Take Two Aspirin and Transition in the Morning! by Beth Williams Edited by Holly H. Hart Artwork by Andrea Lena DiMaggio

Scrrrreeeech, I’ve no idea what in the world was going on. My mind seemed thoroughly befuddled, almost as though I’d been drugged. The pain in my left leg and pain in my groin are the worst; but there are pain signals from all over my body; but my leg and groin hurt the worst. The leg hurts, badly; the pain seems focused somewhere below my knee. The groin feels like someone took a baseball bat and hit a homerun, using my testicles for the baseball.

“Good, you’re waking up, feel like some ice chips?” an overly perky and happy voice asked as she attached the blood pressure machine to my left arm. I figured out the screech was the nurse pulling the curtain back. ‘Great, I’m a genius because I can figure out a sound, but what in the world is causing the pain?’

I groaned loudly from the pain. No words came out; the inside of my mouth felt like the desert. I sucked on my cheeks as she continued her ministrations, “It hurts,” I screamed at her, “make it stop, please,” I begged as my eyes finally focus on what was clearly a nurse.

“I’ll see what I can do about the pain as soon as I finish taking your vitals.” Her priorities needed adjusting. and were totally screwed up in my opinion.

Personally, I couldn’t give a damn about my vitals at that point in time. Relieve the pain and the vital signs will begin to approach normal.

Tears began to pool up and flow down my face and into the oxygen mask they still had on my face. The tears made a little gurgling sound as I breathed in. All I wanted was for the pain to go away. “It HURTS,” I managed to scream, putting every bit of energy I could muster in it, “make it go away,” I continued, realizing I was moving as much as I could, trying to get away from the pain.

Another nurse joined us; this one a sterner faced matron in her late fifties. “Hush now, I’ve brought what the doctor has prescribed,” she says as she injected something into the heplock, this hatchet faced angel of mercy injected half the syringe in quickly, which, in 30 seconds or so hit with a surge of warmth and comfort, taking much of the pain away. The rest of the syringe she pushed into the lock at a much slower rate. “How’s that?” she asked.

Daring to try and make a joke, I quote from Oliver Twist, “Please ma’m, may I have some more?”

Hatchet face looked at me with a smile, “Well, let’s let this one settle into your system. If you’re still hurting in 10 minutes or so I’ll see about getting you some more dilaudid. I wasn’t familiar with the drug, but I sure wanted more.

The first nurse has by this time removed the oxygen mask and replaced it with a canella, giving a little extra oxygen but letting me chew on a few ice chips.

“How do you feel?” Chipper But Clueless asked.

By this time I’m remembering where I am, and why I’m here. They’ve amputated my leg below the knee. That explains the pain in the leg. But there’s no reason I can think of that would explain the pain in the groin.

“How do I feel? I feel like someone has hacked my leg off with a meat cleaver and then, for good measure, pounded my balls into the table with a ball peen hammer. I hurt like you can’t believe, and please, I need some more of the pain meds, I won’t be responsible for how loud I scream if you can’t relieve the pain some more."

Cute and Clueless looked at me like I’m some kind of naughty child while Hatchet-faced goes over to the drug locker and comes back less than five minutes later.

“Here you go, I’d have been quicker, but the drug locker is timed. I’m going to set you up with a machine that gives you a continuous drip and allows you to add a bit every few minutes,” she said as she injected the elixir of life, well, pain med anyway.

I could learn to love Hatchet-faced. By now I’ve been given my glasses, and discover her name is Doris. Clueless is Hope.

“Thank you, it still hurts so bad you wouldn’t believe it, why is my groin hurting so much?”

Doris turned and told Hope to check on the PCA, whatever that is, “and don’t come back without it. “

Once Hope was out of earshot Doris turned to me, “You’re going to have to wait for the doctor for that explanation,” Doris told me.

“Why do I need to speak to an urologist? The operation was on my leg, NOT my balls.”

“Hon,” Doris began, “I don’t have all the information. All I know is there was a problem with the catheter. I’m not supposed to say anything, but if I were you I’d get a good lawyer before you agree to anything. There’s been extensive damage to your urethra. It shouldn’t have happened, but it did. From what I’ve heard, the hospital knows it’s in trouble, and will probably offer you money just to keep your mouth shut. Be sure to get a lawyer before you agree to anything.”

Doris was becoming the love of my life. I don’t know why she would be so open about the hospital, but she was. “Thanks Doris,” I said. “I’ll keep that in mind, but why bite the hand of the hospital that feeds you, so to speak?”

“Hope will be back any time. Let’s just say that I hate seeing anyone butchered unnecessarily in the OR.”

Ouch! Doris had an attitude. I’d settle for listening to her advice, and watching my own back.

“Is my wife in the waiting room?” I asked.

“Yes, she is, but you need to wake up a little bit more and get your pain under control.”

Hope returned with something on a stand and an IV Bag. Doris took the device and explained, “This machine is called a PCA which stands for personally controlled analgesia. We’re going to connect it to your IV and load it with a large syringe of Dilaudid. Dilaudid is a synthetic morphine type of drug. The PCA will deliver a metered dose and every 8 minutes you can press this button (which she handed to me) which will allow you to give yourself a little extra “oomph” to your pain meds.”

I was pressing the button before Doris had completely programmed the machine and went to the drug lock box and came back with the biggest syringe I’ve ever seen. She loaded it into the machine, locked it and entered a code which gave me a beginning dosage. By this time, it had been an hour or more since I came into the recovery room.
The pain was under control, just barely, when Doris helped move me to the ICU. There, my wife Debbie was waiting for me. As soon as she saw me she burst into tears. I turned to Doris, “Is it that bad?” I asked.

“Yes,” was all Doris needed to say.

“Hi gorgeous,” I greeted Deb as they settled me into the room, and attached telemetry leads to my chest. “Hon, don’t cry, it’ll all work out, it always has, hasn’t it?” I asked her. She gave me a tentative smile.

“I’ve been so worried about you!” she said. “They said there was a problem, but that the leg amputation went well. Then they said there had been a problem with the catheter and in the process of trying to remove it they tore your urethra, they said you’ll never be able to have sex again!”

Doris interrupted as she finished rolling me into the ICU bay assigned to me, “Well, this is where we part ways. Please read this note with your wife as soon as possible.”
I thanked her for her care; then turned back to Deb.

“Hon, I don’t know that we really have anything to get upset about till we get a chance to speak with the specialist, the urologist.” I opened the note Doris had left. Basically it suggested getting a hold of an attorney as soon as possible and to transfer me to another hospital. Not that she thought they would do anything overtly, but little accidents can have big results.

I shared the note with Deb, and asked that she could find a PI attorney just as fast as she could. Since she worked as a legal assistant for a small legal office it was a matter of calling into her office and asking her boss who would be best in handling my case. Deb rolled her eyes and smiled.

“Boris wants to take on this case himself. He’s going to prepare some preliminary documents and said to expect him within 2 hours, and you’re not going to believe this, but Boris said he’d front the money, but because I work for him he’ll bill his hourly rate. From what I’ve told him he can’t wait. I think he’s looking for the publicity he’ll get from the case.

‘Oh joy.’ Now don’t get me wrong. Boris is almost as good as they come. It’s just he and I have never cared much for each other. I would have preferred a different lawyer, but when your wife’s boss decides he wants to help, it’s better just to get out of his way. Like I said, Boris Butonoff is a PI, that’s Personal Injury, attorney. The thing that pisses me off about him is he won’t take a case that he isn’t sure he will win. I still cling to the idea that the courts should dispense justice. I know, naíve; I still believe in the tooth fairy so what can I say?

I was still hurting so I asked the nurse for something more. Seems I was suddenly the hospital’s fair haired boy, the hospital’s “hospitalist” had been called. He came in immediately with a man that I was sure was an attorney — he had “that” look. The doctor changed the meds, and I was suddenly feeling much better. I’d never heard of a “hospitalist” and asked the Dr., Dr. Asimov, what in the world was a hospitalist.

“Most of the doctors that work in a hospital have private practices. Escondido Methodist has four doctors, one on duty at all time who work solely for the hospital. Those doctors are called “hospitalists.” Their sole job is to keep up on new drugs and procedures. You might call them generalists”

“Good, then maybe you can tell me what’s happened to me, and why my wife was crying as soon as she saw me?”

“I’ll try to give you a summary. First, the man with me is the hospital’s general counsel. He has been told, in absolutely no uncertain terms that he is to arrange a settlement, regardless the cost. His name is Richard Tracer, Esquire.. But he goes by Rocky.”

‘Obviously trying to soften people up’, I thought.”

“I’ve looked at similar cases and I’ve suggested at least $5 million plus all expenses; now and in future medical procedures. It’s one way to correct the damage done here. Do you have any children?”

“Three,” I replied.

“The Hospital will further guarantee all school expenses for your children’s education.”
Damn, this guy was seriously spending the hospital’s money.

The attorney was a bit green about the gills. Obviously he did not like giving in without a fight. “I’ve also suggested another $1 million just to keep your mouth shut. We gain the publicity that we take care of you if we make a mistake.

“First, the hospital knows there’s a problem, we know we’re at fault, and it would not do our image any good fighting this. So, while I’m sure you’ll have a lawyer to negotiate, I want to be as open as I can. The hospital is picking up the costs for your surgery, and whatever corrective surgery may be indicated. If you need anything, call me, or have the nurse call me immediately. Here is an in house beeper. It will beep me or the on duty hospitalist regardless of the time day or night.

“Now, as to what happened. You clearly told the anesthesiologist that you have problems with catheters. That we had to be certain the catheter was inserted completely or you’d have trouble after the surgery.

“That piece of information didn’t get passed on to the OR nurse. The catheter seemed to be inserted normally, and everything seemed fine to the nurse. It wasn’t. It took too long to get you in the OR. Then it took too long during the surgery. The best we can reconstruct things is the place where the urethra joins the bladder was where the catheter wound up. Sometime after the initial placement the catheter slipped way, WAY out of place the catheter was inflated, but nothing was draining. Oh there was some initial draining of urine. Then it stopped. A nurse inflated it some more. At the same time the Urethra itself began to swell, totally from the damage done to it. Your bladder was totally stopped up by the catheter, so nothing was draining. The first thing we noticed was wrong was when you started bleeding through your penis. The doctor told the nurse to deflate it and remove it. It didn’t deflate much. The nurse pulled the catheter out anyway and tore your urethra from the entry to the bladder to a little more than half way up the penis.

“By this time you were bleeding rapidly. We were pumping blood into you about as fast as it was leaking out. The surgeon in charge was an orthopedist, but he panicked and tried to repair the damage. He turned the closure of your amputation over to his assistant. He did NOT call me He screwed things up. By the time he had the bleeding under control and an urologist in the OR and taking over, you were a mess. As per regulations the urologist called me in and I scrubbed up to observe what was happening. The testicular arteries on both sides had been clamped to stop the bleeding. By the time the repair got to the testicular arteries the testes had been without blood for more than 2 hours. We thought things were under control. You have a urethral opening at the base of your penis. That was to control the damage in the penis and allow it to heal. When the urologist got to the testes, neither had been receiving blood. They both were essentially dead, and removed to prevent sepsis. That’s what I know. I know your Lawyer will want to sue the Hospital. We want to avoid that. Dick here might want to save the hospital money in the settlement. That is not his job. His job is to work out the details of the final settlement. Here’s a copy of our conversation. The Hospital will go along with what I’ve said. I really can’t wait to see your lawyer.” First he smiled, and then he laughed.

I begged off any further conversation, making it clear that I wanted to think things over. I admitted to a little cruelty in wanting to watch the great Boris Butonoff negotiate on our behalf.

Debbie sat next to me while I pretended to be sleeping. I knew what was going through her mind. I had just been given my heart’s desire and the means to make it happen. What was that? To put it bluntly, I am transgendered. I suffered from gender dysphoria; because of this screw-up there would be money for treatment and also plenty of money to take care of my family in style. I know a smile had crept onto my face. I’m sure everyone except Debbie attributed it to the pain meds.

True to his word, Boris Butonoff showed up just a bit before his self imposed 2 hour deadline had passed. He was wearing Armani, with some aftershave that I wouldn’t be caught dead wearing, even as a woman. You could tell this was important to him; he’d worn his 2 inch lifts. He came in with all the bluster of a Monarch Butterfly, demanding a table to be brought into the ICU room I was in. Soon everyone except me was seated. By this time is was clear Dr. Asimov had the notes from earlier typed up as “Physicians Notes” Everyone was quiet, allowing the shark to feed to his heart’s content on the information, occasionally muttering a phrase or two.

Boris looked up and smiled as he told the hospital’s attorney that they must assume responsibility for whatever repairs were necessary. Rocky argued a bit that the damage was the responsibility of the doctors operating and not the hospital. Boris made it clear he would be going after the doctors separately; he then argued for free care. Rocky, the Hospital’s attorney, swiftly agreed. Then Boris put on his act; what an insipid life I’d live without sex. At that, Rocky snorted. For that and the rest of the Hospital’s share, Butonoff insisted on $3.5 million dollars. Dr Tracey argued the hospital did not have that kind of money.

I decided it was time to drop the hammer on Mr. Boris Butonoff .

“Excuse me, Mr. Tracer, but I was quite happy with the agreement you and Dr Asimov offered me earlier, at least as far as the hospital is concerned”. Dr. Asimov blanched, Mr. Tracer turned green. Boris looked confused.

“Jeff, stay out of this,” Boris told me rather imperiously, “I’ve got them to agree to probably $4.0 dollars. I’m sure that’s better that you were offered.”

“Boris, I respect your work, and I know you mean well but I’ve already gotten far more than your $4 million. All medical care and pharmaceuticals for the family will be taken care of for life, a flat payoff, for the Hospital anyway, of $5million has been agreed to. Another $1 million will be held in interest bearing annuities paid directly into my 401K to keep my mouth shut. Altogether, the Hospital has agreed to pay out no less than $10 million by the time I reach 65.”

Dr Asimov and Mr. Tracer looked at one another, then told a completely confused Boris Butonoff that was the offer on the table. I really didn’t feel too bad at the additions to my 401K, I was, after all, thoroughly drugged — or so everyone at the table except Debbie thought.

“I sure do appreciate your getting dressed up for all this, and I suppose it’s worth 4 or 5 hours to oversee the documents. So thank you for coming in. Now, Dr. Asimov, since it’s lunch time don’t you think you can get the documents prepared while we have lunch? That way everyone gets everything done before my next procedure. Oh, and Dr. Asimov I’m sure you and Rocky can include substantial personal life insurance policies for Debbie, the kids, and myself should anything happen. Don’t you agree Butonoff? That way the hospital will have the necessary documents on file, Mr. Butonoff will check over the documents and file the appropriate paperwork to turn the hospital’s generous offer into a living family trust over the weekend to be filed with the courts on Monday. Yes, I think that covers everything, so, Dr. Asimove why don’t you join Debbie and me for lunch while Rocky and Butonoff finish the paperwork during a working lunch.

Debbie and I Smiled while the rest of the assorted parties began to scurry along with the various tasks assigned. Two hours later luncheon was finished. Copies of each and every one were signed and notorized. I knew Buttgoniff was capable of filing the papers with the court. He was also carrying Deb’s two week notice or resignation.

“Mr. Butonoff, one more thing, you’re welcome to go after the doctors involved, IF you do the work pro bono. I’ll be happy to contribute your discounted hourly fees to some worthy charity, after you succeed in suing the doctor. You get a nice tax write off, free publicity for the charity, and you come out looking like a hero for going after such disreputable doctors” I smiled as though drugged, and watched the great and greatly bemused Boris Butonoff, Esquire, slink down the hall and into the elevator.

“Mrs. Collins, I understand you worked for that ass?” Richard “Rocky” Tracer entered the conversation constructively for the first time. Debbie replied that she indeed had worked for him. “If you would like, I’m sure we can find a position that pays far better than Mr. Boris ‘I look so cool’ Butonoff

“Mr. Collins when everything is sorted out and all your health issues have been resolved; I truly do believe I’d pay handsomely to have you on my staff. If you can handle someone like Boris Butonoff Esquire as magnificently drugged as you are now, I can’t imagine how totally ruthless you would pursue something you really believed in. I truly am sorry we have badly screwed up your life”

Debbie couldn’t stand it any longer. “Screwed up his life?” she laughed. You two morons have given him his heart’s desire. He’s been to several shrinks, hell; I went with him to one of them with him. He’s been diagnosed as being a transsexual. You didn’t even check your own records — he’s been to a support group in this building. Now you can put him together the way he wants to be. Not only that, but you’ve agreed to pay him, me, and the family for his “trouble.” Then you offer “her” a position as part of your management team.

“Finally, just to cap things off,” by now Debbie was laughing hysterically, you” she said while pointing at the lawyer Tracer, “offer me a job at a better salary than I have now!”

“Are you two crazy or am I the Looney one??” Debbie was dancing from foot to foot. “This has been so funny that if I don’t get to the restroom I’ll pee my panties.” With that, Debbie skipped off to the ladies bathroom laughing the whole way. When she had gone beyond earshot, Dr. Asimov couldn’t help it. He started laughing, woo boy, hoisted on our own petard! Dr. Asimov turned to me, “is it true”

“Every word” I replied.

“Dr. I assume we fight it under these circumstances?” Tracer asked Dr. Asimov

“What are you nuts? We are in the wrong here. Can you imagine how much this would cost us in the end? Not only that but we’d have every gay, lesbian, and transgendered civil rights group out there picketing. I suggest you remember our purpose is to keep this whole affair low key, and keep Mr., or rather Ms Collins happy!

“Mr. Collins, I have to say you are one stone cold negotiator, even whacked on pain meds. By the way, the job offer still stands.”

Dr. Asimov programmed in an additional bolus of Dilaudid then he and the attorney left me in a pleasant glow. I’d finally live my dream