LIFE
is ubiquitous. Entropic eddies swirled
by stars.
Life
can best be seen as a river flowing through time. The river takes a branch at chaos. Not so much a branch as a focusing.
Johnnie, my nurse, is gay.
"I just had my pap smear" he informed me.
I looked up from my desk. He
thinks he has surprised me.
"People like us get those, you know." He said.
My drama alert radar was beeping.
"The
doctor went down there and scrapped."
Johnnie decided to go into detail.
"It hurted me,” he said, “But it also felt good." He giggled
and laughed at me. I get no respect.
I
was finishing a note in a chart. I can
write and think at the same time, but I can never talk and think at the same
time. Sometimes that's a problem.
"Mrs.
Hernandez is here," Johnnie said handing me a chart. "She's saying something about how she
fell and a dog was running, I don't know, you have to talk to her." He
passed me the chart with a shooing away jester.
"She's in room five."
He said. And he was gone.
A
new patient can best be seen as a gift from a stranger.
When
I entered room five Mrs. Henandez was standing, leaning up against the
examination table, holding her rib cage like this is the big one.
Mrs.
Hernandez was an short, overweight, middle aged Hispanic woman with a full head
of wavy grey hair and yesterday’s makeup.
I knew her very well. We went
back.
"Oh
doctor Clark!" she started out then suddenly cried, "OH! OH! OH!
OH!" she clutched her ribs with both hands, "OH! OH!" she exclaimed.”
"Hi
Mrs. Hernandez." I said, "What’s goin’ on?"
"He
ran out the door!" she blurted out between heavy breaths. "It was Sparkey my dog.” She took
several deep gasps. “Not Trixy.” Gasp,
“It was Sparkey."
"OK,"
I said, gently patting the air in front of me, "it was Sparkey, I got
that, but what happened."
"Out
the car door!” She cried. “I opened the
door and… OH! OH! OH!" She was
wincing in pain holding her ribs and I was starting to get an image.
"OK,"
I said, stepping to the side. "You were standing next to the car like
this." I indicated where a car
would be with my hands. She was watching
me now. "And you opened the door
like this." I motioned like I was
opening a door.
“Sparkey
shot out!” She gave a shooting motion with her hand and then,” OH! OH!"
She was holding her ribs again.
"Hmmm,
I think I get it." I said, "The dog jumped out. You ran after it. And you fell on your face."
"Yes." She said with finality.
"Gee."
I said, looking down at the chart. Mrs.
Hernandez had a body like a potato walking on toothpicks. I pictured her chasing after a little dog and
falling headlong. I winced.
"OK
Mrs. Hernandez let's get you up on the table so I can check you out."
I
put both my hands under her arm pits and gave her a little. After some effort she and I negotiated her
mass up onto the examination table.
I
put my stethoscope in my ears and listened to her lungs. There
were clear breath sounds all over which was good. Her heart was working overtime but
regular. I helped her lay back. "Ohhhh Ohhhh." She said quietly
while we laid her back.
She
had an abrasion on her right knee.
"And
my hand." she said.
I
look at the palm of her hand. She had
taken quite a tumble.
I
raised her blouse and checked out her rib cage.
I didn’t see any bruises but when I felt her ribs she winced.
“You
might have cracked a rib.” I said to
her. “You should probably go to the ER
to get an x-ray.”
“I
can’t afford that doc.” She said, and
gave me a look.
I
surveyed the situation. She was
breathing fine. Vitals OK. A few scrapes but otherwise nothing major. Even if she had a cracked rib, they probably
wouldn’t do anything.
"What
would you like for pain?" I asked.
"What
you got?" She answered.
Now
I had her interest.
"Well,"
I looked at her and said, "I could write you for some vicodin. which is
exactly what I would be asking for if I was in your shoes.
"Yah,"
she said brightening up. "Give me
thirty vicodins"
Which
started me laughing.
I
know I shouldn’t, but I laugh at my patients all the time. I'm sorry.
"Hold
on now Mrs. Hernandez.” I said, “I’ll
write you for some vicodin but I don't think you need thirty."
"Just
so I can sleep." She said in a
little voice.
I
got out my drug reference manual and thumbed through the pages looking for
vicodin. I always use a book. I’ve never had a patient express surprise that
I’d be using a book, which has always surprised me, however, if I’m ever in court
that’s the book that I’ll throw at them.
I
ran my finger down a page and got to vicodin.
“Make
it the 10 miligram.” Mrs. Hernandez said.
“Geesh,”
I said and then. “OK, I’ll give you ten
of those.”
Life
is ubiquitous. Everywhere from the
deepest hot vents at the bottom of the ocean to the highest levels of the
stratosphere. And so beautiful.
Life
can best be seen as a river flowing through time. Birth, life, death. Birth, life, Death.
If
we could look back each one of us would see three billion years of
uninterrupted generations.
Everyone.
A
few minutes later, Mrs. Hernandez was leaving the office and I heard her say to
Johnny, “Doctor Clark is my favorite doctor.”
I
looked up from my chart and called out,
“If
you love me, give me one of those vicodin.”
“No
way!” she laughed.
Laughter
is a good indication.
Los
Angeles 2017