notes from above ground

v

I had a dream I was going skydiving. I was excited, having never skydived before. The guy in the helicopter told me that the challenge would be psyching myself up to jump out. While he was saying that, I jumped out. It felt amazing to know that I'd saved myself a lot of torture by just jumping instead of thinking about jumping, and I felt good knowing that I’d successfully cheated the system. Most importantly, I’d probably impressed the guy in the helicopter.

The view from above the clouds was amazing. I sat in an invisible chair, taking in the view in all 360 degrees. I didn’t feel like I was falling that fast. There was no fear. I had plenty of time to enjoy the freefall.

When I finally broke through the clouds, and the ground started getting closer, I thought about my parachute. I realized that I hadn’t asked the guy in the helicopter how to deploy it. The ground was getting closer.

I reached for something to pull, since that’s usually what people do to summon parachutes. There was nothing on my right side, and I didn’t have time to try the left; the ground was too close.

When I hit the ground, everything went black, just like that. No splatting sensation, no smooth transition into the beyond, no nothing. Just black.

I woke up. I pushed the dream aside, hoping to forget it as quickly as possible.

“I’m not dead,” I told myself, not fully believing it. “I’m alive, and I’m a medical student, and it’s the first Saturday of the weird year,” I said.

I spent most of the first week learning some of the things we do to prevent terrible outcomes. My question, which I worry might have no answer, is how we could ever prevent all the terrible outcomes. And what about the terrible outcomes that we cause by preventing other terrible outcomes?

For example, the little girl, barely past toddlerhood, getting her tonsils out yesterday. The anesthesiologist told me to spend some time with her before the operation to acclimate her to the hospital, with its unfamiliar people (everyone wearing the same outfit), objects (needles and knives and lasers), and customs (getting pulled around in a wagon by a stranger). The goal, he said, was to make her transition into the anesthetized state more peaceful, less like hitting the ground after a freefall from a helicopter.

She was sitting in her wagon in the pre-op area when I met her. I sat on the floor next to her and played with the mask that would deliver her sleepy gas in the operating room. I showed her that it wasn’t something that would hurt her—more like a toy. She put it on her head and said “hat.” Her mom kept reminding her not to drop it; she never did.

When it was time for surgery, I pulled her in the wagon to the operating room. One of the nurses picked her up and sat her down on the operating table. They gave her a stuffed animal to cuddle. The plan was to let her hold the mask and slowly fill it with oxygen and happy gas—no sleepy gas until she was sufficiently happy.

When it was time to begin, someone pressed the mask to her face with sleepy gas coming out, and she seemed to get high almost immediately. She squirmed and screamed for a few seconds as three grown-ups pinned her to the table. They held the mask, which was a hat, which wasn’t supposed to hurt her, against her face. She desperately tried to pull it off, but she was outnumbered.

Then she was asleep, motionless, and the room took a collective sigh of relief.

I didn’t move or speak. There was nothing to do, nothing to say. I stood there with a pit in my stomach. I felt cheated, and the anesthesiologist’s sidelong glance in my direction suggested a similar feeling.

I’m not sure how the whole thing might’ve affected her. Maybe she didn’t process any of it, and she’ll forget about how scared she was when they pinned her down and forced the mask over her nose and mouth.

It’s also possible that it did affect her, zapping her so suddenly from the above ground and chemically preventing her from going anywhere else. It’s possible that some part of her will remember how it felt.

We checked in on her after surgery. Her mom was trying to feed her a popsicle, but she didn’t seem to notice. She was trying to cry but couldn’t. How can you cry when you’re faced with a kind of suffering you’ve never known, when the reality sets in that no one can make it go away? These questions don’t matter in the above ground.

Her tonsils were successfully removed. She didn’t die. A bad outcome was prevented. For all intents and purposes of the above ground, of the hospital, the outcome was good. She fell asleep, and she woke up. The rest is just details.