ENCINITAS — Michael Punaro hallucinated on and off for several hours in a hospital bed following a gallbladder operation. After several days of this, paranoia set in and he was convinced the hospital would harm him.
It’s a scary part of Punaro’s life that eventually became the first 38 pages of his recently released debut short novel “Delirium Intersect.” From page 38 on, the book shifts gears into a fictional, cat-and-mouse crime novel, exploring what would happen if Punaro’s real-life hallucinations were reality. Punaro wants the book to entertain, but above all else, he hopes to alert more people to the phenomenon of hospital delirium.
“Hardly any people know about this, unless they’ve experienced it,” Punaro said. “And even when they have, they don’t know what they experienced and they’re embarrassed to talk about it.
“People don’t want to talk about hallucinations; others will think they’re weird or crazy,” Punaro added.
By writing about his own experience, Punaro hopes to deflate any hang-ups or reluctance to address hospital delirium.
At one point during his time in the hospital, he heard a nurse tapping on the wall outside his hospital room, as if communicating in secret code. He imagined a secret room on his side of the wall where nefarious activities took place. That’s the where the fictional part of his book picks up and takes over.
“Bringing fiction into it is a powerful tool — a way to flesh out and keep the story moving,” Punaro said.
Punaro outlines several effects of hospital delirium in the book, but suggests that current medical studies don’t entirely explain its causes or a cure.
An estimated 7 million people a year in the U.S. experience hospital delirium. As well as being frightening for many, there are significant medical implications.
Episodes can delay patients’ initial condition, extend their hospitalization and increase healthcare costs. Once released from the hospital, the odds of requiring a short-term or long-term stay at a rehabilitation center go up.
They’re also at increased risk from complications like pneumonia and blood cots, according to HELP (Hospital Elder Life Program), a resource that is placed in more than 200 hospitals.
Now retired, though he’d quibble with that designation because, “book promotion is a full-time gig,” Punaro, 78, previously worked in graphic arts and managed publication teams.
Although he has a background in the publishing industry, he’d never written more than a handful of poems, a different animal from long-form storytelling, he said. But Punaro finished his debut book in less than three months thanks to the fact that he “felt so inwardly compelled to do so.” His efforts paid off; he found a publisher for the book about a year later.
“That was an honor, especially in this day and age when getting published is so difficult,” Punaro said.
While Punaro is very serious about shining a light on a topic that he maintains isn’t being talked about enough, his sense of humor and a taste for the absurd can’t be denied. Dressed as one of the characters from “Delirium Intercept,” he recently donned a cape and handed out fortunes to those passing by at the Fall Festival Street Fair to call attention to his book.
And when asked if he’ll pen another book, he answered jokingly: “I don’t know if I’ll write one again unless they take out another organ.”
Surreal as Punaro’s novel and personality can be, his ultimate goal is to raise awareness.
“I’d like them to walk away with a knowledge that there is something out there that really needs looking into,” Punaro said. “And that they take friends and relatives to the hospital, they be aware that there is such a thing.”
To prevent hospital delirium, HELP suggests: bringing a patient’s familiar objects from home, coming to the hospital prepared with all medications and necessities like glasses and hearing aids, orienting the patient throughout the day by speaking in a calm voice and staying with the patient as much as possible, among other tips.
“There’s good information out there, but more research needs to be done,” Punaro said.