Saturday, March 1, 2014

NIght Clinic Delivery

                           

“What should we do about it?” I asked for the thousandth time. “I’m not even done with my training. Having a baby was definitely not in my plans. A nice cushy Dermatology fellowship was more what I had in mind.”
“Well you should think about such things next time you take off your pants,” Miss James responded. “I did go to nursing school and it definitely takes two parties to make one baby.”
“So what are you going to do?” I asked again, only leaving the we out this time.
“Well,” she said with ice in her voice, “in about two hundred and thirty five days we, God willing, will be parents to a beautiful baby boy or girl.”
She turned and walked up to the front of the clinic to respond to the bell we both had just heard.
Me, a father? I’m barely a doctor. Well…it could be worse. I’m sure I can figure out a way to be a father with the lovely Miss James and I still be a Dermatologist. I thought I was being clever, telling that murderous Dr. Adams that Miss James was pregnant, but I guess I was clairvoyant.
“Look at this,” Miss James remarked as she placed a package on the table. “It was on the reception desk, no delivery man, no mail or UPS truck, just this package. It isn’t even addressed to anyone. Just this.”
She tilted the package forward and showed me the white label on the top:

A.T.

To

A.P.

“Very strange, strange indeed,” I observed. The package was about two feet, by three feet by two feet, covered in brown wrapping paper and tied with string. It was pretty light; I almost thought it was an empty box.
“Should we open it?” my companion asked.
“I’m not sure…but there’s the bell again. I guess we’ll have to deal with this later. Time to go to work.”
We put the package on the floor behind the table in the break room, not completely hidden, but also not in plain sight. Miss James began all the administrative paper work on out new patient while I took a few moments to look at the offers I’d recently received for Dermatology fellowships.
Southern California looks good, sun and sand…maybe Arizona, no rain, no cold weather…
“Mr. Phelps is waiting in exam room one, Dr. Schlemiel,” Miss James announced, still with a frosty edge to he words.
I hope this doesn’t go on all night.”
I picked up the chart and read about Anthony Phelps. “Fifty one, No Allergies, No Meds, chief complaint: fever and rash.”
Right up my alley.
I knocked and went in and greeted Mr. Phelps with my usual bedside banter, “Good evening, Mr. Phelps, what is the problem you are having today?”
“Hello, Dr. Barnes. Tony Phelps,” he rose from his chair and shook my hand. His grip was tight, a little too tight as if he was trying to establish some sort of hierarchy. “I’ve had a fever for several days, nothing much 99.8, a hundred and I’ve also developed a rash on my buttocks. It is quite uncomfortable.”
“Just on your backside?”
“Yes.”
“Did it start as a small area and spread or did it start by covering the whole area?”
“The whole area.”
“Come in contact with anything unusual? Been traveling? Any allergies?”
“No, no and no,” he replied, but he looked around as he answered my questions, as if someone else was listening. Then he added, “I’m usually very healthy.”
“Well, I guess I should check out the culprit. Here’s a gown. Take everything off from the waist down. I’ll be back in a minute.”
“Before you go, Dr. Barnes, I was wondering, were any strange packages delivered here recently. I was told I might find what I’m looking for here.”
“We get things delivered here all the time. Medical supplies, test results, free samples from pharmaceutical companies. What does this package look like?”
“It would be about Yay big,” and he held his hands about twelve inches apart and feel like there was a jar or bottle inside.”
“No, I can’t say we’ve received any such package, at least not that I know of. Now, your gown?”
“The package may have been bigger. I was told it would be here.”
“I’ll tell you what,” I finally said, “you put this gown on so I can finish checking you out and I will check with my nurse about your missing package, OK?”
He murmured an affirmation and I left him alone. I found Miss James checking in another patient and gestured for her to join me. She handed a very large man a clipboard to fill out and then we went to the back to look at the package. It looked smaller to me and felt a little heavier.
“Maybe this is what Mr. Phelps is looking for,” Miss James concluded.
“I don’t know. I get the feeling we’ve been drawn into some sort of international espionage. Maybe it’s a ‘Mission Impossible,’ after all he is Mr. Phelps. I don’t think we should give him the package without some sort of proof that it’s his even if his initials are A.P.”
I went back to check on my patient. He was laying face down on the table, properly attired in his gown. I pulled up the gown to see a cacophony of skin disorders all come together on his buttocks. There were patches of obvious bacterial infections, others which looked like chemical burns, reactive dermatitis, weeping sores and petechial rashes, all limited to his derriere.
“Your buttocks are quite unusual, that is the skin disorder you have is unusual. Are you sure you haven’t come in contact with anything toxic or out of the ordinary? Because, it looks like you’ve been attacked by a mixture of Strep, acid, fire ants and I don’t know what else.”
Mr. Phelps closed his eyes, pulled his gown over his butt and turned towards me. He looked a bit sheepish.
“It’s hard to explain, Dr. Barnes. In my line of work there is the potential to come in contact with a variety of toxins and poisons, dangerous chemical and biological agents. One way to deal with this is to intentionally expose oneself to these noxious materials to build up a sort of immunity or at least a tolerance. I think I tried to do too much at one time.”
“What are you some kind of secret agent or a garbage collector? Well, I suppose it doesn’t matter. I’ll give you a prescription for some antibiotics and some cream to put on your backside. Try it for three or four days. If you’re better, fine, but if you’re not improving, come back. I gave him a prescription for Cipro and another for some antifungal, antibacterial, steroid cream.
“Check out with Miss James at the front and if there’s no improvement come back here or see your own doctor.”
“Thank you, Dr. Barnes. You’ve been very helpful,” Mr. Phelps replied as I escorted him to the front.
I left him to look at the chart of my next patient, the very large man I’d seen in the waiting room, K. Gutman, no age listed, no medical problems, no allergies, chief complaint shortness of breath, blood pressure 180/95. I was about to go when I felt the pocket of my white coat and realized I didn’t have my stethoscope.
Must have left it in the break room.
I heard some rustling and furniture moving as I approached the break room entrance. I stopped and peeked inside and saw a man in a beige rain coat bending over behind the table. When he stood up I saw that it was Mr. Phelps, now holding our mysterious package.
“I’ve been searching for this for years. Never would have thought it turn up in some rinky dink medical clinic in the middle of the city,” he commented as he put the package under his arm.
“Do you think it’s safe for you to just walk out of here carrying that bundle. Don’t you think they’ve been following you?” I answered.
Phelps looked around, up and down, towards the window, inside his coat and then he put the package back behind the table.
“You’re right; they’re probably watching me right now; probably don’t believe that I would come to the clinic with a real medical condition.”
He stroked his chin as he thought, “I’ll tell you what. You keep it here, keep it safe. I’ll give them the slip and then come back for it.”
He didn’t wait for me to answer. He put on a pair of dark glasses and snuck out the back of the clinic. I shrugged my shoulders, found my stethoscope and went back to see Mr. Gutman.
Gutman, that name sounds familiar.
“Good evening, Mr. Gutman, my name is Dr. Barnes. What’s the problem that brings you into our wonderful little clinic?” I began.
“Nice to see you, doctor. I will dispense with the usual pleasantries and get straight to the point,” he replied.
Great. When someone says tey’ll get straight to the point, they usually do everything but get straight to the point.
Gutman was big, rotund, with beads of sweat dotting his forehead. He was dressed in finely tailored gray suit and I detected a slight accent in his voice.
“I’ve been having trouble catching my breath, Dr. Barnes. I first noticed it on the train from Istanbul to Prague. Since then I’ve noticed that I have to stop and rest on a regular basis.”
“Have you seen a doctor before?”
“No, I haven’t have had the time. I frequently have to leave one venue for another on very short notice and doctors have not fit into my busy calendar. Fortunately, my travels have crossed with your clinic and so, I thought I would ‘kill two birds with one stone’ as you Americans so quaintly articulate.”
“Well, it’s good that you stopped here. Your blood pressure is very high and I can see thta you are dangerously overweight.”
“Yes, yes, one of the consequences of living one’s life from hotel to train to cruise ship and back to hotels. One never gets the proper opportunity to exercise or to eat healthily.”
“I think you’ve done a bit too much eating, healthily or unhealthily.”
“Harrumph,” was all he could say so I continued.
“Your blood pressure is dangerously elevated, you have bilateral carotid artery bruits which suggests to me that you are heading for a serious stroke. You have wheezing in both lungs and your legs look like tree trunks. In short, you are a walking time bomb. I recommend you start on a medically supervised diet and medication for your blood pressure. We need to get the results of your blood work also, I’m betting your sugar will be high which means you’re probably diabetic. We can manage your health problems here at the Clinic or you can follow up with your own doctor. But, I would not ignore these medical conditions, that is if you want to live beyond the next six months or so.”
“My dear Dr. Barnes,” he responded, “I am grateful for your concern, but these ‘medical problems’ are mere trifles in the grand scheme of this world. I have been in pursuit of a truly remarkable and valuable treasure and I have followed it to your clinic. I believe a package was delivered here earlier?”
I didn’t answer, but I think he could tell from the look on my face that he was correct.
“This package, sir, is one that I have following for many years. I thought I had finally secured it in Oslo three years ago, but, at the last moment it eluded my grasp, only to resurface in Cairo. My contact there met with an unfortunate accident before he could make delivery. I’ve since chased this prize through every corner of the continent and now it has turned up in your medical clinic. As one can easily surmise, sir, I have spent a considerable sum of money chasing this prize. And, if you were to be so kind as to deliver it to me I would pay you handsomely for your brief troubles.”
I looked at him and saw the combination of greed and desperation in his loose jowls and pig like eyes.
“What, if I may be so bold as to ask, is in this little package?”
“A magnificent bird, fourteen inches tall, made of solid gold and bejeweled with perfect diamonds, emeralds, rubies and sapphires. It was a gift to the ruler of the Ottoman Turks in 1647, but was lost in 1800. It reappeared briefly in London in the 1820’s and also was held by a private collector in Paris some years later. It was taken by the Nazi’s during the occupation and was thought lost forever, a victim of the war. It was only after the fall of the Soviet Union that it resurfaced, first in Moscow, then Budapest.”
“This bird manages to make it all over Europe,” I commented. Gutman only raised his eyebrows slightly at my remark.
“I have it on very reliable information that the package which was delivered, quite mistakenly, to your clinic is the priceless falcon. And now, Dr. Barnes, I will take that package. If you would be so kind as to bring it here.”
I was staring at a pistol.
Why do I feel Like Humphrey Bogart? Give him his package; it’s probably a fake anyway.
“OK, OK, I’ll get it for you. It’s been nothing but trouble since it arrived anyway. Don’t forget, however, that you need to look after yourself. Remember, if you don’t have your health, you don’t have anything.”
I went to the break room and found the package behind the table where I’d left it. As I started to bring it to Gutman, Miss James stopped me.
“Where are you taking our mysterious box?” she wondered.
“Mr. Gutman says it belongs to him and he has a nine millimeter handgun that makes it difficult for me to argue.”
“Oh,” was all she said. “Probably for the best anyway. It has been nothing but trouble.”
I picked the box up and noticed that it was much heavier than I remembered.
Solid gold bird would be pretty heavy.
I started to hand the box to Gutman who was sitting on the exam table. He had more sweat on his forehead and his head was bent down and he was struggling to breathe. The pistol was hanging on two fingers and crashed to the floor followed shortly by Mr. Gutman.
“Mr. Gutman…Mr. Gutman, can you hear me?” I asked. He was still breathing and his eyes were looking around the room as if he was trying to remember where he was.
“The bird,” he whispered, “do you have it? May I see it?”
“I have the package here. I’ll put it in your arms,” I answered. I gently lay the package across his chest and folded his arms around it. He held it tightly to his chest and a smile graced his face.
“At last, at last, after years and years of …” his voice trailed off.
Miss James was already there with the crash cart as Kasper Gutman breathed his last breath. We performed CPR and the ambulance arrived, all to no avail. With considerable effort they managed to get him onto a stretcher. I even thought we had brought him back, but then he went back into V. Fib and then asystole.
I put the cursed package back in the break room and then filled out all the paperwork which is required if someone dies at the Clinic. The Coroner’s assistant arrived and carted Gutman away and that was that.
“Anyone else waiting Miss Ja…?” I started to ask but was interrupted by a person dressed in black medieval armor, holding a long, shiny, sharp sword gracefully pointed at my heart.
“I will take the Grail,” the muffled voice commanded.
“Grail?” I asked, my voice filled with confusion.
“The Holy Grail. I saw it delivered here today. I’ve been on a quest to retrieve it for years and years. Now, young sir, you shall deliver it to me or suffer the consequences. Perhaps,” he mused, “I shall run you through just for the sport of it and then take my prize anyway.
They don’t pay me enough for this.
“I’m sure I don’t know what you are talking about. This is a Medical Clinic. We take care of sick people here. We don’t have any grails.”
He pushed his sword against my chest, then raised it above his head as he prepared to run me through. As his arm moved forward and I closed my eyes I heard a loud “CLANG” as metal struck metal.
A second knight, this one clad in silver armor had appeared.
“Forsooth and avast, ye wicked Black Knight. You shall never possess the Holy Grail as long as I can draw a breath,” the Silver Knight shouted.
Avast? Don’t pirates say that?
My attention returned to the ensuing battle.
“Sir Lancelot, you are more relentless than I imagined. But the Holy Grail shall be mine.”
Swords clanged together as the two knights battled from one end of the clinic waiting room to the other. Chairs were slashed, potted plants upended and magazines strewn about.
A very large woman came in as the sword fight raged. She walked past the two knights, ignoring the combat, to the reception desk.
“Ya’ll open?” she asked in a very demanding voice. “Cuz my back is killin’ me and I can’t get no sleep.”
I stared at her and then at the two combatants and then back at her.
She saw the confused look on my face, but went right on talking.
“Listen up, Dr….Barnes,” she stared at my ID badge, “When I’m talkin’ to you, you pays me propa attention. That Fightin’ goes on all the time in this neighborhood, but I’sa hurtin and you got’s to do somethin’.”
I turned my attention to her. “Certainly, Ms….”
“Angelina, just like Angelina Jolie. Angelina Babbett. Like I was sayin’, my back is sore like someone’s stickin’ a knife.”
“OK, Ms. Jolie, I mean Babbett. Fill out these forms and we’ll get you right back.”
She took the clipboard and sat down while Lancelot and the Black Knight fought on. The clanging of metal mixed with Ms. Babbett’s murmuring as she answered the pages of questions. Every time a chair was knocked over or there was an especially loud crash she looked up and gave the knights an especially dirty look. Finally, she couldn’t stand it anymore. She jumped up from her seat and rapped the Black Knight on his helmet with the clipboard. The fighting stopped abruptly as both surprised Knights stared at her.
“You two good fo’ nuthin’s get yo asses out o’ my way. My back is killing me and I canna get this here paper filled out with all that there racket. You got fightin’ to do, you does it outside and leave this here clinic fo’ the sick folks.”
I approached Lancelot.
“I’ll keep it safe for you, right here. You go battle the Black Knight and defeat him and then you can come back for the Grail.”
“Excellent plan, young doctor. But, be sure to keep it safe or it shall be you I will pursue.”
“I promise I will treat the package with all the respect and care it deserves.” And I opened the door and ushered him out. The Black Knight had already made his escape and when Lancelot saw his adversary riding away he made a hasty exit and mounted his armored horse.
Au revoir, good Doctor,” he shouted as he rode away.
I have to admit it was quite a sight, two men in full armor, each astride an equally armored horse, racing down the street with swords raised, illuminated by the pale light of the street lamps. I turned away, shaking my head.
This box…this mysterious box. I don’t think I want to know what’s really inside. It’s going to get us killed.
“Miss Babbett is waiting in room one. I suspect a shot of Dilaudid will send her on her way,” Miss James reported from the doorway.
I looked again towards Lancelot and the Black Knight as they faded into the night and then turned and headed back into the clinic.
“Do you think we should open it?” Miss James asked.
“Perhaps,” was all I could say. I thought for a few more moments. “I think I know what we would find inside. We would be disappointed.”
“Do you think it’s empty?” she wondered out loud.
“I think it’s full and empty and everything in between.”
“Please, don’t speak in riddles,” she replied.
“I have no choice because that little package is just that…a riddle. ‘A.T. to A. P.’ is a riddle. Now, I’m going to see poor Miss Babbett and maybe you can solve the riddle while you’re waiting.”
Before I could escape to the exam room a quartet waltzed through the door, an unusual group, even for the Clinic.
“If you please, sir, I believe there is a package here that would be of great benefit to us,” said the little girl.
Why am I not surprised.
Standing at the reception desk were Dorothy, The Scarecrow, the Tin Man and the Cowardly Lion.
The Scarecrow explained, “We’ve been following that box all the way from Oz. It’s the only thing that will give me a brain or the Tin Man his heart…”
“Or me my courage,” the Lion chimed in.
“And it will help Dorothy find her way home,” the Tin Man added.
“Now wait a minute, wait a minute,” I replied. “I do believe that the Wizard was supposed to have granted all your requests.”
“The Wizard? You mean the Charlatan,” Scarecrow answered. “Do you really believe that a fake diploma from some fake ‘university’ qualifies as a brain? I was laughed right out of the cornfield when I showed it to one of the crows. That crow said he was smarter than me and stole all of my corn just to prove it.”
“And that heart?” the Tin Man added followed by a sigh. “I was so careful with it, Kept it around my neck right over my chest. Five days after he gave it to me it started running backwards and then it went ‘Fhht’ followed by complete cardiac arrest, if you get my meaning. If I was dependent on it to pump blood I’d be face down in the gutter. Hmmph, how could I be duped to think a two dollar drug store clock is as good as a Jarvik seven.”
“That medal was nice,” The Lion said in a soft, almost embarrassed voice, “although it hurt when he pinned it on.”
“Yes, yes, very nice and what did it get you? The first time you tried to stand up to another beast they laughed and that was just a squirrel. What did you do?” Dorothy asked.
“Please, don’t tell, don’t…”
“He runs away and hides in the bushes; some courage. And, I guess it’s clear that I am not in Kansas, Dr….Barnes.”
“Yes, this is definitely not Kansas. Just what makes you think that this box you’re looking for has all these things which you desire?”
“It must, we were promised. I sold my ruby slippers to get what’s in that box. The man promised.”
“Someone from around here?” I surmised.
“Yes, he had a black coat and an ID that said he was from the government and would help us,” she answered meekly.
They can have it, the stupid box. It’s been only trouble.
“Well the box is here and you are welcome to it. Just wait here and I’ll fetch it for you.”
I went to the back to retrieve the troublesome parcel. I looked behind the table, but there was no box. I looked under and around and over every nook and cranny: no box. I went to find Miss James, but she had no idea where the box disappeared to.
Miss Babbett was standing in the doorway to the exam room and saw us searching high and low.
“Looking for something?” she inquired.
“There was a package back here, wrapped in brown paper about so big,” Miss James explained.
“You mean that there stinky box that was in that room back there? I throwed it away. I couldna’ stand the stench, almos’ made me to vomick. It’s in the garbage dumpster. Now what about my back?”
“I’ll be right back and take care of you,” I said as I ran towards the back of the Clinic.
It was getting late, almost 5:30 and this was garbage day. I heard the roar of a truck in the alley and ran outside just in time to see the garbage truck driving away. I peered over the edge of the dumpster and saw only a few dirty rags which had clung to the bottom. I went back to inform Dorothy and her companions.
“I’m terribly sorry, Miss Gale, but the package you are seeking is gone. It was inadvertently thrown away and now it’s on that garbage truck which you can see down the street. I pointed to the truck and,before I could say another word, the four raced away after it. I went inside to take care of Ms. Barrett just as a big RV pulled up. There was a colorful logo painted on its side:

JASON and the ARGONAUTS

I’ve heard of them, some sort of rock group.
A solidly built young man emerged from the door on the RV’s side and came inside.
“I’m Jason, lead singer for the Argonauts. I was told I might find something here, something I’ve been searching for…”
I stopped and stared into his eyes. He was tall with blonde hair and a dark complexion.
“If you’re looking for the Golden Fleece you are about five minutes too late. If you hurry you can probably catch it. It’s in that garbage truck you just passed. Just look for a truck being chased by a little girl, a scarecrow, tin man and lion.
“Thank you, doctor.” And he turned and walked out.
I went back to the exam room to tend to my patient.
“That ther’ box sho did stink. Almos’ made me fogit about thes here back pain. But, now it’s a throbbin agin. Musta bin some sort of dead possum or rottin’ trash in thet package.”
“How long have you been having back pain, Ms. Barrett?” I asked, trying to focus on her problems.
“Wha was in thet ther’ box anyways? Do you knows?” she wondered.
I stopped and thought for a moment, staring off into the distance.
“Dreams, Ms. Barrett, lost and unfulfilled dreams,” I replied in a soft voice.
She looked at me as if I had lost my mind.
“But, for you, I think a shot of Dilaudid will work just fine and then you can follow up at the Back Clinic over at County Hospital.”
“Demerol woks better,” she interjected.
“OK, Demerol.”
“Seventy five IV.”
“OK, OK.”
Miss James gave her the medication and we sent her on her way.
Afterwards it was just the two of us alone in the Clinic.
“What are you thinking?” although I didn’t really need to ask.
“That box; so much hope wrapped up in a plain brown wrapper. Do you think any of them will ever find what they are looking for?”
“I suppose they’ll all find something and, in the end, they will probably be disappointed. It’s the anticipation of something better which keeps us going. How often are we let down in the end? But, back to ‘A.T. to A.P.’ What is the answer?”
“You keep thinking about it, Dr. Barnes, that’s what you’re best at,” Miss James commented, but then she patted her belly. “Well, I have to admit, you are good at a few other things, too.”