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(Garbage and Paradise Lost) No sleep, one gooey red something or other shrink wrapped bun, coffee out the wazoo, and weird shit going down everywhere made Biblical frogs by the mile seem unremarkable. So who reads signs nowadays anyway? What is it again? Frogs, hmmm, is God pissed with me? No, maybe, just disappointed - tapping a heavenly nickel on your window. Yo. Wake up. Locusts. That's miffed. That's more than a wake up call. First born, now that's pissed. Really really pissed. Is there a look up table, like logarithms, for heavenly pissedoffedness? Plague of:
Who knows this stuff? OK, not the guys in three piece suits. But why is it that we look to the zoners who can't seem to get their buttons in the right holes to read signs for us? You wonder if Zoroaster had his sandals on the wrong feet half the time. If then was like now, it's what you would expect of a prophet. Hey! Maybe that's why wizards wear blankets and go bare footed! Whatever. This man was no seer. If there was a green haze descending, Macaluso didn't see it. How would he? This very long day of surgery was weeks later, almost a month since the Teson Hall meeting. During that time, Shannon went from unconstrained round the clock school girl giggling enthusiasm with endless phone calls to and from students at Teson to a more measured working determination to a curious mute silence. Milton Blake hadn't returned yet and his secretary, inside out with fear, had placed his office belongings in a bank depository and vanished. There was no shortage of uneasy and unreconciled ruminations in this surgeon's psyche. Odd stuff was happening. Garbage men asked his wife, Mina, why they had no garbage lately. The question was followed by a warning. Watch out. Missing garbage is a bad sign. Sign? Of what? Why would anybody take our garbage? She wondered, and asked Marcus. He had no idea and so dismissed it. It does not take much to dismiss that which you do not understand when you are up to your hair in what you do understand - your work. Face it. Few of us understand most things. We don't get all bent out of shape because the process of calculating the dark matter in the universe from known celestial mass estimates and expansion of the universe measurements and all that sort of shit is not clear to us. Really. Screw it. Celestial doesn't live around here. That's somebody else's deal. Fixing kids was his. Garbage is - garbage. You put it out so that it will go away. Gone is good. Right? But as a question, it was still a raw end. Who steals garbage? Who spreads rumors about how one is.. well.. structured in their nether parts? There is just too much to do to be wasting mental energy on such crap. So you just do the work at hand and let that stuff go away. Immediacy was a monumental undertaking as it was. After a very long day of surgery, eight operations beginning at seven AM sharp, including three charity cases from the North Ward nonstop until six o'clock in the evening, he was a little annoyed that on top of an impending emergency shunted over from Northeast Mercy, somebody from the North Ward was in the visitors waiting area waiting to have an unscheduled conference with him. Although, a congress woman? What could that be about? Whatever it was, that, the whatever the Mercy kid was, and whatever else might still pop up with a contrary ball busting Melissa at the switch, this night could get interesting. "I need to take a leak and get some food, not take bows," grumbling to his circulating nurse who had slapped the visitor message into his palm as if it were a surgical instrument. "Damn. I'll never get home. .. was up all last night.. need a break.." The adrenaline that had him so pumped was now ebbing as he dragged himself through the staging area. Except for one woman pacing watchfully, the visitor's area was nearly empty. A very distinguished black lady introduced herself, "Hello. Doctor Macaluso! I'm Congresswoman Woodrow?" looking at him expectantly and transparently waiting on him for a spark of recognition, as if he should know who she was. She could see that he was dragging even though he tried to project anticipatory enthusiasm about her visit. Macaluso just offered his hand in a very slow and uneasy way while peering into this lady's borrowed eyes. A very uncertain and slow, "I.. know.. you," trickled from him. "Yes. You do." He wasn't at his sharpest. "Uh. You're with the kids I just operated on? Do you sponsor children? I wasn't aware these kids had sponsors." "Well, you do so many. I wouldn't come here at night for that. But yes, we are aware of your splendid work. You help so many of our children." Now he was riveted to her. "Damn! I know you. Your.. voice. Say something else. Anything. It'll click." Marcus was trying to reel her in. "Congresswoman Shondra Woodrow, formerly Shondra Smith. Still saving folks are you, Squid?" a very generous hint, as Marcus bellowed, "OH MY GOD! CONGRESSWOMAN! SHONDRA? YOU DID IT! Shondra. You. Damn. This is sooo cool." He was bear hugging her off her feet and shaking her when the next logical connection was made, "WOODROW! You married Lyle! Oh oh oh. Now there's a happy guy. He must have a perpetual hard-on!" "Easy Ajax!" drawing on his old nick name and laughing at the last nearly correct deduction. "Actually, I've had this title for three years now, and Lyle is a sweetheart." "I never made the... I didn't uh..." "Never you mind. I'm here on ugly business." She got quickly serious. "Can I help you?" Marcus's knee jerk response. He took her to a secluded cul-de-sac, nicknamed the mourner's corner or lawyer's foyer, where doctors often spoke with family members about ominous problems. She corrected, "No. It's you who needs help. Doctor, there are people hanging around folks in government - regulatory circles - spreading stories about you. Nasty stories. Here is a photo." It was a lewd photograph showing the doctor in a perverted act with sleazy looking women and men. "Jesus! Shondra... these are fakes. Look. Not that you'd know, but I don't have a wanger like that. Wish I did." "You and every other man. It doesn't matter. Who knows that? Any billboards out there with your, uh, physique posted on them? You and I know this is trash. The question is, why is this happening? Who's putting up the funds? This took money to produce. There is a considerable bankroll being spent to smear you. Why?" "Shondra, I have no idea. I'm just a surgeon." "Didn't you testify to the Consumers' Advocacy Board about the abuses in medical coverage of disabled and children with chronic illnesses?" she reminded. "Hell, I've been swiping at that windmill for the last five years. It goes nowhere. Nobody gives a damn. You must be the only person outside the transcriptionist who even knows about it," Marcus passed it off. "I don't know. Must be something. Somebody's got a bug up their butt. Watch it." "Gee, that's great! As if I don't have enough to do. Now I have to look in alley ways." His own remark made him suddenly recall missing garbage, though he didn't mention it. "Aja... Doctor Macaluso, I almost called you Ajax again, If you get any clues. Call me. Here are my home and office numbers. This is my aide's number - remember Eunice Tyler? She's digging around trying to see who's behind this. She's very good at loosening lips." "Belts too, I recall?" "Especially belts," Shondra laughed. Then almost as a nearly forgotten aside, "Oh. An old old friend wanted me to give you this. He says wear it." As the expected, "He who?" and "What is it?" was being iterated to no immediate answer, a salmon-red amulet on a thin gold chain was being disentangled from her purse. It was a small carved hand, a right hand, folded into an odd fist, but with the empalmed concealed thumb, protruding out between the index and middle fingers. Washington, she offered, had passed it along to her to give to the doctor. "Benson?" as she nodded affirmatively. " A little cerebral palsy hand. Carved in what?" "Red coral. I'm pretty sure that's red coral." "Hey, when you see Washington, gee I gotta look him up, if you see him before me, tell him thanks. This is so neat. He knows I treat C.P.?" "Doctor! Everybody knows you! Goodness. Anyway, Washington said the hand was given to him to give to you, although, I think, in fact I'm sure he added the chain. But, is it a palsied hand? Mmmm, nah.. I don't see it as a cerebral palsy hand, myself. Looks ethnic, doesn't it?" "Ethnic? So who.. what's Washington doing these days? Don't tell me, senator?" "Better than that. He's moved up in the organization, so to speak, definite successor to Frank." "Oh man. Damn. I gotta get back there. That place has never left me. I carry it everywhere. It is in me." The congress lady just stared at him wondering, silently, and slipped, "More than you know. You really don't have a clue." "Hmm? What? The squid thing?" As she laughed and waved him off dropping her polished professional diction for old time style, "Honey, you are somethin else. Every chile on the hill talks about Jazz Man and his squid kid. They all know the drummer. But the little ones would stand in line to actually see the squid hisself. You're part of story time. Big time." Then, as the doctor was laughing, head bowed shaking side to side, rubbing his upper lip with his right hand, flashing back to story time, she asked him to do her a personal favor so that she could keep her own promise, seriously eyeballing him, so he agreed in advance. "Wear the charm." "That's it? That's the favor? Sure." He put it on. "Keep me informed." "K" Shannon's emissary burst in, "Doctor. The Northeast Mercy girl is out in staging. Here's her x-rays. Rashaad says you'd better hustle your buns. He's putting an I.V. in right now. Macaluso, held one of the several films up toward a ceiling light and muttered, "You betcha. Is Kirshenbaum around?" "Yea. I already, just in case, well, actually Rashaad told me.." "Good. Good. Yea. Good." "Dr. Kirshenbaum says we have no Doppler reading in the arm." Mac quickened. "Everybody! Move! Clear room three, now! Move. Come'on..." rushing to the staging area, where, however, at the control desk, at that very moment, nurse Tawney was on the telephone telling a Dr. Fischbein to get his patient ready. There was, and this is how she phrased it calling after Dr. Macaluso, who trotted right past her, a "torn knee cartilage requesting the CO2 laser" then reacting to a confused spin about with a nonverbal facial grimace, clarified, "Dr. Fischbein asked for the room first." She was shaking the list at the back of Macaluso who had returned to his business of examining the young girl's arm. He barely acknowledged the parents who were standing at the side of the stretcher nearly frozen in fear? They had only asked a single question, "How bad is it?" to get a hand gesture out of the child's view which indicated that it was not good. Except for this girl, her parents, Dr. Macaluso and the control desk sitting at the portal to the hallways of O.R. rooms, the staging area was, at this point, empty. Neither Dr. Fischbein nor Fischbein's patient were present, although Fischbein's office was just across the street, about 3 minutes in an all out run. There was a girl here, right now, and she had no pulse. There was no feeling at all in any of her fingers of that right arm, her dominant side. That was way more than enough to act. "She needs her arms for her crutches" a crying mother offered the doctor, a plea to him to be his best. It could just as well have been "save my baby" or "I'll trade my life for hers." He'd heard this sort of supplication many times before. It never diminished in impact, though. "I'll do my best.. but let me tell you... I must tell you .. you really have to know certain things." He quickly told a petrified mother about the possible loss of function and even the very real risk that her child could suffer loss of the actual arm as a father trying wildly to bolster his own resolve had to sit down with his head between his knees, muttering "Just do what you have to, doc. Just do what you have to." "Let's move." Macaluso was pushing the stretcher with apparently no help as only a single nurse arrived and appeared to be vacillating as to what to do. Macaluso coaxed her. "Come'on. Steer. Grab the other end. " He was now faced with three statues. The first unresponsive nurse, a second nurse who just arrived behaving equally torn, and a smiling Melissa Tawnwy who declared that "this case" was "Here!" pointing to the bottom of her add on list triumphantly. AS Macaluso muttered a confused, "What?", Tawney went on, "Dr. Fischbein does not yield his slot! I told you!" "Call him now! Tell him we have a pulseless extremity... five dead fingers... no time, no time for this, call him, please!" "You have to call him." "No. You do. Get him on the phone, I'll talk!" Macaluso turned to the parents, "I, I, uh I don't ... mmmm it's Scylla and Charybdis.." turning about and calling for triage, loudly, "Who's triage? We need triage!" He engaged the nurses to get triage, quickly. "Fischbein's on the phone!" Tawney called. Macaluso jumped at the phone, went rapidly through the history emphasizing the very serious findings. However, Dr. Fischbein was simultaneously going on about how his cases aren't taken seriously. Athletes are people too. His patient was very important to a high school's championship team. He had promised to get the athlete back playing this very weekend. The laser required certain nurses. As Macaluso exploded "You don't need a laser to fix a meniscus you ass hole! You need it to charge double!" then capping with, "And to get more complications!" slamming the receiver with "Bastard! Thinks I swallow that line of bull shit?" Tawney was smiling, "Well?" Macaluso looked right at her and stated flatly, "Dr. Fischbein says by all means proceed with the emergency. He's happy to wait. Now let's get this child going!" As the child was being wheeled toward the operating room the locker room door exploded open. Fischbein, out of breath, stormed at the procession grabbing the gurney with both hands, still in street clothes, drooling spittle and shaking all over. "You're NOT taking my slot! I do NOT yield my time! I do NOT! Put her back there! You're out of control Macaluso! But an anesthesiologist was now in charge. Gerry Yount who had arrived just in time to witness this farce, having been called urgently by the nearly psychic Rashaad, made a throat slitting gesture to Dr. Fischbein and proceeded to dislodge the latter's staying hands from the gurney, pushing the child even so much the faster toward the operating room, "Which one?" "Room three. Dr. K's got it set up, hopefully." There are two doctors you don't argue with, pathologists and anesthesiologists. What they say is law, at least until a hearing is called, but that's another day. That simple throat slit gesture meant simultaneously, "Fischbein, you're wrong. Leave now. You are dead if you don't yield immediately." So warned, he withdrew shaking and seething get evenisms. Dr. Kirshenbaum a young golden hands hand surgeon who hadn't yet been tainted by "the system" and the radiology techs were indeed ready, as were three nurses who had, on their own, stayed around and quietly set up the room. Kirshenbaum snapped, "Let's boogie." Woodrow curious about this turn of events had, followed to the door of the staging area, but then stepped back as if leaving, out of the way, but nevertheless, watching long enough to observe the melee and a furious Dr. Fischbein storming out, spitting oaths as he passed her. She thought to herself that this was a place where it was easy to make enemies. Then too, a place where allies were important. How like government. Power was more important than truth. Truth without power is tragedy. She left. It was jazz, two doctors, Macaluso and Kirshenbaum, playing off each other, with the x-ray tech and nurses following in the harmony, individuals yet, a singularity realigning a shattered arm, coaxing long stabilizing pins through a confusion of bone fragments in locking crossing patterns to procure stability, venting the very large hematoma - an internal pressure forming lake of hemorrhage - from the fracture site and decompressing the artery. "Intimal flap?" Kirshenbaum wondered as this was being played out. But then the once absent drummer was heard. The beat. Life itself joined the set. The Doppler began whoosh whoosh whoosh whoosh whoosh... It was the pulse! "Flow! Other side!" A hurried scramble to compare the new whooshing beat, the pulsing flow with that of the other extremity. It was about 90 percent. "It'll do," was Mac's whispered observation. Kirshenbaum then asked the anesthesiologist to wake her up enough to test sensation but be ready to crash her again, as Yount astutely queried "Fasciotomy?" Both surgeons harmonized, "I don't think so," then laughed at their synchrony. The deep pressure measurements seemed quite good. "Probably was all arterial," Kirshenbaum added hopefully. Dr. Yount was speaking in measured cadence into the child's ear, asking her if she could wiggle whatever finger felt something scratching. She began to respond and did quite well on the ring and small finger then gradually improved on the thumb, index and middle fingers. He had adjusted the drugs to suppress pain but not alertness or sensibility. It takes a good practitioner of the art to do that, twilight anesthesia in a ten year old. Mac declared, as Kirshenbaum held a thumb up, "Wake her up." He then mentioned, to no one in specific but everyone in general, that he was going to keep her on IV just in case she "soured" and had to come back. "It isn't over, yet." Splints were made so as to allow circulation and nerve checks and inspection for pressure spots. Tension in the room had ebbed with that in the arm. Where masks had been, there now were smiles. It's good to win one. That's how they felt. Triumphant. As the youngster was wheeled past the control desk en route to the recovery room, the victory parade received no decoration, no honors, no praise, but rather, Tawny's jeer, "Your ass is grass, Macaluso!" as the doctor grumbled, "Well, I guess this isn't exactly Aieda." The young girl's parents, nearly deathlike with the fear of their daughter being possibly further disabled by the loss of her arm, hung on the doctor's every syllable as he met them to relate that things had gone well. How well? There was still some muscle testing that would determine if all her median nerve function had returned. For sure, the ulnar nerve was recovered, and the radial nerve seemed spared. It would take time to see how well her index finger and thumb would do. The anterior interosseus nerve branch was still in question. That might take a few months. They turned to specifics. Can she use crutches? Play in Special Olympics? The doctor shifted gears for them from soothe saying to immediate needs. They were disciplined in danger signs of circulatory compromise down to the minutest subtleties. Mother and father would stay with her in her hospital room and keep watch, supplementing the nurses and pediatric residents. False alarms were better than missed alarms. That night, barely home, he got two calls from two high ranking administrative doctors whose pretexts were that they wanted to know what exactly had gone on in the O.R.. It was clear that this was a prelude to a process. Some process, a done deal. He was, after all, "yelling in front of parents" scaring them to death in an "unprofessional" manner according to Doctor Kauravas who Macaluso called Ming One, which Kauravas didn't get at all. Right now this bringer of darkness to light was in his typical way eclipsing reality with embellished accusations. Macaluso was droning, "Yes, oh great shadow," as the caller pointed out that once again, as is in his record so many times, he had not spoken to a colleague, Dr. Fischbein, in a collegial way. "Let me get this right, my Darkness, you have my hospital record - at your home? Let me guess, you jack off to it. You could go blind doing that, Kauravas. But if you could briefly free up one hairy palm to grab a pen, just jot a note next to the part about my fiery Latin temperament, saved child's arm from wolves." Of course Kauravas wasn't enquiring. He blathered on with his threatening generalities. "Gee, you can ceaselessly assert without even pausing for breath. Pretty good trick. Bet you have a ram jet air intake in your rectum which is piped straight to your vocal cords." Marcus was about to tell this man to drop dead but Mina grabbed the phone, "Percy Dumplings?", a familiarization which he had no idea anybody knew. "Who's this?" "Who do you think this would be with Marcus at this late hour? It's Mina, his wife. Is Linda there? I wanted to ask her something." There was a long silence. Nothing was coming from that phone but disordered breathing. Marcus whispered, "There goes my ram jet theory." A distant click broke the connection. "OK. Who's Linda?", he asked. "Not his wife," Mina Grinned. "Oooooooooo. I love you when you blackmail my antagonists." "So, Marcus, who'd you tell to fuck off this time, the Pope?" "See? Even you. You assume that I, having nothing better to do with my time, went out of my way and found some fine upstanding citizen on whom to practice my vituperative skills." "Vituperative skills?" "Yes, those." The phone rang. Mina was silently mouthing vituperative as her husband answered. This was Dr. Lornez, upbraiding administrator number two. Marcus looked to Mina expectantly mouthing Lornez, but she didn't know this one, "Your on your own sweetie, " she patted his cheek and left laughing toward the family room. His interpersonal deficiencies and delinquencies were curiously stated in exactly the same order and way by this second caller. Marcus politely insisted that administrators ought to first get their facts straight, that he would not appear before them, and then asked how could they have possibly gotten any comprehensive unbiased information so soon. He asserted that in acting so precipitously the only process they represented was the release of a bear trap. This caller droned on as Macaluso just growled into the phone, "I vituperate you." "What's that mean?" "It's a wild card?" "What? What's that?" "Make up your own deprecating remark about you, from me. Maybe something with a duck in it. I'm too tired to tell you, in a clever way, how little I think of what you are doing. So, go make up something really nasty slur and consider it as being from me." "That's stupid!" "Oh, and the false bull shit you're spewing isn't?" "We'll have an enquiry, Macaluso!" "Oh? An enquiry? A detailed finding of facts? Did you know that a Congresswoman was standing right there? Did your source tell you how a representative of our state government was pushed aside like dirty laundry? How about this, we have the enquiry in her office? I really want to see your slimy ass writhing when she tells you what she thinks of you to the commission which she chairs." "What commission?" "Oh, don't bother now, it'll come out in the enquiry. But, do me one big favor?" "Which is?" "And please don't misunderstand me. I want to be totally clear and sincere and I mean this in the purest sense. So don't misconstrue what I have to say. You are shit on the shoe of medicine. Go fuck yourself." Mina was taking this in, nodding her head in repetitive approvals with her lower lip thrust way out, waving an overhead fist. Nobody out vitupers her man. Despite all of this, it was not the Fischbein incident that troubled Macaluso's lightening lit dreams. That weenie was annoying but not in the least unnerving. There was no mystery about petty people acting petty. No, that wasn't it. Falling into a tailspin through old and recent recollections, false photos, missing garbage, even distant things his sister said years ago, things about not putting too much soul into bonds of blood but rather bleeding for bonds of soul, weird shit like that had him flipping all over the bed throughout the night pulling the bed spreads in all directions. He was rambling, "not thicker, not thicker.." And Mina, denuded of sheets for the third time finally jabbed him and asked if he had ants in his
pants, pulling the covers once again back to her side. Sheet flinging and other-worldly throaty groaning worsened until, finally, Mina got up and made a quick trip to the kitchen. Returning, "Here sweetie. Have
some milk." She was rubbing his temples as he sipped only half awake and barely aware, then settled in her lap beneath her breasts. She startled at the unexpected amulet hanging around his neck and asked,
sounding his depths, where he got the fig, but he was gone, way deep. Someone was beckoning him. Someone with answers. If only he could reach... if only.... |
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