Monday, December 2, 2013

Winter Night Clinic

                             

“I’ve braved the rain and sleet and snow and have returned for another exciting shift here at the fabled ‘Night Clinic’,” I announced as I shook the snow and slush from my boots. “Maybe the bad weather will keep it quiet.”
“Don’t hold your breath; all the exam rooms are full and five more waiting,” Miss James reported. “You can start with the swollen ankle in one.”
Her voice was cold with more than a touch of annoyance.
What did I do now? I put my dirty clothes in the laundry, washed the dishes, put the toilet seat down, let her…
“Miss James,” I began, “have I done something to upset you?” I did my best to feign contriteness.
“The time is 7:30. Our shift starts at seven. Why are you always late?”
“Well, today I had to…”
She just walked away, not really interested in an answer to what I now surmised was a purely rhetorical question. Her point made, we went to work.
“Gregory Jackson, ankle injury playing basketball; nineteen, lives on Maple, unemployed,” the chart reported.
I knocked twice and then went in and saw a very tall, thin young man with his ankle elevated and swathed in an ice pack.
“Good evening, Mr. Jackson, what happened to you?”
“Well, Doc, I was driving to the hoop and was about to do my Dr. J, you know fly under, up and over the hoop to slam it home when this little guy, Bennie, I think is his name, undercuts me. I landed right on my ankle and then it swelled it almost the size of the ball. The other guys almost had to carry me here.”
I pulled off the ice pack and then looked at the X-rays which were already pulled up on the screen. I blew them up as big as I could.
Soft tissue swelling, separation of the joint, nothing broken.
I looked more closely at the ankle which was very swollen and had a slight purple hue. When I tried to move it my patient winced in pain.
“It looks like you have a very bad sprain, Mr. Jackson. I’ll wrap it up for you, but you need to keep it iced down for at least the next twenty four hours and stay off if for about two weeks. I’ll give you the number to the Ortho clinic at the University Hospital, call or go there to make an appointment to be seen next week, OK?”
“Got it, Doc. Oh, by the way, can you get me the number or address for Medusa?”
“Excuse me?”
“I saw her go into one of your exam rooms, this chick we call Medusa. We see her around all the time, but she won’t talk to anyone. But, she’s one hot chick. Every guy I know wants to get ‘in’ with her, if you get my drift.”
“Sorry, you’re out of luck. You’ll just have to do that on your own. Just check out with Miss James at the desk. She’ll have all the instructions and the number to call for follow up written down for you.”
I went on to room two, but I did glance at the chart for room three. Sure enough the name was Medusa , while the rest of the chart was blank. First, however, there was abdominal pain in two.
I glanced at the name, Rufus T. Horsefly, fifty five, abdominal pain for two days.
“Good evening, Mr. Horsefly. I’m Dr. Barnes,” I began, trying not to betray my desire to dispatch him and his abdominal pain as quickly as possible so that I could move on to this mysterious Medusa. “What is the problem you’re having?”
“Hello, Dr. Barnes,” he answered as I sat down across from him. “I’ve had this pain in my stomach and back for two days.”
“How did it start?” I asked, trying not to look too bored.
“It started in my back then moved to the front. Today I had some numbness in my legs and I almost passed out. I figured I better get it checked out, you know, better safe than sorry.”
I was actually beginning to get worried at this point and, as it turned out, with good reason. I quickly gathered the rest of his history: untreated hypertension, cigarette smoking, some alcohol use, father died suddenly at age sixty.
“Let me check you now,” I requested/commanded. He lay down on the exam table and I felt his abdomen. He cringed slightly as I palpated all over his abdomen, particularly just above his umbilicus as I felt what I feared, the prominent thump, thump, thump of what I presumed was an abdominal aortic aneurysm. I felt his femoral pulses, which were only barely palpable, while his carotid and radial pulses were strong. I looked at the chart again, recorded blood pressure was 180/95, heart rate was sixty.
“Miss James, call 911 please and request an ambulance,” I called out to her at the front desk. I started an IV on Mr. Horsefly and drew some tubes of blood to go with him for a type and cross and lab.
“Mr. Horsefly,” I started to explain, “you almost certainly have an abdominal aortic aneurysm, either expanding or already ruptured. This is a very serious condition, one which is life threatening. An ambulance is on the way to take you to the hospital where you will need some sort of surgery. Do you understand?”
The look on his face told me everything as his light hearted countenance was replaced by fear.
“I’m going to call the hospital and ask that Dr. Singer be standing by; he’s the best vascular surgeon around, OK?”
He nodded his head and I left the room. Luckily, Dr. Singer was available and I was able to speak to him directly. The ambulance arrived and Mr. Horsefly was wheeled out to the waiting vehicle, lights flashing in the snow, siren ready to sing.
As he was leaving, I had to lighten the moment a bit, “Mr. Horsefly, by the way. In the movie Duck Soup, Groucho’s name is Rufus T. Firefly, not Horsefly.”
Mr. Horsefly smiled as they were loading him into the ambulance.
“I know, ‘the horseflies were on the Firefly’s and the Firefly’s were on the Mayflower,’” were his parting words as they loaded him in the back. I made a mental note to check on him the next day.
Back to the grind, and Medusa.
I knocked on the door and entered room three.
“Good evening Miss…” I started my usual introduction but stopped when I saw the young woman waiting inside.
She was sitting on the chair, dressed in a very thin coat, her legs were bare and she had her arms wrapped around her chest. She wore ragged boots with a hole in the bottom. She had long black hair with a white bandana and her skin was the color of chocolate mousse, smooth and silky. Her eyes, those eyes were the most amazing eyes I’d ever seen, dark brown with long lashes. All in all, even as dirty and disheveled as she was she was an amazing, striking beauty. I caught myself and started my introduction again.
“Miss Medusa, I am Dr. Barnes. What is the problem that brings you in here tonight?”
“Cold,” was all she said.
I was caught a bit off guard by the brevity of her answer. “Excuse me, did you say that you have a cold?” I asked.
“No, I was cold and needed a place to warm up,” her voice was as silky smooth as her skin and there was an aura about her which beckoned to draw me into her world. I had to stop myself and even shake my head to return my focus to medicine.
“I’m sorry, but this clinic is for those who are sick or injured. I know it’s unusually cold tonight and wet and dreary, but there are other places you can go. There are shelters and there is the mission over on Fourteenth Street.”
“I can’t go to those places. Bad things happen to me. Oh, why did I ever come to this place and time. I never should have been so trusting.”
Her words started to pique my interest. “Place and time?” She certainly was not the Medusa known from mythology. No snakes for hair or gnarly face and teeth. Indeed, she was the complete opposite. There was great beauty which radiated from her and filled the room and that aura, a remarkable feeling which emanated from her soul, reached  out and touched me. She did seem to be in some sort of trouble, but a chief complaint of “cold” did not require my medical services. However, the profound sense of sadness which surrounded her, as well as the inexplicable attraction I was beginning to feel overwhelmed any necessity to follow the book.
“We are sort of busy, but you can stay in our little break room for a little while. You can warm up and I’ll see if we can find a better place for you to go.”
Maybe my apartment.  No,no, don’t forget Miss James.
“Thank you,” she replied.
I led her to the back of the clinic, got her a cup of coffee and a blanket.
“Tea please, if it’s not too much trouble,” she requested, but to me it seemed to be more than a simple request. I fixed her a cup of tea, English Breakfast, from the supply that Miss James kept and started to go back to work, but I almost couldn’t drag myself away from her. Finally, the slightly irritated voice of Miss James snapped me back to reality.
“Dr. Barnes, patients are ready in rooms one, two, three and four and the waiting room is full.”
I felt a jolt back to reality.
“I must go,” I said to Medusa, “but I will come back and check on you when I can.”
“Thank you, Doctor,” she replied, clutching the mug of tea tightly in two hands,
I picked up the chart for room one, Mo Smith, lacerated arm. I knocked on the door and went in to find Mr. Smith sprawled out on the table, a towel soaked in covering his left arm.
“Good Evening Mr. Smith, what happened …”
And so it went room one, then two, then three, four, back to one and on and on, diarrhea, fever, back pain, headache, belly pain, broken ankle, broken arm, broken hand until it was four a.m.
“Just one more patient, Dr. Barnes, waiting in room two,” Miss James reported. “A Mr. Persy, sore neck.”
“Thank you, Nurse. I think I’ve earned my money tonight. How many patients have I seen?”
“Forty eight. Mr. Persy will make forty nine. I think that’s a record. The cold weather brings them in, I think,” She concluded.
I knocked on room two and went inside.
“Good morning, Mr. Persy. I’m Dr. Barnes. What is the problem you are having?”
“Is she here?”
“Is who here?”
“Medusa. I’ve been searching for her for quite a while.”
What does HIPAA say?
“I’m sorry Mr. Persy, but I do not know any ‘Medusa’ and if I did and she was a patient I would not be allowed to tell you; rules you know.”
I wasn’t sure why I didn’t give him some intimation that I had at least seen her. Technically, she had not been a patient, just cold and all I had treated her with was a cup of tea. I tried to learn more.
“Maybe, if you could tell me something about her I could help you. She may have passed through here under an assumed name. It has been known to happen before. After all, we are here to help people who are ill or injured. All we want to do is make them better. Most of the time we don’t care if the name is real.”
He scratched his head and then stroked his chin.
“OK, let me tell you about her. Medusa was born in what would be modern day Turkey, a long time ago. Nothing is known about her parents, but she had two sisters, both of whom are dead. They were all hideously ugly and the two sisters pined away, wishing to be beautiful, like Medusa. Medusa, however, was a real beauty, but this beauty was more of a curse.
 “She is most beautiful,” I blurted out, before I realized I’d blown her cover.
Mr. Persy smiled before he continued. “As I stated, she was a beauty. But, Medusa, ah Medusa, she was always lost in thought. She could read and write and could remember every little detail of everything she had ever seen, heard, or done. And, more than anything, she was wise. From the time she was twelve people came to her for advice.
“Kings would come and ask if they should go to war or surrender. Men would ask about marrying, women would ask if they should accept proposals. When was the best time to plant, if the rains would be coming and on and on. And, she was not clairvoyant, just wise. She had a way of sifting through a mountain of information and distilling it down to its essentials and then rendering precise and accurate judgment. This was a gift from the gods. Being human she could not help but boast. She was reported to have said she was wiser than Zeus and Athena.”
“Wait,” I interjected, “are you telling me that she has been around for thousands of years. That the Medusa who is or was sitting in my little break room, drinking tea and wrapped in one of my blankets is the same Medusa from Greek mythology?”
“Yes,” was his terse reply, “but she is far different from the beast depicted in the mythology.”
“That is for sure,” I answered, “but, I should not have interrupted. Please go on with your story.”
“Medusa is and always has been the epitome of beauty, grace, charm, the perfect embodiment of womanhood. You have, I’m sure, seen her, been with her and felt the strange allure. That is Medusa. Think of history, the great beauties men have given their very being to possess; women that men have fought and died for: Helen of Troy, Nefirtiti, Bathsheba, and how many other nameless women. She was all of them. Medusa was Solomon’s favorite concubine, coming to his chamber night after night, she was consort to Roman Emperors, Arthur’s Guinevere and so many more. She is ageless and she is timeless, yet through it all she suffers.”
“Suffers?” I asked. “I would have thought she would have everything she could want, but, from what I’ve seen, she has nothing.”
“Of course she has nothing. She wants nothing but to be alone, to be removed from the curse?”
“I still don’t understand,” I had to admit.
“That is because all you see is a beautiful woman and in your mind beauty opens many doors. You feel the intoxication, but don’t see that there is a person there. I, on the other hand, know what she wants all too well and I can help free her from her sorrow. I have pursued her for all these years, because I want to take her away and free her from her burden.”
I listened closely, not sure if any of it was true or if this Mr. Persy was merely a pimp trying to get his hooker to tow the line.
After a bit of thought and reflection, I knew that it was up to Medusa to make some sort of decision.
“Wait here, Mr. Persy,” I instructed.
I went back to our break room. Medusa was still there, still wrapped in the blanket, sitting on the chair with her arms holding her knees tightly to her chest, slowly rocking back and forth.
“I’m still cold,” she cooed and then she gave me her smile and I knew why men throughout the ages would fight and die over her. But, my professional demeanor took over.
“There’s a man here looking for you, Medusa. He says his name is Mr. Persy. Do you know him?” I asked softly.
 I put my hand on her shoulder and she pulled away and shook her head violently back and forth.
“NO, NO and NO,” she shouted. “DON’T LET HIM, DON’T LET HIM, please?”
I saw the fear of the caged animal in her eyes as the door burst open and Mr. Persy entered.
‘Medusa, my Medusa, you’ve eluded me for so long, but now I’ve found you, alone, and I will have my victory. I will fulfill the task set before me and she will be mine forever,” Persy hissed.
“You’re mad, Perseus. She’s been dead for thousands of years. No matter what you do to me you can’t have her. She’s probably nothing but dust by now, dirt which has grown op and become grass, then consumed by some lowly animal, a cow perhaps, or a bull, or the Minotaur. Yes, consumed and digested and rejected like dung. That’s all your precious Andromeda is; Minotaur dung and that’s all you deserve.”
Miss James came in to check out all the commotion, startling Mr. Persy, that is Perseus, and I took the opportunity to step between Medusa and Perseus, but the crazed Greek “hero” pushed us all away, reached into his overcoat and pulled out a very long, very sharp gleaming knife.
“There is no help for you here. No king’s guards to protect you, no smitten Alexander to offer you refuge. Only these pitiful mortals. I’ll have your head and my happiness. Andromeda will be free and we will fly away together.”
He moved closer towards Medusa, his knife held high.
I heard a loud thump in the waiting room.
Maybe it’s the police or a disgruntled patient tired of waiting.
There was a loud crash as the door to the break room ripped away from its hinges and fell to the floor. A sleek white horse bolted through, its black eyes determined, white wings sprouted from its back as it reared up and brought its front legs down on Perseus, knocking him to the floor and then kicking him to the side like a the piece of garbage he truly was.
Pegasus.
The winged horse bounded towards Medusa and she effortlessly climbed on its back. The powerful beast kicked a huge hole in the back wall and the two rode off into the east towards the just rising sun. A faint glow arose from horse and Mistress as the snow fell around them and they made their escape. Miss James and I stood silently and watched.
“Perseus,” I exclaimed.
He was up on his feet, brandishing his knife at us.
“I have no quarrel with either of you. But, if you should ever see her, call me. The things I told you are all true. What she said is mere fantasy; the product of a deranged mind. I bid you farewell.”
He left a card on the table and stepped towards the opening in the wall.
“But, let us check you. You may be seriously injured. Pegasus’ kick packs quite a wallop.”
“I have lived for all these thousands of years and suffered far greater injury than a trifling kick from an old nag.”
He stepped through the hole in the wall and was gone. I looked up to see him flying towards the east, his boots had wings.
Like Hermes’ boots.
I turned away and looked into my companion’s eyes.
“Do you believe any of this, Miss James?” I asked.
“What’s not to believe? There is a big hole in the wall and then there is him.”
“Him?”
She gestured for me to look behind and there, standing in the doorway, was the Minotaur. He was dressed in a black suit and had a gold ring on his finger, but there was no doubt as to the beast’s identity.
“This is not some sort of Halloween gag, is it? Because, trick or treat and Halloween were months ago.”
“I’m sorry,” the monster apologized, speaking impeccable English with a slight accent. “I saw that you’re light was on and that you were open, so I thought you might be able to help me. You see I have this rash…”
“Miss James, would please take Mr. Minotaur…”
“Just the Minotaur, if you please. It commands more respect.”
“Would you please take the Minotaur to room one. I’ll be there in a few minutes.”
What time is it? Isn’t this shift over yet? Five thirty, an hour and a half to go. I guess I need to face the Minotaur.
I did remember reading something about the Minotaur recently, but the details eluded me at that moment.
I knocked on the door to room one as I glanced at the chart:

Quinton Arbus Taurus Aegus Minos, “Minotaur”, DOB unknown, originally from Crete, previous neck trauma, recently hospitalized following severe exposure with dehydration, previously prolonged exposure to cold, starvation…chief complaint: rash on upper chest.

“Good evening, Minotaur, or rather, good morning. What’s the problem that brings you in this fine morning?” I asked, trying to maintain my professional appearance.
“I’ve had this rash along my upper chest for almost two weeks now, right where my body transitions from fur to hairless skin. I’ve tried all the usual creams and nothing is working. It’s driving me crazy,” he reported, his manner polite and refined.
“You’re in luck. I’ve been rotating through Dermatology this month. I’m pretty well up on all the rashes. Let me take a look. Does it itch a lot?
“Horribly, day and night. I can’t sleep. I thought I might have fleas, even went to the vet for a flea dip, but nothing helps.”
“Well, let’s take a look.”
He took off his black overcoat and suit coat, followed by his white shirt and tie. There was an abrupt transition from the short, coarse hair of his bullish shoulders, neck and head to the smooth white skin of his human half. At this changeover point the skin was red and thickened with vesicular lesions. There was some excoriation where the Minotaur had been scratching.
Very strange, very unusual indeed.
“I need to take a closer look at the hairline, but I think I know what the problem is,” I informed the Minotaur. I found a magnifying glass in the exam room drawer and began a very close inspection of the beast’s hair. Sure enough they were there, tiny whitish “nits” on the hair and I noticed some tiny bugs moving about.
“You, my dear Minotaur, have lice. I’m surprised the flea dip didn’t help, but sometimes these tiny monsters can be very tenacious. Give me some time and I’ll do my best to get rid of most of them. It might be best to shave a lot of your hair, particularly along this transition zone. But, first you’ll need a shampoo.”
Lice was a fairly common complaint at the clinic and we maintained a supply of medicated shampoo which usually worked well to kill any adult forms of the vermin. I gave him a vigorous lathering, let it sit for a bit and then rinsed.
Next, I pulled out a fine comb and began going through all is hair, brushing away some of the whitish eggs, while pulling out hairs that stubbornly held on to their cargo. This, I had learned over the years, was the only way to get rid of the nasty “nits” which were cemented to his hair.
“While I’m working, Minotaur, I was wondering if you know anything about Medusa and Perseus? I assume you were around during their time. What is the truth?”
“A sad story, that’s for sure. The events actually took place before my birth, but I did get a firsthand account from one of the old guards in Minos’ palace, before I was locked away in the Labyrinth.
“Medusa always had amazing beauty, but also intelligent and wise. So beautiful, in fact, that all the lady “gods” were jealous. They concocted the story which has become the myth which has survived all these years. Medusa, one of three Gorgons, was supposed to be so ugly that anyone who looked at her would be turned to stone. She had hair which was snakes and eyes which turned anyone who gazed into them to stone. This kept most everyone away. But, this was not enough for Athena and Aphrodite. They were so jealous of her that they plotted to have her killed.
“Perseus was their dupe. He really did venture out on a quest to kill her and to bring her head to King Polydectes, as recounted in the myth, but, like most myths, that was the only kernel of truth in the story. The gods promised Perseus that he would have Andromeda as his bride if he could vanquish Medusa. Andromeda was young and very pretty and her father was very powerful. Perseus immediately was smitten by her charm and the prospect of ruling the land as the next king and vowed to return after he was successful.  
“Perseus did manage to find Medusa with the aid of the gods. But, he first had to deal with Medusa’s two sisters, who were truly ugly just as it says in the myth. Their job in life was to shield their stunning, gifted sister from unwanted visitors. Perseus was a truly great warrior, however, and he was determined to vanquish Medusa. He brutally murdered Medusa’s sisters.
“He came upon the young, innocent, beautiful maiden and threatened to kill her if he did not tell him where he could find the supremely ugly Medusa. He was still expecting a Medusa with snakes for hair and hideously gnarled features, which is what the entire world assumed Medusa to be. That young maiden, who really was Medusa, realized the danger she was in and tricked Perseus. She sent him up into the hills, saying that the repulsive Medusa was in one of the caves. Perseus charged up the incline, his sword raised and his shiny shield slung over his back, ready to do battle with a monster. Meanwhile, Medusa made her escape on the back of Pegasus. And she’s been on the run ever since.
“It’s sad, so sad,” he continued. “Medusa has only good qualities. She has to be the most beautiful and tragic woman to ever live. Meanwhile, Perseus has lived with this obsession for thousands of years. Andromeda is long dead, the Greek gods have been relegated to myth; only a few of us live on. Myself, Pandora, Perseus, Medusa, Hercules, and a few more have survived through the ages, through all the sordid years of human history.
“Pegasus, by the way, the winged horse, is Medusa’s greatest friend and ally. She raised him from a colt and he is never far away from her. That is one reason she has managed to survive and escape all these years.”
The Minotaur finished his story and sat while I continued to comb through his hair. Miss James, by this time, had joined me.
“Finished,” I announced. “I think all the nasty little creatures and their eggs are gone. To be really thorough you could slather on some olive oil and leave it over night. That will suffocate any little beasts who may be lingering. Oh, and good look on you new job at the University. I do remember reading about you and your remarkable life in the paper. I think you will turn the Department of Antiquities on its head.”
“Thank you, doctor and nurse,” the Minotaur answered. “I wish you well. And, don’t worry about Medusa. She will be alright. Look for her, someday, on a movie screen or on the arm of a powerful senator or prince. Oh, and look for my story. I think you would enjoy it. Good morning.”
And he left.
Miss James and I stared at each other, shrugged our shoulders and waited for the next shift.
“Breakfast? Or a bath?” she asked.
“Both,” I answered.
A few minutes later we left together.