Friday the 13th

Ellis Island building detail

Every Friday the 13th I tell myself I am NOT going to work. I am so over the bad luck. 

Is it really that much worse than other days? Are people sicker? Is it maybe that everyone is walking around irritable and more afraid than usual and it boils over into how they interact with others? Am I just hypersensitive? Is it a self fulfilling prophecy? 

I dunno. 

All I know is that I don’t want to do it anymore.

Then it sneaks up on me. Every single dang time.

BAM! 

There is nothing to do but just get through it. Buckle down and get it done. 

Survive. 

And we do. 

We always do.

This Friday the 13th it was different, though.

“She looks yellow…” the medical assistant whispered as I pulled up the chart. 

I scanned her info. I’d never seen her before. Hypertension. Diabetes. Cholesterol. Nothing else remarkable.

Knocking authoritatively on the exam room door, I entered.

“Hi! I’m Dr. Denisof. Tell me what’s been going on?” I shook her hand, taking in her appearance. She was quite jaundiced. 

“I don’t know. I woke up this morning and pretty much freaked out when I looked in the mirror.”

“Any other symptoms?”

She shook her head. “Nothing.”

“No fevers? Abdominal pain? Nausea? Diarrhea?” She shook head no each time. 

“Hmmmmm.”

I started examining, working my way from her head down. Eyes, ears, nose, throat all fine. Lungs clear. Heart regular rate and rhythm, no murmurs. 

“Let’s have you lie down.”

She complied.

Her abdomen sounded normal. I pulled off the stethoscope and palpated her abdomen. No masses. Liver felt maybe a bit enlarged. No pain. 

I helped her sit up.

A strange look came over her face and she doubled over, gagging. Blood poured out of her mouth and into her hands, dripping onto her lap.

“Call the ambulance!” I yelled out the door then grabbed an emesis bag, thrusting it under her mouth. She gasped and the vomit stopped for a moment before another retch wracked her body, bringing up more. The room filled with the scent of rust and iron. 

“Need help?” An MA stuck her head in:

“You called 911?”

“Yes ma’am.”

“Can you print a chart summary and her last set of labs for the EMS?”

“Sure thing!”

“And let the other patients know I am going to be running late while we deal with an emergency.”

“No problem.” 

Sirens were audible in the background, growing louder. Having a clinic so near the fire station definitely had its benefits.

Another retch, more blood. 

I put my hand on the patient’s back and looked into her frightened eyes. “You are going to be OK.” She nodded but did not look convinced.

My mind was running through the differential diagnosis. Causes of rapid liver failure, fulminant hepatitis…. infection? Some sort of aggressive cancer? Drugs? A closet alcoholic? 

The sound of a stretcher came from outside the door and two hunky firefighters in dark blue uniforms stepped in. 

“What do we have here?” the tall one asked.

I gave the run down of what I knew, pointing at the bloody emesis bag. 

As I spoke four sets of eyes grew bigger and the firefighters suddenly backed out of the room. 

What the hell?

“Hang on, I’ll be right back,” I told the patient. I left the door cracked so I could hear any more vomiting or any sounds of distress.

One of the men muttered into a radio receiver on his shoulder. The other took a step toward me, his hands raised.

“Doc, we need for you to step back into the room.”

“Why? What’s going on.”

“You are quarantined.”

What?” More sirens. Through the windows I could see police cars racing into the parking lot, surrounding the building.

“Look, no one can leave this clinic. No one. The CDC will be here shortly and they’ll explain everything.”

*****************************************

The above was a bit of fictional doctor horror brought to you by the month of October…

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Flight

Birds in flight inside the American Museum of Natural History in NYC

“I asked her, ‘Aren’t you afraid?’ She touched my face and smiled. ‘No. Not at all.’

‘How can you not have fear?’

‘Because I have you. You are the strongest man I know.’”

He stopped for a moment, emotion stealing his words.

“The tumor doubled in size in 7 days. I don’t know what to do, how to help her… how to let her go.”

I have had so many conversations like this, two just this week. I always marvel at how the afflicted can be so strong, so full of peace and resolve even as those around them are falling to pieces. 

What sets them apart? 

There have been times in my life where I have been so depressed I have prayed to die. 

Please, God, take me in any way that you see fit…

But I was never peaceful about it.

I have fear. So much fear.

Fear of suffering. Fear of the unknown. Fear of the loss of control. Fear of being known for who I really am.

Who am I?

What sets them apart?

How do you come to terms with dying? 

“She says she will see me later, that it isn’t really goodbye.”

Faith.

Is it possible that it is simply faith in love… love which takes many forms… that gives us peace?

The Overseers

Through a window at the American Museum of Natural History in NYC

I see your drones flying overhead,
Your truck driving by.
I know you are watching me,
Following my every move… 
Silently waiting 
For the proper time to strike. 
You know my internet searches,
The names of my kids. 
You know my habits 
And my darkest faults. 
Some days you know my secret wishes 
Before I can even get the chance 
To wish them. 
Always there, behind the scenes 
Your satellites measuring my level 
Of devotion. 
Well placed hints, strategic glimpses, 
All forms of intimidation
Meant to remind me that I am yours 
Entirely,
Forever subject
To your every whim.

*****************************************

If you want to see something fun, zoom in on the bottom left of the photo.

The Twelfth 

World Trade Center

“Mommy, why are there so many police everywhere?”

I looked around. She was right. They stood on every street corner it seemed, decked out in bulky bullet proof vests. New York City, more than any other city in the world that I have visited, possesses a very visible police force. No longer simply protecting us from each other, they stood ready to protect us from them.

Did it make me feel safer? 

Yes. Yes it did.

I grabbed my daughter’s hand as we crossed the street with the crowd of other people. The Empire State Building rose up in the distance. 

“Are you going to take your kids to the 9/11 museum?”

They are six and seven.

“No. They aren’t ready for that yet.”

I’m not ready for that yet.

I dropped my purse and camera into a bin and wiggled out of my jacket, sending it and my ball cap through the scanner then stepped through the metal detector. The security guard nodded silently. We were free to move on to the next staging area. 

“Mom, why is it that everywhere we go here is like the airport?” my son asked.

In truth this was the forth scanner we had walked through on this trip. Long lines made longer by strict security. Stress. My kids felt it. So did I.

“Some years ago there was an attack on two tall buildings here in New York. They collapsed and thousands of people died. There are people who hate Americans and want to hurt them so the police and all of the security measures are trying to prevent something from happening like that again.”

Watching the towers collapse over and over again on the news feed at the clinic between patients, the world shifted. It wasn’t until the next day, as the dust was settling, that it became apparent just how much it had shifted. 

My kids seemed to take in the information and I braced myself for more questions, for fear, or even tears from my daughter, but there was nothing. 

Nothing.

This is their world. They don’t know what it was like before 9/11, a world where simply being American carried with it a certain degree of power and respect. They didn’t feel that shift. They will only know a September 12th world, a world where they are targets. 

Split 

Room in the Metropolitan Museum of Art in NYC

Shadows watched from the corners of the room… ever present, ever vigilant. 

She waited.

Footsteps in the hallway. Raucous laughter. 

The door flung open and he stumbled in, drunk, clinging to the arm of a woman.

Who was it this time? 

It was hard to see clearly in the dim light. 

Her.

Their eyes met for a long moment. Silent words passing between them. Then she turned her attention back to him, allowing him to undress her. He fumbled. The process took much longer than it should have. 

Naked.

She glanced at the mirror again, seeing the other woman once more, the one who looked like her but was more charming, the one whose laughter came more easily. She was the one who was not ashamed of being naked, the one who demanded love and attention from everyone.

The drugs made her beautiful and charismatic. She knew the flame could not burn this high for very long. It would go out soon, extinguishing her in the process.

But it was worth it. 

Every day was worth the price to avoid the loneliness again.

Shopping Around

Macy's in New York City

“She doesn’t have physical exam coverage and her insurance only allows three office visits per year. No lab coverage. No preventive care coverage. She needs her blood pressure and diabetes meds refilled but she cannot come in for a physical.”

I’ve seen this a lot lately.

“No problem. Tell her to come in for a regular office visit so we can at least check her blood pressure. I will code a 99214 and she may get a 30% discount off that as a cash pay patient. I can send her to a discount laboratory for labs that will save her hundreds of dollars. In October she can get a $99 mammogram at one of the local imaging centers. Her flu vaccination she can get cheap at the health department. We will just have to postpone her PAP another year.”

So she came in….

Crying.

“I pay over $700 a month for this insurance.  I work for myself and with my diabetes no one will cover me otherwise. I can’t afford anything else. They told me that all of my doctors were covered and my meds were covered. They lied.”

She did not read the fine print. Not that she really had any other options available to her… 

It used to be like this ten years ago. People with expensive but essentially useless policies. Here we go again. Now, at least, I have access to a discount laboratory. 

This Far and No Further

Statue of Polish king in Central Park

Raccoons are not cute

Neither are possums or armadillos or squirrels. Don’t even try to argue the point with me because it’ll get you absolutely nowhere. I used to be like you, in love with all of God’s creatures. 

Not any more. 

I am not against wildlife, mind you. I am content to share my yard. If an animal wants dig up and trash my potted plants over and over again looking for God knows what, I am cool with that. But so help me, if one decides to crawl into the attic or walls of my house and DIE, we will have words and many of those words will consist of only four letters.

Here’s the thing….

I love my house. It is not a big house but built in the 1940’s it has tons of character. It is big enough without being pretentious or too expensive to cool in the hell heat of summer. It is located in the center of a little city/town. Best of all, it’s completely paid for. No mortgage.

Now, the thing about old houses in this area is that they are built on pier and beam, meaning there is a crawl space under the house that could fit a grown man on his hands and knees. As you can imagine, animals like that area quite a lot, too. Warm or cool depending on the season. Hidden. Food nearby. What’s not to love?

Shortly after buying this house, the first hint of odor wafted through the walls upstairs. Within 24 hours it was very clear an animal had died somewhere. I searched everywhere to try to find that carcass. Never could find it. Do you know how long it takes the stench of a liquefying animal to burn off? 

About five days, as it turns out.

Now, I am certain I am not the only one this happens to. Dead animals in your walls is of those dirty little secrets no one ever wants to admit to for fear of being judged… like enjoying oral sex. But it happened to me and my house several times a year for a number of years. 

Dead animals were not the only problem, though. Hoards of bot flies would descend upon the house from time to time like a plague straight out of Egypt. You know how flies are. 2-3 buzzing about feels like a lot. This was over fifty. Inside my house. All at once. Bot flies like dead animals. They LOVED my house. I am a pretty good shot with a fly swatter now, after all of that practice. 

Almost as bad as the flies and the stench was waking up to an MMA fight in progress in my ceiling in the dead of night. And did you know that chewing sounds are magnified by sheet rock? Sounded like some sort of jack hammer. The sleep deprivation was real, people. I would hear loud noises in the yard and run outside only to find entire families of animals, specifically raccoons, scrabbling up the side of my house. 

How were they getting in?!??????!!!

Finally, I was at my wits end. My family and I had endured QUITE enough and I was ready to torch the place, paid off or not. How could I in good conscience pass off this to someone else?

I couldn’t.

So I scoured the internet for advice, all of which was most unhelpful. Those animals practically scoffed at the nauseating stench of the red fox pee that was sprayed all over the house and property. The only thing it deterred was me. You name it, I tried it.

The man of the house took to using one of those *humane* traps, thinking if we could catch them before they ended up in the walls and attic that might help. We placed *inhumane* traps throughout the attic crawl spaces that could be reached. We caught dozens of raccoons, possums, and armadillos. Animal control knew my voice well.

“Yeah, yeah. We know who you are and where you live…” the man on the other end of the line would growl.

Something tells me that they were not taking those animals *away* to release them. 

One day, whilst bemoaning the vermin issue with a neighbor who was experiencing similar issues, I was informed that an old lady down the street was feeding the raccoons by putting food out for them at night. Rarely have I felt a desire to do violence against another fellow human being but this was one of those times. She did die eventually but not by my hand…

You know what seemed to work? Chicken wire. Chicken wire all over the eaves and attic vents. Chicken wire along the base of the house. Chicken wire anywhere an animal might try to weasel its way inside.

And…. that lady down the street? She stopped feeding the wildlife…. 

The Artist

Room detail, Metropolitan Museum of Art in NYC

Over twelve years ago I met an artist.

What she had was a gift. I never had to tell her what to do. It was like she just knew. Left to create on her own she did the most amazing work.

Today was my last appointment with her. 

My hair stylist is retiring and I am grieving. She was the first and only person to ever take charge of my hair and make it look GOOD. She made me feel better about my hair, about myself. I cannot put into words how important and life changing that was.

When I ask patients what they do, often I’ll get the, “I’m JUST a…. fill in the blank.” Hair dresser, office worker, mail handler, Mom, etc. I hate, hate, hate that phrasing. 

Never doubt that what you do has an impact. No matter what your job happens to be, it matters to someone. 

It matters to me.

Maybe I will find someone just as good. 

Maybe I won’t. 

I loathe this kind of change so it will be a growing experience regardless but for now, I grieve. She was an artist in the true sense of the word and she will be missed.