out of reach

Tolga had surgery today.  It wasn't a huge surgery, but I took the day off anyhow.  He has cysts just under the surface of his skin in his head that are benign and not serious, but continually get infected causing pain and stress, and eventually hair loss in spots that get badly infected.  He had one cyst removed before we were married - but since being married, the problem has gotten much worse.  He had three small cysts removed last year, and two the year before that, as well as one in his hand.  The the treatments vary from person to person, and so does the success rate.  Doctors aren't sure of the cause, but I'm a little suspicious it may have something to do with marrying me...

The first time he went for surgery three years ago, I didn't go with him - and Tolga admitted later that he felt very alone - it was a bigger surgery then we expected and he had been admitted for the day.  After that, I realized I would never put work first - no matter how small the surgery - because work will never be more important than the smallest of events when it comes to family.

So I had to arrange my schedule, swap classes, get permission, and I was set for today.  We left at 9am for surgery at 10, which was delayed because of some emergency the doctor was called into, and Tolga finally went into surgery just after noon.  He was back in the room by 1:30 with his head fully bandaged.  In the end, they had removed 5 cysts that still had infection underneath in spite of Tolga's rounds of heavy antibiotics.

The surgeon had spent time in New Rochelle, New York and had an excellent accent.  I commented on this, to which he replied: "Well, I did live there for three years."

And that was about as productive as any conversation I had with him.

The hospital was a different one then we usually go to.  It was new and slick and expensive.  Their patient manual was in Turkish and English and touted everything modern medicine should - about patients being informed and advocating for themselves.  This may seem common sense, but is not.  In fact, it's culturally opposite.  Turks have a lot of trust in their doctors and medicines and do not question decisions.  In fact, questioning nurses and doctors is often received with confusion if not aggression.

Example:
To my OB-GYN: What is the labor and delivery procedure?
Doc: What do you mean?
Me: I mean, I'm not sure - I haven't experienced it - but I've read lots of things about methods.  Like birthing bars.
Doc: (confused) Um, there's a bed and you will labor there.
Me: Can I walk around?
Doc: (confused) sure.
Me: Will I have to stay in the bed?
Doc: sometimes.
Me: Oh.

Today, after reading the literature and meeting this well-spoken doctor, I hoped to have more of a medical conversation - but instead I got the same blank stares.  Behind those eyes I'm not sure what I'm seeing: fear because of language, disdain because of my lowly questions, or simply confusion with my questions.

Doc: Where you sick before the surgery?
Tolga: No, maybe a bit of stuffed sinuses.
Me: And you had that virus or something
Doc: what do you mean?.
Me: He was sick for a few days, diarrhea
Doc: that's a bacteria
Me: okay

(awkward)

Me: (trying to make conversation) Was it hard to cut his skin?
Doc: (blank stare)
Me: His last surgery they had trouble cutting through his skin because... nevermind (sigh).

Me: Can he take any other pain medicines?
Doc: (blank stare) We're giving him something.
(they were giving him Tylenol)
Tolga: Can I use ibuprofen or should I put ice?
Doc: No, it's not necessary.
Tolga: But I'm feeling quite a bit of pain in my head.
Doc: It's normal.

Arrrrrrggggghh!

Thankfully, these are small issues - but when I hear of others with more complicated issues - I just have to shut down because what I perceive as normal concerned questions I receive more confusing answers.

Tolga's cousin is really sick right now.  In America, we would say he has terminal cancer and he's on hospice care.  But here, it's been more dramatic because of the lack of knowledge or communication or who knows.  He was diagnosed last year and had a tumor removed from his neck.  They followed up with radiation, he visited Kusadasi in June, and in August he had a stroke - which he recovered from.  The stroke, may or may not have been related to the cancer - but at that point the realized the cancer had returned.

The family decided not to tell our cousin.  He's 55 years old, married (his wife also had cancer this year), and a grown son from his previous marriage.  Apparently, you don't have to tell patients everything here.  They said he couldn't have surgery, and then, a month later - they were putting all their hopes on surgery.  Surgery and a medicine that cost 12,000 lire.  That's the information I got - and I learned much later the medicine was called chemotherapy.

Arrrrgggghh!

This past week - they learned he couldn't have the surgery and called us to tell us he was going to die.   I wasn't sure what to do with the news - it all changed so much and so suddenly and was delivered so extremely.  With the news he couldn't have surgery, and the news he had many blood clots (which, aren't those treatable?) he was asking to see Hakan and Tolga's parents.  They got in their car and drove the next day to Istanbul to say good-bye to their cousin /nephew.  Actually, Baba couldn't bring himself to make the trip - he was too heartbroken.  Over the weekend, more medical issues have come up.  It's all being presented like one more thing on his list of illnesses - but I think the medical translation is his body is going into failure, and going fast.

There are so many things about this that I'm trying to process.  Part of me wants to know all the medicines, and options, and alternatives.  I want to have a list of questions, action-plans, and answers.  But I'm not that assertive for several reasons - because the other part of me knows that even with all that knowledge or ideas, we still may have no impact on the outcome other than deluding ourselves to believe that we do.  Badgering the doctors may only be perceived as a patient who just can't understand or accept the situation.  And sometimes, in the end, that's all it is - something that's happened and all that's left is to make peace, hope, and pray.