Archive for the 'Short Stories' Category

A Moving Target

He was a new patient. His medical records described him as severely hearing impaired and suffering from a rare movement disorder. He arrived with a caseworker for his 11:30 first appointment and I was running late.

“Why is a new patient or a minor surgery procedure ever scheduled at the end of the morning instead of at the beginning”, I asked Autumn, rhetorically.

The man seemed to be bouncing around in the small exam room. His head bobbed randomly and his body moved like waves in a wading pool full of three-year olds.

I introduced myself. His caseworker, clipboard in her left hand, shook my right hand. The man floated toward me, cocked his head suddenly and hollered while pointing to his right ear:

“I can’t hear!”

“For how long?” I asked.

He didn’t seem to hear me.

“At least a few years from what I know”, his caseworker answered, drowned out by the man’s repetition, “I can’t hear, I can’t hear!”

He seemed irritable, frustrated, and there was an air of desperation in the room. The caseworker looked helpless.

It was 12:35.

“Let me check your ears”, I said, gesturing with the wall mounted otoscope.

“I can’t hear!” the man shouted.

As I leaned toward him I could smell the odor of ear wax. I tried to gently grab and pull his right ear upward and back while I held the otoscope head between my right thumb and index finger and leaned the pinky-side of my hand against his cheek.

His head moved back and forth, up and down. Pushing my right hand firmly into his cheek, I moved with him, as if we were both bouncing on an underinflated air mattress.

All I saw was ear wax.

I repeated the procedure with his left ear. It, too was impacted with black, smelly cerumen.

“Let me flush your ears”, I said, loudly, into his right ear.

“I can’t hear!” he hollered back.

“I’ll be back”, I said and gestured with my index finger straight up as in “one minute”.

So followed an awkward dance with the man sitting in the exam room chair by the sink, Chux pad on his shoulder, the caseworker holding the cup under his ear and me flushing his right ear with lukewarm water from a large plastic syringe. All three of us moved in near-unison, again and again in what looked like multiple attempts to master a Tango step, sometimes rising at the end, sometimes sinking down or pausing mid-movement, all three of us.

The ear wax poured into the cup and large amounts of water saturated the Chux pad and the side of the man’s neck. Some of it landed on me.

As I eased myself away each time from our virtual embrace to empty the cup of clumpy wax soup into the sink, I watched through my splattered glasses for a reaction.

After the fifth or sixth serving, the man’s movements stopped suddenly. He shook his head like a wet dog. Slowly, he cocked his head and I could sense how he was trying to listen.

The aura in the room changed. Everything seemed quiet and peaceful. He was perfectly still for what seemed like half a minute. The caseworker picked up her clipboard and clicked her ballpoint pen. The ceiling air vents blew their gentle, artificial breeze. Someone walked down the hall outside the exam room.

“I can hear again. Thank you”, he said in a normal voice.

“Fantastic. Are you ready for the other ear?” I gestured with the otoscope. It was 12:49.

His head started to gently move again.

“Let’s roll!” he grinned.

If 911 Worked Like a Medical Office Phone System

Thank you for calling 911 or your local emergency response number.

Please listen carefully as our options have recently changed.

If this is a life threatening medical emergency please press “1”.

For non-life threatening medical emergencies, please press “2”.

For fire, press “3” but for a fire with life threatening burn or smoke inhalation victims, please press “31”.

For fire with non-life threatening injuries, please press “32”.

For Police, press “4” if you wish to reach State Police.

For your local police department, please press “5“.

If you don’t know which police authority to call, please press “6” for traffic related complaints, “7” for domestic assault that has happened in the past, but “71” for ongoing, life threatening assault and “72” for ongoing, non-life threatening assaults.

Press “8” for burglaries that have happened in the past.

For burglaries in progress, please press “9”.

For all other inquiries, please press 0.

To repeat these options, press the “#” key.

The Night Before Surgery

On a hot afternoon in July Harold “Junior” Bray walked around his small farmhouse one last time before it was time to leave for the hospital. Everything was in order – the coffee maker was unplugged, the windows secure and the message on his brand new answering machine informed callers that he would return their call as soon as his health permitted.

Every step was deliberate, slow and painful. Whenever he could, he leaned on something close by to redistribute his weight away from his arthritic left hip.

Harold Bray Jr’s place was neat as a pin. Widowed for fifteen years, he ran his one-person household just the way he had run his little store. Everything was always well organized, clean and fresh. Even now, he rotated the dry goods in the kitchen cupboards, so that nothing ever went out of date.

At precisely one fifteen he locked his front door and hobbled across the gravel front yard to the car. As he turned the ignition, the gas gauge rose to FULL and the small motor started obediently. He drove exactly the speed limit all the way to Cityside Hospital and arrived promptly at three o’clock.

The woman at Central Registration had his paperwork, a plastic card with his personalized information embossed and a bracelet with his name, birthdate and his orthopedic surgeon’s name.

Up on the orthopedic floor, a nurse and a young doctor, an intern, assigned to Dr Oberlin’s service, greeted him. He answered questions, signed some papers and underwent a detailed and lengthy physical exam by the young doctor, who was obviously very nervous, but Harold could tell how sincere and enthusiastic he was about being an intern.

After dinner, which was actually better than he had expected after hearing his neighbors’ and friends’ accounts of their hospital stays, Dr. Oberlin stopped by. He wore a wrinkled summer blazer and a white button-down shirt with a loud, wide paisley tie. He spoke confidently about how routine this operation would be and wished Harold a good night.

“See you in pre-op at seven tomorrow”, he waved on his way out of Harold’s room.

Harold watched some TV until a night nurse came in and announced it was time to start preparing him for tomorrow’s surgery. A Nurse’s Aide arrived and he was id-checked and sent to the bathroom with special soap to shower. After he had dried off, the nurse came in with a sleeping pill. He wasn’t sure he needed one, but accepted it to be sure he had a good night’s sleep. By nine o’clock he was sleeping peacefully and when an orderly rolled his gurney into pre-op at six forty-five, he really didn’t feel nervous. He figured he was ready, and he had waited long enough for his new hip.

.

On a hot afternoon in July, Harry Bray paced the floors of his run-down little farmhouse. Opening cupboards, closets, desk and kitchen drawers, he searched for the letter with pre-op instructions Dr. Gleeson’s office had sent him. What time was he supposed to stop eating? When was it he was supposed to shower with that special soap? When did he need to be at Cityside to check in in the morning? Was it really five thirty?

He finally found the instructions and threw himself, as much as his a sixty-eight year old arthritis-ridden body allowed any sudden movements, down in his blue velour recliner. He had managed to swing by the refrigerator and now he popped open a cold beer – after all, the sun was over the yardarm, and he definitely needed something to steady his nerves.

Harold Bray, III’s house was the same one his father had spent most of his life in, the one he had died in at the ripe old age of 88. Harry inherited it, just like he inherited his father’s crippling arthritis. He looked around from where he sat – the place was a mess, even he admitted it: Overfilled ashtrays everywhere, piles of magazines, clothing strewn about, and now drawers left open from his panic-stricken search a few minutes ago.

He lived alone, always had, and he seldom left the house. He was nervous about driving through the woods to town all by himself at four in the morning, the worst time for wildlife.

The afternoon passed slowly. He had a couple more beers, tried to watch TV, tried to get his cousin Ned on the phone and actually managed to take a short nap after his three o’clock pain pills kicked in. At five thirty he opened a can of beef stew and ate it cold – it was too hot to bother warming it up.

After he ate, he watched some TV, ate a bag of chips and finished off the beer in the refrigerator.

All night he tossed and turned, catching fifteen minutes of fretful sleep here and there. He dreamt about hospitals, about something going wrong with the anesthesia or surgery, about hitting a moose driving through the woods at four in the morning.

At three o’clock he gave up. He got dressed and almost drank a cup of coffee before catching himself – he wasn’t supposed to eat or drink anything before the surgery.

Route One was dark. One of his headlights was dimmer than the other; the plastic lens was all scratched and fogged up. His eyes kept fogging over, too as he tried to watch the edge of the woods and the yellow centerline at the same time.

Suddenly, rounding a curve, there he was – the big bull moose from his nightmare. Harry slammed the brakes and swerved to the right. The moose froze and the car slid in slow motion toward the steep ditch. Suddenly the moose turned to the left and ran. Harry turned the wheel sharply to the left. The old pickup truck groaned and bounced back in position in the road again but with an unmistakable grinding in the right front end; he was driving on the wheel rim.

At exactly five thirty Harry hobbled through the hospital pneumatic doors, drenched in sweat, dirty to his elbows and with black rubber stains even on his forehead.

He cleared his throat as the receptionist raised her eyebrows and looked him over:

“I’m Harold Bray, III and I’m here to have my hip operated.”

Life and Death

Elmer Ladd built the little pink house at the end of our road just in time for their wedding on New Year’s Eve 1953. The pre-cut Aladdin home caught Elmer’s eye when he first saw the catalog. Eileen picked the color and the two of them knew from the day they moved in that they would always live there, close to his work at the train station. Every day after the 12:05 had left, Elmer came home to eat lunch with Eileen. At precisely 12:50 he put his cap back on and left to greet the 1:05 southbound Express. Every afternoon when their daughters returned from school, Elmer was home again to spend a few minutes with them before returning to the station for the next train.

After Elmer retired from the railroad, he and Eileen spent all their time together at home, caring for the little pink house and the small garden. For the first few years he would still listen for the trains, but eventually he learned to ignore them. Ten years after his retirement the trains stopped running through our town and weeds grew quickly between the abandoned tracks.

One day a stray dog wandered into their yard, an off-white spaniel mix with brown spots scattered over her back. Eileen thought the dog looked like a large mushroom when she first noticed her through the kitchen window. They called her Mushroom, and she quickly filled the void they had both felt in their life.

With Mushroom two paces ahead, behind or to the side, Elmer did the rounds around town morning and afternoon. The sweet-tempered dog made friends along the way, and Elmer tipped his old uniform hat to passers-by and shopkeepers as they walked. He had found a purpose and a routine again, and he was thriving. He constantly talked with or about the dog, and called her his little girl.

Then the seizures began. The veterinarian was not able to control them with medication, and Eileen worried that Elmer wouldn’t be able to get the dog back home again if she were to have a seizure on one of their walks. They stayed closer to home and Elmer’s world got smaller again.

Mushroom, sweet and gentle as ever, seemed content to stay inside the house or in the yard. On warm summer afternoons she dozed under the white porch swing while Elmer and Eileen sipped lemonade in the shade. More and more often and without warning, the dog would suddenly start convulsing to the point of losing control of her bodily functions, and the helpless elderly couple would kneel beside her and quietly pray for each spell to end. After she came to, Mushroom would seem confused, docile and grateful to be near them. She would wag her tail quietly and put her muzzle in the nearest hand or lap and fall asleep.

Summer turned into fall, and then winter. As the seizures worsened and came more often, Eileen broached the subject of putting Mushroom out of her misery.

“But does she suffer?” Elmer asked.

“I don’t know, but we mustn’t be selfish if there is any chance that she is”, Eileen replied.

“It’s not for us to play God. He gives life and only He can take life away from any of his creatures.” Elmer’s voice almost failed him as he spoke back to his wife.

Weeks passed, and the seizures grew in intensity. On a cold January morning, Mushroom collapsed at the end of the driveway and seized more violently than she had ever done before.

“Elmer, you’ve got to take her to the vet. You can’t let the poor dog suffer any longer.” Eileen sobbed: “Can’t you see it’s time?”

Without saying a word, Elmer put on his hat and jacket and trudged through the freshly fallen snow to the dog who lay quivering down the hill from the house.

He lifted Mushroom and walked slowly back up the hill. As he approached the car, Eileen ran out to open the back door for him.

His face was dusky, his breathing wheezy, and he moaned quietly as he leaned into the vehicle with Mushroom, whose limbs hung flaccidly as he coaxed her into the crowded back sat of the small sedan. The dog snored and exhaled loudly.

Silently, Elmer put his arms around Eileen. She sobbed. Then he opened the driver’s side door and sat down behind the wheel. Just as he turned the ignition, he took a deep breath as if he meant to say something. Then his head slowly nodded as his body fell, lifeless, over the steering wheel. The horn blared and the dog raised her head in the back seat.

Eileen reached in and tried to pull him away from the steering wheel. She managed to turn off the ignition and as she did, she knew her husband was gone. She acted quickly, but the ambulance crew pronounced the love of her life dead at the scene.

Mushroom came prancing down the street this afternoon, her spaniel tail and feathers waving in the warm breeze of what felt like the first day of spring. Ten paces behind came Eileen. The two of them make their rounds every day now the way Elmer and Mushroom used to. The new veterinarian in the next town seems to have found the right medication to control the dog’s seizures, and life somehow goes on for Elmer’s two girls.

The Gift of One Day

A hard frost had claimed the white Geraniums in the flower boxes on the south side of the little red farmhouse a week earlier. Then Columbus Day weekend brought bright sun and the gift of summer temperatures again.

His family brought him outside around noon and placed him carefully near the east-facing wall where the unseasonable warmth of the sun and the gentle breeze made the temperature just right for the ailing elder.

His cough, which had rattled his chest every few minutes day and night for the past several weeks, ceased in the warm afternoon air. His facial expression relaxed with the slowing of his respirations. His clear, brown eyes squinted in the bright light as his furrowed face turned toward the sun.

From where he sat he could see the tall apple tree in the front yard, the raspberry bushes by the edge of the woods, all leafless now, and the big asparagus patch in the middle of the east lawn. He knew every inch of this place; he could follow each path through the woods in his mind, even now when his legs couldn’t carry him there anymore. He loved this place, this little farm, his place on Earth.

He fell into a quiet, blissful sleep. The neighbor’s potato harvester groaned in the distance and the sound of restless geese, preparing for their autumn flight, echoed from the riverbank nearby. He nodded his head quietly without opening his eyes just as his favorite horse, a kind, gray mare, made her usual blowing sound of contentment from her sun drenched spot along the red barn wall. She stomped one hoof after the other into the hard barnyard ground to chase away flies that had returned with the warm weather.

Later, when Cheryl and Allan pulled up the long driveway in their white convertible with the top down for the last time this season, on an impromptu foliage tour from the city, he opened his eyes and squinted in the sunlight again. He leaned forward and puckered his lips, half frowning, when their border collie lapped his scraggly chin like an ice cream cone.

Whenever Cheryl and Allan came, it was always time for coffee. They offered him sips, but he didn’t drink much. He fell asleep to the tinkling of cups and chatter of voices on the lawn as the warm afternoon inched toward evening and the sun moved westward across the sky.

He woke up with a slight chill and someone pulled his blankets tighter around his shoulders. He coughed slightly and the family quickly started moving inside.

He watched with a twinge of disappointment as Cheryl and Allan piled into their little sports car and buckled the dog’s harness in the back seat. They had a long drive back to town.

By suppertime he was fast asleep in his temporary bedroom in the glassed-in front porch with the heater going and several blankets to keep him warm. This space had allowed him to still be part of all the comings and goings of farm life while confined to his sickbed.

After the supper dishes were done and the barn animas had been tucked in for the night, everyone else went upstairs to their bedrooms. The old one slept peacefully in his glass bedroom downstairs under the cold, starry night sky. Frost formed again on the lawn and rooftops.

The goats chewed their hay. The gray mare stomped her hooves now and then against the barn floor. The old one’s breathing grew labored and quick with a faint wheeze. A chevron of geese appeared in the southwestern sky. Their faint, rhythmic whooshing sound followed the breaths of the old one and grew louder as the birds’ silhouettes crossed the bright yellow harvest moon on their long, inevitable journey from this one to their other home, thousands of miles away. As the sound of their flight grew quieter again, the respirations of the old one grew fainter and further apart. He was already almost home.

(For S…)

The Dance (2011)

The band members brought their instruments and their small amplifier system into the activity room through the big glass doors facing the parking lot. As they tuned their instruments and warmed up, the residents started to stream into the big, bare room.

Some arrived in their hospital beds, some were pushed in their wheelchairs, some shuffled in with canes and walkers and a few strolled in with the spring of anticipation in their steps.

There had been bands there before, but this was a real dance band with horns, percussion and a female vocalist.

He walked down the long hall with a group of others from the dementia unit. By now he knew the way, even though his eyes failed to guide him because of his advanced macular degeneration. He could see the nurse’s aides in their brightly colored scrubs, but he had trouble making out his fellow residents in the slow caravan.

As they approached the activity room he heard the sweet sound of the vocalist and the wind instruments. The rhythm energized him and he remembered dancing to Glenn Miller and Artie Shaw tunes like “In the Mood” and “Begin the Beguine” in the Forties. He suddenly felt sad. Where was his wife? Why wasn’t she there with him?

One of the aides escorted him to a chair along the sidewall, close to the band. They were playing something Latin he didn’t know what to dance to. He couldn’t see if anybody was dancing yet, but the music was cheerful and made him feel good.

Eyes turned toward her as she entered the room. She felt pretty in her blue dress and shoulder-length black hair. She saw him sitting by the band and quickened her steps, her left leg swinging outward in a slight semicircle and her arm kinked at the elbow. It had been six months since her stroke and this was her first dance since then.

He noticed the blue dress as she approached him, but couldn’t tell at first who she was.

“Have you been waiting long?” she asked.

“Well, hello, dear. I just got here.”

“I’m so glad to see you”, she whispered in his ear before planting a discreet kiss on his cheek. She sat down next to him. She made sure to place herself so she could touch him with her good arm.

The band started playing a new song. He realized after the first few bars that it was “Tuxedo Junction”. Years ago he would have done the Lindy Hop to it, but he couldn’t pull that off now. This would be a nice, slow swing dance.

“May I have this dance?” he asked.

“Well, certainly”, she answered and gave him a slight squeeze.

She led him onto the improvised dance floor with her right arm and they stood there for a few bars, her right hand in his left, both of them just moving slightly to the rhythm. He led her into first the basic step, then a push-out and then an underarm turn. She followed beautifully. They danced the whole song without saying anything at all.

The next tune was a slow waltz. She was able to put her left arm up on his right one and he danced gently with small steps. His eyes strained to see her facial expression, but he didn’t see the tears that had begun to well up in the corners of her eyes.

“I’m sorry I was away for such a long time”, she whispered.

“It’s all right”, he answered, patting her on the back as they danced.

“I was really sick and couldn’t come to see you.”

“It’s okay.”

He didn’t see the scars on her bare arms or the tracheostomy scar over her windpipe.

“I’m so glad I am here with you today.”

“I’m glad you came”, he said and added “I love you.”

By now, two floods of tears were streaming along her pale cheeks and down her neck, across her demon and snake tattoos, wetting her jet-black hair.

“I love you too, Grandpa.”

Switching Places

At 3 o’clock in the morning the emergency room was quiet. The aroma of fresh coffee from the staff lounge seemed welcoming and reassuring as I slowed my steps walking down the long, chilly corridor from the on-call room in the old psychiatric wing of the hospital.

One week into my psychiatry rotation, with almost two years of residency experience behind me, I was on call for psychiatry for the first time.

All I knew about the patient I was about to see was that he was a middle-aged man who was “seeing things”.

I poured myself some coffee and took a few sips. My sleepiness dissipated as the coffee warmed my chest. Walking into the nurses’ station I got sassed about working on the psych ward now instead of where the real excitement was.

I gulped a few more sips and put my cup away in a corner where I might find it again later. Grabbing the chart, I scanned the available background information on Jan-Erik Melander, a married 45-year old engineer, who was “seeing things”.

He rose politely as I entered the room. His wife sat next to him, red-eyed and quiet. She looked sad and tired.

I introduced myself and we sat down. “What’s been happening?” I asked, in Swedish.

Jan-Erik sighed and pulled his long-fingered hands through his thick, unruly hair. His eyes were dilated and he must not have shaved for several days.

“Nothing has happened”, he answered with an impatient tone in his voice. His wife looked at me, then back at her husband.

“Tell him about the TV”, she said quietly.

He gave her an irritated look.

“You don’t believe me”, he hissed.

There was silence.

“Believe what?” I asked.

“It’s not just the TV. That just confirms it”, he said emphatically.

“Tell me”, I suggested.

“OK, I’ll tell you what I know”, he said in a low, controlled voice, pulling his chair closer while fixating his eyes on mine.

“I have come to realize”, he explained calmly, “that we are not alone in our solar system.”

I made myself nod.

“Analyzing various coincidences I have realized there is a planet at the opposite point in the solar system from Earth with the exact same molecular composition. Everything there is an exact replica of everything here, even you and me!”

I nodded again and let out a “huh”.

“It cannot be seen, because its location is exactly at the opposite point of Earth’s orbit around the sun.

I found myself in no hurry to end my encounter with Jan-Erik. It was an interesting thought, perhaps the plot of a sci-fi movie, and I didn’t feel alarmed.

As if reading my mind, he looked furtively around the room, moved within inches of my ear and whispered:

“In three days our planets will switch places. They will be here and we will be there, and then we will be annihilated!”

His eyes widened again and he raked his greasy hair with his long fingers.

“I happened to intercept one of their radio signals on the UHF band on the TV in the den a few nights ago.”

He got up and started pacing.

“Jan-Erik, please stop!” his wife sobbed. “You’re not eating, you’re not sleeping. You’re driving us all crazy!”

“None of you believe me”, he accused, his pale blue eyes boring into mine.

It was my turn to speak, to do something as the resident on call for psychiatry. Nothing in my medical school training had prepared me for choosing the right words.

“Are you the only one who knows?” I asked.

“Yes. Nobody else knows. Nobody else believes what I tell them.”

I thought for a moment.

“I don’t know what to believe”, I said. “You must be exhausted, the only one with knowledge of something this huge…”

“You’ve got to help me stop this”, he said. “There isn’t much time. We need to tell the government and the military!”

“I can’t help you get through to them, and I can’t help you convince them. I’m just a small town doctor manning the fort until 8 am”, I said. Inspired, I continued:

“What you need right now is to avoid exhaustion. You are already running on empty. If you hope to get through to someone in charge and have them take you seriously, you need to be clear-headed. My suggestion is that you stay here tonight, get a couple of hours’ sleep and figure out in the morning how to proceed. Nobody in charge is going to be available at 3:30 anyway.

He seemed suspicious.

“You’re safe here”, I reassured him. “You can sleep in one of our observation beds. Then, in the morning I will introduce you to the head of our clinic and he can help us deal with the situation.”

He hesitated. My heart pounded and my mind raced. Swedish law, at least in 1980, made it impossible to commit psychiatric patients involuntarily from within a hospital that provided psychiatric services. An outside physician had to petition the legal system for this. Besides, there was no indication at this point that Jan-Erik was homicidal or suicidal. Maybe he wasn’t even dangerous to himself or anyone else – yet.

“Maybe just a couple of hours”, his words interrupted my internal dialogue.

“A wise decision”, I affirmed.

Suddenly he flew out of his chair and darted toward the exam room window that overlooked the highway between the hospital and the nearby soccer arena. Before I was even out of my chair, he had opened the window and climbed up on the marble windowsill.

“Wait!” I called out as his wife ran over and grabbed his arm. “Don’t get hurt, and don’t wear yourself out!”

“OK”, he resigned. “I’ll stay until eight.”

I called for the nurse and an orderly and we brought Jan-Erik over to the psychiatric ward, where he was checked into a room near the nurses’ station.

I slipped away to the on-call room and laid down on top of the bed with my already rumpled scrubs still on.

An hour later, my pager went off. The charge nurse wanted me to come and see Jan-Erik. When I arrived on the unit he was standing on a chair, talking loudly to a couple of patients in the TV room. Their interest seemed to be fading quickly and as they turned away from him, he caught sight of me.

He put one foot on the back of his chair and reached for the skylight molding. Heaving his lanky body up into the light well, his legs wiggled in all directions. The wooden chair fell to the floor with a loud clatter and there he hung, legs still flailing about.

“You’ve got to get some rest”, I said as calmly as I could.

“OK, just help me down”, he said.

Together, the nurse and I guided his descent and he allowed us to lead him back to his room, where he finally settled down.

After morning rounds I was no longer responsible for Jan-Erik Melander’s physical or emotional safety. The assistant chief of the psychiatric clinic took over with a slight nod of approval after I presented the case history to him.

Driving home, I thought about the twin planets at opposite ends of the solar system and how Jan-Erik’s life had taken such a drastic wrong turn out of the blue.

At home I showered and fell into bed. I must have fallen asleep instantly.

I woke up at noon to the smell of fresh coffee. The sheets were twisted around my body. My heart was pounding and I felt clammy all over. My throat was sore and my muscles ached. I remembered running, screaming desperately to warn people about the impending switch of the twin planets.


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