It Might Get Messy

In 1883 in the morgue deep in the bowels of the Berlin City Hospital (I do not in fact know that the morgue was “deep in the bowels” of the building. I make the assumption for purposes of narrative interest), a guy named Hans Christian Gram was trying to find a way to make bacteria stand out from lung tissue in microscope slides prepared from tissues of pneumonia patients. Gram devised a procedure by which the thick sugar-and-protein cell wall of certain bacteria could be stained purple, via a method that left bacteria lacking the peptidoglycan layer pink. For a long time, Gram staining was a critical method in bacterial identification and description.

Many human pathogens are Gram positive. And many of the most ubiquitous antibiotics work by interfering with the production of the thick layer of sugar and amino acids that characterize Gram positive bacteria. Streptococcus and Staphylococcus are both Gram positive. 

When I was a kid, I had bad lungs. I know that’s not very specific. My lungs definitely were bad. I had chronic asthma, which occasionally erupted into acute asthma, and often tended to devolve into bronchitis, inflammation of the upper respiratory tract. 

Occasionally, the bronchitis would slip deeper and more permanently into my lungs as pneumonia. On the fundamental assumption that my lung infection was of streptococcal origin, at this point Dr. G would start me on antibiotics and send off a swab of tissue for culture identification. Generally by the time the lab results came back, the antibiotics had corralled the infection and I was on the mend, winding down from heavy dosages of norepinephrine, room-temperature apple juice, and weak tea with honey (but NOT with the shot of gin that Armenian-born and Soviet-trained Dr. G recommended, because gin and tea is absolutely disgusting, sick or not), and finally getting some sleep because I could lay almost horizontal without shutting down my respiratory system.

Except one time. My asthma acted up, bronchitis arrived, pneumonia crashed my lungs. Dr. G gave me antibiotics and sent off a sputum sample. I remained drastically ill. Serious difficulty breathing. Increasingly intense asthma. An all-around respiratory mess that dragged on and on. 

The lab results came back. Turned out I did have a bacterial, not a viral, infection. But it was Gram negative. The “normal” antibiotics had no constraining effect on its reproduction. As soon as we swapped meds to one that would wack the cell wall construction of my Gram negative inhabitants, the pneumonia loosened up and I started to recover. Was an uncomfortable couple of weeks.

I was reminded of that incident earlier this week. The antibiotics Dr. K gave me for a possible sinus infection, which treatment had Dr. H’s concurrence, were having no noticeable effect. My throat was swollen, pain was increasing, swallowing was increasingly impaired. In the short term, I kind of thought I’d feel better with the infection knocked back by the antibiotics, and that there would follow a slow increase in throat irritation as the new damaged tissue that Dr. H discovered expanded. 

Instead, my throat continued to hurt for a couple days after the antibiotic prescription ran its course. Then it started to feel better. Less pain. Less disruption. Less blockage. Less ickiness. And definitely less mucous. 

My speech has been responsive to my Arabic exercises. I don’t hurt down in my throat. I got all my pre-operation tests out of the way last week. On Friday I go under the knives for Dr. H to slice biopsy samples from the back of my throat. Until a few days ago, I thought this was an exercise in futility. That there was clearly new tumor tissue sprouting around my mouth, tongue and throat. Now I’m not so sure. I think it’s possible there’s just another nasty sore spot left over from the radiation. The way long time ago radiation.

But that’s where we are at the moment. I’m optimistic. My mouth’s not sore. Swallowing still sucks, but I’m moving back toward solid food, lacking the pain that would justify skipping it. With a little luck, I’ll have a productive week at work, and a negative biopsy on Friday.

That would set me up for a wonderful winter. If I don’t have to be treated again, so that I can continue to reconstruct my professional life with duct tape and super glue, I’ll be happy. And healthy. Er. Healthier. I gotta live with the reality of an impaired oral apparatus. But if it’s not a recurrent malignant impairment, things’ll just be rosy. This week? Set me among the living, and the happy to be alive. And we’ll just have to wait and see what the biopsy results are before we decide which bucket to dump me in next week.