Chapter 46
"Exam Room Three"
I WAS STARTLED TO READ THE SIGN ON THE DOOR: "EXAM ROOM #3" …
I SHOULDN'T HAVE BEEN SURPRISED, SINCE IT WAS FAMILIAR TERRITORY. I RECALLED SOME OF THE IDIOTS I'D SEEN IN SIMILAR FREE-CLINIC ROOMS IN JERSEY, WHINING ON AND ON ABOUT THEIR SYMPTOMS. I ALWAYS SAT ON THE WHEELED STOOL AND ROLLED MY EYES AT THEIR UNINFORMED INSANITY WHILE I PRESCRIBED ANOTHER BOTTLE OF M&Ms …
I WONDERED IF THIS DOCTOR REGARDED ME IN THE SAME MANNER. PROBABLY. HE HAD NO IDEA WHO I WAS OR WHERE I CAME FROM, AND BRINGING ME IN HERE FOR A QUICK LOOK-SEE WAS THE LOGICAL CHOICE. HE WOULD LOOK OVER THIS LATEST IDIOT AND FIND OUT WHAT THE SCORE WAS.
ED THOREAU PUSHED ME FORWARD INTO THE ROOM, WHICH LOOKED JUST LIKE ALL THE EXAM ROOMS AT EVERY HOSPITAL EVERYWHERE IN THE CIVILIZED WORLD. AND SOME NOT SO CIVILIZED. EVEN THE WALLS WERE PAINTED THE SAME BORING: "TOOTH-DECAY YELLOW".
HE TURNED THE WHEELCHAIR AROUND AND PUT ON THE BRAKES IN FRONT OF A GREEN-UPHOLSTERED EXAM TABLE BUTTED AGAINST THE FAR WALL. "ARE YOU ABLE TO STAND LONG ENOUGH TO TRANSFER YOURSELF TO THE GURNEY, KYLE?" HE ASKED. "OR DO YOU NEED HELP?"
I SAID: "NO, I CAN DO IT." I RELEASED THE TENSION ON THE RIGHT LEG REST AND LOWERED IT, AND THEN PUSHED BOTH OF THEM TO THE SIDES. I WAITED FOR HIM TO BUZZ THE TABLE DOWN TO ITS LOWEST SETTING. CAREFULLY, I PUSHED OUT OF THE CHAIR, PIVOTED CRAZILY ON MY LEFT FOOT AND SAT DOWN ON THE SOFT VINYL SURFACE. THOREAU BUZZED THE TABLE UPWARD AGAIN AND LIFTED BOTH MY LEGS WITH EXPERT CARE AS I TURNED TO LIE DOWN. HE CONCENTRATED ON MY FACE AS HE REMOVED MY LEFT SHOE. "DID IT HURT WHEN I LIFTED YOUR LEGS?"
I SHOOK MY HEAD 'NO' AND MADE AN EFFORT TO RELAX.
HIS RIGHT EYEBROW ARCHED. HE KNEW A LIE WHEN IT WAS SHOVED AT HIM. HE QUICKLY COVERED ME TO THE WAIST WITH A SHEET AND REQUESTED THAT I LOOSEN MY JEANS. I STARED AT HIM POINTEDLY, AND HE INSTANTLY UNDERSTOOD THAT FROM A STRAIGHT, SUPINE POSITION, I WAS NOT ABLE TO REMOVE MY OWN BLUE JEANS.
HE WAS TESTING MY REACTIONS WITH EVERY REQUEST. I CAUGHT ON QUICKLY. I ALREADY KNEW HE HAD FIGURED OUT THAT I WAS A DOCTOR ALSO …
HE NODDED TO HIMSELF, PURSING HIS LIPS TO A THIN LINE. NO PITYING LOOKS; JUST BUSINESS. "UNBUCKLE YOUR BELT AND UNZIP YOUR PANTS. LIFT YOUR BUTT AND I'LL PULL 'EM STRAIGHT OFF. READY?"
I NODDED BACK, BRACED MYSELF AND DID AS HE REQUESTED. HE EASED OFF MY JEANS LIKE PULLING THE CASING OFF A SAUSAGE, AND PLACED THEM TO THE SIDE. HE ALSO SLID BOTH MY SOCKS OFF BY DRAWING THEM DOWNWARD SLOWLY AND STEADILY BY THE TOES.
"I'M GOING TO TAKE A LOOK AT YOUR LEG AND FOOT NOW, OKAY?"
AGAIN, I NODDED, INSTANTLY WARY. I COULD FEEL MY BODY CLENCHING INSTINCTIVELY; ALL MY PROTECTIVE REFLEXESS IN PLAY. I GRABBED THE EDGES OF THE GURNEY AND HELD MY BREATH.
"RELAX, PLEASE," HE SAID SOFTLY.
I TRIED.
As had been my practice for more years than I can count, my attention was forever centered on shielding my bum leg from potential harm. No bumps, no sudden shifting of weight, and no sharp movement that could cause extra pain. At least that was always my intent, although in reality life doesn't treat cripples quite that well. I always experienced my share of lumps and bumps because of what I did for a living. It's difficult to keep a lame leg out of harm's way when you're working with nervous patients. Hard to keep it out of harm's way, period!
Watching this man standing over me now, I could read his intentions in his eyes. But my basic instincts also told me he was an ally.
And no … he didn't think of me as an idiot.
Thoreau lifted the sheet away from my right leg and bent down for a closer look. I crossed my arms stiffly beneath my head and watched him like a hawk as he scrutinized every inch of the offputting mass of scar tissue. After about thirty seconds, he asked for my permission to touch it, even while drawing on a pair of rubber gloves. Eyebrows raised, I nodded, holding my breath.
His hands were soft, cool, and extremely cautious. He ghosted his fingers slowly across the thick rim of keloid neoplasms, and into the atrophic chasms where my quadriceps muscle had once resided. I stiffened. There was no jolt of actual pain; it was pure reflex action on my part. The nerve endings were so close to the surface that even his gentle touch caused me to recoil sharply. The sensation I experienced was more along the lines of mild electrical shock … like the little traumas that make you jump when you rub your hand across something made of wool and then touch metal.
"You're in varying degrees of pain most of the time, am I correct?" He murmured.
"Yeah … pretty much. There was an embolism in my femoral artery. The only symptom was agonizing pain, and they misdiagnosed because they thought I was a drug user. When they finally operated, the muscle had died."
"I'm looking at the residual evidence from two surgeries here, right?"
"Three," I offered quietly. "They botched the first one because they waited too long. The second one took place without my permission when they went in again and removed the vastus lateralis and part of the vastus intermedius. Muscle death. They removed the necrotic tissue with a backhoe, I think. That's why there are keloid and atrophic scars in the same area. The wound was twice as wide and it had to heal from the inside out. One of those geniuses nicked a nerve bundle. When the nerve endings misfire, the leg seizes or goes into spasm. That's how I became addicted to opiates. Couldn't take the added pain on top of everything else. I still have issues with that."
"Why was there a third surgery?"
I hesitated a moment, but the truth would have to come out eventually. I took a deep breath and took the plunge. "My fault. I visited an experimental lab and pretended to be interested in their research. I stole some of the vaccine and injected myself with it. I was desperate for any kind of relief. Anything. But it caused tumors to form above my knee.
"I tried to perform surgery on myself to remove them before they metastasized, but I got the shakes part way through and couldn't finish. Ended up in the emergency room where they did more meatball surgery. It hasn't healed right since then, and I know now that it never will. I haven't been able to bear weight for a year. The calf is atrophied … my knee doesn't bend unless I do it manually … and my foot is going into contracture and inversion …"
Thoreau straightened and looked down at me as though my need to explain these facts to him was overkill of the highest level. Surprisingly, he ignored my confession. "I'm going to check your foot now, okay?" He sat down on a wheeled stool that stood nearby, and glided slowly to the end of the gurney.
I sighed; pulled my arms down and was barely aware that my right hand had moved almost immediately to cover the scar. "Go ahead. I have a neuropathy issue that drives me crazy, and I have trouble trying to reach it …"
He nodded. "Understood." He cupped my instep in his left hand as he quickly snapped my ankle back into line with the right.
"I wasn't expecting that," I gasped.
"Hurt?"
"Oh yeah …"
He placed my foot back on the table and looked at me. "I'm sorry for hurting you. It's all necessary to evaluate you correctly. If you continue here, there is a long series of tests and treatments while we determine the best course to take in your procedure. I'm going to give you a shot of Lidocaine now, and cut your toenails. They're wa-ay too long. When was the last time you were actually seen by a doctor?"
"Quite a while. Why?"
He smiled, definitely in a sardonic manner. "Oh … probably because of that judgmental gleam in your eye. You've been treating this yourself … and you're your own worst patient." He was smiling. "No insult intended."
Thoreau opened a drawer and removed a tiny syringe with the numbing drug. "It's obvious that you're in a hellish amount of discomfort and trying to keep it under wraps. I'm only interested in deducing what's going on. I understand that you're wary of all this. You get no real sympathy from anyone, because nobody realizes what chronic pain can do. All you get is sad looks and prurient stares."
He swabbed the area below the talus and inserted the needle. A pinch and done. My foot numbed very quickly. It was almost nirvana to feel nothing. And gratifying to know that somebody else knew the score.
Silently, I watched him lop off my ugly yellowed toenails with a pair of medical clippers that looked like it could snap the cables on the Golden Gate Bridge. He cupped his opposite hand over the top of my toes to keep chunks of keratin from hitting the walls like tiny projectiles. When he finished, he asked whether my other foot needed a similar trimming; and I scoffed. "That one I can reach."
'That one' made him laugh …
I watched further as he palpated the tightened ligaments of my right ankle, gently twisting and turning and otherwise manipulating the entire foot. If it hadn't been as limp as a dead fish from the anesthetic, I would probably have gone right through the ceiling. However, with the Lidocaine's action and the diminishing effects of the Demerol as my ankle was carefully rotated, I found that I was lying there watching him as he diagnosed and experimented and gradually extended his reach toward the calf. I remained pleasantly relaxed while he worked.
He caught me off guard … again … by pushing suddenly against the ball of the foot, causing my Achilles tendon to extend. I quickly ouched away from him.
"Hurt?"
I gasped. "Yeah. Felt that one all the way to my ass cheek. It's not numbed up there …"
He smiled. "Tell me exactly what you felt when I pushed on it." His eyes darkened and he stared at my face as though any answer I gave might solve a problem he'd been anticipating.
"The skin around the scar tightened. I felt pain deep in the bone. It stopped when you let go, but it ramped up my leg again, and the effects of the drugs are backing off as we speak."
Thoreau placed my foot down gently on the surface of the gurney and turned back to the drawer where he'd found the drug and syringe. I saw him withdraw a black, open-toe, open-heel compression brace with bone staves covered with soft velour. He drew it over my foot to just below the knee and positioned it quickly, before the anesthetic had worn off completely. Next, he grabbed my sock; pulled it over my toes and over my ankle. "This might help correct the inversion, or at least slow it down. They're samples. Something brand new … we have a bunch of 'em. Try it for twenty-four hours. If it hurts after that, take it off, or recruit somebody to take it off for you. Guess I really don't have to tell you that …
"From your reactions and some other things I noticed, you're definitely going to lose your leg at some point. I'm sorry. There are too many signs presenting here to ignore. And you're right: it won't get better. Only worse. You're run down from fighting the pain, and that's definitely not good. I'll give you time to consider, but you should set up further appointments. Would you like me to do that?"
He replaced the other sock and reached for my jeans and shoe. He assisted me to put them back on and steadied me as I sat up and slid my feet over the side.
I looked away from him and stared at the ceiling. "It's not like I didn't know what's going on, Doc … so yeah … let's get it done with."
"You're fully aware then … ?"
"Truthfully? I knew how it was eventually going to go the first time a crowd gathered around my bed to learn how to change my bandages and tend the wound. I've been fighting to keep my leg for going on twenty years, but I've also seen the writing on the wall. It won't be much longer. When I heard about you, I decided this was where I should be if I wanted the job done right. I saw some of your team's handiwork in Binghamton, New York … a man named Samuel Adams. He uses one of your earlier prosthetics, and I wouldn't have known if he hadn't showed it to me."
Thoreau smiled. "Samuel. Tall guy. Bald. Has a stud in his ear and a rock on his pinkie finger. Yeah … I remember Samuel very well. I liked him. He takes his name very seriously. He let me use him as a guinea pig for a new product. Now there are about a hundred of them in use."
"He said you'd remember him … asked me to say 'hello' …"
For the first time I saw Thoreau's face redden in embarrassment. "Thank you, Kyle. It's always nice to receive a vote of confidence. When the time comes, I will be happy to do my very best for you too."
He knew I was spent and exhausted before I knew it myself. He saw me getting nervous and antsy; stirring uncomfortably and needing to move to combat the prickling neuropathy. I needed to take my meds and get to the head … in that order.
He stood and held out a hand so I could stabilize myself on the gurney. He saw that I was light-headed. I grasped his arm firmly to pull myself forward and reach for the back of the wheelchair, which was still locked in place.
Thoreau quickly lowered the gurney until my foot touched the floor, and then unlocked the chair's brakes. He steadied me while I transferred myself from one seat to the other. I aimed for the open door of the head and rolled inside. Closed the door behind me.
I relieved myself, washed my hands and listened to him talking on the phone to somebody.
When I rolled back out into the room, the tall, exotic APRN stood beside the gurney with my crutches in her hands. Thoreau was nowhere in sight. I suspected he had already left to consult with the other members of his surgical team.
"I need to ask you a question, Dr. Calloway," she said softly.
It hadn't taken Thoreau long to inform her that I was, indeed, a doctor. Her soft, dark eyes looked at me with such compassion that I could almost feel myself drowning in them.
I looked up expectantly. "What's that?"
"Are you able to drive home? If not, we'll have someone drive you, and someone else will follow along in your car …"
"I'm sure I can drive, Ms. … ?" I said.
"My name is Hazel Braddock."
"Hi Hazel … nice to meet you. My car has handicap controls, and I've driven many times when I was in far more pain than I am right now."
"You're sure?" Her head was cocked and those eyes were throwing sparks in my direction.
I smiled innocently, but I'm sure she could feel the icicles in my return glare. "I'm sure. I've been like this a long time …"
She walked along beside me to the elevator and we rode back to the ground floor. When I transferred from the wheelchair to my crutches near the back door where I'd entered, she walked along outside and opened the car door for me. "Dr. Thoreau is going set up an appointment for you to meet his team and have them do a follow-up examination of your leg; examine the density of your femur. Run some tests. We'll be in touch within the next week or so. In the meantime … nothing strenuous. It was nice to meet you, Dr. Calloway, and we'll see you again."
I thanked her sincerely and assured her that "strenuous" was no longer in my vocabulary.
When I drove out of there, I thought of the all bullshit that would happen at one time: I would receive the final deed to the Sylvester House; the painters would do the outside work and then move inside and put new colors on my walls.
My stuff (Holy shit!) would arrive from Princeton, and I'd have to figure out where to put everything. And I still needed a chair and a sofa.
In the middle of all this, I must begin an involved series of tests to determine the precise area of my leg where they would eventually activate the buzz saw …
I also knew I would be the Thoreau Team's next "Big Project".
I could still see Hazel's striking face in my rear-view mirror as I turned the car onto the road back to Etna.
*Holy crap! All this stuff going on at once … I'll be cooped up over Christmas. Bet me!*
I aimed the Dynasty toward Etna and poured on the gas …
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