Case Report

DISCLAIMER: "THE METAMORPHOSIS," all characters and related indicia, presumably belong to the estate of Franz Kafka and are in no way my property, intellectual or otherwise. NO copyright infringement is intended and NO money is being made. I admit to being influenced by Vladimir Nabokov's conception of Gregor Samsa as a beetle rather than a standard cockroach, and applaud him for a thoroughly worthwhile analysis of this piece.


Never mind how you got there, or what year it is, or what you're wearing. All that's important-all that matters-is the job at hand and how quickly you can do it, and do it well.

Pretend you speak German for the sake of convenience. Fluent unaccented German with all the dots balanced in the right place and all the Capitals capitalized. They stare at you: a father in a uniform that was probably once impressive but is now dingy and unkempt, a mother whose wheezing respiration shouts of asthma, a sister who is thinking many things at once and not sure yet which one she thinks the hardest. And he is there, on the floor, unmoving.

Ignore the family and concentrate on him. He looks like a proper beetle, with hard elytra-wing-cases-over membranous wings beneath. Maybe three feet long, and rotund, like a June-bug; quite unlike a cockroach. Six legs, branched antennae. About halfway down one elytron, the remains of a rotten apple is visible beneath pale mold spreading outward from the impact crater. The elytron is broken in several places and very clearly the wing beneath is involved. Dark liquid gleams in the cracks.

You ask the sister to help you lift him to the dining-room table to make this easier, and the look on her face tells you a lot about his experience here these last few weeks. All right, you'll do it on the floor. Hand over your instruments and demand that they be boiled.

Remember your entomology. How do beetles breathe? He's far too big; there's a reason why beetles don't grow above a certain size in nature. That won't work. He has eyelids, which beetles do not have, and he has nostrils. What the hell is he? It matters from a physiological standpoint. Give him enough sedative to relieve the anxiety and distress of a human male of roughly average height and weight. Explain that you're here to help. His mouthparts make pronunciation difficult for him: reassure him that it's all right, he will be much better soon. He's very warm to your touch, and he's shivering like a frightened child.

Where are your instruments? Ask someone to check on them. The Librium seems to be working, so infiltrate with local as you would for a similar wound on a human. You can get the needle in between the edges of the broken chitin plates. Ignore the stink of the apple, or whatever it was, embedded in his back, and the cloud of fruitflies that rises when you approach the wound. It's foul, but you can feel sick later.

Finally your instruments are brought. Use swabs dipped in surgical spirit to clean away the whiskers of white mold. Under the alcohol his elytron's the deep glossy brown of a fresh chestnut. Dissect away the apple from the shards of chitin stuck in it and drop the rotting core on the carpet. It's all right to take a little quiet satisfaction in their disgust.

When the apple's out you can see that you were right, there are wings under the elytra, but the ulcer left behind has spread infection in a halo and the left wing is a lost cause. It'll have to go. Infiltrate the wing's root before excising what's left of it just after the joint. That can join the apple on their carpet.

The ulcer, once you've cleaned away the exudate, goes perhaps an inch into the tissue of his back. There's none of the evidence of critical infection you'd look for in a human, no red streaks in the flesh, but he's hot enough and in enough distress that some fairly hefty antibiotics are called for. This is what, 1915? Long before the sulfas, let alone penicillin. No idea whether he's allergic. Hope for the best and shoot him full of one of the broader-spectrum cillins.

With that done, you can debride the wound and wash it with boiled water-no chance of sterile saline here and now-and pack it with gauze before applying a light dressing. Now you can repair the elytron. He won't ever fly, with one wing gone, but it will at least look neat.

Use a sheet of acrylic to form a support for the broken pieces and a quick-dry epoxy to bond it. Prop it open with rolls of gauze to stop it coming into contact with the injured area while it cures. He's trying to talk to you again; stop and look him in the face despite the fact it's all bristles and jagged mouthparts.

No, he doesn't need to know your name. You don't matter. This matters, not you who've done it. You're done; it's done. It's time to go.