Gatsby's Long Haul

Did you know that one of F. Scott Fitzgerald's draft names for Jay Gatsby was James (Gatz)? I was never a huge fan of The Great Gatsby, but every now and again I can't help but notice my son embodying a meme-like stance of decadence and defiance as he sits and waits, sits and waits, sits and waits. He doesn't have the Long Island Sound to sit and stare at, but our view out the window at Weill Cornell ain't a bad place to wait: we get to see Roosevelt Island, morning NYC sunrises (weather permitting), and all the boat traffic scooting by on the East River. And no, these images are not James taking up smoking; that's a fruit snack. 

Meanwhile, as we wait, we find more and more ways to defy the system while seated. Even if we can't go home, we found a way to get him outside: it's as simple as a wagon ride. Of course, to achieve this we also needed to complain about being cooped up for over five weeks, add a little scientific argument about vitamins and sunshine, and remind them daily how much they take going outside for granted by asking them to tell us about the weather during rounds.

And what magical, mystical, blessed sciences does rounds reveal?

Nothing. Or little to nothing. Or virtually nothing.

They (doctors and nurses) are still confounded. They monitor bloodwork for reduced this's and that's, elevated odds and ends (yesterday, elecrolytes; today, albumin and IgA; "wait and see" for tomorrow's menu...); they still tally his daily pleural chest tube output (seems to be getting a little higher, not a little lower, which everyone says is strange, and means sooner or later they'll start talking about ligations and catheterizations and such, but "wait and see"...); and they still watch James stare them down each and every time they enter the room from behind the curtain (did the Wizard of Oz once say, "wait and see"?...).

This is, sort of, a standard protocol for chylothorax, "wait and see," because there is no steadfast cure, no proven way to expedite recovery, and almost no mathematical or scientific way to determine how long it will take (means, modes, standard deviations can't help us here). And while James seems to be defying even the norm here, letting doctors see virtually nothing as we all "wait and see" the days fly by (today is.... Day forty-one going on forty-two? but who's counting?... Everyone. James has surpassed the majority of patients most hospitals have seen in terms of duration of hospital stay for chylothorax, and he's on track to exceed them all...), it seems we need to embrace the big ideas for any long haul -- patience, steadiness, perseverance. With maybe an occasional dose of decadence, and a healthy batch of defiance.