The old man’s friend
In medical school, during the pulmonary block we learned that pneumonia used to be called “the old man’s friend.” Why? Because before the days of antibiotics it almost inevitably led to the peaceful demise of elderly men. Well, I had pneumonia last month and it sure wasn’t peaceful, and it sure wasn’t my friend. Happily, that must mean that I don’t yet qualify as an old man. Or maybe my particular strain of pneumonia missed the lecture. Anyway, for whatever reason, it was hell. But I guess I shouldn’t complain since, as the alert reader will deduce, I survived.
It began when Ari, my younger grandson, came down with a severe upper respiratory infection. He had a fever and cough, and was really knocked for a loop. A few days later, as Ari was recovering, his dad inherited similar symptoms. And then it was my turn. We all tested negative for Covid multiple times. Joey spiked a high fever and was really sick. Similarly, I had a fever, dry cough, body aches, and lost all energy.
Joey recovered and returned to work, but my symptoms persisted. Then, disturbingly, my coughing got quite a bit worse, and my pulse oximeter said that my blood oxygen saturation was quite low. Finally, despite my reluctance Annie, persuaded me to go to urgent care (yes, it’s true–doctors indeed make the worst patients). The nurse practitioner said my lungs were clear and agreed with me that this was a persistent viral URI (I suspected it was RSV– respiratory syncytial virus). She prescribed a bunch of cough remedies that, also from lectures in the pulmonary block, I knew were worthless. But out of desperation I still got them. Of course, they didn’t help.
By this time I couldn’t lie flat in bed. So I slept in the old green recliner in the living room, getting up frequently to catch my breath and slowly wander around the house. For several nights I was coughing every 30 seconds or so for extended spells. I lost my appetite, a lot of sleep, and nine pounds.
The coughing got yet worse, and my oxygenation went further south. So with Annie’s encouragement (well, insistence) I went back to urgent care. This time another nurse practitioner ordered a chest x-ray: I had a dense left lower lobe pneumonia. Now I knew why I felt so sick! She ordered an antibiotic, but I suspected that it was inappropriate for my situation. Fortunately I’m still in touch with a good buddy of mine from medical school who is board-certified in both pulmonary medicine and infectious disease—what could be a more perfect background! He suggested another antibiotic, which I forwarded to my internist, who agreed. So after a day on suboptimal therapy I began curative treatment. Of course I didn’t respond instantly, and realized that I was short of breath virtually all the time. Annie managed to track down an oxygen concentrator, which delivers extra oxygen through a nasal cannula. What a difference that made! It was as if I’d been thirsty for weeks but no matter how much I drank, I still felt parched. As soon as I started the oxygen, though, my thirst was finally quenched.
The antibiotic kicked in after several days, and I gradually improved. My oxygenation crept back to normal, and I weaned myself off the concentrator. Finally my cough abated, and I was able to sleep in my bed for the first time in three weeks. I guess it turned out that the antibiotic, not the pneumonia, was my friend!
Strangely, one of the most memorable things about this illness was my change in eating pattern. For breakfast, for example, rather than my usual pot of tea I couldn’t even finish a single cup. And curiously, though I always drink my tea black, during this illness I regularly added a bit of milk. I also took much smaller portions of food than usual, and often didn’t finish what was on my plate. Even at the time I felt some pleasure in simply stopping when I felt full rather than being compelled to finish every bite and every sip. Eating and drinking thus became more mindful. Though I’m trying to hold on to this healthier approach to nutritional ingestion, it’s already slipping. I suspect that in a few weeks I’ll be back to my regulation pot of black tea and will automatically consume everything on my plate. A pity.
In the midst of my illness, up much of the night with perpetual coughing and shortness of breath, I longed simply to feel normal. So now, weeks later when I finally just about do, I’m incredibly grateful. As is true for many people who have made it through a close call or a serious illness, I treasure every day I’m alive, and profoundly appreciate what a gift it is to be healthy. In that sense the pneumonia was my friend after all–not because it did me in, but because it didn’t. It gave me perspective on my life in ways I couldn’t have appreciated had I not been sick. But what takes the edge off this euphoric feeling is the near certainty that these feelings will wear off. Just as my eating habits are reverting to my pre-pneumonia norm, and just as my earnest New Year’s resolutions seem always to go by the board.
I wish I had a formula for how to hang on to my appreciation of how sublime it is to be well. Maybe from time to time I should make a habit of drinking only a single cup of tea (with milk, of course) and eating just a half a slice of toast for breakfast to remind me of how sick I was, and thus celebrate my glorious return to health.