A year ago right now I had just gotten home from the hospital, and was sitting in an easy chair with my feet up because of lingering edema in my ankles, a nasal cannula shooting oxygen into my nostrils. What joy!

I got out of the hospital as soon as I did because of two doctors who were very aggressive. A week earlier, on the day before Thanksgiving the pulmonologist, Dr. Cosio, had swooped into my room in the Progressive Ventilator Care Unit and announced he was going to remove my tracheotomy. The respiratory therapist was aghast. She said, "You mean you're going to downsize it, right?" He looked at her like she was from Mars. He said, "Why would I do that?" She said, "Because it's the protocol." (She was right, of course. Standard operating procedure is to spend a week or two downsizing the size of the trach, and watching how the patient responds, before taking it out entirely.) Dr. Cosio said, "I decided to put the trach in, and now I've decided to take it out!" (By this time several of the unit's staff members were in my room to watch this novelty.) Dr. Cosio laid out some instruments on my open New Yorker magazine on the bedside table, snipped out the trach, bandaged up the wound, and started out the door! On the way out, he said, "Oh. Say something." I said, "What do you want me to say?" He said, "Sounds fine," and left. I was actually unsure what had taken place. My nurse stood there with a big grin on her face, and I asked, "Um, what is there in my throat now?" She said, "Nothing! He took it all out!"

After that I certainly did not need to be in the PVCU, but there were no staffed rooms available on one of the regular hospital floors. (It's not that they didn't have rooms available; with the nursing shortage, they had no staffed rooms.) As it turned out, I only spent two nights in a regular room. At the time I had been very frustrated to have to stay in the PVCU. But, as it turned out, I got the best care available during my hospitalization because the ICU and PVCU were staffed by RNs. On the regular floor, RNs were scarce. I was cared for by LPNs. Frequently over the loudspeaker system would come the announcement, "A nurse is needed in room ___." There were a couple of RNs on each shift, and they would move from room to room when they were needed to perform procedures that only RNs are authorized to do. That's a little bit scary, huh?

I only spent two nights in that room because of the aggressiveness of the internist who was coordinating my care by that point. He was always trailed by four or five adoting residents (which he seemed to enjoy very much). When he first met me in the PVCU, he paid me a tremendous compliment. I was still on the ventilator. I had been confined to bed for the weeks of my hospitalization. But he said to his students: "Ladies and gentlemen, this is a century bicyclist." Present tense! He was a triathlete himself, and he didn't think I needed to be babied. I'd have been in the hospital for days longer if he had not been calling the shots at that point. A year ago yesterday he came in and said, "Some of your numbers aren't where we want them to be yet. But this room is depressing for you. We need to get you out of here. You'll get better much faster at home." He assumed that I would do all I could to rebuild my strength. Of course, that's what happened.

When I go to bed tonight, I'll think of how dark and how quiet the bedroom was to me! In fact, in that darkness and quiet, it took me a while to relax for sleep: there was no call button nearby! What if I would have difficulty breathing? And I had been sleeping on my back for more than a month. It was hard to get used to the idea that I could sleep on my side!