First Person

How a Trip to the Hospital Sent Me Into the Dark Recesses of My Own Mind

Last fall, I walked into Sarasota Memorial Hospital under my own power. This is the story of what happened next.

By Hannah Wallace September 9, 2022 Published in the September-October 2022 issue of Sarasota Magazine

It was a Tuesday or a Wednesday last fall when I felt the first stomach pain. I figured I had overdone the previous day’s ab workout, maybe tweaked something on a mountain climber. I’d had countless sports injuries in my life. This was just the universe telling me to spend some time on the couch.

Twenty-four hours later, my appetite dwindled. So it was probably food poisoning. Or gas, or possibly appendicitis. Maybe something related to perimenopause. I had just turned 42.

On day three, I tried going for a walk. Fresh air and therapeutic activity will straighten things out, I thought. I made it to the neighbor’s house before turning around and padding tiny, careful steps back to my door.

My cheap drugstore thermometer never got above 99.9, and my temperature was normal more often than not. After three days, this—whatever this was—didn’t seem to be getting any worse. I didn’t want to make a fuss over something that would just go away on its own.

But when the pain woke me up two nights in a row—a brief but piercing flash of agony that vaporized all other thoughts—the emergency room began to feel like a reasonable option. Tomorrow was Sunday, anyway. Maybe Sunday wouldn’t be too busy.

So, mid-afternoon on Oct. 24, I texted my mother and asked her to take me to the E.R., as she had been suggesting for several days. We drove together to Sarasota Memorial Hospital, and I walked into the building under my own power.

Within an hour, a computed tomography scan revealed a perforated bowel from previously undiagnosed diverticulitis. An infected abscess in my colon had burst through the intestinal wall, sending bacteria into my abdomen and my bloodstream. I needed immediate emergency surgery.

That’s what we knew then. What I didn’t know—nobody did—was that I would spend the next three weeks in the hospital’s intensive care unit, undergoing not one but six surgeries to flush my abdominal cavity, to bypass the damaged section of my digestive tract, to establish a colostomy and then, on Nov. 11, to place a prosthetic fascia of porcine biologic—“pig mesh”—and close a 12-inch incision that stretched from my sternum to my pelvis. Complications over this time included peritonitis, kidney injury, respiratory arrest, prolonged intubation, leukocytosis, malnourishment and C. diff.

I’m told my recovery has been outstanding—especially, people like to add, when you consider the low points. Medical staff and friends alike have since greeted me happily, and then leaned forward to add in whispered relief, You really scared us, or, They weren’t sure you were going to make it.

I was scared, too, but I was rarely conscious. Fevered and under prolonged sedation, I experienced the illness not as a series of procedures that eventually helped me heal, but as a series of endless, convoluted horrors and nightmares. My hospital trauma, as I experienced it, centered on kidnapping, cruelty and murder.

Image: David Junkin

Oct. 24

“Uhhh. Perforated bowel, dude,” I messaged my friend and ice hockey teammate Jenn from the E.R. exam room. If it weren’t for the pandemic, I would have been prepping to join her and the rest of the team at a tournament the next weekend in Fort Lauderdale. I’d been wearing No. 8 for the Gulf Coast Ms Conduct since 2005.

“Are you fucking serious???” Jenn typed back. “OMG. Incoming more drugs.”

Jenn, like many hockey player friends, was a veteran medical professional. Her 20-year career was in veterinary medicine, but the science remained relevant.

“Waiting to talk to the surgeon,” I added. “I don’t care about needing surgery, just worried what the outcomes could be.”

“Depends on the degree, I suspect. I mean, if it makes you feel better, Hattrick perfed twice”—Hattrick was her three-legged cat—“so maybe now you will want to eat erasers.”

I’d been through surgeries before (usually sports-related). And I figured I was fit enough: a longtime devotee of running and weight training, hockey (since I was 25) and soccer (my whole life before that). Despite slowing down with age, I maintained the hubris of a lifelong athlete.

On the other hand, I was also a heavy daily drinker who’d avoided medical checkups for nearly four years. And now I’d delayed seeking attention for this, too.

Maybe I had this coming after all, I thought.

[Doctors’ notes for this story are taken from my 142 pages of medical records.]
 
PROCEDURE:
1. Exploratory laparotomy, sigmoid colectomy.
2. ABThera wound VAC application.
3. Lysis of adhesions 40 minutes.
4. Extensive intra-abdominal lavage.
 
POSTOPERATIVE DIAGNOSIS: Perforated sigmoid diverticulitis with multiple intraabdominal abscesses.
 
This patient is a 42-year-old female who has had abdominal pain for 4 days, primarily in the left lower quadrant. She stayed home. However she did this I do not understand.
The patient tolerated the procedure fairly well. She was taken to the recovery room in satisfactory condition. She will be maintained in the Intensive Care Unit, most likely on the ventilator, until we return her to the operating room for reexploration and abdominal washout.

It felt like I had taken a recreational drug, something kind of pleasant. Invigorating. I was vacationing on a rocky Canadian coastline. There were boat tours.

But the drugs were lasting longer than expected, and the high began to sour.

A boat overturned. The guides, inept, didn’t care to remedy the chaos.

I had been kidnapped, strapped inside a car. I was rescued. I was kidnapped again, tied down, staring out a dark windshield.

Now I was in water up to my neck, trapped under a dock. My cousin appeared, peering below the planks. “Why would you do this to us?” she scolded. “Now, I came back because I thought I should. The rest of them have left.”

Something terrible had happened to a family member—my grandmother? my aunt?—and it was my fault. The boat in the nearby slip was on fire.

Though exact figures vary, delirium is a common complication in critical care treatment, with disturbances in consciousness and cognition affecting between 30 and 90 percent of ICU hospitalizations, especially patients on mechanical ventilation. A 2015 article in the American Journal of Critical Care identified four recurring themes of “ICU delirium”: memory issues (often paired with feelings of guilt); an inability to communicate; disorganized thinking; and fear exacerbated by hallucinations, weakness and being restrained.

After my recovery, a Tampa-based nurse told me that medication side effects and sleep deprivation are among the most common causes of these disturbances. Sepsis, too, can trigger a “chemical cascade” that inhibits blood flow as organ dysfunction progresses.

“With traumatic experiences,” the nurse added, “the brain tends to block out things to protect us.”

Oct. 25

On mechanical ventilation for sepsis and plans to go back to the operating room tomorrow for additional peritoneal lavage, likely colostomy placement.

Discussed with her mother and her father at the bedside. Although she appears very ill, encouraged them that prognosis for recovery should be very good.

My mother called my twin sisters, Kathryn in Raleigh and Elizabeth in San Diego, to tell them what she’d been told—that I would probably be in the hospital “for 10 days to two weeks.” She also texted Jenn, and Jenn texted the rest of our hockey family, including close friends Corinne and Heather.

“When everything looked very bad,” my mother wrote in her notebook later that week, “we were always told that she would respond to treatment and that she was young and strong.”

When I finally got my bearings, I was relieved to realize that I was indeed in Germany, right where I was supposed to be. A hospital in Dresden. Or was it Düsseldorf? Something beginning with D.

The long flight had aggravated my father’s back, and the German doctors were going to perform a procedure to fix it.

They asked if I would like to be examined, too. I had chronic knee problems, after all—a holdover from years of competitive soccer. Maybe the doctors could help.

But, almost immediately, something felt wrong.

“Do you know where you are?” the nurses asked.

“Germany. We’re in a hospital in Germany.” I was sure of it.

“You’re in Sarasota, Florida,” they said.

So now I had confirmation: These people were lying to me.

My problems had all started with an adolescent boy in the hospital lobby. I’d tried to return a card he’d dropped, but it turned out it was for his sister, who’d just died. I’d apparently responded, “Well, that’s one less person to worry about at Christmas.”

That didn’t sound like me.

Regardless, a reality show producer had witnessed my cruelty and pegged me as a perfect TV villain. And now my confusion and unhappiness were being manufactured, filmed and broadcast.

Oct. 27

At this point, the patient has fever up to 104 overnight, on pressors, probably secondary to ongoing peritonitis.

Signs of acute kidney injury. Acute respiratory failure postprocedure.

Oct. 28

Ms. Wallace remains on mechanical ventilation, sedated.  Off Levophed overnight. Eyes closed. Does not respond to stimulation.

At this point, the patient continues to be critically ill.

Sorting through updates from my family and Jenn, my hockey teammate Heather, a physician assistant, called the hospital directly to have a nurse fill in the gaps. “There was talk about the wound not being closed,” she told me later. “There was talk of a trauma surgeon getting involved. All of it made me very worried.”

This damn TV show, I thought.

Now I was on a couch, on the screened-in back porch of a large wooden house. It was pitch black outside. Two people were handcuffed to me on either side. The house was filling up with water.

They’d sunk the whole structure to the bottom of a massive pit.

Silent minutes ticked by. The water rose to our knees. Wires in the house crackled and fizzed.

Now we were being hurried together upward to an attic space, the water pressing in from the other side of the walls. An official with a stopwatch timed each of us to see how long we could hold our breath, to see if we were capable of swimming to the surface. If we made it together, we would win the show’s challenge.

Except I kept gasping prematurely, fighting to breathe and hold my breath all at once. They finally gave up, enraged. I had become a liability. We’d need to be rescued.

Nov. 2

The patient was extremely restless this morning with increase in her heart rate and blood pressure. Remains deeply sedated with propofol and Dilaudid, but with intermittent episodes of alertness and agitation requiring additional boluses of pain medication.

May need to have a minimum of 2 weeks of therapy since the prior surgery. Will depend on the operative findings today. This may need to be extended.

Nov. 3

Continues to have the open abdominal wound. She was noted to be awake, restless but not following any commands this morning on exam. Yesterday, there is a concern that she may have aspirated. She was noted to have some bilious secretions when her mouth was suctioned. Oxygen requirements also somewhat worsened. Noted to have fevers up to 101.7 degrees Fahrenheit. Might require a tracheostomy with anticipated prolonged hospitalization, requiring multiple operative procedures.

The patient is at increased risk for life threatening deterioration.

My parents watched as I tried desperately to protest the mere mention of more surgery. All they could make out was, “Home. I want to go home.”

A physician assistant told my mother, “There’s a chance she won’t survive hospitalization.” Kathryn and Elizabeth booked flights into Sarasota.

Wherever I was, the water persisted, streaming from the ceiling. Relentless humidity. I always felt damp. The reality show setups used a lot of water, which is why this hospital set still dripped and flooded, even now.

Now it was an indoor pool in Las Vegas. At my bedside, a furious woman held live wires from a wall-mounted defibrillator to my chest. My skin smoked.

It wasn’t the dying that was scary, it was the uncertainty. It was the repetition. It was the waking up and doing it all over again.

I woke up.

Now it was a parking garage. They left me in the back of an ambulance filling with carbon monoxide.

Nighttime again. An insulin overdose.

A vial of poison.

Now they were changing the room’s air pressure to rupture a weak spot in my brain. If I survived, I’d never be able to write again. My depth perception already warped like a cubist painting. I wondered who would be able to care for me.

Now it was an elaborate haunted house. Booby traps and optical illusions flummoxed my would-be rescuers.

I kept waking up.

This wasn’t going to stop.

Every timeline attended by an endless swirl of muted scrubs. I threw at least one feeble punch to the stomach of a man who responded, calmly, “Don’t hit me.” He nodded to an older, dark-haired man in a bright red and blue shirt. Now who the hell was that guy? Just some stranger off the street? It’s like they were casting this thing as they went.

Nov. 5

Text from Jenn to the hockey team: “Hannah is still in critical condition. We are obviously in a holding pattern with what we can do, but please do not stop praying and sending all the love. She has a LONG way to go.” Then: “I almost forgot the most important part, a sign from above. She is now in bed #8.” My jersey number.

I woke again as the bed raced through hospital corridors, past ceilings and walls gushing. People shouted over the sound of waterfalls. An elevator door opened, and the water crashed down the empty shaft in spates.

Just like that, the whirlwind ended in a still yellow room, bone-dry, quiet and frigid.

“I’m cold,” I said.

“It’s OK. We’re going to take care of you.”

One by one, the faces of friends, teammates, circled into the light above me. Of course! I’d forgotten how many of them had medical training. They’d all made a special effort to get official access to my case.

As my vision tunneled and the warmth closed in, I felt a proud little thrill, to see them all here in their professional element.

Nov. 9

I had a very long discussion with the mother of the patient, who is currently consenting for her. I explained to her that we are at a damage control mood [sic]. The idea is hopefully we can ... bridge the abdomen with a biologic mesh and obtain a temporary closure. As of now, we have at least a 10 cm fascial defect, even with the help of the Wittmann patch, we still have a very big defect.

Elizabeth first arrived in the ICU days later. “Your face was so swollen,” she later recalled. “Even your eyeballs were swollen. They looked tight and shiny, like they were too big for your eyelids.”

I sat in bilge water, pinned by debris. This wasn’t a house, or a hospital or a Vegas pool. It was the dank hold of a sailboat, bright sunlight outside. The ceiling too low to stand.

“You should know how boats work. Just use the control panel to call for help,” people sneered. But the switches and radio jargon baffled me.

Now I was outside, in the bay, backpedaling away from the boat. A woman on the bow pointed a long-barreled gun in my direction. A flash and an impact in my midsection like a piston knocked the wind out of me, a hot sting in my eyes. It must have blown right through me, I thought. A perfect hole where my stomach used to be, like a cannonball through a cartoon character.

Now I was sinking backward into the dark, and it didn’t even hurt that much. And what a relief, not needing to breathe anymore.

I just wished I could pass along a message. When they find the body, I wanted to tell someone, they need to know it’s me.
 
“Your mouth would sort of hang open a little,” Elizabeth later recalled, “and it's the bit that stuck with me the most, that it was opened but downturned. Your whole expression was like someone had surprised you with something horrible, and your face was stuck like that.”

Nov. 10

Ms. Wallace is seen on rounds today. Showed excellent results. Today she is extubated and talkative. Overall, great results from OR 1 day ago.

She looks towards me when I call her name.

The physician assistant raced down the hall to retrieve my parents at check-in, urging them back, saying, “They’re getting her up!”

When they arrived in my room, I was extubated, sitting on the edge of the bed, following instructions from the physical therapists.

But later, in furious whispers—a voice both disused and conspiratorial—I told my mother that I wanted someone else to consent for me.

“Who do you want?” she asked.

“Not you.” This persecution had gone on far too long. The night before, since no one else was coming to free me (and believing the tubes had melted into my skin), I’d grabbed the I.V. tether attaching me to the bedside machine and yanked out a large I.V. line in one go.

Now the dark-haired man in the red and blue shirt was back. This time I heard him introduce himself as “doctor” something.

“That’s not what a doctor wears,” I hissed.

“This is a soccer jersey,” he said, unfazed. “Hannah, do you like soccer?”

Oh, wait. I do like soccer. Derailed, my mind raced with happy, sporty memories.

He continued: The shirt had something to do with Madrid and Barcelona, Spain’s two most storied teams. He liked one of them very much and the other not at all. They were fierce rivals. But a young relative had given him the shirt, so he wore it for her.
I wanted the story to go on forever.

Nighttime. I woke up in a large, clean vacation house.

“Do you know where you are?”

Gosh, where was this tournament again? “Wisconsin?” I tried. “Or maybe Minnesota?” Somewhere with frozen ponds.

“You’re in Sarasota, Florida.”

That didn’t seem right.

But this weekend’s roster felt kind and familiar. Teammates I didn’t quite recognize attended to me. The house was sleepy and comfortable.

Now it was bedtime, hockey in the morning. I just had to climb out of this deep chair and find my room. I struggled over and up on all fours.

Concerned voices startled me, and for a split second I remembered being told that I needed to ask for help, saw how precarious this must have looked: my climbing the furniture in the middle of the night, gown dangling, bare backside to the world.

The question was more urgent this time: “Do you know where you are?” In a blink, they’d righted me, still in bed, and tucked me warm and secure up to my chin.

“Oh, God,” I said. “Please let it be Florida.”

They finally came to move me out of the ICU in the dead of night. A brief whoosh through icy new corridors, clean and dry and quiet as a museum.

Settled at last into the cozy darkness of my new room, I stared at the wall in front of me for hours, examining what I believed were layouts for a community newsletter: pets for adoption and kosher recipes. Maybe they wanted me to write for it. I couldn’t sleep for joy.

Nov. 13

The patient is resting comfortably.  She has been transferred from the ICU to the floor. She is breathing comfortably on her own.

Abdomen is soft, some tenderness, clean dressings at surgical wound, multiple drains, G tube in place, colostomy in place with tube. Positive bowel sounds.

Mood and affect are appropriate.

I woke to a reassuring bustle and din. Sunlight poured through a window, though I suspected this cruise ship wasn’t actually docked outside Belfast, as I’d been led to believe. The clock on the wall never lined up with the daylight, even when I added hours for European time. At least now the confusion felt benevolent. Rehabilitative fibs.

“I found a sports channel, but all the coverage is out-of-date,” I told my mother and sister. “I guess they do that on purpose, so people don’t get riled up.”

I apologized to the nurses for interfering with their shore leave.

“Oh, don’t worry about it. That’s what we’re here for!” one said, and I believed him. “Do you know where you are?”

Not Ireland. Don’t say Ireland. Not Ireland. Don’t say Ireland.  “...Sarasota?”

“That’s right! Sarasota Memorial Hospital in Sarasota, Florida. Do you know what month it is?”

“Is it September?”

“Close, it’s November.”

What happened to Halloween?

“How did this happen?” the nurse asked. “How on earth did you get here?”

“Oh. I don’t really want to talk about it. It was kind of a—a domestic dispute, I guess.”

This was too lovely a setting, too nice a morning. Too soon to talk about the reality show. The sailboat. The shotgun.

Trays of actual food—a barbecue sandwich and crisp, creamy coleslaw, biscuits and gravy, chocolate milk and protein-packed supplement drinks. Physical therapists walked me to the door and back (a new C. diff diagnosis confined me to the room). A young nurse brought combs and waterless conditioner and spent the last half hour of her shift trying to remedy my matted hair.

One doctor came regularly, an older man with tufts of white hair: the surgeon who had been on call that first night and led the way since. The one who had made that first long cut, combed through the bog of “purulent material” and washed my entrails. Now he sat at the foot of the bed and talked generously about the local theater people we both knew. About all the times he’d seen my father onstage.

The dark-haired man in the soccer shirt returned, too. He was, it turns out, the trauma surgeon who’d been called in, days after I arrived, when it became clear my insides refused to cooperate. Originally from Iraq, he spoke readily about the four nights he’d spent training at the medical center at Abu Ghraib.

“I saw some men, they’d given up. They’d seen the Angel of Death,” he said one day, examining my staple-filled abdomen. “You probably saw him, too.”

And then, still unfazed, he added: “This is healing really nicely.”

Nov. 22

Respiratory failure, resolved. Acute renal injury, resolved. Leukocytosis, trending down. The patient has no new complaints. She is feeling better and wants to go home tomorrow.

Kathryn, via text: “How is Hannah?”
Mom: “Very talkative and stubborn.”

Nov. 23

I was discharged the Tuesday before Thanksgiving. Outside the hospital, my early, speedy recovery gave way to more jagged progress.

I got myself a primary care physician, as well as a team of gastroenterologists who told me they didn’t expect my condition to return. They told me that fiber is my friend, and nuts and seeds are absolutely fine. That a glass of wine won’t kill me, but to “lean away from it.” I celebrated with frozen yogurt.

Because of the hernias, weightlifting isn’t happening, but 10-minute miles are. Hockey remains a "wait and see."

In January, my fingernails grew trenched lines, and my hair began falling out in thick handfuls—delayed effects of malnourishment and trauma. I was hospitalized again with an abscess on my incision and kept for five days with high blood pressure and low sodium. A nephrologist report classified me as both “pleasant” and “tearful.”

I continue most days to field a rolling, low-level panic that peaks with every muscle twinge and stomach cramp. And even now, on the calmest afternoons and most routine errands, I still catch myself wondering if “they” could have noticed some small ingratitude or avarice, and will that offense soon be used against me in the cruelest possible way?

At some point in the coming months, when my medical team determines I’m thoroughly healed, I’ll have to return for more surgery, to reverse the colostomy and repair the hernias. And when that happens, they will open this same long scar all over again.

I don’t yet have a moral for this experience. Things are often good. Things are complicated.

One of my early personal milestones came on Nov. 18 or 19, when I finally felt poised enough to ask for my phone back. My sisters handed it over, fully charged, along with a set of headphones.

During my next quiet moment alone, I soaked in the room: the window casting a bright square of Sarasota sunlight. The informational whiteboard in front of me. The clock on the wall that read 1:24 p.m., just as it should. The warm onset of normalcy.

Then, at last, I scrolled through my phone’s library of playlists and podcasts. I stopped at Lin-Manuel Miranda’s In the Heights, and I remembered how I’d first fallen in love with that show at the Westcoast Black Theatre Troupe’s smash 2017 production. A community singing to one another. I tapped play.

The second song is called “Breathe.” In it, Nina has just returned home, reeling from recent crises and worried about how her family and friends will respond—even as those same loved ones, from the opening notes, welcome her back and encourage her onward:

Sigue andando el camino por
toda su vida
Respira
Y si pierdes mis huellas que
Dios te bendiga
Respira

Keep walking the road for
all your life
Breathe
And if you lose my tracks, may God bless you
Breathe

I swelled and flooded and burst into tears.

Hannah Wallace was a longtime editor at Sarasota Magazine and is now a freelance writer based in Sarasota. Her latest work includes a script for the London-based fitness app Zombies, Run!

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