No More Gifts
"The Rest-Cure"
(Part I)

FROM THE MEDICAL DIARY OF
TRISTAN GRADUS, M.D.

Today marks three days since the admission of a case most curious under my care. Still there is no improvement; the sickness, it seems, is getting worse. I feel quite the quack… if I escape legal action after all this, I will consider it a miracle.

Thus I shall use the space below these lines to jot down, in a few quick words, my best recollection of the events heretofore, in the likely event I shall be needing them again during some unfortunate future court proceedings. Hopefully it shall not come to all that – but, at any rate, a man such as I must always be prepared.

The case arrived on my stoop three nights ago. I saw her first when I opened the door: "Christine" was how she introduced herself to me. She was standing alone, a mess of blonde curls and rumpled orange skirts, and immediately I feared the worst had occurred against her. Understandably so; a woman of her substantial beauty (though she be less bosomful than I perhaps would like) in a state of disorder as that, in the middle of the night as this, could be considered as, for lack of a better phrase, an 'attractive nuisance.'

My chivalry demanded me to rescue this darling damsel shivering upon my stoop. I went to pull her into my apartment, latching a helpful hand upon her wrist in a way as to guide her, but she resisted me with a determination most inexplicable and most befuddlable. She explained she must have gotten the wrong door, repeating no less than three times that I was not the man she was looking for; but eventually, in her providing the address, I was able to find the source of her womanly error.

The man she sought was truly not I; instead it was my neighbor, an elderly Persian man (with whom she had no business associating, in my personal opinion). I told her, to her dark dismay, that I had not seen him around in a great many months – though I was quick to add that I'd heard he still retained his lease, and so must certainly be intending to come back eventually.

As she stood there moaning (ah!) over what horrible luck it was to have 'just missed' her Persian friend, I happened to look askance to see, behind her, parked by some overgrown shrubs, a dark form propped like a very large doll upon an ornate-looking push-chair.

"Who is your friend?" I asked casually.

Her reply came in the most tremulous and fearful tone: "No one!"

But I insisted, as is my wont, and drew near. On this closer inspection I found it to be a man, clad from head to foot in fine funereal black. He was still, very still indeed, probably unconscious, and did not seem to even breathe, at least to my perception. So I regarded this pretty little lady standing beside me, and asked fairly reasonably,

"Is he dead?"

And she whispered, quiet as a shiver: "No, he is quite alive, I believe… so beware!"

Well! Beware I did, I should say! Readily I presented myself as a physician to this Christine and reassured her in all my best words that I could take great care of this ailing friend of hers. She demurred in a hundred different ways; I ignored each and every one. I took the handles of the chair into my eager palms' grips and wheeled her man straight into my apartment.

She came along behind me, fussing all the way, but eventually came around to seeing the intelligence in accepting the hospitality of my aid. It was clear to both of us the man was dreadfully ill and needed immediate care. She helped me extract the man from the chair and lay him down upon my folding cot, and thusly I began my emergency examination.

I was stopped just as quickly as I began, at the the moment I reached out to remove the peculiar mask which obscured the entirety of the patient's face. It was a black satin piece, sculpted but bland, and I complained to this Christine that it was impeding my examination.

"You will keep it on," she insisted. "My husband is a very… well-known man and I wish to… keep his identity a secret! Yes, that's exactly it. I will pay you well for your discretion, good monsieur."

Husband! Ah, the misery to be had at hearing that word! Anyway – she gave, and I accepted, no money upfront, which is a point I believe my future lawyer will be quite thankful to hear. Perhaps her bribe was a bluff; I still have not seen a single franc from her. Nor have I requested any compensation as of yet for my services. I think we are quite beyond that now.

I proceeded in my evaluation, regardless, with this singular stipulation in mind. She allowed me to undress him (down to his underclothes only, and all within tight range of her close supervision). With the dark wool suit removed, as well as the other cumbersome miscellaneieties such as the socks and their garters, I found the man soaked in sweat but still breathing, despite my earlier fear.

Auscultation of his chest revealed an un-alarming symphony of murmurs, clicks, and rasps. I assessed his age to be about sixty, give or take ten years in either direction, although this assessment I noted to be quite limited due to my inability to view my patient's face. But a sixty year old man is bound to be ill sooner or later, I thought to myself, as sickness is just the reward of age. No man should expect to live past forty without accumulating a variety of aches and pains. It is all quite natural.

All things thus considered, I decided it was rather likely this man had suffered a simple attack of sorts of the heart – a 'heart attack', if I may be so poetic. Despite his presentation, which was some middle point between pure unconsciousness and mild obtundation, I doubted this condition to be critically concerning. The heart, as we all know, is one of the least significant organs in our body, especially in comparison to the almighty brain, which controls all of our thoughts, and the edenic liver, which is the source of all our humours. Furthermore: angina pectoris is an insevere condition that assails many individuals in our time, and though inconvenient in the way it strikes one down with chest pain of the most biting breed (allegedly), there simply is nothing that can be, or needs to be, done for it beyond a little rest and relaxation.

I said as much to Christine, and she called me "an idiot."

My examination continued through the systems. Neurologically the man was intact; respirologically I found no issue, besides some rhythmic rattling in his upper chest; dermatologically, however, I found my main concerns.

The man was extraordinarily thin, and his pallid skin was as fragile as dried leaf. The tips of his nails were ashen and cold, the nails jagged and cracked. I found an unsettling array of scars that ran along his frame, far too numerous to count but old enough in their appearance that I regarded them as most likely irrelevant to the condition at present. Tortuous blue veins similarly sprawled across the length of his entire form; the thickest of them, upon such areas as the arms and feet, were hardened over with scar tissue formed from what appeared to be many small pinpricks.

Christine was not very helpful in the information she provided. She confirmed my suspicion that the patient had a long-standing drug habit, though she could not tell me what substance it was that he so often used. She attested to seeing him smoking substances that "did not smell like pure tobacco" before, and also admitted he'd taken pills of some unknown sort occasionally in the past. In fact, when she found him unconscious (which had been some point earlier this night; I noted she did not elaborate much on that at all), there had been a myriad of tiny pills scattered around his feet which he ostensibly dropped. No, she said, she did not know what they were; but she retrieved a phial from his folded jacket and handed it to me, saying the pills had come from this container.

"This would be very helpful," I remarked upon receiving it and turning it around in my hands, "if there were any pills left in this bottle for me to look at."

Of course the bottle was unlabeled – why would a patient ever dare to make things easier for his poor doctor? – but I considered the situation with two possibilities, as I held the opaque thing before me…

The discipline of pharmacology instructs its pupils that medicines have three distinct relationships with illness. First: a drug may cure an illness. Second: a drug may cause an illness. And third: a drug may obscure an illness.

Which of these three was I dealing with here? What was the purpose of these mystery pills? As I said, I saw two possibilities. Either the patient took the drugs and fell ill, or fell ill before having a chance to take the drugs… in simpler words, either the drugs were bad and he took them, or they were good and he did not. And there was no way of knowing, without holding them physically in my hand to inspect.

But every diligent student of medicine knows the creed of Occam's razor: Entia non sunt multiplicanda praeter. Entities should not be multiplied beyond necessity. So let us not consider the most outrageous fantasies first; instead let us assume the simplest, most normal conclusions. Let us see the way the patient presents, with lethargy and rapid heartbeat; let us take into mind the account of his previous bouts of sickness that his wife the beautiful Christine gave to us. Let us see that this man was unwell; let us see that he was old and probably suffered from angina, and had a prescription of pills to alleviate the symptoms; and let us conclude, in the least convoluted manner, that he probably just had a minor 'heart attack', and nothing else is to blame.

I do believe though, against the creed of Occam, that there is the minute possibility that this could have been a case of… something else. I hardly wish to write it, how little I believe it to be true! But I will say it: poisoning. Of course, of course, of course I do not suspect Christine of such a horrible deed! – but rather I suspect the unconscious husband himself. It is not so unheard of for a person to do such a thing to himself, especially in a moment of madness or distress… I suggested this possibility to Christine in the most delicate way I could manage, but the girl was furious with me for even suggesting such a notion.

"He would not do that," she declared, with such disturbing confidence that I did not dare press the subject further. But still I wonder.

Still I worry.

That night the patient's urine was as red as the blood coursing through my own veins. Hematuria is not a typical symptom of angina… not that I have seen, at any rate. It is more classically a symptom of kidney injury. Of course it is possible that it was not a heart attack, as that was merely my preliminary diagnosis. There are any number of other things that could cause toxicosis of the glomeruli and apoptosis of the nephrocytes.

And he awoke, lucid but silent, near dawn. He sat straight up in bed, staring at the foot of his cot where Christine was pitched over and sleeping. For a long while he just looked at her, cresting his gaze upon the arch of her back – until finally he blinked, and laid himself back down and went back to sleep.

Christine stirred not fifteen minutes after that. She seemed furious with herself for falling asleep, and in this state of aggravation she leaned over his face, peered into the eye holes of that strange black mask, and mumbled something about how tense he looked in his repose.

"Is there anything you can do?" she demanded of me, as I drew near.

"Convalescence will take time," I told her. "I can do nothing to speed up the process."

"Of course," she said. She folded her arms across her bountiful bosom and contemplated her husband's form for a good many silent minutes, before looking back up to me and regarding me with a stare of solid stone and jaw set firmly with resolution.

"What can you do to extend it, then?"

To my attorney, I apologize. I could not resist her girlish charms; I answered her question fully.