Halloween generally connotates things that scare us. I think of goblins and witches and marching down Broadway as the Frankenstein monster in the annual children’s parade in Yonkers, New York. Allhallows Eve activities usually include carved pumpkins made into jack-o’-lanterns, trick-or-treating in the neighborhood, magic, visiting haunted attractions, telling scary ghost stories, watching horror films, and dressing up in costumes at work or parties. Who would know that the most terrifying activity involved the medical community, costumed practitioners, and ….
After shaving and brushing my teeth on Halloween, Saturday morning, October 31st, 2020, I experienced soreness in my left hand centered in my thumb’s meaty muscle. The pain rapidly advanced up my left forearm and then just as fast shot up into my upper arm. The discomfort was so intense, I felt lightheaded and nauseous. I thought back on past health lectures and recognized the symptoms of a heart attack. I feared for my life beyond whatever Halloween activity I had ever experienced as a child. My mind pictured scenes from the 1970s television sitcom Sanford and Son with the junk dealer Fred Sanford, played by Redd Fox. Fred would often manipulate his son Lamont saying, “Oooo… It’s the Big One… You hear that Elizabeth… I’m comin’ to you; I’m comin’ home to Georgia.”
Assuming this was indeed my big one, I recalled I had been told what immediate action to take – so I took an aspirin and asked my spouse to drive me to the nearest medical facility. Extremely uncomfortable, my mind shifted into anxiety mode as my PTSD got triggered and I lost track of reality.
I walked into a nearby Urgent Care and faced a Halloween costumed lady with a broad-rimmed black peaked witch’s hat and black floor-length cape. She had a green face highlighted with bloodshot eyes and a tongue red enough that she could have just sipped a gallon of blood. She embodied The Wicked Witch of the West – the malevolent ruler of Winkie Country in The Wizard of Oz. She could have been the daughter of Margaret Hamilton, who perfected this part in the 1939 movie.
Her job, of course, was to ask me the usual screening questions we face today. She took my temperature, found it normal, squinted her eyes at me, and confirmed I did not have bluish lips. She asked, “Are you in severe and constant pain, or do you feel pressure in your chest?”
I sought to understand her questions and formulate cogent answers recognizing that I had been triggered and was bordering on erupting with a demand that I get inside and be seen right away. “Yes, I started experiencing really bad pain in my left hand about thirty minutes ago. I’m worried because it’s moved steadily up my forearm and now has reached my upper arm. I think I am having a heart attack. I need to get inside.”
She checked a box. Then asked, “Are you having difficulty breathing?”
“No.” I closed my eyes and wondered how long it would take to get past this costumed guard of the bastion. Someone inside could help me if I could only get in.
“Are you experiencing severe and constant dizziness or lightheadedness?”
“Well, yes. The pain is so bad that, frankly, I am feeling lightheaded and dizzy. As I said, I’m worried that I might have had a heart attack. I really need to get in and see someone.”
She checked another box. Then she asked, “Are you experiencing any diarrhea?”
At this point, I began to debate how I should answer these questions. How we react to unexpected events is often shaped by our upbringing. For example, my mother chased me around the house with a wooden spoon if she caught me lying. I bought into the Boy Scout precepts of being trustworthy and obedient. I earned the Eagle Scout and God and Country awards.
Trying to be as truthful as I could, I told her, “I just re-started a medication that has that side effect. I’ve had the runs as a reaction before.” As she started to check another box, I interrupted her and emphasized, “Diarrhea has nothing to do with the pain in my arm.”
I hyperventilated and slurred my words. After all, I talked through a pandemic-inspired mask, had difficulty getting thoughts to match words, and might have raised my voice a tad answering that last question. Diagnosed with PTSD, I often drift from reality into fanciful and usually harmless delusions.
Of course, being lightheaded, disoriented, confused, and having left arm pain and speech difficulties are, in fact, symptoms of a heart attack. I tried to explain, “what I’m experiencing has nothing to do with the COVID.”
Still, she checked two more boxes. Her facial reaction and raised eyebrows told me that she decided she’d struck the jackpot. There must have been a hidden button on the floor or perhaps under the desk.
Claxons, alarms, and sirens went off. Oooh gahhh, oooh gahhh, oooh gahhh. Multiple flashing neon arrows descended from the ceiling pointed directly at me. Underneath my feet, a pulsating red circle appeared. Drop-down steel gates crashed against the concrete as the entryway past her shut with a thud, preventing access to urgent care.
The Wicked Witch of the West squinted her eyes and said with the most authoritative voice she could muster, “Sir, you cannot enter the facility through this entrance. Please drive around to the side where you will see a white tent, and someone will finish your screening there.”
My jaw hit the floor. I knew what that tent was for, and it had nothing to do with a pain in my left hand or a heart attack. I backed out of the hallway, and as I turned, I looked to see if she had melted into the floor—no such luck. I knew entry into the Emerald City and the Great and Powerful Oz could save me, but my visa was yet to be stamped.
My wife drove us around as we had been instructed. I was so upset that I didn’t see if she followed a yellow brick road. As I exited my vehicle, a Women in White (1948 movie) wearing a Hazmat suit met me – no Halloween costume, although she might have easily been mistaken for a ghost. She held a clipboard in her hand and went over the same questionnaire I answered with the Wicked Witch of the West. I stressed that I might have had a heart attack and needed to see the Great Oz quickly.
She looked at me and said, “Sir, you reported all the symptoms associated with the COVID. We’re going to have to take a nasal swab and test you.”
So, I watched in horror as she pulled out a five-foot bamboo probe with cotton at the end and rammed it up my left nostril. Until it reached the end – then she twirled it. And left it in, twisting, for at least ten minutes. It was painful. Dorothy never had to go through anything like this when she met with the Guardian of the Gates to the Emerald City. She extracted my sample and bagged it. We talked more. I repeatedly said, “Nothing I’m experiencing has anything to do with the COVID.”
“Sir, you can take that up with the doctor inside.”
At least I was going to get inside the Emerald City.
Seated in an urgent care examination room, a nurse practitioner tip-toed in decked out as a Glinda, the Good Witch of the South. She wore a crown just like in The Wizard of Oz. She held up a clipboard and checked my questionnaire answers. After thinking for a bit, she said she was sure I was not COVID positive, and they would destroy the sample.
I responded instantly. “No way. You already had someone stick a ten-foot telephone pole up my nose, rotating it for fifteen minutes like she was spinning a cone for cotton candy. I saw her put the sample inside a biohazard bag and seal it. Please, please, please, send it in for analysis. I’ve already paid the price.”
She made a phone call, waved her magic wand, and verified that my sample was, in fact, properly safeguarded. She ordered it sent for analysis.
I breathed a sigh of relief.
Glinda left the room. A Munchkin from the Lollipop Guild came in, fluttered around the room, and drew my blood. He did not offer me a lollipop. Someone dressed as a Winged Monkey flew along with me to a different area of Urgent Care where a technician dressed as the Captain of the Winkie Ceremonial Guard took an X-ray of my left hand. He donned a tall bearskin hat and marched me back to the examination room when we were done. I hummed “Oh-Ee-Yah! Oh Yah!” as we approached the drawbridge into the inner sanctum.
While I waited for someone actually to help me, I wondered how all the staff had coordinated their Halloween costumes so well. A sparkling Glinda with her white fairy dress arrived, and she told me the blood tests for a heart attack were negative, and the X-ray showed nothing broken. I felt immediate relief. She suggested I take an over-the-counter medication for the discomfort. She gave me a lollipop. I left the Land of Oz and went home to Kansas without having met the Wizard. My head hurt, but the pain in my arm had mysteriously gone away. Halloween magic worked.
Later in the afternoon, around 4:00 PM, my left hand hurt worse than earlier that morning—just the hand and thumb muscle – not the arm this time. On a scale of 1-10, where ten is a root canal without Novocain, I was clearly at an eight. Maybe nine, but I didn’t care to quibble. Tears flowed from my eyes and wet my shirt. I screamed at my wife to take me to the Emergency Room this time. I took some over-the-counter pain medicine and a double dose of medical cannabis tincture.
I don’t remember much of the drive other than wishing we were there, and a competent physician was treating me for pain. Pain … pain … pain … I could think of nothing else. I wiped away tears. I knew childbirth must be this painful. My wife dropped me off at the ER entrance, and I told her to go home. It would likely be hours. She sped away as fast as she could. I vowed to apologize later.
I entered the emergency medical facility wearing my pandemic mask. I faced another intense lady behind a desk barring entry with an actual railroad crossing gate. She was dressed in a Halloween costume resembling Cloris Leachman as Nurse Diesel in the 1977 film High Anxiety. She had used her skills to draw on peaked eyebrows, apply thick black lipstick, and she had painted blood drops coming from the corner of her mouth. A jack-o’-lantern sat on the corner of her desk.
She also had a clipboard and a thermometer. Her job was, of course, to ask me the same questions I had gone through earlier in the morning. She took my temperature, found it normal, squinted her eyes at me, and confirmed I did not have bluish lips. She turned to her computer terminal, managed a smile, and asked my name and date of birth. So far, so good. No questions.
Then the other shoe dropped. “Sir, you have been tested for COVID and cannot enter the facility through this entrance.” Once again, claxons, alarms, and sirens went off. Oooh gahhh, oooh gahhh, oooh gahhh. Multiple flashing neon arrows descended from the ceiling pointed directly at me. Underneath my feet, a pulsating red circle appeared. The steel railroad crossing gate flashed warning red lights. It remained fixed against the concrete floor, sealing the entryway, preventing access to Professor Lillomanthe and the Psychoneurotic Institute for the Very, Very Nervous. I wondered how much of what I was imagining resulted from the medical cannabis or the PTSD being triggered again.
“Wait, I was the one who asked Urgent Care to process the sample.” I followed this up with a long and reasonably coherent explanation of why I had answered the COVID screening questions the way I did. I emphasized that I had convinced Glinda, the friendly nurse practitioner, to send in my sample instead of destroying it.
Nurse Diesel rolled her eyes and said, “Sir, you can take that up with the ER doctor inside.” She pointed to a large but empty waiting room devoid of extra chairs and people. “Meanwhile, sit over there in that quarantine area and wait until someone comes to get you.” She revealed oversized wax teeth as she smiled.
My jaw again hit the floor. I knew what that quarantine area was for, and it had nothing to do with a pain in my left hand. My left hand throbbed. My head hurt. Mental note to self: pull up my electronic medical record and uncheck the box that permitted sharing. As I crossed the threshold of the quarantine room, the drawbridge closed behind me. I wondered if there were piranha in the moat.
Someone dressed like Cloris Leachman playing Frau Blücher in the 1974 movie Young Frankenstein came into the high-risk waiting room from outside the building. She wore the regalia of a 1930s German domestic. Her hair parted down the middle and bunched into a bun at the top. A surgical face mask did not cover a dark irregular mole on her right cheek, highlighted by thick black hair growing out of the center. Frau Blücher escorted me through the parking lot to an external ER fire exit and into the first examination room on the right. As I entered, she left the door open and took my temperature – normal.
I said through a clenched jaw, “I’m in excruciating pain.”
The cell door clanged shut, and through the plexiglass, I could see she affixed yellow crime scene-type warning tape across the entrance. I shouted “Blücher,” and I swear a horse neighed from somewhere.
After about fifteen minutes, a small person in a blue Hazmat suit and small clear face shield entered and introduced herself as my doctor.
“Doctor, I’m here for really bad pain in my left hand. I need something quickly.”
“Sir, we first need to talk about the COVID test. Why was it ordered by Urgent Care this morning?”
I went through the entire story, starting with the Wicked Witch of the West, barring my entrance. By this version, the nasal probe had grown to twenty feet and included a rotating Brillo Pad on the tip. It ended with me pleading I really needed something for the pain – now. I pointed to a wall chart describing levels of agony. I told her I rated my distress as an eight and didn’t want to learn how a nine, let alone a ten, felt. She withdrew, probably for consultation with the young Dr. Frederick Fronkensteen, who was perhaps experimenting somewhere else in the facility. I thought they covered pain and its treatment in medical school.
After about fifteen minutes, the doctor returned, still in her blue Hazmat suit and face shield. I still had no idea how she looked. She leaned into my cell and told me, “We have no choice. The protocols require we treat you as COVID positive.”
I retained sufficient wits about me to not argue and politely concurred but made a request. “Fine, but what can you do about my pain? I need help – now.”
She withdrew, perhaps for some more consultation? Could it be she missed the day they taught baby docs about pain relief? Maybe Dr. Fronkensteen had a laboratory table that would elevate me into the heavens and cure the pain.
In about fifteen minutes, Igor, with a humpback, broke through the yellow crime scene tape and entered my cell.
I guess this was his punishment duty for having delivered the Abbey Normal brain after he dropped that of Hans Delbrück.
From his voice, I surmised he was a young male but could not tell visually because he also was decked out in an orange Hazmat suit. He rolled in a portable X-ray machine fully wrapped in clear plastic. Obviously, they didn’t want my COVID cooties getting into the apparatus. He also didn’t care about my pain because he required me to turn my thumb this way and that way regardless of my protestations. Each time the machine fired off green kryptonite radiation into my painful thumb, the young man left the room. Each time he returned, the hump had changed sides. He put up new crime scene tape as he slid my cell door closed. I felt weaker as the kryptonite took effect.
A ghostly attired nurse slid open the door to my cell and asked me questions from the safety of the hallway. I asked her for something for the pain, and she responded the doctor was handling that and, in the meantime, she had some questions I needed to answer. The interrogation was identical to those questions I answered at Urgent Care earlier in the morning. This time, I replied in the negative to everything they asked. So much for the Boy Scout training. She slid the door closed and escaped her near-death experience. As the ghostly apparition left, I said, please ask someone to bring me something for the pain.
I waited, waited, and waited, and realized I needed to relieve myself. I buzzed for help, and another female wearing just a surgical mask and face shield slid open the door and peered in from the outside without crossing the crime scene tape. I said, “Ma’am, I need to use the restroom.”
“I’m sorry, but we cannot allow you out into the rest of the facility.” She slammed the door closed without asking if it was number one or number two. The Wicked Witch of the West must have a relative working in the ER.
You know the feeling when you got to go? You got to go. I had to go. Immediately.
I searched the examination room for a urine container. In previous hospitalizations, I used such things. I found nothing familiar. After all, you weren’t supposed to spend a long time in an emergency examination room. I remembered from previous visits there were multiple toilets within walking distance. But no, I was not allowed to cross the threshold and possibly condemn everyone to a slow and lingering death. But I really, really, really had to go.
I found something round made of clear glass that might work. It had an open top, and it appeared I could empty my bladder without overfilling whatever it was. I kept my eye on the sliding door to see if anyone was about to discover me.
With my left hand hurting like the dickens and the need to hold the container while I aimed my schwanzstucker and discharged my internal bodily fluids, I must have looked ridiculous. Once I started, I didn’t care. I just needed to relieve myself. I emptied at least a gallon of liquid into that container. Well, maybe less, but the problem was that I held in my hand a warm, clear glass container filled to the brim. In fact, if I tilted it, I was sure it would slosh over on the floor and my shoes. Somehow, I managed to set the container on the side of a sink in the room. And, of course, I zipped up before anyone came into the room.
In the past, I’ve donated urine for lab tests. You fill up a small cup and then use the toilet to dispose of excess fluids. Then you take the cup, screw on the cap, and place it somewhere for retrieval and analysis. Where the hell was I going to dispose of this extra-large sample? No toilet in the room. Just a sink. With a drain. Maybe Dr. Fronkensteen would need a urine sample? Better save it just in case. I put the container on the floor under the sink.
After some time, I decided that the olfactory disturbance in the room outweighed leaving my sample for unscheduled urine analysis. I poured the container’s contents down the drain and turned on the hot water, letting it run for an exceedingly long time. I rinsed and put the container on the floor under the sink. I figured I would explain what happened the next time someone slid open the door to my cell.
I waited, waited, and waited. Then I had to relieve myself again. So, how does that adage go? Wash, rinse, repeat. So, I repeated draining, disposing, and flushing. I didn’t even bother to look to see if I was going to be interrupted. And I was getting proficient at managing to hold the container and my schwanzstucker without spilling anything on the floor.
After another hour or so, my doctor returned with the Hazmat suit still on, but the face shield flipped up. Now that I could see her, I realized she looked like Teri Garr playing Inga in Young Frankenstein. She said with a slight Teutonic accent, “Sir, you probably don’t haff the COVID, but ve vere required to treat you as if you were positive.” She said there were no broken bones in my hand and that I likely had a soft tissue injury compounded with existing arthritis visible in the X-rays.
“OK, but what can you give me for the pain?” I had come to guess the hospital protocols forbid just giving pain medications to disabled veterans with a known PTSD diagnosis. That is unless they could validate the pain. And how do you do that with no visible wounds?
She continued with her prepared speech. “You need to see an orthopedic surgeon. Ve vill make an appointment for you on Tuesday morning.”
Inga finally addressed my pain. “I’ll write you a prescription for some really good stuff.” She winked. Finally, help.
I looked at her a bit closer and soon pictured her lying in the wagon next to Gene Wilder singing, “Roll, roll, roll in ze hay.” I nodded as I recognized the name of the really good stuff as an amazingly effective, highly controlled pain medication. Yup, she finally got to see something that permitted her to conclude my pain was real and not imagined.
Inga held out a pill, and I grabbed it before she changed her mind.
I glanced around for a small cup but saw none. I saw the liquid container on the floor under the sink, and I explained I used the container to relieve myself earlier.
She smiled, left the room, and brought back a paper cup with water. I used it to swallow the tablet.
Inga said she would send in Frau Blücher with a thumb immobilization brace, and she wished me well. Before she slid the door closed again, she told me to look for an email or text message no later than Monday with the COVID test result.
I texted my wife and asked her to leave the house and return with ransom money.
After about ten minutes, Frau Blücher came into the room without anything covering her face other than a routine pandemic mask. I had been incarcerated for some hours by now, and she asked if I wanted some “varm milk” or Ovaltine in a German accent. I declined and instead wondered if the ER had any Halloween candy. She said no. Then she fitted me with the brace, escorted me out of the emergency fire exit back door into the parking lot, where I met my wife in the dark of the Allhallows Eve. I did not look back or repeat Blücher as we sped away from the scene of the crime and the really good medication started to take effect. We got home well after the hour that any little ghosts and goblins would show up for a trick or treat. I drifted off to Never-never land.
Sunday night, about twenty-four hours after returning from the ER and long past my Halloween to remember, while brushing my teeth, I looked out of our bathroom and saw our bed with one of our cats sleeping. The all-white ghostly cat named Caspar. For the first time, I then remembered a few days before my pain, I tripped in the middle of the night over Caspar. In my attempt to not disturb my wife, I turned the light off coming from the bathroom. Failing to see our cat, I had fallen forward and reached out with my left hand, which hit the corner of a square bedpost. Two hundred twenty pounds of body weight thrust my left hand into the right-angle corner of an immovable object. I winced with the memory.
Before that moment, I had no recollection of the trauma, and for some reason, I did not have any discomfort the morning after the fall. Not until a few days later did the pain erupt. But at least I finally understood what triggered the events of my very special Halloween. I went to bed. The really good medication worked, and I slept like a baby.
After breakfast on Monday morning, I received both an email and text message to check my electronic medical file. I logged in and learned I tested negative for COVID. The next day, I went to the appointment with the orthopedic surgeon. He diagnosed me as having experienced a trauma-induced sprain of the carpometacarpal joint of the left hand. He said it could be excruciating when compounded with existing basal joint arthritis of the thumb.
I nodded and told him I was an expert witness on the subject of trauma-induced pain.
He could not explain why it was days between the fall and the agony I experienced.
He told me to take some over-the-counter meds twice a day for a week and the really good stuff only when I needed it. My discharge instructions said I should wear the brace for a month and only take it off when I showered. The staff made an appointment for me to come back to see him on December 1st.
Had I not been raised the way I was, I might have prevented how health care professionals, all guardian angels and not Halloween witches and goblins, did their jobs. I know they were trying to do their best to keep me and others alive by keeping me locked up. I don’t criticize anything that was done to me over those twelve hours of my most unforgettable Halloween. They were doing the best they could under the current overwhelming circumstances. However, despite my upbringing, the next time I ever answer any of those COVID screening questions, I may not be quite as forthright. And I will not insist my nasal swab be sent in for analysis unless a doctor tells me I actually might have the damned affliction. And I no longer extinguish the light when I exit the bathroom at night if Caspar or one of his cousins decides to lay outside the bathroom door again, waiting for it to open.
After all, there are often unintended consequences to seemingly routine non-threatening events in our lives. And sometimes, the scariest Halloween is brought on by events that are never associated with this annual homage to All Hallow’s Eve.