Practicing Medicine

I was not feeling well. Actually, I had a sudden screaming pain in my right side under my ribs. Is it a gallbladder attack? My lungs? Liver? Pancreas (e gads), or perhaps a misanthropic appendix taking revenge for all of that Dairy Queen of late? Note: I’ve always wanted to use the word “misanthropic.” I learned it from Charles Dickens and it’s fun to say.

 

            “Hello, I’d like to make an appointment with my doctor,” I began.

 

            “What are your symptoms?”

 

            “I have a severe pain in my right side.”

 

            “Do you have a fever, chills, body aches, sore throat, cough or shortness of breath?”

 

I wanted to say that I almost always have body aches, but this wasn’t the time to be a smart aleck.

 

            “Well, yes, I’ve had a tickling cough for a couple of weeks, and I can’t breathe because of the pain in my side. It’s hard to catch my breath.”

 

            “Have you had a Covid test?”

 

            “Yes. It was negative.”

 

            “Where were you tested?”

 

            “CVS.”

 

            “Oh. You need to have both a rapid and PCR Covid test at our facility due to your symptoms.”

 

            “You mean the shortness of breath?” I asked.

 

            “Yes, that.”

 

            “But that’s because of the pain in my side.”

 

            “I’m scheduling you for the test, and also for a TeleHealth appointment.”

 

            “With my doctor? I can’t see him in person?”

 

            “You need to get the Covid test,” she said.

 

            “Ok, fine.”

            

            “Your TeleHealth appointment is with your doctor’s assistant, an APRN.”

 

What the Hell is an APRN? I look it up. Advanced Practice Registered Nurse. Great.

 

Fast forward. I endured two more Covid tests. The ones where they stick a swab up your nose way further than the way I did it myself at the CVS drive thru. I guess that’s the point. Cool, I must have Covid. At least I’ll know why I can’t breathe and why I’m in such pain.

 

            “Your rapid test is negative. Please log on to the link I sent you,” she says later that day.

 

            “But my appointment isn’t for two hours.”

 

            “Did you get the link I sent?”

 

            “Yeah, hold on, I need to get my laptop.”

 

Sadly, my biggest concern was that I wasn’t dressed for this. I planned to at least comb my hair and put on a t-shirt with sleeves. Instead, I looked like I just woke up and got back from shopping at a Florida Walmart.

 

            “What’s your blood pressure?” she asked.

            

            “I don’t know.”

 

            “Do you have a home blood pressure kit?”

 

            “Yeah, but…”

 

            “I’ll wait,” she said, and did.

 

            “Bzzzzzz, bump, bump, bump,” went the machine.

 

            “It says 145 over 92. That can’t be right. I always have really good blood pressure.”

 

            “145 over 92,” she wrote, “What’s your pulse?”

 

            “Oh, wait, I took off the cuff.” Had she mentioned this earlier I would have made note of the reading.

 

            “Bzzzzzz, bump, bump, bump,” went the machine again.  “It says 78. That can’t be right. My pulse runs around 62.” Both pulse and BP were no doubt elevated due to aggravation.

            

            “78. Please hold, he will be with you shortly. Are you taking the following medications?” (she rattles off a series of drugs, mispronouncing most of them)

 

            “No, I haven’t taken those in years. They were for different things at different times.”

 

            “No meds,” she stated.

 

            “Do you smoke?”

 

            I’m starting to. (I didn’t actually say that.) “No.”

 

The laptop screen comes to life. All I can see are thick eyebrows and a forehead with ceiling tiles in the background. An adjustment is made. Now I can see eyes as well. The APRN appears to be East Indian and quite young. Young people generally know how to use computers.

 

            “So you’re having shortness of breath and a cough,” he said.

            

            “Well, actually a pain in my side, but I do have a slight cough and I can’t breathe because it hurts.”

 

            “You probably have a virus other than Covid. I’m going to send two prescriptions to Walgreens. One will be a six-day steroid pack. The other will be an antibiotic.”

 

            “Should we get a chest X-ray?” I prompted.

 

            “Oh, yes, I was going to suggest that. (yeah, right) I’ll put an order in. You can walk into our imaging center any time.” 

I’m there within a couple of hours.

 

Fast forward. Walgreens closes at 8 pm and doesn’t care if the orders that came in earlier in the day are complete. As a result, I have no medication for the pain in my side, and it is worsening by the hour. By 1:00 am, I cannot sleep. There is no position I can find that isn’t excruciating. I pace the floor, stretch, and attempt to breathe deeply but can’t. Eventually, I take a couple of extra strength Tylenol, then two more an hour later. At this point, I’m not concerned about my liver. I try to sleep sitting up, propping a pillow under my chin so my head won’t fall uncomfortably forward, resulting in an almost certain headache from neck strain. It is a very long night.

 

The next morning I am the first customer at Walgreens. After a short wait, I am handed three prescriptions. I expected two. The third is an Albuterol inhaler with no explanation of why I’ve been given this or how to use it. Whatever. I go home and swallow the first row of steroids in the six-day series of progressively shorter blister-packed rows. Within hours the pain begins to subside. I now understand how Oxycontin can so quickly become a problem, especially after day three, when my much shorter row of pills allows the pain to return. I need more of this.

 

            “Hello, I really need to have an actual visit with my doctor. The pain in my side is now extending from my shoulder to my waist. I had a slight fever last night and still can’t breathe because of the pain.”

 

“You have a fever?”

 

            “No, not anymore. Last night.” (I realized it was a mistake to admit this)

 

            “Are you using the inhaler?”

 

            “First of all, I didn’t know I was getting that, and I wasn’t told how to use it. But more importantly, I can’t use an inhaler when the pain in my side prevents me from inhaling. I feel like you’re not listening to me.”

 

            “I will schedule you with your doctor. But first, you need to get a Covid test.”

 

            “I had two of them a few days ago.”

 

            “That was before you had a fever. We have to make sure.”

 

Fast forward. The doctor refuses to see me in person, but at least he knows how to aim his laptop camera to capture his full face. He says the additional Covid test isn’t necessary. I don’t present like a huffing and puffing COVID-19 patient. Probably because I am sitting still.

 

He proceeds to tell me that I most likely strained my intercostal rib muscles while coughing. He prescribes me two weeks of Meloxicam. It has been five days since my chest x-ray. He mentions that I have fluid in my right lung, the one near the pain that was my original complaint. Whatever fluid was in that lung has now been there for five days, probably having fluid babies and growing a fluid family.

 

He puts my on a short course of Lasix (water-removing pill) and a potassium supplement to counter the electrolyte-depleting action of the Lasix.

 

            “Does that sound like a plan?” he asks.

 

            “Yes, but I should probably mention that I’ve been coughing up a little blood.”

 

            “Well, that’s alarming for sure. But small amounts are not a concern. They may be originating in your nasal passages and traveling down your throat.”

A pattern has emerged. Everything I say travels up the branches of a decision tree to a box that says, "That's nothing."

 

I now repeat the Walgreens experience, but this time I show up in the store before closing. They have had my order in their system all day and are clearly planning to make me wait until morning. I plan to refuse to leave until I get my meds. I envision police action, me carried off in cuffs demanding my rights and ending up a Florida law enforcement casualty on the Lester Holt evening news. Florida Man. They produce the prescriptions. No ruminated police were necessary. I gobble the new pills the minute I get home.

 

This is not the end of the story. I am still advocating for my care, demanding that tests be done properly and completely. You might recall that I ran blood tests in a hospital for eleven years. I know more than enough to be dangerous. Doctors find that to be a bit off-putting, though I am kind when I ask them to raise the bar on terminology and reveal my background. I don’t pretend to be a doctor. But if I were one, I would hopefully listen to my patient and attempt to find underlying causes instead of just treating the symptoms. At that point they are not practicing medicine, they’re practicing insurance.

To read the rest of this story and more than seventy others, please consider buying Park Ridge Memories on Amazon. Click on the image below.

 

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The First World Problem

Poor or developing nations are spoken of as “Third World.” We are fortunate to live in a wealthy First World country. Our challenges are typically not due to lack of sanitation, potable water, electricity or all of the various other infrastructure elements we take for granted, despite our government’s struggle to fund the much-needed maintenance of these critical items.

We can joke that a delay in our mail, a flat tire, a problem connecting to WiFi, rising gas prices, a backorder on Amazon or an assortment of other inconveniences are “First World problems.” “Oh my gosh, Whole Foods is out of organic cranberries!” But have you ever experienced a power failure that lasted more than a few hours or days? How about a lengthy city-wide boil order for your tap water?” Perhaps a nationwide toilet paper shortage was enlightening. Suddenly your perspective changes, albeit temporarily. Some of us go camping to get back to basics. But have you ever traveled to a Third World destination where this is the norm?

 

We have gone to one such place. A trip to see our son while he was in the Peace Corps, stationed in Guatemala, was an eye opener. He lived for three years in villages where undrinkable water came in periodic “falls” – the opening of a village-wide pipeline on a few specific days during the week or month. From that the villagers filled concrete reservoirs in their homes. These were called “pilas” – dual compartment basins used for washing clothes, dishes, hands, and bucket by bucket, for manually flushing a toilet.

 

There was no cable TV, no sewers, no waste disposal or telephone lines. Interestingly, cell phone technology allowed for an infrastructure leapfrog in the traditional evolution of telecommunications. Everyone carried cell phones. It was much easier to install a few cell phone towers in remote locations than it would have been to string miles of wires along thousands of installed telephone poles.

 

We stayed with our son in his single room, a spartan cinderblock, windowless cube in a building that was similarly unglamorous. We toured the town, walking on mostly unpaved roads, meeting his friends, host families and coworkers. And on market day, he took us shopping at the local Costco, an open-air farmers market where he purchased a few onions, potatoes and rice, whatever he needed for the week.

 

Guatemalan people are generally quite small. They are mostly “Ladinos,” of mixed European (Spanish) and Amerindian descent. The men average about five foot four inches in height. The women are around four foot ten. Our family, at five foot nine to six foot one, was noticeably gigantic. As we strolled through the little marketplace, we routinely ducked under blue tarp tents that shaded the produce sellers.

 

Those who knew our son were aware of our visit. Others quickly noticed the obvious American outsiders and watched us pass by. It was as we passed by one tiny woman, dark brown and wrinkled from age and a difficult life, missing several teeth, but smiling broadly, that I became an object of fascination unlike at any other time in my life. Looking up into my eyes, with her radiant smile and quiet demeanor, she gently reached out and touched my arm. Was it to see if I was real? For good luck? As a gesture of kindness or honor? I’ll never know. Perhaps she spoke of her encounter to family at dinner that evening. I simply returned her smile and continued on through the market. Our culture and languages separated us, but we shared a moment. And then I went back to the comfort I take for granted in the United States and she continued to sell vegetables for the rest of her life.

 

Since then, whenever I go to the grocery store, or any store, not just Costco or Sam’s Club, I am struck by our bounty of choices, the immense quantity of food and other goods from which we can choose. Our trip to the Third World changed me forever. I frequently comment on how lucky we are and how little we struggle. Perhaps that’s our real First World problem.

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If you like fiction and you're in the mood for over 50 short stories, please consider buying "Natural Selections," at Amazon.com.

Or if you'd prefer seventy non-fiction stories inspired by a town in Illinois, please consider buying Park Ridge Memories also on Amazon. Click on the image below.

 

 

 

 

 

Evergreen

Wally held up a glass test tube, gazing with pride at its phosphorescent green contents. He turned off the lights in his basement laboratory to better view the effect. A gentle swirl between his thumb and forefinger stirred the fluid to greater brightness. Suspended sparkling motes pulsed with life, combined in twos and threes, grew and thrived.

 

            “Dinner is ready!” urged Alice from the top of the basement stairs.

 

            “I’ll be up shortly dear,” he replied for the second time without looking away, mesmerized by the glow of his creation.

 

If the results of his experiment were as hoped, eating food would never be quite the same. He took a deep breath, looked briefly to the top of the stairs, then back at the test tube. He threw back the contents like a shot of fine whiskey, expecting the swallowed rush and burn of a high proof liquor, but feeling none. The mild essence of chlorophyl, of a summer day rose up the back of his throat and into his nostrils. And then it hit.

 

Wally could not suppress the operatic scream he released as he doubled over from a sensation that was not entirely pain. It was metamorphic, gripping his diaphragm and radiating outward past his ribs and internal organs, down the nerves in his arms and legs, and upward to his skull in an optic light show that caused the room to color and spin, his stomach to clench and sweat to pour down his face. He sensed an upswelling loss of consciousness like a profound sleepiness and allowed his body to rather gracefully collapse upon the cement floor.

To read the rest of this story and more than fifty others, please consider buying "Natural Selections," at Amazon.com.

😎

If you like fiction and you're in the mood for over 50 short stories, please consider buying "Natural Selections," at Amazon.com.

Or if you'd prefer seventy non-fiction stories inspired by a town in Illinois, please consider buying Park Ridge Memories also on Amazon. Click on the image below.

 

That Which We Remember

Twenty-one years ago I worked with a consultant to build a new billing and estimating tool for our in-house design team. It was a completely custom project, including a hands-on classroom training experience, detailed reference materials and in-depth exercises. The application touched every element of our business. We had to get it right.

We loaded the necessary software on computers in a training room off site, away from office distractions. It was important that students, our coworkers, focus on the lectures and exercises we had prepared. Three days of training per student was allocated. Coverage for their duties was taken care of and lunch provided. Everyone arrived early for the first day of class. It was September 11^th, 2001.

 

I left for work early to meet our consultant, heading up the Tristate Tollway and onto a long exit ramp. It was a sunny day, one of the last of summer in the post-Labor Day period that serves as a transition to cooler autumn temperatures and shorter days. I listened to the news as always. In that short stretch of highway, two airplanes crashed into the World Trade Center.

 

As shocking as that was, it soon got worse. I parked my car, walked toward our waiting consultant and asked him if he’d heard the news. Chris Kubica and I became bonded for life in that moment. He looked at me as if I was joking. He hadn’t heard. I am the person who told him about 911.

 

Students arrived and took their seats, some just becoming aware of the tragedy, others unaware. All of our students brought up their web browsers, pretending to be paying attention, but searching for news as Chris nervously attempted to conduct the class. The internet bogged down, barely able to assemble on-screen pages. Twenty years ago, bandwidth at our company was far less robust.

 

Planes had hit tall buildings before, but not commercial jets. Still, the double strike might be a bizarre coincidence. During the first hour of class another plane hit the Pentagon. And then another crashed in a field in Pennsylvania. When would it stop? Was the White House next? When the Pentagon was hit, the story changed. Our mood darkened and the day intensified. The country was under attack. We took a break earlier than had been scheduled. At this point we should have sent everyone home. It was clear that nothing would be learned that day.

 

We all refreshed our screens, made phone calls to loved ones, hoping not to hear reports of other attacks, perhaps nuclear strikes - more horrific main events following the sinister and distracting first wave. Families were separated at jobs and in schools. What chaos might erupt on city streets as everyone suddenly scrambled to get home?

 

We didn’t realize that we were in the middle of “911.” It hadn’t been named yet, or compared with Pearl Harbor. A ground stop emptied the skies of planes, an eerie silence we’d never seen before. Our traveling coworkers were stranded in other countries or locations within the U.S. We had never heard of TSA and couldn’t imagine the protocols that would become a normal part of travel going forward. We all watched in horror for many days as video was displayed on the evening news in a seemingly endless loop. We began the process of “never forgetting” that some of us recalled from November 22, 1963. On that day, our President died. On September 11^th, our national innocence perished and we entered a new era, every one of us.

 

On every September 11th for the past twenty-one years, my good friend Chris and I exchange notes in recognition of the link that was forged that morning. Our children have grown, our careers changed, but we commemorate who we were at 7:45am, Central Time on that morning, and who we became one minute later.

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If you like fiction and you're in the mood for over 50 short stories, please consider buying "Natural Selections," at Amazon.com.

Or if you'd prefer seventy non-fiction stories inspired by a town in Illinois, please consider buying Park Ridge Memories also on Amazon. Click on the image below.