There were eleven signs in the ultrasound room. This is an impressive number for such a small space. Three of them were just covered in phone numbers, and the rest reminded you to wash your hands and similar hospital procedural stuff. Most I couldn’t even read because the light in the room was dim, so they were of questionable use.
I am sure it was eleven signs because I counted three times, which was the reason the lab technician walked in on me with my pants off.
To be clear, she told me to take my pants off. And then lay on the table and put a towel over my underwears. Instead, I had taken my pants off and was standing around counting signs.
So after she came back into the room with an exclamation of ‘Oh!’, I quickly scrambled up on to the bed and threw the towel over myself. She sat down at the machine and grabbed something that looked like a ketchup bottle you’d find at a diner and squirted a clear gel onto my left leg.
“Do you do ultrasounds all day long?” I asked her, which in retrospect sounds a bit like asking her ‘do you come here often?’ First the pants, now this. Jerk.
“Yes, here in the dark all day long,” she said. “But everyone comes in with something different. Keeps things interesting.”
I decided to shut up and let her work, instead studying the back of the ultrasound monitor, which looked like it had been installed upside down. Someone had written on it with a black marker, probably some sort of inventory number. Surely the hospital could afford a label maker?
I watched her as she worked, eyes focused on the screen and both hands working in unison. Her right hand moved the scanner around on my leg, and her left clicked and typed. A round clock on the wall made a satisfying tick-tock sound.
Scan, click, type. Tick-tock. Scan, click, type. Tick-tock. She smeared the gel all the way down to my ankle and back again. Eventually she broke her focus on the screen and looked up at me.
“Ok, so I found something,” she said.
I had been thinking about signs since the day before I found myself lying pantsless in the ultrasound room. Thinking about how they are everywhere, some obvious tangible ones like the red Stop sign on the street corner, others so small you could miss them, like someone’s body language that’s subtly telling you what they really think.
It’s those ones we miss that I was thinking about the most. Sometimes it is impossible to pick up on all of them. Other times we see them but choose to look away because we don’t like what they are telling us.
It was mid afternoon and I had decided to walk to the shops. As I got up from the chair where I’d been working, I felt pain in my calf. This was odd, a pain that came on out of the blue.
I usually know when I’ve hurt myself doing something stupid or risky or just overindulging in some form of physical activity. And while I had gone for a run the night before, aside from running into a curb in the dark the run was a good one. I didn’t pull up lame at any point, after the run I was fine, and I was feeling good in the morning.
So the pain in the calf was a mystery. I wrote it off to a combination of my encounter with the curb and to being old, and hobbled around for the rest of the day.
Later on I was in bed reading. I came across a story about a medical study that found that cells in the body go through molecular changes as you age. The interesting part about the study was that the changes didn’t happen gradually as they expected, it was more in chunks. The first time is around the age of 44, the second happens at sometime in your sixties. And when describing the changes in your forties, the story mentioned - among other things - a greater susceptibility to thrombosis. I had heard of thrombosis. It was a thing that happens when you sit for too long in airplanes. Something to do with swollen limbs and killer blood clots.
I thought back to the last time we went on a long flight, 14 hours from Melbourne to Los Angeles. My feet had swollen so much I had to take off my shoes. That was terrible, because it forced me to walk around the plane in my socks, which is a perilous endeavour if you value your socks like I do.
Thinking about that, I fell asleep.
I woke up with my leg throbbing in pain. Strange. My leg wouldn’t throb if I’d pulled my calf running into a curb in the dark. A sign.
Thrombosis. ‘What’s thrombosis?’ I typed into ChatGPT. It was 1 am.
‘A blood clot in a vein or artery. Often forms in the legs.’ Tick.
It went on to say that venous thrombosis is bad. Arterial thrombosis, really bad.
‘Symptoms of venous?’ I asked.
‘Swelling.’ Tick.
‘May occur suddenly.’ Tick.
‘Pain that feels like cramping.’ Tick. More signs!
‘Calf feels warm to the touch.’ I’d been lying in bed. Everything’s warm.
I was wide awake now and sat up, rubbing my leg.
‘Causes?’ I typed.
‘Extended immobility.’ I had been sitting in my chair for a while when I first noticed the pain.
‘Damage to the blood vessel walls.’ Maybe I damaged blood vessels when I ran into the curb? That didn’t seem likely.
‘Cancer.’ Don’t think so?
‘Pregnancy.’ Not a sign.
‘Obesity.’ I’d like to think not, though I did recently start buying pants with a 31 waist instead of 30.
‘Smoking.’ Nothing outside of meats and line drives.
I shouldn’t be susceptible to thrombosis, I sniffed. Though I also shouldn’t be susceptible for gout either, but I’ve spent a night or two rolling around on the floor while trying to keep my big toe from touching anything or the wind blowing on it wrong.
‘At what point should one,’ I didn’t want to let on to ChatGPT that I was worried about my health, ‘seek medical attention?’
‘You should seek medical attention immediately if you suspect you have a venous thrombosis.’ If the clot gets dislodged, it could find its way to your lungs and you’ll make a bloody mess before possibly keeling over.
My heart was pumping now. Was that the clot? Or was I just freaking myself out?
I decided to try and take my mind off of things by reading something other than health news. I opened up the book I’d been reading to a chapter called ‘The Perfect Host’, which turned out to be about going to parties where the only food on offer is an assortment of dips. Nothing like soothing prose about hummous and baba ganoush to put one to sleep.
Coincidentally I already had a doctors appointment scheduled for the next morning to talk the doctor about another issue. The other problem seemed insignificant as I rode to the doctor’s office on my bike, making sure not to pedal too hard with my left leg.
Just as the appointment was ending, I brought up my calf. I told the doctor about the pain that had popped up the day before. She poked my leg, then measured the circumference of my left and right calves to check for swelling, like a tailor making you a pair of pants.
“I think you should get an ultrasound, to make sure it’s not DVT,” she said. DVT. Deep vein thrombosis.
A few hours later and I was sitting in the waiting room of the imaging centre at John Fawkner Private Hospital.
I could see 21 signs from my chair in the corner, a crazy amount of information. Typical, though, for a hospital. These places always have issues with signage, I knew. My time working in construction included a couple of hospital projects. They would spend hundreds of thousands of dollars on signage consultants, and a couple hours after opening you’d have stuff taped to the wall.
Some of the signs I could not read, and not because of my terrible eyesight. They were A4 sheets with 12 font. That’s not a sign, that’s somebody’s homework stuck to the wall.
One that I could read said ‘Please turn off all Mobile Phones’, which I noticed as I was punching notes into my phone, and also listening to a woman named Carol on the other side of the room. She was having a loud chat with someone on the phone about rescheduling because she’s getting a hip replacement.
The closest sign to me had a barcode and the words ‘We value your feedback’. If I were to scan their barcode, I would provide something along the lines of “Sort out your fucking signage”.
I sat thinking about the sign I’d received the day before. Hopefully it would be as innocuous and ignorable as the sign about mobile phones.
But what if it wasn’t? What if it was the sign on the border between what came before and what comes after? “Leaving the State of Being Generally Healthy”, I could imagine it saying.
“Ok, so I found something,” the lab tech said.
“You’ve got a small clot in your leg. It’s right around here,” she said, pointing to a spot just below my knee.
I poked at it; it felt normal, felt like my leg. “Now what?” I asked.
Stay tuned for part 2, One Night in the ER.
How timely - I just got back (Europe to USA) and was staring at my swollen ankles wondering... if I got up 6 times during my 8 hour flight, walked around, stretched, drank plenty of water (1.5 liters), AND my ankles looked like marshmallow...what did everybody else (who didn't get up even once) look and feel like. Excellent post, Luke! The writing, the cliffhanger ending but most of all the relevance - signs everywhere, some we read, some we don't, some we follow, some we don't...and the nagging, what if I had paid/not-paid attention to them. Thanks for sharing your clever writing!