Chapter 16: Healing Hands

MY PHYSIOTHERAPIST within days becomes the most important person among all the doctors and specialists who visit me to check the numbers. All the “approval for discharge” sign-offs by Samra and Nigel will come to naught if Wendy cannot assure herself that I can safely walk without assistance when I return home, navigate the stairs to go upstairs to my bedroom.

As it turns out, Wendy is a wiry Caucasian, grey-streaked hair. What looks like a small build belies the strength in her hands when she helps me to come to a sitting position on the side of my bed. The routine she prescribes begins with this particular position. She says it is the most important exercise I have to do, so I must do it religiously, twice daily. It involves forcing myself to cough, as hard as I can. It is quite painful the first few times. It takes some effort to sum up the courage, because I worry that I might disturb the surgical wounds that need to heal, tear the stitching. Of course, the fear is entirely unfounded. Basically the coughing shakes things up from the throat down to my intestinal system, and it helps the cuts to heal properly, and avoid the soft tissue sealing into hard scars. The action also pushes at the muscles, tissue and flesh that, quite naturally, have clenched and tightened with the invasion of Samra’s scalpels; the coughing helps everything to ease, relax. Coughing is exactly what I need.

Post-op in Singapore, November 2019, with Bhaskaran
Nair, the best man at my wedding.

The rest involves simple exercises — walking, standing on tip-toe, half-squats. Wendy walks by my side at first, one arm wheeling the tower that holds the bags of medicine and food that connect by tube to various parts of my body, the other keeping a firm hold of my arm as I step and walk tentatively. I am shocked at how weak my legs have become because of all that bed-time.

But I need to get out of there, leave it all behind, go home to heal, sleep beside my wife, watch TV, wear a sarong instead of hospital gowns — the everyday things you come to take for granted — so I add to my exercise routine. Of course, I check with Wendy if it’s OK to do more. Absolutely, she says. “Just remember, a little pain is good, and it’s natural, after what you’ve been put through. You should know when the pain is too much. And don’t exhaust yourself. Go for it.”

In two days, I am wheeling the tower myself, the physiotherapist doesn’t have to hold me. I am determined to get out of here as fast as possible, and it fires my discipline and diligence: I do my sessions three times a day.

With Samra’s nightly visits, I always sense a new presence in the room even when I am sleeping. Samra’s most repeated question is: “Have you passed wind?” Apparently, it’s the first sign that the healing is coming along well. When it finally comes, late one night about five days after surgery, I let out the longest fart of my life. It lasts 10 seconds, at least. I imagine the whole ward can hear it. I put out another APB on WhatsApp: “I farted.” When I report it to Samra, he says it means I will be discharged in days. The real party is yet to begin.

*****

Having passed that little pit-stop, the astronaut food is jettisoned and I move to porridge, oats, the softest-possible noodles Helen can cook. Two days later, I am allowed to return to coffee and a bit of dairy milk. It coincides with a morning visit by Arun, who does the honours at the cafe on the ground floor and brings up a flat-white, no sugar. That first sip is pure pleasure, and Arun films the moment on his camera, and shares it with me. I still have it on my phone. The smile on my face after that first sip is not an act. It’s up there with the fart-milestone. I am getting better. I am healing.

  KL, 2012: From left, Leslie, Surinder, Helen and I.

My cousin Leslie visits almost every day. He tell me he’s expecting me to come for Christmas eve dinner in his home in Petaling Jaya, just outside of KL. “Here’s hoping,” I say.  “No, no, no. No maybes, no nothing. You’ll be fine, OK. You’re coming and that’s it.” Leslie’s Christmas eve dinners are legendary, even for non-family. Helen and I always get the only guest room in the house when we return to Malaysia. For Leslie and his wife, Surinder, their home is always open to us. It’s the best place to be on Christmas eve in KL. About 2am on Boxing Day, sitting among the merry stragglers, I’m often playing guitar to people who actually listen, or hitting a plastic pail for my own tabla while someone else sings. I can take a few steps to my own room later, have a shower and just crash. Leslie’s insistence that I will have the guest room again next Christmas is his way of telling me I’ll come through this on top.

Every day, a lady in uniform from the kitchen visits in the morning and hands me a little form, on which I tick my preferred food. Today’s form is different. It doesn’t say “Light Food Only”. Suddenly, I can choose pasta, a tuna sandwich, a meat sandwich, vegetable lasagna or, Oh! My Goodness!, Chinese-style stir-fried chicken, white rice and mix vegetable.

Dinner is delicious when it arrives, I eat it all, and the aroma lingers for hours in my room. I’ll never forget the look of that meal, the bite-size pieces of boneless meat in a rich mix of thick black sauce and rice wine, the veggie. Of course it leaves me with a bit of abdominal discomfort, but it’s worth every pin-prick of pain, every cramp, feeling all bloated.

D-Day Minus Two, and Wendy takes me for a walk to the fire escape. By now, we have become close. I have told Wendy about all Helen has gone through, losing her three sisters, and then moving into caring mode again because of me, no time to breathe, no time to grieve, no rest for the loving. I tell her about how I hide my symptoms because I just can’t do it to my wife. Tears fall as I talk to her in that stairwell about the last few months. I have to show her I can do three flights down and then back up. Take your time, she says. I pass with no trouble at all. As she says ciao for the day, Wendy is also emotional.

The next day, Nigel puts me through my last test and, if I “pass”, I’m home free. It’s very simple. Drink 750ml of water in 10 minutes and go down to a section where they immediately do a type of abdominal scan that allows them to see how my body channels the water in real time — no X-rays are involved. The process measures the time it takes for the water to descend to the bladder. The doctor who conducts the test gives me the thumbs-up with a big smile, knowing she’s given me my ticket home.

Back in the ward, the discharge procedure takes forever. Checks by all the doctors, prescriptions handed over, packing, checking I’m not leaving anything behind. When it finally comes, the head nurse has to go over all the medication I need to take home, noting what has already been administered for the day. She returns all the medicine I came in with, which they had to confiscate because all medication and treatment may only come through the hospital, not from previous prescriptions. She wishes me well on my journey through unsupervised care and recovery.

I look at the box of medicines. Something is missing in this checklist, the one medicine I detest most because it reminds me that life will never return to the normal I crave for. “So, I guess I’ll keep administering the insulin for my diabetes, using the diabetes pen?” The nurse looks at me, confusion showing on her face. She is flustered, momentarily at a loss for what to do, wondering if she’s made a mistake. We look at each other. I know I look worried. “Bad news,” I immediately think. I’m just confirming the bad news.

“Just give me a minute, Mr de Cruz,” she says, “and let me consult the diabetes doctor’s notes.” She leaves the room and is gone for a few minutes. “Mr de Cruz,” she says on her return, “we stopped giving you insulin these last three days.” I am confused. No, bewildered. Make that confounded. I dare not say, You must be mistaken.

“The doctor says your insulin levels have returned to normal,” the head nurse continues. “Your pancreas is producing all that you need. You are no longer diabetic. But your endocrine doctor will check to confirm everything, and he’ll advise you. Until then, you won’t have to administer insulin yourself. But it’s probably a good idea to keep recording your blood-sugar levels.”

The idea I may be free of D-T1 is almost incomprehensible. But there she is, the head nurse, and she is saying exactly that. GPs, surgeon, oncologists… everybody and everybody else have said I will be on insulin for the rest of my life. This is not just something I have not prayed for. This is something I never believed I could pray for.

As Helen and I take in the news, we can both sense the apprehension in one another. We can’t accept it as given, that it’s over, that the next few weeks will only be about anxious monitoring. It’s about 3pm when all the papers are signed. As we head to the lift, and I say my goodbyes to the nurses at reception, a voice comes through, from a secluded little room I have not noticed before. It’s my physiotherapist. Wendy comes rushing out. “Were you going to leave without saying goodbye?” she says, grinning. “Good luck, darling. You’ll be fine, don’t you worry.” Big hug.

Helen and I take the lift down, decide that I will need something to sustain myself over the hour or so of peak traffic ahead. We stop at the hospital cafe, for a pie and coffee, one sugar, my first proper test on this new path. It’s only a snack in a public place, but it’s momentous.

By the time we get home after the long drive, it is all I can do to wash the hospital off me, get into a sarong and crawl into bed. I simply cannot think about this. I am too exhausted to even think of the possibility that D-T1 might return to contaminate the precious life that has been returned to me. As that cardiac surgeon has put it, I can’t control it, leave it, don’t think about it.

I continue to prick my fingers and test my blood-sugar levels, at first before and after each meal, and later, only in the morning and night, after the OK on the endocrine hotline. Each reading is carefully double-checked by an ever-watchful Helen and we meticulously note every number in the the other Moleskine Leslie has given me — red, Woodstock-edition. The readings are consistent. Every few days, we telephone in the results to the endocrinology department at St George, reading out the details as someone on the other side notes it all down for the doctor. As far as we tell, the numbers show normal blood-sugar levels.

About one month after my discharge, the last station is a consultation with the endocrinologist from Malaysia, the same young man who breaks the news to me that night in ICU, as I groggily return from the edges of the diabetic ketoacidosis coma. He looks at all the notes Helen and I have made of my blood-sugar readings over four weeks. “Let me double-check,” he says, as he rolls his office chair to the desk. He looks at his PC. He looks intently up and down that monitor, scratching his cheek as he goes. He whistles, turns to me. “Mr de Cruz, you no longer have diabetes. In all my years of practice, I have never heard of it.”

“Are you sure?” I say, immediately wishing I have not given voice to the words that speak to the possibility they have all got this wrong. “Yes,” he smiles, “I double-checked.” He points to the PC. I note long fingers. The bugger is actually beaming. “You’re free to go. And,” he laughs, “I hope I don’t have to see you again.”

“You mean, unless we bump into each other in a pub, and I shout you one?” He laughs.

“Doc, thank you, thank you, so much.” And there it is, again, another man of science speaking of the one thing that cannot be substantiated and authenticated by science, empirical data, peer-review. “It’s not me,” he says.“It’s the man upstairs. You should thank God for this.”