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SAND CRAB Doctor: I recently walked along the bay with my five-year-old nephew. What are those little holes with bubbles coming out? he asked. Sand crabs, I said. They hide under a thin layer of sand to protect themselves. Have you ever seen one? he wanted to know. Yes, I said, thinking of my first day at the Washington V.A. hospital. A young man, age twenty-two, was hidden under a white sheet. He was pale as a moonbeam, and his mouth puckered in and out with each breath. He returned from Vietnam with acute leukemia. His name was Howard, I said out loud. You're making it up, my nephew laughed. MR. BIGGERS Patient: I have a friend, Jeannie Mayer, who says that a name tells us a lot about the person, much the same way that dog owners often bear a resemblance to their dogs. While I've given little credence heretofore to this homespun philosophy (Jeannie isn't exactly Kant or Descartes), lately I see its wisdom. Dr. Plummer is a urologist on staff. Then, too, there is Mrs. Muffin, a nurse's aide who gives out breakfast. Nurse Nancy Smith behaves quite anonymously, and Joan Desirée, R.N., is the local heartthrob with whom Dr. Robert Radcliffe is cheating on his wife. These are things you come to know. Secrets waft out through porous walls. I am in the midst of an oceanic all-day soap opera, I say to Mr. Biggers, who nods as he mops vigorously under my bed.
ONE WORD Doctor: A man at the bus stop stooped to retrieve a dime rolling toward the drain. Looking at me, he said, No ordinary dime, mister. Really? I said, thinking how life is sometimes reduced to a single word, a reflex, a courtesy. Like the time I interviewed this young man for a job in my lab, my mind wandering, not attached to the conversation, at best noticing his outdated tie. Perhaps in response to some statement, I said, Why? Then sensing the opportunity he answered more eloquently, and that changed everything. Like the time a woman walked into my medical office for one thing, and I put my fingers in the crevice of her neck, the right side, and touched a fullness deep within, and I knew that moment I would say one word to her and nothing would ever be the same again. to easily. When my mother was ill and lost forty pounds (though still not skinny by any means), she was admonished to take in more nourishment. All her life she craved ice cream, but now a cholesterol of 350 was forgiven. The creamier the better. Cherry Garcia, Chocolate Marshmallow Swirl, Oreo Cookie Crunch- just the names brought her rapture. Dr. Donovan says I can have strawberry milk shakes for breakfast. Forget lamb chops. They taste like tires. Bring me a large bowl of Rocky Road topped with Reese's Pieces and a midnight snack of Double Rich Black Forest Seven-Layer Cake with lots of almonds. Oh, it is almost worth being sick if we can indulge that thing we most crave without guilt: delicious, foolish, and obscenely rich. SCARLET CROWN Doctor:
I met a man my age running a greenhouse. He pointed to the pots with pride, saying they contained a thousand separate cacti. Not much interest in these when I started, he said. He pointed to the barbed bristles (glochids), the bearing cushions (areoles), and the names of many of the two hundred genera: brain, button, cow tongue, hot dog, lace, coral, and silver ball. In my work, I said, I'm burdened with such straight- forward terms: lung cancer, lymphoma, breast cancer, leukemia. I'd love to switch to pond lily, star, or scarlet crown. Really? he said, pointing to other plants named hatchet, devil, dagger, hook, and snake. Or perhaps a diagnosis of this: rattail, white chin, wooly torch, or dancing bones. PAPER CUPS Patient: Charlotte awakens me at daybreak to pass out pills from little paper cups. There must be at least five medications per patient, I tell her after quick computation. More, she answers. The unit isn't filled today. So how do you keep track with all those paper cups? I want to know. I tear off a small piece of cardboard, she says, write your names, and place it underneath. Isn't there a possibility for mistake? Oh no, she answers. The greens are placebos. They do no harm. This yellow one, shaped like an octagon, is for heartburn. Who couldn't use that? And the pink one- you're the only one on it. I hope you're joking, I say. Of course not, she says, shaking out two blue oblongs and handing one to me. PINE NUTS Doctor: Just five pine nuts and my nausea from the Platinol is gone, a thirty-two- year-old woman in the chemo room told me today. A man undergoing similar treatment nearby offered that wrapping one's face in a hot towel soaked in mentholated oil works much better. By now I have heard countless anecdotal remedies that are probably ineffective except for their placebo effect. Yet each time I think to dissuade their use, I have to remind myself of an incident when I was five. I had fractured my right forearm against our stoop, having attempted to ride down its six cement steps on my new twenty-inch Schwinn. Grandma Katy washed and then wrapped my badly discolored skin in a cool compress of honey, tree sap (from a pine, I presume), and another ingredient that smelled a lot like cesspool sediment. The pain disappeared completely, and my bones were set some three hours later without anesthesia. ELEVENTH FLOOR Patient: A van near the west parking lot sells bagels, jelly rolls, hot dogs, and soda. I can't read its sign from here, but I see a workman holding a can in one hand and with the other eating food from a paper wrapper. I don't know why they design these buildings so high. A conference on hospital architecture should have been convened to establish the optimum height. I doubt many have paid attention to this. What if a patient is acrophobic? Wouldn't it be better if they were level with a flowering dogwood, a Japanese maple? From here I look down on sunsets. Why the eleventh floor? Admissions is on the first, radiology the second, surgery the third, pediatrics the fourth, obstetrics the fifth. Everyone knows what's in the basement. Perhaps that's why oncology is so far away.
APOCALYPTIC PRAYER Doctor: The apocalyptic prayer Sister Mary mouthed in the chemo room was a touch too loud and had the sibilance of a dirge, but nonetheless Thomas Borland chimed in with a slow hymn, a southern spiritual, I guessed, and then Rabbi Goldfine began a Hasidic chant, the kind generally accompanied by clarinet, and elderly Mrs. Booth ... You can imagine how this must have sounded, a cacophony of five or six patients all singing in different keys. But in fact it was something akin to a choral symphony, the voices discrete instruments precisely timed together. Afterward Sister Mary said, Please, everyone, try your best to be on time next week. DOLDRUMS Patient:
They come to give cheer: nurses, candy stripers, elderly volunteers ... and Aunt Ethel. At age six I secretly believed she was the Wicked Witch of the West. Today she reminds me why as she bounds in blowing a kiss and wearing black stockings, red miniskirt, and faux mink stole (and this is summer). She has cornered a man again, poor seventy-five-year-old Harold from Miami, who believes she's far younger than eighty-three. I listen to her litany of complaints, bone by bone, as she devours all the candy she's brought. She fills me in on the gossip, looks at her watch, and springs up. Your old aunt was here to lift you out of the doldrums, she waves, teetering out the door on three-inch heels. I laugh so hard I have a coughing fit. The family all mock this old painted bird. But just now I love her dearly, so irreverent and beautiful. ANGIOGENESIS FACTOR Doctor: How did this happen? they always ask. Someday I'm going to say, It starts as a mutation, a deletion at chromosome 19, inherited no doubt-that tumor promoters, carcinogens, transform the cells over twenty years. First dysplastic, then neoplastic. That angiogenesis factor augments metastasis elsewhere, and ... By now they look at me limp-lipped numb. And that took six years to learn, to assimilate, I want to add, and all you want to hear is-I don't know. No one knows how this happens. LILIES OF THE FIELD Patient:
This basket of flowers is stunning but I wish they'd stop sending them- my room is a veritable botanical forest. And the thing is, most wilt in two days, and as for the rest-I don't have a predilection for spending an hour a day maintaining them, so I give several to Angela to pass out to the staff. And what do they think I can do with six hundred pounds of candy and gargantuan fruit baskets? And why in God's name must Aunt Bertha visit daily? She is so dark and elephantine and showers me with despondency. I should have been more protective of my father in that last aching month. APPLE CORES Doctor:
Suppose, just suppose, you're shown an apple core and asked to describe its inside, having seen hundreds before (they've all been pretty much the same), but the question put to you, almost as a matter of life and death, makes you wary-there may be an exception, a core unlike any you've ever seen, yellow and luminescent with garnetlike seeds, or no seeds, or no core. Do you generalize, not having analyzed the issue, having no statistical data? And even if you knew everything about apple cores, the very latest studies and their methodology, would you answer simply, or would you equivocate, knowing each word is a shard of glass, translucent, dazzling, and dangerous?
CRICKET Patient: They keep this place so clean. It's Hector, a slight elderly Hispanic man who mops here twice a day. Twice a week he uses an industrial polisher. We barely converse. Today I said, Hector, I hear a cricket in this room. He was mortified and began to search behind the radiator and under the bed until I was able to explain I was teasing. I apologized. I told him how much I rely on him that this room is meticulous. After three weeks in this hospital it's almost the only thing I can count on. SAY YES Doctor: If I cut down on fatty foods, lose fifteen pounds, work out three times a week, will I avoid a heart attack? If only every question were that simple. It's an opportunity to answer unequivocally, to give patients a sense of purpose and hope, even if they've always been obese, refractory to treatment, unable to comply with a regimen. Still, just to say yes is palliative, even though they know the answer isn't accurate. They don't want to hear statistics and vacillation. Just to be like the surgeon who says, It's a hundred percent curable-I got it all, omitting the possibility that a cell, a micro- metastasis, may already be elsewhere. Say yes-a sliver of grace in an excoriated world. I must try it sometime. HUMMING Patient: I find myself humming at odd intervals. Sarabeth pokes her head in my room and looks quizzically at me. What can I say? I am unaware of it. Oh, a Handel oratorio, I volunteer. Sounds a bit more like Madonna, she says, smiling. Albert, the phlebotomy tech, advises I write it down. Retro rap, he calls it. Mrs. Quinlin's little granddaughter, Allison, visiting this morning, started tap dancing, and Monsignor Brady, praying at the next bedside yesterday, offered that it reminded him of a holy incantation he heard as a seminary student in Perugia many years ago. I am confounded by these inexplicable noises from my mouth that each recognizes as familiar. I think God hears them as my prayers. CHIMES Doctor: It sounded like chimes. How else would a five-year-old hear an anapestic beat, Aramaic, with an internal rhyme? Kaddish de-rabbanan, a prayer for the dead, an incantation said on the Sabbath and High Holidays. I knew it by heart, this sonorous dirge-quick alliteration, hard-voweled words, and in retrospect the first poem I learned. I admit now I liked it. Early on I was asked to lead the congregation. I would liken my voice to a violin, the bowstring (Continues...)
Excerpted from NOT GOD by MARC J. STRAUS
Copyright © 2006 by Marc J. Straus. Excerpted by permission.
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