Chapter 9

"Diving Into the Undertow"

IT'S TAKEN ME HOURS TO GET THIS EXACTLY THE WAY I WANT IT …

I'M NOT USING REFERENCE LITERATURE AND NOT COMPILING A BIBLIOGRAPHY. WHY BOTHER? IT'S GOING TO BE COMPLETELY EXTEMPORANEOUS. SORT OF A PSEUDO-TYPE ORIGINAL IMPROMPTU IMPROVISATION. THEREABOUTS OR CLOSE-TO … SOMETHING LIKE THAT. A FEW SUGGESTIONS OF SPECULATION AND A TOE TO TEST THE WATER, SO TO SPEAK.

I MAY BE THROWING IN A BIT OF POETIC LICENSE, OKAY?

I'M CAREFULLY MANIPULATING THE TERMINOLOGY AND THE LANGUAGE; POURING OVER EACH TINY DEFINITION AND CHECKING THE PLACEMENT OF EVERY PUNCTUATION MARK. I'M CAPITALIZING ON COLORFUL INUENDO IN THE INFLATED MANNER OF GREGORY HOUSE, THAT NOTORIOUS, GENIUS DIAGNOSTICIAN, LATE OF NEW JERSEY.

*SO EASY TO DO, SINCE HE'S ME! I WONDER: SHOULD I REALLY KNOCK HIM OFF? NOT YET, MAYBE. I SHOULD WAIT AWHILE … SEE WHAT (IF ANYTHING) HAPPENS.*

I'M INCLUDING HERE, JUST ENOUGH TECHNICAL JARGON TO TEASE EVEN THE MOST CYNICAL OF READERS; ADDING MORE THAN ENOUGH BUZZ WORDS AND OBSCURE, MANUFACTURED-PRODUCT INNUENDO TO DILENIATE RENAL DISFUNCTION AND RAPID KIDNEY FAILURE. I'M INSINUATING THE USE OF EXACTLY THE CORRECT AMOUNT OF ADVANCED TECHNIQUE FOR AN INNOVATIVE PROCEDURE, MAKING IT VIRTUALLY IMPOSSIBLE TO CONFIRM OR DENY WITHOUT AN EXTENSIVE BATTERY OF TESTS AND SCANS TO BOTH PROVE AND DISPROVE THE DATA …

WHICH WILL LEAD NOWHERE, EXCEPT BACK TO THE BEGINNING. "ROUND ROBIN", SO TO SPEAK.

UNLESS THEY KEEP A TOWER OF REFERENCE BOOKS AT THEIR ELBOWS. AND EVEN THEN …

I'm also including step-by-step specialty procedural recommendations with enough confusing psycho-babble that would render a translation utterly redundant. The paper is a stroke of genius, of course.

Look who wrote it!

What an absurd labyrinth of double-speak; a total pain-in-the-ass to read. The language is legitimate, however. The step-by-step tedium of the entire article presumes to be a work of intricate and extensive research.

What it does is subtly allude to the medical idiocy that emerged between doctors when I had the infarction and they could not diagnose it.

What it doesn't do is make a damn bit of sense.

I rest my case.

I smiled as I read through it the second time, thinking, "Wow! Sounds just like: 'The Song that Doesn't End', by Lambchop."

Happily, I scrawled the byline: "Kyle Calloway, M.D.", and made no effort to disguise the flamboyant handwriting of the signature. I addressed it to an obscure medical journal published somewhere in California. (California will publish just about anything.)

Definitely not to JAMA. Not yet. I had to get that strange moniker a little more well-known first … try to make the hogwash go viral.

Down the line somewhere it would be inevitable that some intern on his lunch break would attempt to plough through it. An eyebrow would raise, then a head-scratch of confusion. His "bullshit" monitor would heat up to RED ALERT …

What I was counting on was: a busy, overburdened senior doctor would glance at the thing being thrust in his face by a first-year Probie. He would squint at the terminology, wonder if he'd been working too hard, and toss the thing in the trash in disgust. That might open a six-to-eight-week window before somebody responded with a letter to the editor, wanting to know who in hell this idiot "Kyle Calloway" was, and the accusation that he was a total quack, or had made a breakthrough in kidney disease research that would revolutionize modern medicine.

*We shall see what happens next …*

Tonight I'm perched on the front porch with my leg propped on a pillow before me. I'm sweating like a race horse and I have the shakes. I just finished a round of leg exercises and I feel like I've been rode hard and put away wet. There is no drink beside me because I'm not capable of carrying one out here, and my hand is clamped over leg spasms that resulted from forcing all my muscle fragments into doing the work of a quadriceps that is no longer there. I'm still trying to deny how much the damned thing hurts, and also trying to wait another hour before taking a second Vicodin.

I've been doing the exercises Hooley took me through the second day I was here. I didn't tell him that I'd learned them my first year in med school, but he probably already guessed. I'm trying to make it work this time with the same sort of determination I used after the infarction to avoid them.

I know I'm getting close to the end of my range of options, and if I don't do something now, and keep up with it, I will probably never walk again without crutches. I'm more afraid of that than I am of the pain. So I do the exercises, and then sit and gasp and sob with twice the pain I would have endured if I hadn't chickened out and done them the first time around.

Wilson tried to tell me a long time ago, but I just wouldn't listen. And now here I am …

My fear of the pain that the exertion caused years ago, even knowing it would eventually get better, added to my crummy attitude while I sat and felt sorry for myself, and then lurched around the hospital like a three-legged frog. It's coming back to kick me in the ass. I would not let another person, then, see me in so much agony that I was reduced to tears and rocking back and forth squeezing my leg in a death grip.

Now I don't care … most of the time. Hooley has seen it on occasion and has not blown it out of proportion. It is what it is. He's a good guy and we get along well. I try to take his suggestions even though his profession is … can I say … 'beneath mine' … ? But we are not so close that we have begun to share a history. I know nothing of his personal life, and I'm not really interested. Neither is he, I suspect, in mine. He knows I've lied to him at least once, but it doesn't seem to bother him.

When he sees I am in the kind of pain that reduces me to my lowest common denominator, Hooley understands. He gives me space, not sympathy. Tylenol 3, not a hug. He will knead the angry muscles if I ask, but I do not do that often. He gets it.

The last time I talked to him, I asked him if he could scare up an old radio somewhere so I can listen to other kinds of music besides Calypso. Some rhythm & blues would be nice …

"Not a problem, Mon," but that's what he always says when I ask for something … which isn't often either. He did drag the old rattan chair and stool out here for me, and a small table for odds and ends that I use mostly to hold my laptop, an ashtray and a coffee cup. Sometimes a glass with something stronger than coffee. I sit here in the evenings, doused with insect repellent and my leg propped up, hurting like hell after the exercise sessions. I just stare out over the water, distracting myself with odd cloud formations and watching the shadowy forms of kids cavorting further down the beach.

From here I can catch a few strains of the juke box at Amos' Tiki Bar as it floats on the tropical air, and I listen for the occasional strains of Dean Martin or Frank Sinatra thrown in with Don Ho and Israel Kamakawiwo'ole. It's pleasant, but boring. I'm a little too far up the beach to actually catch what goes on there, but I can hear the high-pitched laughter of the women sometimes, and kids playing and the caterwauling of the 'Wah-Wahines' whether I want to or not. Slide guitars and mariachi rhythms are not my first choice in music, and after a while it has a tendency to put me to sleep even when I don't want to sleep.

I sip my drink, smoke a cigar or two and picture the noisy little dive as I remember it the night I first arrived on the island. I wasn't in very good shape then, but I'm better now. At least I don't feel as though I might pass out every time I try to walk. I can now clean up my own mess, make my own bed, cook and do dishes. It takes me some time, but I get it done.

And I do the leg exercises regularly; sometimes twice a day. I have to, or I'm in deep shit. It isn't a choice anymore.

There is new, fragile scar tissue forming over the open wound above my knee, and when I'm inside the cabin I can usually move around okay with the cane. My knee doesn't bend very well yet, so going outside is a different story. Some days I get restless and go out to wander around near the back of the cabin … check out the generator and the fuel and the water tanks. After a few months here, none of the gauges on those things seems to have moved more than half-inch or so. When I go out there … let's face it … I keep a watchful eye out for fresh footprints and furtive figures in the bushes. And I use the sturdy arm-canes that Hooley brought me.

Truth to tell, I'm glad for them. I'm not stupid, though some people might tell you different. But I know what I know, and I know my leg isn't going to get much better that it is right now. I can't bear full weight on it. Not even close. My knee swells and is totally out of whack. I can feel the beginnings of contracture.

After I attempted to fillet myself in my bathtub back in Jersey and had to have another bout of surgery, things are pretty much screwed up forever. My foot turns inward, and in the mornings I'm totally useless until I can work it loose. That hurts like hell, and exercises don't touch the foot part. I guess the only way I can straighten it permanently is with a sledge hammer.

I haven't told Hooley. He has promised he will not interfere again, and he hasn't. But I'm beginning to see the writing on the wall.

The longer I'm alone to think, the more I realize the ungodly mess I've made of my life. My thoughts wander around in ceaseless disarray when I think too much … but so be it. I'm also beginning to realize I need to reconcile those thoughts and deal with them in a rational way instead of stuffing them up my ass to fester and swell to the point of blowing myself apart in a shower of entrails. I tell myself over and over again that "feelings" isn't a dirty word.

There was a time when there were people I liked and who liked me. A long time ago I had one or two friends I went to football and soccer games with; played golf with and bar-hopped on weekends with. Went cruising for pretty females with … doctors like me. Wilson was one of them. We played poker and got drunk on weekends. We ate lunch in the cafeteria and raised hell with older staff physicians until they all hated us. But we were good at what we did and they knew it and always cut us some slack.

I even thought I was in love once. No, twice.

The first time might even have worked for both of us if I hadn't let myself turn into such a pure, unadulterated ass.

Stacy Ames was a constitutional lawyer. She was gorgeous, built like a brick shithouse, and had a quick comeback for every smart remark I ever made. She was my intellectual equal in every way, and she was my friend first. Our relationship blossomed quickly. Like a flower in bloom, and almost overnight she moved into my flat. Our love grew and flourished, and we did things in a big way and went everywhere together. We argued and teased one another, made mad passionate love and got up in the mornings and did it again. We shared breakfast and then went our separate ways to work.

We laughed a lot and I toyed with the idea of asking her to marry me.

Then the infarction hit, and I turned into a screaming, insane wild animal, out of my mind with pain, and the hospital staff accused me of drug seeking. But I was a doctor, for god's sake, and some of them knew me and knew I didn't use drugs. Nothing I might have said or done, had I been able, would have convinced any of them that I wasn't about to overdose or kill myself once the first accusation hit other ears. I was screwed.

They isolated me, thinking to detox me, and I spent hours screaming in agony until my voice was gone and I didn't even know who or where I was. I lay sweating until the bed covers were wringing wet; cursing and striking out at anyone who came near me. Only when I went into cardiac arrest did they do anything to help me. They never found needle tracks on my body, but they still were not convinced.

After that it was like something tripped a switch in my brain and I turned into an out-of-control madman. I snapped and lunged, tore at the sheets until they finally sedated me with the drugs they'd accused me of Jonesing for. Then they let me lay there doped out of my head. Stacy could make no headway with them. I messed the bed and vomited green slime all over the sheets.

I was finally taken to surgery for a procedure that revealed I'd had an aneurysm in my femoral artery that clotted and caused an infarction. My quadriceps muscle became necrotic and they bypassed the dead muscle to restore circulation to the rest of my leg. I would not let them amputate, and opted to be placed into a drug-induced coma instead, until the worst of the pain receded.

Stacy changed all that while I lay unconscious, and I don't even want to think about the rest.

I turned away from everyone who cared enough to want to help me. I should have sued that fucking hospital for malpractice and put that entire medical team out of business. I still don't know why the hell I didn't. I insulted anyone who didn't meet my increasingly high standards … which was pretty much everybody. That way I made sure I kept myself on that pinnacle of control where no one could reach me, or even care to. I became detached, remote, indifferent and very much alone. I thought I liked it that way. Cold chills of hatred ran down my spine when I thought I saw someone look at me with what I interpreted as pity or disgust in their eyes.

Even Wilson avoided me, giving me space until I regained control of myself and calmed down. Time went by and I withdrew more and more. I didn't want to see anybody or be seen by anybody.

After my discharge and refusal to attend physical therapy, I holed up in my dirty little apartment and didn't even attempt to go back to work. I felt utterly useless, hobbling around on crutches. Stacy gave up and moved out.

As I look back on it now, I spent almost a year lolling around on my smelly couch, wrapped in a smelly blanket, eating Vicodin like M&Ms … my useless leg propped on a smelly pillow.

It hurt too much to bathe, so I didn't. I didn't eat, except for cholesterol banquets I had delivered from some pizza joint or other, and let the containers accumulate until I had made a fortress of old pizza boxes.

I went through booze by the gallon and Vicodin by the wheelbarrow full. I soon looked and smelled like an inmate in an insane asylum.

Enter: James Wilson and Lisa Cuddy.

*Christ!*

These were the only two people I couldn't get rid of. It seemed like one or the other of them was ringing up my house phone at all times of the day and night. When I finally pulled the phone cord out of the wall, they called my cell phone. I turned it off and hid it in my sock drawer.

Cuddy had a hospital to run, so it was mostly Wilson she dispatched to keep checking up on me. When I disabled all the phones, he used his own key that I had given him in an insane moment years before, and let himself in. He would 'mother-hen' me; clean up the living room and burn the pizza boxes in my fireplace. He would change my bed, practically carry me to the bathroom and see that I cleaned myself up. He once said I looked good unshaven, because the scruff hid the hollows in my cheeks that marked the weight I'd lost while dealing with the pain.

That might have been the turning point for my willingness to begin recovery, because I adopted the scruffy look as though it had been my own idea. Damn him! He would check the wound on my leg and bandage it when it needed bandaging and sometimes apply a heating pad when the skittery muscle remnants threatened to go into spasm. I would bat his hands away and berate him for everything he did to help. I tried very hard to chase him away so he would let me alone and get a life. He would ignore me and cook us a meal or send for 'healthy' take-out. When I yelled, he ignored me. When I became abusive, he would simply move to another room and return when I ran out of insults.

Now here I sit, thinking about the article I have just composed … the stupid, incomprehensible article written for only one purpose: to get the attention of the one person I knew who faithfully read medical journals. And I smile to myself. We are joined at the hip, Wilson and me. We always were and we always will be. I miss him, and I will find him if it takes the rest of my life.

I heard the dune buggy before I saw it.

I heard the "putt-putt-chug-putt-putt" of the motor coming up past the Tiki Bar. I heard the whoops and hollers and shouted greetings as Hooley raced past the crowd of people that seemed to hang there day and night, and I heard him give a war-whoop in return and hit the anemic little horn of the beast as he answered their greetings.

I had to smile to myself further as the bright orange buggy bounced into sight in a shower of sand in front of the cabin. Hooley grinned up at me from behind a pair of shades so dark that they blotted out his eyes. "I see you are out and about today," he teased as he hopped lightly out of the vehicle and hurried around to the passenger side.

"Oh yeah … Callaway went thataway …"

I watched him remove the sunglasses and reach into the back. He then upended what appeared to be a very large wooden box and raise it to his shoulder. Then I realized …

"You asked for a radio, eh, Mon? I brought you a RADIO! This one probably broadcast Franklin Delano Roosevelt declaring war on Japan!" He was grinning ear to ear, and soon I was laughing with him, as excited as a kid with a new toy.

I hitched myself out of my chair and reached down for the arm crutches ...

I followed him inside as he set the thing on the floor. It was big. It came up beyond my waist, and I'm a tall guy. Mouth hanging open like an oven door, I walked around it, peering at it from all sides. It was a powerful old Zenith floor model, probably manufactured in the late thirties. The dark wood cabinet was beautifully crafted; walnut, maybe? It had a large, round, black dial, and I could see that it was rigged for AM, FM and short wave. I could probably bring in stations from Tokyo if I wanted. The back of the case was open, the hard cardboard dust protector probably disintegrated years before. I could see inside the base that held the vacuum tubes, the speaker and the other electrical components that I knew nothing about.

My leg suddenly didn't hurt and I was grinning again. "This is beautiful, Hooley. Thank you. Does it work?"

He pretended to be insulted, but I knew better.

"Ah, Kyle Calloway … would I bring you a radio that does not work?

"Would you like me to plug it in?"

61