Life is ubiquitous

 

 

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 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