very confused and he started getting scared and yelling out.  This turned into security coming, and holding him down, and giving him a sedative as he shouted out for help at the top of his lungs.  At that  moment, with tears in my eyes, I decided that it was time for me to get off my butt, and go for a walk.  And so I did.  This experience with my new neighbor was only one of many such sagas that happened in there, just during the short time I was in there.  I became more and more in awe with the staff, their patience……..and more and more in awe with the patients, each with their own story.  And this was just ONE hallway in ONE hospital on a large planet.

On these first walks around the halls, I was still a little rusty on some things.  I was still feeling pretty crummy, so I moved pretty slowly and deliberately, and without really thinking everything through.  Of course, my rolling IV stand came with me everywhere.  The first thing I didn’t really think through (or maybe I just didn’t have the energy to care) was that it’s probably best to tie up the back of your gown when you go for a walk around the halls – one of the nurses set me straight on that one as I crept past the nurses’ station.

I was told early on that I was going to have to provide a stool sample.  Under the circumstances, this seemed like a Herculean task.  I hadn’t eaten much for several days, nor gotten any exercise.  It seemed like my digestive tract was on vacation.  So I told them that I’d be on the look out, but that I hoped there was no pressing deadline on this request.  Well, my friend Matt came down from Berkeley to hang out with me one afternoon.  And he brought goodies: I was drinking Santa Cruz organic lemonade, eating cherries and blueberries, and even some of those awesome “salt and vinegar” potato chips.  We had a grand old time (all things considered), and after he left, it occurred to me that all indicators were pointing towards the fact that my time may have arrived.  This stool sample, the one task that had been lingering over me for days, was suddenly feeling like it was within reach (so to speak).  It turned out that the magical moment of the stool sample coincidentally coincided with a shift change at the nurses’ station.  I left my “day’s homework” in the bathroom and told the nurse when she came in that it was in there.  As I was brushing my teeth at the sink just outside the bathroom, I could hear all sorts of noise coming out of the bathroom where that nurse had just gone in search of my stool sample.  A few minutes later, she came out empty handed, suddenly looked at a small plastic container sitting on the sink, and said, “Was I supposed to keep a sample of that?”  Game over.

There’s a bit of pertinent information I have to provide before I can get into this last story.  Because I was on an IV, they told me that I had to pee into a particular plastic bottle so they could measure how much pee I was producing compared to the amount of fluids I was taking in.  Made sense.  I didn’t mind this one bit.  In fact, I was in heaven: I didn’t have to ever get out of bed to go to the bathroom.  Well, a few days later, I went on a particularly long walk – not just around my hallway, but out into other parts of the hospital too.  I was feeling a lot better.  After 40 minutes or so, I returned to my room, rolling my IV stand along with me.  Just as I was about to lay back down on my bed, the nurse came in picked up my pee bottle off of my IV stand and went to measure it and dump it out.  “Was that hanging there on the IV stand this whole time?” I asked her.  I already knew the answer.

The date is now August 5^th, and I am at home in Minneapolis, still waiting for the definitive answer on what allowed me to have this comical and yet trying experience.  I’m feeling much better, and of course, with Hornsby’s Storm-petrels being dangled in front of me by my friends at sea, I’m dying to get back out there.  Being that my symptoms have not returned, it’s looking like a Chapter 3 will not have to be written, which is good: Chapters 1 and 2 were more than enough…..