Morgan’s hospital therapy involves pounding—hard—on his back and chest with plastic cups. This loosens the phlegm in his lungs so he can cough it out. I augment the morning and evening pounding by hospital therapists with sessions mid-morning and afternoon. It’s done in rhythmic sets on his upper back, upper chest, each side along the ribs, and finally along his middle back while he lies on his stomach. For each area I pound in patterns to pass the time. This work is repetitious and physically challenging. I sometimes need a change of clothes after a session. But the variation in movement over the surface of upper back, upper chest and sides, as I aim to loosen phlegm in as broad an area as possible, defeats my efforts. The moments drag, the Seinfeld dialog in reruns on the TV high up on the wall a slow drone beneath the thudding. Except when Morgan’s on his stomach. Here I pound in precise rotation: three groups of eight, left-right, four times, just above the small of his back; then up two inches; then up again, returning to begin the series over. That regularity makes the work pass in a flash. The sound, the rhythm, a meditation, a mantra collapsing time.
At home, the rhythm of his life is shaped by his therapy, 2 ½ hrs. four times a day, with 90- to 120-minute breaks between and a brief 4 AM wakeup to nebulize (inhale a mist) a drug to open bronchial airways before sleeping till 7. Maintaining an absolute rhythm, an unvarying pattern day in and day out, is essential not only to staying well as long as possible, but to his sense of control over the disease.
In hospital, with its shifting array of IV antibiotics in 4-, 6- or 8-hour cycles, amid the visits of various teams—pulmonology, hospitalist, medicine, nutrition, etc.—on their rounds, that control of pattern is nearly impossible. Hospital time, after several days, becomes an expanse of no-time. We lose track, debate, Is this week 5 or 6? Did you come in on a Tuesday or Wednesday? Search for events outside the room—a hurricane, baseball World Series, mall shooting—to locate our place on the calendar.