After I had the nasal swab and was given a bed in my own little room in the emergency department, things progressed only slowly. My emergency was not a life-threatening one. Various subsets of a crew of four women, a nurse, a senior doctor, the main doctor and a trainee doctor, kept coming into the room, doing this and that to me while I was anxiously awaiting the results of the Covid test.
The nurse tried to test me blood for oxygenation. I don’t know if she was successful. Drawing venous blood is easy and relatively painless. Drawing arterial blood is a pain. I don’t do well with needles in the body in the first place. When the nurse kept pushing and digging to find the artery, I threw a bit of a hissy fit. It was the most painfully uncomfortable experience I’ve had in a long time.
Then they did an ultrasound. This gave an explanation to an observation the doctor had made during the initial examination. My right lung sounded dull. There was not much air flowing. This explained the shortness of my breath and was in turn was explained by what the ultrasound revealed, a lung surrounded by liquid.
There’s always some liquid in the pleural sac, which covers the lung. This smoothens the inflation and deflation of the lung during breathing. When there’s too much water, it keeps the lung from inflating and pumping enough air. The pleural sac of my right lung was filled to the brim with liquid. This was confirmed less than an hour later by the most efficient CT I have taken so far, but the next step was already clear before that.
“I need to do a thoracentesis”, the doctor said, or would have said, had she spoken English. Maybe she would have used the term needle decompression. I would have been none the wiser, since I had never encountered either term before. In German, she said she’d puncture my thorax, which was about as clear as it needed to be. She explained that she’d feed a cannula between two of my ribs, just high enough to avoid my liver, and then drain the liquid as much as possible, largely by gravity. She spoke of 1.5 to 2 liters. I didn’t want to hear or see any more. The knowledge that there would be local anesthesia was enough for me.
It didn’t take long for me to be wheeled down to a temporary patient storage area with small but fully equipped units separated from each other by pale yellow nylon curtains. It’s curious that the meals in the hospital are distributed to the wards by robots, but nurses still push the beds. Half an hour later, the doctor was back, an ultrasound in tow. While I was sitting on one side of the bed, she got to work on my back, using the ultrasound to identify the best pair of ribs to push through. After injection of the anesthetic, I didn’t feel anything. A good ten minutes later, it was all over. The doctor showed me a large plastic bag full of amber liquid and declared the procedure a success. I should breathe much easier now, the doctor said, but not expect miracles. There was still quite a bit of liquid left.
There was no talk about where all this liquid had come from, why it had filled one pleural sac right now, and what might keep it from coming back. This is for a consultation with my oncologist, I guess. I was promised free passage home if I remained under observation for another couple of hours, still in the mysterious patient storage area.
This is when I received the result of my Covid test. I remain negative. My powers of deduction are obviously weak. On the other hand, my betting on corona as the culprit might serve as an illustration of what some call the Holmesian fallacy. You can rule out options for sure only if you know everything about them, and no one does. An hour and a half later, after eight hours on the emergency ward, I was on the bus back to town, not fully restored but in good spirits.
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