New Outlook

Lookout at Rockefeller Center in NYC

The beeps. 

I know those beeps.

From where? 

I don’t have the energy to find out. My head hurts something fierce. I slip away, choosing to remain in the darkness for now.

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

The pain at my sternum is excruciating. 

Make it stop!

Except that I don’t have a voice. There is a tube down my throat and I cannot speak. I try to grab the hand at my chest by my arms do not respond.

“Dr. Slaughter? Wake up. Can you hear me?” The voice is much too loud and the words are spoken slowly as if the man enunciating them were speaking to an imbecile.

The pain stops. Then I realize…

A sternal rub!

My eyes are open. He moves his face close enough to mine that I can smell his aftershave. 

“Dr. Slaughter? My name is Dr. Holcomb.” He was too young to be a doctor. Too young to be competent. “Wake up!” he shouts into my ear. 

The pain again. Stop with the damn sternal rubs you f***er! I AM awake.

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

“The patient is a 45 year old male who happens to be a local physician. A neurologist. He suffered a brain stem hemorrhage two weeks ago and is currently in a persistent vegetative state. He has no family we have been able to locate.”

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

I take inventory. What can I move? Arms? No. Legs? No. I try to tense my abdominal muscles. Nothing. A shift or a scoot to take pressure off of my hips. Not even a millimeter. Smile? No. Wrinkle the nose? No. Tongue? Not that either. Blink? Ok. Yes. A blink. I try to move my eyes. Left. No. Right. No. Up? Yes. Down? Yes. 

Not much to work with but it’s something.

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

My dog! Who is feeding my dog?

He was probably dead by now.

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

“Well, his catheter caught on the IV pole so when they were wheeling him down for the MRI, it got rippped right out. We have to place a new one.”

“Should we use the lidocaine jelly?”

“Nah. He can’t feel anything anyway.”

I felt it, bitch. I felt that catheter rip right through my urethra. Use the goddamn lidocaine jelly. Come on. Look at my EYES. See me moving them? Blinking? 

Please? Just LOOK at me. Really look look at me. Someone?

I can make tears.

The night nurses here suck. 
*****************************************

The woman is smiling at me. 

Who is she?

She’s gorgeous. Dark hair. Blue eyes. Long lashes. I have this strange feeling. I think I should know her. 

“Remember me?” She whispers. 

No. No, I don’t.

“I was the intern you came on to ten years ago. A newbie. You told me to go get some gauze and then followed me into the supply room, locking the door and forcing yourself on me. I made it seem I was flattered.” She fixed her gaze onto my eyes and leaned in closer. “But I wasn’t.” 

Her hand was under the sheet, stroking my genitals. An erection. Horror and pleasure washed over me.

Oh, God.

The heart monitor registered the increase in heart rate. A nurse stuck her head in. The hand was withdrawn.

“Oh! Dr. Rutherford. I didn’t realize you were in here.” 

“Dr. Holcomb asked me to see the patient.”

The nurse nodded then stepped out, drawing the curtain closed behind her.

“I hate you.”

Suddenly, fingers wrapped themselves around my scrotum and squeezed tight. Painfully tight. I closed my eyes, fighting the excruciating pain.

“You have locked in syndrome, don’t you, Dr. Slaughter?” She laughed. “You can feel everything but you cannot move. Well….” she chuckled again. “You can move your eyeballs up and down and blink but they haven’t figured that out yet, have they? You taught me well about so many things…”

Another squeeze. More pain.

“You probably know better than anyone that you likely won’t recover.” She smiles sweetly. “But I’ll be back to check on you. Every single day…”

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Pumped Up

IMG_1233

“Well, you see… I was benching 300 pounds and felt something give in my right shoulder. It’s been hurting ever since.”

“How long ago was this?”

“Um.” He searched his memory. “Three months ago? Maybe longer.” He shrugged, then winced.

“Why the hell are you benching 300 pounds?” 

Did he really do that? Or was he maybe exaggerating just a smidge?

I mashed around on his shoulder, bringing on another wince, and walked him through some range of motion exercises to evaluate the joint further. This was his sixth injury from lifting in past 24 months. I had already told him he needed to back off a bit.

“I need to gain weight. I need more muscle.” 

He came from a long line of average height, thinly built people. He had already put on 25 pounds of muscle since the last time I saw him. Much more was going to be impossible.

“You are fighting genetics, you know. You are not going to be able to bulk up more than you already have without doing dangerous stuff.”

He look back at me, clearly horrified. “Oh, no, I’d never do that, Doc! But I’ve at least got to make my chest look good. That’s what the ladies want.” He puffed up his chest for effect.

“I’m a lady. That’s not what I want. I don’t think that is what most women want.”

He stared at me with a single eyebrow cocked up in disbelief standing out on his fresh-out-of-college face.

“So, what do women want, then?”

“Security. Respect. Love. Not necessarily in that order.”

He rolled his eyes and laughed. 

Had no one said this to him before?

“Sure, Doc….” His reply held a hint of sarcasm.

“Don’t get me wrong. I appreciate a man who takes care of himself, who stays fit. That in itself is an act of love, but having impeccable pecs is really not necessary. Pushing the envelope is really not necessary. A guy who says, ‘You need to carry the groceries in yourself, hon, because I can’t lift the sacks with my jacked up shoulders and I can’t walk with this bum knee,’ isn’t really sexy if he did it to himself.”

There was silence as I ordered an MRI in the computer. Thousands of dollars already spent treating his injuries, what was a few more?

Then he laughed.

“I guess you’re right, Doc.”

Damn right, I’m right.

“Just take it easy on your body. It has to last you the rest of your life…”

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

I have had several conversations like this over the past year. I talk a lot about how body image issues affect women but there is a ton of pressure for men, for boys even, and it is getting worse. A distortion and misrepresentation of what is possible and what is desired is being perpetuated by media, by people selling lies. 

Fight back, I say. 

Fight back.

Thursday Thoughts From The Throne #3

Black and white Gerber daisies

The nice thing about your loved one continuing to ignore your advice about going to the ER for their severe right lower quadrant abdominal pain until their appendix eventually ruptures is that in a few weeks when it is clear they will live and the post op pain subsides (you have to be nice to them until then) you will have ammunition to use for the rest of their life… if you are the kind of person who does that sort of thing.

*wink*

Worn

Interior, Metropolitan Museum of Art

Every year around this date I especially find myself marveling at love…

Love that is gained and lost, and found again. Love that is unrequited and unrewarded and yet still persists. Love that claws its way through the heart and lodges itself there against all logic and stays regardless of physical presence or absence. Love that endures despite being utterly spent, never quite reaching the point where it simply cannot love anymore. 

Lonely love.

Brilliant love.

Eternal love.

For over twenty years I have loved this love. At times gingerly, even tentatively, and at other times fiercely and with conviction. Is it more valuable for bearing all of the scars and scuff marks, the wear and tear of time and hurt? Is it more precious for simply surviving?

Perhaps….

But then, all love is precious. 

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.

Recognizing Patterns

“I did an internet search for my symptoms and after doing a bunch of reading, this is what I think I have….” She pulled a sheaf of papers from her large purse and passed them over to me. 

Erythromelalgia.

I scanned through it quickly.

It wasn’t anything I had ever heard of before, but then her symptoms were not something that I recognized either. Hands that turned red and burned like they were on fire. They got better when she raised them up overhead or ran them under cold water. It had been going on for years. The pain was excruciating and now occurred at a more frenzied rate to the point she was afraid to leave her house.

“I think you might be right,” I told her. 

Now, if I were honest with you and with myself, I would admit that my pride didn’t want her to be right. I wanted to be the hero. I wanted to be the one with the answers, not her and certainly not Dr. Google, but here we were anyway. 

We did bloodwork to make sure it was not caused by something more serious and she started aspirin. Like magic, the pain was gone. Somehow, she still considered me her hero even after I told her I probably never would have figured it out on my own…

Several months later, a new patient showed up in my clinic telling me of the pain she was experiencing in her hands and feet. The pain came and went with no rhyme or reason. It burned terribly, kept her for doing things for fear it would appear.

“Do your hands and feet change colors?”

 “YES! They turn red and I have to elevate them or run them under cold water to get them to stop.” Over the years she saw half a dozen specialists and was diagnosed with all manner of things: Fibromyalgia. Anxiety disorder. Neuropathy. Malingering. 

She cried. She had clearly suffered and I suspect the implication that she was crazy was just as excruciating as the physical pain itself. 

This time I got to be the full on hero. “You are NOT crazy. What you are experiencing has a name and a treatment!”

And by golly, she got better.

I have patients who come in all of the time and say sheepishly, “I know I shouldn’t be reading online but…” 

But what if that first woman had not? 

Maybe I would have referred her to someone who could eventually figure it out. Maybe she would have ended up like the second patient spending years suffering, passed from one specialist to the the next, always told it was all in her head. Then when that second patient showed up, I wouldn’t have had an answer for her, either. 

Patients teach me new things every day, sometimes it is something simple… like keeping my pride in check so I can actually hear what patients are saying.

Fatherless

Rose window example, San Antonio

“Can you tell me anything about your father’s medical history?”

“No. I don’t know him.” He shrugged as if it was no big deal but his voice said otherwise. 

Next patient…. 

“What about your father’s medical history?”

She scrunched up her face. “I think he’s still alive? I don’t know for sure. I never knew him.”

Next patient…

“So your mother is alive and has diabetes. Do you know anything about your father?”

“I’m not in contact with him.” The disdain came across loud and clear in her voice. “I hope he’s dead.”

If fathers ever think they don’t matter, they should sit in my seat and listen to the pain they can generate even when they are not there.

A Virtual Reality Devotional

Stained glass window

The body lies prostrate

On the confessional floor

A weakened avatar

Your closed door

Heartbeat slowed

From afar

Fading finally

Into empty code

Mere tokens

Conquests

Meaningless and broken

Nothing of value

Can be taken

Only the memories of love

Gained and lost

And gained again

Virtual virtue

Virtually gone

And truth now clear

Life

Turned into fear

Death 

A final frontier

Hold your breath

It is not so painless 

As they wanted us

To believe

Pecking Order

Flamingos fighting

Just take a nip 
Here and there
So I can be pretty
Fix my hair
Pull and tuck
Gouge at my eyes
Make me look pretty
Slim my thighs
Whiter teeth
A larger bust
I’m still not pretty
Another adjust
Raise those cheeks
Now my nose
Got to look pretty
Paint my toes
Some fuller lips
Sharper jaw
She is so pretty
Fills me with awe
Chisel me down
Tighter skin
I could be pretty
If I were thin
Sew me up
Dress me up
Give me more pain
So I can feel alive
So I can feel loved 
Still not happy
Just a pinch more
Want to be pretty
Want to be adored
Soon I’ll be there 
You wait and see
Soon I’ll be pretty
Soon I won’t be me