Saturday, March 1, 2014
“What should we do about it?” I asked for the thousandth time. “I’m not even done with my training. Having a baby was definitely not in my plans. A nice cushy Dermatology fellowship was more what I had in mind.”
“Well you should think about such things next time you take off your pants,” Miss James responded. “I did go to nursing school and it definitely takes two parties to make one baby.”
“So what are you going to do?” I asked again, only leaving the we out this time.
“Well,” she said with ice in her voice, “in about two hundred and thirty five days we, God willing, will be parents to a beautiful baby boy or girl.”
She turned and walked up to the front of the clinic to respond to the bell we both had just heard.
Me, a father? I’m barely a doctor. Well…it could be worse. I’m sure I can figure out a way to be a father with the lovely Miss James and I still be a Dermatologist. I thought I was being clever, telling that murderous Dr. Adams that Miss James was pregnant, but I guess I was clairvoyant.
“Look at this,” Miss James remarked as she placed a package on the table. “It was on the reception desk, no delivery man, no mail or UPS truck, just this package. It isn’t even addressed to anyone. Just this.”
She tilted the package forward and showed me the white label on the top:
“Very strange, strange indeed,” I observed. The package was about two feet, by three feet by two feet, covered in brown wrapping paper and tied with string. It was pretty light; I almost thought it was an empty box.
“Should we open it?” my companion asked.
“I’m not sure…but there’s the bell again. I guess we’ll have to deal with this later. Time to go to work.”
We put the package on the floor behind the table in the break room, not completely hidden, but also not in plain sight. Miss James began all the administrative paper work on out new patient while I took a few moments to look at the offers I’d recently received for Dermatology fellowships.
Southern California looks good, sun and sand…maybe Arizona, no rain, no cold weather…
“Mr. Phelps is waiting in exam room one, Dr. Schlemiel,” Miss James announced, still with a frosty edge to he words.
I hope this doesn’t go on all night.”
I picked up the chart and read about Anthony Phelps. “Fifty one, No Allergies, No Meds, chief complaint: fever and rash.”
Right up my alley.
I knocked and went in and greeted Mr. Phelps with my usual bedside banter, “Good evening, Mr. Phelps, what is the problem you are having today?”
“Hello, Dr. Barnes. Tony Phelps,” he rose from his chair and shook my hand. His grip was tight, a little too tight as if he was trying to establish some sort of hierarchy. “I’ve had a fever for several days, nothing much 99.8, a hundred and I’ve also developed a rash on my buttocks. It is quite uncomfortable.”
“Just on your backside?”
“Did it start as a small area and spread or did it start by covering the whole area?”
“The whole area.”
“Come in contact with anything unusual? Been traveling? Any allergies?”
“No, no and no,” he replied, but he looked around as he answered my questions, as if someone else was listening. Then he added, “I’m usually very healthy.”
“Well, I guess I should check out the culprit. Here’s a gown. Take everything off from the waist down. I’ll be back in a minute.”
“Before you go, Dr. Barnes, I was wondering, were any strange packages delivered here recently. I was told I might find what I’m looking for here.”
“We get things delivered here all the time. Medical supplies, test results, free samples from pharmaceutical companies. What does this package look like?”
“It would be about Yay big,” and he held his hands about twelve inches apart and feel like there was a jar or bottle inside.”
“No, I can’t say we’ve received any such package, at least not that I know of. Now, your gown?”
“The package may have been bigger. I was told it would be here.”
“I’ll tell you what,” I finally said, “you put this gown on so I can finish checking you out and I will check with my nurse about your missing package, OK?”
He murmured an affirmation and I left him alone. I found Miss James checking in another patient and gestured for her to join me. She handed a very large man a clipboard to fill out and then we went to the back to look at the package. It looked smaller to me and felt a little heavier.
“Maybe this is what Mr. Phelps is looking for,” Miss James concluded.
“I don’t know. I get the feeling we’ve been drawn into some sort of international espionage. Maybe it’s a ‘Mission Impossible,’ after all he is Mr. Phelps. I don’t think we should give him the package without some sort of proof that it’s his even if his initials are A.P.”
I went back to check on my patient. He was laying face down on the table, properly attired in his gown. I pulled up the gown to see a cacophony of skin disorders all come together on his buttocks. There were patches of obvious bacterial infections, others which looked like chemical burns, reactive dermatitis, weeping sores and petechial rashes, all limited to his derriere.
“Your buttocks are quite unusual, that is the skin disorder you have is unusual. Are you sure you haven’t come in contact with anything toxic or out of the ordinary? Because, it looks like you’ve been attacked by a mixture of Strep, acid, fire ants and I don’t know what else.”
Mr. Phelps closed his eyes, pulled his gown over his butt and turned towards me. He looked a bit sheepish.
“It’s hard to explain, Dr. Barnes. In my line of work there is the potential to come in contact with a variety of toxins and poisons, dangerous chemical and biological agents. One way to deal with this is to intentionally expose oneself to these noxious materials to build up a sort of immunity or at least a tolerance. I think I tried to do too much at one time.”
“What are you some kind of secret agent or a garbage collector? Well, I suppose it doesn’t matter. I’ll give you a prescription for some antibiotics and some cream to put on your backside. Try it for three or four days. If you’re better, fine, but if you’re not improving, come back. I gave him a prescription for Cipro and another for some antifungal, antibacterial, steroid cream.
“Check out with Miss James at the front and if there’s no improvement come back here or see your own doctor.”
“Thank you, Dr. Barnes. You’ve been very helpful,” Mr. Phelps replied as I escorted him to the front.
I left him to look at the chart of my next patient, the very large man I’d seen in the waiting room, K. Gutman, no age listed, no medical problems, no allergies, chief complaint shortness of breath, blood pressure 180/95. I was about to go when I felt the pocket of my white coat and realized I didn’t have my stethoscope.
Must have left it in the break room.
I heard some rustling and furniture moving as I approached the break room entrance. I stopped and peeked inside and saw a man in a beige rain coat bending over behind the table. When he stood up I saw that it was Mr. Phelps, now holding our mysterious package.
“I’ve been searching for this for years. Never would have thought it turn up in some rinky dink medical clinic in the middle of the city,” he commented as he put the package under his arm.
“Do you think it’s safe for you to just walk out of here carrying that bundle. Don’t you think they’ve been following you?” I answered.
Phelps looked around, up and down, towards the window, inside his coat and then he put the package back behind the table.
“You’re right; they’re probably watching me right now; probably don’t believe that I would come to the clinic with a real medical condition.”
He stroked his chin as he thought, “I’ll tell you what. You keep it here, keep it safe. I’ll give them the slip and then come back for it.”
He didn’t wait for me to answer. He put on a pair of dark glasses and snuck out the back of the clinic. I shrugged my shoulders, found my stethoscope and went back to see Mr. Gutman.
Gutman, that name sounds familiar.
“Good evening, Mr. Gutman, my name is Dr. Barnes. What’s the problem that brings you into our wonderful little clinic?” I began.
“Nice to see you, doctor. I will dispense with the usual pleasantries and get straight to the point,” he replied.
Great. When someone says tey’ll get straight to the point, they usually do everything but get straight to the point.
Gutman was big, rotund, with beads of sweat dotting his forehead. He was dressed in finely tailored gray suit and I detected a slight accent in his voice.
“I’ve been having trouble catching my breath, Dr. Barnes. I first noticed it on the train from Istanbul to Prague. Since then I’ve noticed that I have to stop and rest on a regular basis.”
“Have you seen a doctor before?”
“No, I haven’t have had the time. I frequently have to leave one venue for another on very short notice and doctors have not fit into my busy calendar. Fortunately, my travels have crossed with your clinic and so, I thought I would ‘kill two birds with one stone’ as you Americans so quaintly articulate.”
“Well, it’s good that you stopped here. Your blood pressure is very high and I can see thta you are dangerously overweight.”
“Yes, yes, one of the consequences of living one’s life from hotel to train to cruise ship and back to hotels. One never gets the proper opportunity to exercise or to eat healthily.”
“I think you’ve done a bit too much eating, healthily or unhealthily.”
“Harrumph,” was all he could say so I continued.
“Your blood pressure is dangerously elevated, you have bilateral carotid artery bruits which suggests to me that you are heading for a serious stroke. You have wheezing in both lungs and your legs look like tree trunks. In short, you are a walking time bomb. I recommend you start on a medically supervised diet and medication for your blood pressure. We need to get the results of your blood work also, I’m betting your sugar will be high which means you’re probably diabetic. We can manage your health problems here at the Clinic or you can follow up with your own doctor. But, I would not ignore these medical conditions, that is if you want to live beyond the next six months or so.”
“My dear Dr. Barnes,” he responded, “I am grateful for your concern, but these ‘medical problems’ are mere trifles in the grand scheme of this world. I have been in pursuit of a truly remarkable and valuable treasure and I have followed it to your clinic. I believe a package was delivered here earlier?”
I didn’t answer, but I think he could tell from the look on my face that he was correct.
“This package, sir, is one that I have following for many years. I thought I had finally secured it in Oslo three years ago, but, at the last moment it eluded my grasp, only to resurface in Cairo. My contact there met with an unfortunate accident before he could make delivery. I’ve since chased this prize through every corner of the continent and now it has turned up in your medical clinic. As one can easily surmise, sir, I have spent a considerable sum of money chasing this prize. And, if you were to be so kind as to deliver it to me I would pay you handsomely for your brief troubles.”
I looked at him and saw the combination of greed and desperation in his loose jowls and pig like eyes.
“What, if I may be so bold as to ask, is in this little package?”
“A magnificent bird, fourteen inches tall, made of solid gold and bejeweled with perfect diamonds, emeralds, rubies and sapphires. It was a gift to the ruler of the Ottoman Turks in 1647, but was lost in 1800. It reappeared briefly in London in the 1820’s and also was held by a private collector in Paris some years later. It was taken by the Nazi’s during the occupation and was thought lost forever, a victim of the war. It was only after the fall of the Soviet Union that it resurfaced, first in Moscow, then Budapest.”
“This bird manages to make it all over Europe,” I commented. Gutman only raised his eyebrows slightly at my remark.
“I have it on very reliable information that the package which was delivered, quite mistakenly, to your clinic is the priceless falcon. And now, Dr. Barnes, I will take that package. If you would be so kind as to bring it here.”
I was staring at a pistol.
Why do I feel Like Humphrey Bogart? Give him his package; it’s probably a fake anyway.
“OK, OK, I’ll get it for you. It’s been nothing but trouble since it arrived anyway. Don’t forget, however, that you need to look after yourself. Remember, if you don’t have your health, you don’t have anything.”
I went to the break room and found the package behind the table where I’d left it. As I started to bring it to Gutman, Miss James stopped me.
“Where are you taking our mysterious box?” she wondered.
“Mr. Gutman says it belongs to him and he has a nine millimeter handgun that makes it difficult for me to argue.”
“Oh,” was all she said. “Probably for the best anyway. It has been nothing but trouble.”
I picked the box up and noticed that it was much heavier than I remembered.
Solid gold bird would be pretty heavy.
I started to hand the box to Gutman who was sitting on the exam table. He had more sweat on his forehead and his head was bent down and he was struggling to breathe. The pistol was hanging on two fingers and crashed to the floor followed shortly by Mr. Gutman.
“Mr. Gutman…Mr. Gutman, can you hear me?” I asked. He was still breathing and his eyes were looking around the room as if he was trying to remember where he was.
“The bird,” he whispered, “do you have it? May I see it?”
“I have the package here. I’ll put it in your arms,” I answered. I gently lay the package across his chest and folded his arms around it. He held it tightly to his chest and a smile graced his face.
“At last, at last, after years and years of …” his voice trailed off.
Miss James was already there with the crash cart as Kasper Gutman breathed his last breath. We performed CPR and the ambulance arrived, all to no avail. With considerable effort they managed to get him onto a stretcher. I even thought we had brought him back, but then he went back into V. Fib and then asystole.
I put the cursed package back in the break room and then filled out all the paperwork which is required if someone dies at the Clinic. The Coroner’s assistant arrived and carted Gutman away and that was that.
“Anyone else waiting Miss Ja…?” I started to ask but was interrupted by a person dressed in black medieval armor, holding a long, shiny, sharp sword gracefully pointed at my heart.
“I will take the Grail,” the muffled voice commanded.
“Grail?” I asked, my voice filled with confusion.
“The Holy Grail. I saw it delivered here today. I’ve been on a quest to retrieve it for years and years. Now, young sir, you shall deliver it to me or suffer the consequences. Perhaps,” he mused, “I shall run you through just for the sport of it and then take my prize anyway.
They don’t pay me enough for this.
“I’m sure I don’t know what you are talking about. This is a Medical Clinic. We take care of sick people here. We don’t have any grails.”
He pushed his sword against my chest, then raised it above his head as he prepared to run me through. As his arm moved forward and I closed my eyes I heard a loud “CLANG” as metal struck metal.
A second knight, this one clad in silver armor had appeared.
“Forsooth and avast, ye wicked Black Knight. You shall never possess the Holy Grail as long as I can draw a breath,” the Silver Knight shouted.
Avast? Don’t pirates say that?
My attention returned to the ensuing battle.
“Sir Lancelot, you are more relentless than I imagined. But the Holy Grail shall be mine.”
Swords clanged together as the two knights battled from one end of the clinic waiting room to the other. Chairs were slashed, potted plants upended and magazines strewn about.
A very large woman came in as the sword fight raged. She walked past the two knights, ignoring the combat, to the reception desk.
“Ya’ll open?” she asked in a very demanding voice. “Cuz my back is killin’ me and I can’t get no sleep.”
I stared at her and then at the two combatants and then back at her.
She saw the confused look on my face, but went right on talking.
“Listen up, Dr….Barnes,” she stared at my ID badge, “When I’m talkin’ to you, you pays me propa attention. That Fightin’ goes on all the time in this neighborhood, but I’sa hurtin and you got’s to do somethin’.”
I turned my attention to her. “Certainly, Ms….”
“Angelina, just like Angelina Jolie. Angelina Babbett. Like I was sayin’, my back is sore like someone’s stickin’ a knife.”
“OK, Ms. Jolie, I mean Babbett. Fill out these forms and we’ll get you right back.”
She took the clipboard and sat down while Lancelot and the Black Knight fought on. The clanging of metal mixed with Ms. Babbett’s murmuring as she answered the pages of questions. Every time a chair was knocked over or there was an especially loud crash she looked up and gave the knights an especially dirty look. Finally, she couldn’t stand it anymore. She jumped up from her seat and rapped the Black Knight on his helmet with the clipboard. The fighting stopped abruptly as both surprised Knights stared at her.
“You two good fo’ nuthin’s get yo asses out o’ my way. My back is killing me and I canna get this here paper filled out with all that there racket. You got fightin’ to do, you does it outside and leave this here clinic fo’ the sick folks.”
I approached Lancelot.
“I’ll keep it safe for you, right here. You go battle the Black Knight and defeat him and then you can come back for the Grail.”
“Excellent plan, young doctor. But, be sure to keep it safe or it shall be you I will pursue.”
“I promise I will treat the package with all the respect and care it deserves.” And I opened the door and ushered him out. The Black Knight had already made his escape and when Lancelot saw his adversary riding away he made a hasty exit and mounted his armored horse.
“Au revoir, good Doctor,” he shouted as he rode away.
I have to admit it was quite a sight, two men in full armor, each astride an equally armored horse, racing down the street with swords raised, illuminated by the pale light of the street lamps. I turned away, shaking my head.
This box…this mysterious box. I don’t think I want to know what’s really inside. It’s going to get us killed.
“Miss Babbett is waiting in room one. I suspect a shot of Dilaudid will send her on her way,” Miss James reported from the doorway.
I looked again towards Lancelot and the Black Knight as they faded into the night and then turned and headed back into the clinic.
“Do you think we should open it?” Miss James asked.
“Perhaps,” was all I could say. I thought for a few more moments. “I think I know what we would find inside. We would be disappointed.”
“Do you think it’s empty?” she wondered out loud.
“I think it’s full and empty and everything in between.”
“Please, don’t speak in riddles,” she replied.
“I have no choice because that little package is just that…a riddle. ‘A.T. to A. P.’ is a riddle. Now, I’m going to see poor Miss Babbett and maybe you can solve the riddle while you’re waiting.”
Before I could escape to the exam room a quartet waltzed through the door, an unusual group, even for the Clinic.
“If you please, sir, I believe there is a package here that would be of great benefit to us,” said the little girl.
Why am I not surprised.
Standing at the reception desk were Dorothy, The Scarecrow, the Tin Man and the Cowardly Lion.
The Scarecrow explained, “We’ve been following that box all the way from Oz. It’s the only thing that will give me a brain or the Tin Man his heart…”
“Or me my courage,” the Lion chimed in.
“And it will help Dorothy find her way home,” the Tin Man added.
“Now wait a minute, wait a minute,” I replied. “I do believe that the Wizard was supposed to have granted all your requests.”
“The Wizard? You mean the Charlatan,” Scarecrow answered. “Do you really believe that a fake diploma from some fake ‘university’ qualifies as a brain? I was laughed right out of the cornfield when I showed it to one of the crows. That crow said he was smarter than me and stole all of my corn just to prove it.”
“And that heart?” the Tin Man added followed by a sigh. “I was so careful with it, Kept it around my neck right over my chest. Five days after he gave it to me it started running backwards and then it went ‘Fhht’ followed by complete cardiac arrest, if you get my meaning. If I was dependent on it to pump blood I’d be face down in the gutter. Hmmph, how could I be duped to think a two dollar drug store clock is as good as a Jarvik seven.”
“That medal was nice,” The Lion said in a soft, almost embarrassed voice, “although it hurt when he pinned it on.”
“Yes, yes, very nice and what did it get you? The first time you tried to stand up to another beast they laughed and that was just a squirrel. What did you do?” Dorothy asked.
“Please, don’t tell, don’t…”
“He runs away and hides in the bushes; some courage. And, I guess it’s clear that I am not in Kansas, Dr….Barnes.”
“Yes, this is definitely not Kansas. Just what makes you think that this box you’re looking for has all these things which you desire?”
“It must, we were promised. I sold my ruby slippers to get what’s in that box. The man promised.”
“Someone from around here?” I surmised.
“Yes, he had a black coat and an ID that said he was from the government and would help us,” she answered meekly.
They can have it, the stupid box. It’s been only trouble.
“Well the box is here and you are welcome to it. Just wait here and I’ll fetch it for you.”
I went to the back to retrieve the troublesome parcel. I looked behind the table, but there was no box. I looked under and around and over every nook and cranny: no box. I went to find Miss James, but she had no idea where the box disappeared to.
Miss Babbett was standing in the doorway to the exam room and saw us searching high and low.
“Looking for something?” she inquired.
“There was a package back here, wrapped in brown paper about so big,” Miss James explained.
“You mean that there stinky box that was in that room back there? I throwed it away. I couldna’ stand the stench, almos’ made me to vomick. It’s in the garbage dumpster. Now what about my back?”
“I’ll be right back and take care of you,” I said as I ran towards the back of the Clinic.
It was getting late, almost 5:30 and this was garbage day. I heard the roar of a truck in the alley and ran outside just in time to see the garbage truck driving away. I peered over the edge of the dumpster and saw only a few dirty rags which had clung to the bottom. I went back to inform Dorothy and her companions.
“I’m terribly sorry, Miss Gale, but the package you are seeking is gone. It was inadvertently thrown away and now it’s on that garbage truck which you can see down the street. I pointed to the truck and,before I could say another word, the four raced away after it. I went inside to take care of Ms. Barrett just as a big RV pulled up. There was a colorful logo painted on its side:
JASON and the ARGONAUTS
I’ve heard of them, some sort of rock group.
A solidly built young man emerged from the door on the RV’s side and came inside.
“I’m Jason, lead singer for the Argonauts. I was told I might find something here, something I’ve been searching for…”
I stopped and stared into his eyes. He was tall with blonde hair and a dark complexion.
“If you’re looking for the Golden Fleece you are about five minutes too late. If you hurry you can probably catch it. It’s in that garbage truck you just passed. Just look for a truck being chased by a little girl, a scarecrow, tin man and lion.
“Thank you, doctor.” And he turned and walked out.
I went back to the exam room to tend to my patient.
“That ther’ box sho did stink. Almos’ made me fogit about thes here back pain. But, now it’s a throbbin agin. Musta bin some sort of dead possum or rottin’ trash in thet package.”
“How long have you been having back pain, Ms. Barrett?” I asked, trying to focus on her problems.
“Wha was in thet ther’ box anyways? Do you knows?” she wondered.
I stopped and thought for a moment, staring off into the distance.
“Dreams, Ms. Barrett, lost and unfulfilled dreams,” I replied in a soft voice.
She looked at me as if I had lost my mind.
“But, for you, I think a shot of Dilaudid will work just fine and then you can follow up at the Back Clinic over at County Hospital.”
“Demerol woks better,” she interjected.
“Seventy five IV.”
Miss James gave her the medication and we sent her on her way.
Afterwards it was just the two of us alone in the Clinic.
“What are you thinking?” although I didn’t really need to ask.
“That box; so much hope wrapped up in a plain brown wrapper. Do you think any of them will ever find what they are looking for?”
“I suppose they’ll all find something and, in the end, they will probably be disappointed. It’s the anticipation of something better which keeps us going. How often are we let down in the end? But, back to ‘A.T. to A.P.’ What is the answer?”
“You keep thinking about it, Dr. Barnes, that’s what you’re best at,” Miss James commented, but then she patted her belly. “Well, I have to admit, you are good at a few other things, too.”
Saturday, February 15, 2014
This past week my wife and I visited the great Texas state capitol city, Austin. We stayed at a very nice downtown hotel, took in some of the sites and ate at some very fine establishments. I learned the expression “Keep Austin Weird” words I had never heard until this past week.
I have to say that we thoroughly enjoyed the LBJ Museum and Library and the exhibits at the Harry Ransom Center on the UT campus. The Congress Street bridge bats were still in Mexico, so we missed that attraction. The Zilker Botantical Gardens was a nice stop, although the recent frigid weather has lessened that venue’s appeal, at least until warmer weather brings its denizens back to life.
The most striking thing about Austin, however, the one thing that sticks out in my mind from our entire stay is “Brussel Sprouts.” I know what you’re thinking, “Did he just report that Brussel Sprouts are more memorable than the Gutenberg Bible, which can be seen on the UT campus, or the events leading up to the passage of the Civil Rights Act, exhibited at the LBJ museum?” Maybe it’s a typo or maybe Dr.Gelber has finally lost his perspective, and his marbles.
But, it is neither. Allow me to elucidate. Each day in Austin we would scout out the local restaurants and decide where we wanted to have dinner. The first day we went to “The Chili Parlor” an Austin institution which really did make great chili. It was in the days after this that the Brussel Sprouts insinuated themselves into our vacation.
As we perused different eateries and read reviews online there was an oft repeated phrase: “great brussel sprouts” or “even if you hate brussel sprouts you’ll love them at _______” (fill in the blank) or “brussel sprouts to die for.” I must qualify my comments at this point: All my life I have hated brussel sprouts. I have kept an open mind about them over the years, but every time I try them I reach the same conclusion: I hate brussel sprouts.
But, there we were, inundated with praise for a vegetable that I despise. I am capable of change, however, and my wife has a bit more regard for these miniature cabbages than me. So, we went out to a Japanese restaurant, Unicko, which was truly great, every dish we tried was fantastic, even the Brussel Sprouts.
Hmm, maybe I’ve been too harsh on this leafy green vegetable.
The Brussel Sprouts came drenched in a spicy red sauce, each leaf individually flavored and they were really, really good. After giving it some thought I realized that the reason they were so good is that the sauce overpowered the Brussel Sprout essence and would have been tasty poured over shredded cardboard.
The remaining restaurants reconfirmed my antipathy. We tried fancily prepared Brussel Sprouts on two other occasions and they turned out to be just Brussel Sprouts, still the same as I’d always remembered, proving you can dress up a vegetable as much as you want but it will still be Brussel Sprouts.
After seeing so much enthusiasm for a barely palatable vegetable I wondered if it was just an Austin thing or a national phenomenon. Inquiry among Austin natives was fruitless, Google also was no help.
We finally came up with several reasons why Brussel Sprouts were such a staple on the menus of Austin’s finest eateries:
1. Austin is a college town. Over fifty thousand students attend the University of Texas, all free from parental supervision. Perhaps the prevalence of Brussel Sprouts is a way for parents to maintain a bit of control over their now liberated offspring. Even if they are not physically present to admonish their sons and daughters to “eat you Brussel Sprouts, they’re good for you,” the presence of this vegetable along with the praise heaped upon them by Internet reviewers may deceive the unsuspecting student into consuming their Brussel Sprouts.
2. Brussel Sprouts may be a weapon utilized by unscrupulous characters hoping to influence the politicians who frequent our state’s capitol. Although I have no proof, I believe that Brussel Sprouts may have some sort of concealed effect which renders the consumer docile and pliable. Thus our state Senators and Representatives may be unwitting dupes in an international plot to control the Texas state government. Certainly Governor Perry often acts like something or someone is controlling his mental faculties.
3. Brussel Sprouts are one more weapon in the never ending struggle to “Keep Austin Weird.”
Whatever diabolical reason may be behind the Brussel Sprouts plot we did manage to survive. How? Good Question. Let’s just say we discovered a powerful antidote to the Brussel Sprout scourge:
AMY’S ICE CREAM
Sunday, February 9, 2014
“Oh my god, what is that smell?” Miss James exclaimed as I walked into the clinic. She sniffed me up and down.
“What did you do? Douse yourself with old sweat and then put on a pair of forgotten scrubs from the back of your gym locker?”
“It’s not that bad,” I responded as she sprayed me down with FOE (Fecal Odor Eliminator).
“It’s worse than bad. You’ll make our patient’s sick just by walking in the room,” she commented as she continued to spray. “Why didn’t you clean yourself up?”
“Well…I was out running and got back late and I’d forgotten I was scheduled to work tonight and then I only had time to throw on some scrubs and I guess the ones I picked out were already dirty and here I am.”
Miss James smiled and then started to laugh. She sniffed me again.
“A little better, almost tolerable. Hold on a minute; I think I know I have a solution.”
She left me alone and then came back with some clean scrubs; scrubs which were hot pink and almost see through.
“Put these on,” she commanded.
“I can’t wear these,” I protested.
“Well you can’t take care of sick people smelling like a sewer. Come on, at least they’re size large. You’ll feel much better, I promise and you’ll look extra sexy.”
She gave me a leering smile and I acquiesced. Actually I didn’t look half bad.
“Pink is definitely my color,” I observed as I modeled my new couture for her.
“Enough of the runway show,” she stated. “There’s a patient in room one. Diabetic, short of breath.”
“Work, work ,work, that’s all anyone cares about around here. How can a few sick people compare to the world of high fashion,” I murmured as I picked up the chart outside the exam room.
“Darrell Preston, 23, diabetic since age ten, takes a lot of insulin,” I read.
I opened the door and began my introduction, “Good evening Mr. Preston, I’m Dr. Barnes, what is the problem that brings you in here?”
He was thin, African American, wearing a hot pink tank top and tight fitting blue jeans. He was sitting on the exam table, no he was curled up in the corner of the exam table, his arms folded across his legs which were pulled up against his chest. I was greeted by the distinctly fruity scent of ketones.
He looked up at me with a blank stare and groaned.
“Don’t say another word, Mr. Preston. I’ll be back in a moment.”
I stepped out into the hall and started to call for Miss James, but she appeared as if she had read my mind.
“I’ve already called for an ambulance. I just saw his blood sugar, 585.”
“As soon as I walked into the room and noticed the odor I knew it was DKA; that unmistakable fruity smell. Start an IV of normal saline and run in a liter wide open. Do we have the rest of his BMP?”
“Potassium is 5.3, everything else is normal.”
“Get an insulin drip going at one unit per hour, also.”
She went to work while I went on to the next patient, Shayla Bakerstreet, abdominal pain, nausea and vomiting for one day, 44, previous hysterectomy. Blood pressure 110/45, heartrate 120.
“Good evening, Miss Bakerstreet. I’m Dr. Barnes, what brought you in here tonight?”
She looked “sick” with flushed cheeks, long, matted brown hair, sunken eyes and a protuberant belly.
“I’m sick,” she announced, stating the obvious. “I started vomiting yesterday, my stomach feels like it’s about to explode, I can’t go potty; isn’t that enough?”
“It is,” I replied. I moved a bit closer and the fetid scent of her breath almost drove me back. The typical feculent odor of a small bowel obstruction filled the air.
“How long ago did you have the hysterectomy? And, have you ever had a similar problem before?”
“Ten years ago and no. I’ve never felt like this, ever,” she stated emphatically. “Can’t you do something?”
I lightly touched her abdomen and she winced in pain.
“I’m going to throw up,” she announced as I started to back away and then moved to help her sit up.
I reached for the basin by the sink and as I gave it to her she vomited, her emesis shooting out several feet and drenching me from chest to knees in vile, sewer like vomit.
I can’t get a break.
“Wait here, Miss Bakerstreet. As you can see I need to see if I can find a change of clothing.”
“It’s OK, I feel better after throwing up.”
I went back to the break room and called for Miss James. She had just finished loading Mr. Preston into the ambulance.
“Oh my god, what happened?” she asked and then she began laughing, uncontrollably, again.
“Yes, yes, very funny. Now is there anything else to wear?”
I had already removed the soiled scrubs and had wrapped a towel around my waist.
“Wait here, I’ll see what I can find.” And she left.
The TV was blaring as I sat alone in my slightly damp underwear, debating whether to shed them also.
“...lavender killer still at large. Victim number eight was discovered today in the posh Evergreen Hills suburb. Similar to the previous seven murders, the victim’s throat was cut with almost surgical precision. And, like the other victims, the scent of lavender filled the air at the crime scene . Police have been unable to find any bit of evidence which ties the victims together or demonstrates any sort of pattern…”
Miss James reappeared with a bright purple scrub top and some gray overalls.
“These are all I could find. I don’t know if it’s a step up from hot pink, but it will have to do.”
I eyed my new attire up and down.
“Beggars can’t be choosers,” I murmured as I pulled the purple scrub shirt over my head, stripped off the dirty underwear and donned the overalls.
“Let’s hope no one looks too closely, nurse. I don’t think this outfit hides everything that is supposed to be hidden. You don’t have a belt, do you?”
“I think I have something in my locker, hold on and I’ll get I for you.”
She returned in a few seconds with a bright yellow belt.
“I think you’re ready for the circus, all you need is a big red nose and some floppy shoes,” she commented.
“Fun-ny,” I remarked. “I’ll put on this white coat and I’ll be fine.”
The coat was a bit small for me. I gazed at my reflection in the mirror: my hair was a bit tousled, the small lab coat made my stomach appear to stick out, I was a kaleidoscope of color in my mismatched outfit. Miss James was correct, I was ready for the circus.
Perhaps my unusual look will bring a bit of lightheartedness to the clinic.
“There’s a sick baby in room 4, tempo 103, diarrhea, runny nose. Could be Rotavirus, there’s been a lot of that going around.”
“Thank you, nurse, I guess it’s back to work.”
I picked up the chart. David Thompson, 3 months old, otherwise healthy. Heartrate 130, temp 103.
“Good evening, I’m Dr. Barnes,” I introduced myself. “This is David?”
The woman with him, his mother, I presumed, nodded.
“What’s the problem little David is having?”
“He’s been coughing and vomiting and his bowels are running and running.”
“Is he usually healthy? I mean has he been sick or in the hospital before?”
“Never even been in the hospital. He was born at home and got all his shots at home. He started getting like this yesterday. I gave him some Tylenol, but he’s still sick.”
“What have you tried to feed him?”
“Why, breast milk, of course; greatest thing god ever made, at least for babies.”
“Can’t argue with you on that.”
I gave her a little smile as I started to examine her child.
“Let me look at your eyes, little David,” I whispered. He stared at my face, his eyes wide open. The pupils looked normal and there were tears. I listened to his heart which was racing along at about 130 and his lungs were clear, the only noise was a bit of a rasp from his upper airway which went away after he coughed.
“I’m going to undo his onesie and his diaper now, if that’s OK with you,” I asked softly.
His abdomen was soft and there was no tenderness. As I started to check his genitalia he did what all baby boys seemed to like to do to me and peed all over my purple shirt and then on my face as I tried to avoid the yellow stream.
“He should be a fireman,” I commented as I wiped urine form my face and chest. “I’m not having much luck with my clothes today. At least it’s sterile.”
I turned him to inspect his back and he passed a large, green diarrheal stool which ran onto his diaper, the exam table and onto my shoes.
“Figures,” I muttered. “Miss James,” I called out, “could you give me some help, please.”
In a few moments the door opened and my nurse entered, took one look at me: my purple scrub top was splattered with the spray of urine, there was baby poop on the table, floor and my shoes as I held our small patient in one hand and tried to clean up with the other. Miss James did what any conscientious nurse would do in such a situation: she burst out in uncontrollable laughter, for the third time.
“Dr. Barnes, you really should take greater care to control your bodily functions,” she remarked as she took our young patient from my hands and handed him back to his mother, who immediately diapered and dressed him.
“I’m sorry, Mrs. Thompson, it’s been one of those nights,” I apologized. “Little David has all the symptoms of Rotavirus, which has been going around recently. Be sure to give him plenty of fluids. We have some samples of Pedialyte here and I think that would be good for him. He should start to get better in a day or two. If he is unable to hold anything down, take him to the Pediatric Clinic at the University Hospital or bring him back here. Do you have any questions?”
I’m sure the look on my face was enough to deter any attempt at questioning my medical judgment or instructions. Miss James gave them a twelve pack of Pedialyte and some information on caring for babies with Rotavirus while I cleaned my shoes and rinsed my shirt.
I returned to work and was greeted by Miss James emerging from exam room one looking white as a ghost and holding her hand over her mouth. As the door closed an overpowering stench wafted through my nostrils and almost caused me to join my nurse who was now violently retching in the sink. The smell of fetid stool was filling our clinic, threatening to send all of us out into the street.
“I’ll open the side door, you get all the windows,” I shouted as Miss James composed herself. The cool night breeze helped to carry away some of the foul odor while my intrepid nurse attacked it with a steady stream of F.O.E.
“Perirectal Abscess is draining in room one,” Miss James announced.
“I could have guessed, you know. Now all the mystery is gone,” I replied. “It’s things like this which make me glad I broke my nose in the fourth grade.
I looked at the chart outside exam room one. Eric Miller, twenty nine, complaining of pain in the butt, otherwise healthy.
“OK, wish me luck. I’m going in,” I informed Miss James.
“Wait,” she said, putting her hands on my shoulders. She reached up and gave me a kiss on my cheek. “For luck, in case you don’t return.”
I smiled and then answered her kiss, “If I should fall in combat, please remember me; remember that I gave my life to the neverending battle against pus.”
I took a deep breath and opened the door.
“Good evening, Mr. Miller,” I greeted my patient by extending my hand. “What’s the problem you are having.”
Even though I was making a conscious effort to breathe only through my mouth, the powerful odor still managed to find its way into the olfactory centers of my brain. I summoned all my will power, commanding my dinner to stay put as I faced Mr. Miller.
“I’ve got this terrible pain in my rectum, for five days,” he reported. “It started draining a little bit two days ago.”
“Is that when this powerful smell started?” I inquired.
“I guess so, although I don’t really notice it much,” he stated, although I couldn’t see how he could not notice it.
“Well, let me look at your bottom, although I’m sure you should be at the hospital. You’re going to need surgery, at least an I&D.”
“Incision and drainage of the abscess I’m sure you have. It will make you feel better right away,” I explained as I examined his perianal area and confirmed my diagnosis, all the time struggling to breathe.
The entire posterior and left side of the perianal area was red and hard, except for a black area in the middle. And, I was sure I felt some crepitance suggesting a particularly nasty infection.
“Are you diabetic, Mr. Miller?”
“Not that I’ve ever been told. But, I haven’t been to a doctor in years.”
“Did the nurse take any blood for testing?”
“No, but she didn’t stay in the room very long. She sort of looked sick.”
“Yes, she’s not feeling all that well for some reason, maybe it was your special cologne. Anyway, I’ll draw some blood for testing, but we need to get you to the hospital. Should I call an ambulance?”
“I’ll drive myself,” he decided.
“Good idea, you’ll get there faster. I’ll call the surgeon on call and have a crew standing by to take care of you. Good luck.”
Miss James had recovered and we managed to get Mr. Miller off to University Hospital with minimal fuss. Steve Johnson was on call and he told me he’d have his residents standing by to tackle what I was sure was a case of Fournier’s gangrene, although Mr. Miller didn’t really look very sick. We did do a fingerstick glucose before he left and found it was 350.
A tough way to find out you’re diabetic.
The powerful scent of infected necrotic tissue lingered in my nose as Miss James I had a brief respite from our duties.
“Vomit, poop, piss and pus; I’d say it’s been a very fragrant shift, don’t you agree, Nurse?”
Miss James was only barely recovering from the ordeal and gave a faint smile. The pungent scent of Mr. Miller still lingered in the air and my feeble attempt at consolation only made things worse.
“It’s not that bad anymore. Maybe there’s something else making you sick?” I queried.
“I’ll be OK. I think I’ll lie down for a few minutes. At least until another patient shows up.”
“Fine, I’ll man the front.”
I sat at the reception desk studying the latest treatments for stage four lung cancer when an older man walked in. He looked familiar, perhaps he had been a patient in the past.
I glanced up from my journal as he signed in: M. Adams, headache. The name struck a chord in my brain, Maurice Adams as in Dr. Maurice Adams, Cardiothoracic surgeon who had retired only a few years ago. His name still struck terror in the hearts and minds of medical students and residents. He had been famous for grilling underlings rotating through his service on the finer points of anatomy and physiology.
“Just a few minutes, Dr. Adams and,” I hesitated a bit, “these forms need to be filled out.”
“Of course, young man,” he answered as he took the clipboard and sat down in the lobby.
From my vantage point behind the reception desk something about him didn’t look right.
Of course something’s not right, that’s why he came to the Clinic.
He looked gaunt and old, not the vigorous surgeon I remembered. Miss James came up front at that moment and took over. She looked much better, the usual color had returned to her cheeks and she even managed a smile for me.
“That’s Dr. Adams. I know him from University Hospital, he was their number one heart surgeon until he retired a couple of years ago. There was some flack about him when he left, but I don’t know any details.”
“Well, he certainly smells better than all the other patients we’ve had today,” she observed her nose capturing the fragrance I had missed, a flowery smell which was very appealing.
“I’m not sure what it is, but it is very pleasant and soothing, like being at home” she said.
I must have looked confused.
“Spring floral. You should know it; it’s almost the same scent as those air fresheners I keep in the bathroom.”
I nodded in agreement, embarrassed because I had never noticed any air fresheners.
I took a short break while Miss James ushered the eminent Dr. Adams into exam room one. I glanced at his paperwork:
“Maurice Adams MD, FACS, seventy two, no allergies, no meds, no previous surgery, smokes occasional cigar, retired.”
I knocked on the door, waited a few seconds then went in.
“Good evening Dr. Adams. I’m Dr. Barnes. You probably don’t remember me, but I rotated through your service five years ago. What can I do for you.”
He eyed me up and down before answering, “Oh, yes, Dr. Barnes. I see you managed to graduate medical school, even though you once cut out one of my knots and I had to start over.”
“You remember, sir?” I’m sure I was turning red at the mention of my past misdeed. “I’m sorry about that sir. I was just a third year student. But, what about you? What’s the problem you are having?”
“I see you went into Internal Medicine, good choice, you’ll cause less mayhem.”
I was beginning to grow a little impatient. “What about you sir? It says you’re having headaches.”
“Oh, yeah,” and he pressed his hands against each side of his head. “They’d almost stopped until you reminded me. I couldn’t sleep, my head was pounding, like someone had hammered a seven inch spike into each ear. I took Acetaminophen, Ibuprofen, Tramadol, oxycodone and nothing helped. I was on my way to the hospital when I saw your sign, so I thought I’d stop here instead. Thought it might be quicker.”
“Well, you are right about that, sir. And, I have to say that after an endless stream of patients reeking of poop and vomit, your cologne is a breath of fresh air. Now, besides the headaches, any other medical problems?”
“That’s why I liked cardiac surgery. Just blood, no encounters with the greasy shit pipe or mucus. Just nice, clean blood.”
“Your health, sir,” I tried to direct him back to his problem.
“Nothing, no meds, no allergies, only rotator cuff surgery to fix an old golf injury.”
“OK, let me take a look at you.”
He winced and drew back as I moved closer to examine him. He closed his eyes and wrinkled his nose and then he took out a small vial, unscrewed the lid and took a long sniff in each nostril. I recognized the scent as identical to the one we had noticed in the lobby.
I took out my flashlight to check his eyes. He kept them tightly closed.
“Does the light hurt your eyes?” I asked.
“A little,” he replied.
“OK, I’ll just look at them without the light.”
I put the flashlight away and he opened his eyes. The first thing I noticed was that his pupils were unequal. The right reacted briskly as I moved my hand away from it, while the left was larger and only barely moved. As I looked more closely there was slight asymmetry of the face with the right drooping.
“How long have you been having headaches?”
“Off and on for years.”
“Have they gotten worse recently?”
“I’m not sure. I know it was bad today and nothing helped. That’s why I’m here. Can’t you just give me a shot so I can get some relief? Then I promise I won’t trouble you again.”
“Just trying to be thorough, sir, like you taught me.”
I smiled at him, but he just stared straight ahead, as if I wasn’t even there, like his mind was off in another world.
“I think you should have an MRI, Dr. Adams, but, for now, I’ll get you a shot of Morphine…”
“No,” he interrupted, “Demerol, that works better for me. Usually 75 IV does the trick.”
“OK, OK, but you really need to see a Neurologist. I’ll call Dr. Joint and I’m sure he’ll see you tomorrow, even if it is Sunday.”
“Thank you, young man. Now…Demerol?”
It was more command than request and his insistent attitude made me wonder just a little about the circumstances of his “retirement.”
“The nurse will be back shortly,” I responded, but as I said this I saw that he was back to staring blankly into space.
I found Miss James looking like her normal cheerful self and asked her to give Dr. Adams the shot of Demerol and then went to the break room for a moment. As I rummaged around in the fridge looking for something cold to drink I heard a loud crash. I ran to the front and heard more noises coming from the exam room. I threw the door open and found Miss James being held by Dr. Adams, a scalpel at her throat.
“Stop right there, Dr. Barnes or I’ll finish what I’ve started.”
“Just don’t do anything foolish, Dr. Adams. We’ll do what you want. Just let her go.”
“Oh, I will, I will let her go, once I’ve put an end to her misery.”
I took a step towards them, but he tightened his grip on her and held the blade against her neck. At the same time I saw him wince and close his eyes for a moment. Before I could respond, however, he saw me and I took a step back. He wrinkled his nose and then he put the little vial to his nose and inhaled deeply. The floral scent reached my nose and filled the room.
“What is it, doctor? What is going on? You don’t know, do you, but I do. It’s the tumor, the one in your head pushing on your brain, filling it with ugly, violent thoughts, telling you to use your surgical skills for evil. You know I’m telling you the truth. You’re a doctor, you’re a surgeon, you don’t kill people, you save them.”
“Kill people? I’ve never killed anyone. I perform surgery on them, make them better. Unfortunately, sometimes the patient doesn’t make it. He winced again and took a sniff from the little vial.
“It’s unbearable,” he explained, “the smell, like feces and rotting garbage, night and day filling my head, sometimes all I can do is clench my fist and close my eyes until the worst passes. Lavender helps, it reminds me of my wife.”
“Dr. Adams,” I implored. “You can’t do this. You’re a doctor.”
“I was a doctor. Now I’m famous, now I’m the Lavender killer.”
He started to cut Miss James neck, a careful, deep, even stroke right over the anterior border of the sternocleidomastoid muscle. Blood began to pour out.
“She’s pregnant, you know; you’ll be killing her unborn child. Could you possibly live with that?” I screamed and he stopped. Blood continued to squirt out of the wound as he dropped the scalpel. I ran to Miss James, knocking the distraught Dr. Adams aside. I grabbed a box of gauze sponges and ripped it open and applied pressure to the open wound. Luckily, this seemed to staunch the bleeding.
“Quick thinking, Dr. Barnes. It looks like you messed up another outfit,” Miss James whispered, looking at my blood stained clothes.
The bleeding had stopped and I taped the gauze dressing in place as I called 911 to report the capture of the Lavender serial killer and to call for an ambulance.
Dr. Adams was crying uncontrollably as the police cuffed him and led him away. It turned out that he had a massive tumor which was pressing on the olfactory center of his brain. He died two weeks later.
Miss James had not suffered injury to any vital structures. She recovered uneventfully and was back in work in a few weeks.
“It was quick thinking to say that I was pregnant,” she commented after she was home.
“Well…I remembered that Dr. Adams about how he loved children, he was always very vocal about this during his operations. I figured that the conflict created by the thought of him killing an unborn child would at least get him to stop and perhaps give me the chance to intervene. I think it worked pretty well. I mean, you are still here.”
“And still pregnant.”