The Soul of PerceptionbyAdrian Leverkuhn©
Once upon a time there was a doctor. A surgical resident in a big city hospital, he seemed to care about people, always had a smile ready or a hand out for anyone who needed him. Some people thought he was a doormat, that he couldn't say no to people and that everyone took advantage of him as a result. These people called the doctor a 'Patsy' -- an easy mark -- and perhaps they laughed at him behind his back from time to time. Perhaps there are some who think so little of people like this because they have forgotten that if only occasionally true goodness walks among us from time to time.
This is a little story about goodness, and the price some pay as a result...
Doug Tanner rubbed the corner of his right eye, picked dried flakes of 'sleep' from his skin, then with thumb and forefinger rubbed the tiredness from his bleary eyes. He looked at his watch: 2220 hours. An hour -- he'd had an hour of sleep -- in the last two days! His mouth tasted coppery, cruddy; the air smelled like stale coffee, body odor and cheap after-shave lotion. He was hungry but he hated the idea of food, the very idea he needed food. There were times he resented his own human frailty, and this was one of them.
The pager in his lab-coat buzzed and he picked it out of the rubbish of gum wrappers and throat lozenges, looked at the code on the little green display and groaned.
"Crud, not again..."
Then, from a speaker in the ceiling: "Dr Tanner, Dr Tanner, stat to ER, Trauma Two. Dr Tanner stat to trauma Two."
"Hey, Tanner, sounds like they're playing your song again," a resident sitting in the room said. "Go get 'em, Tiger!"
He didn't know her name, and for some reason he couldn't have cared less. He grumbled something nine-tenths obscene under his breath and pulled himself from the sticky vinyl sofa; he yawned and rubbed at his eyes absent-mindedly while he stumbled out of the 'Residents and Interns Only' break room. He followed the red stripe on the floor to the ER and waded into Trauma Two, a small room set up for emergency surgery and advanced life-support. A couple of other residents had arrived before him and were sorting out the mess.
"Tanner! Gun shot, through and through right lobe. Need you to get a chest-tube in, now!"
Doug Tanner was wide-awake now. He gloved-up, moved to a tray set-up by the patient, a black kid on the table -- wide-eyed, terrified, bloody foam coming from his nose; a nurse opened the kit while Tanner palpated the kid's thorax, then Tanner made an incision between ribs on the kid's left side and thrust the hemostat and surgical tubing into the kids chest. Frothy blood came out the end of the tubing at first, then a steady stream of deep red fluid jetted onto the floor. An anesthesiologist was intubating the kid, the chief thoracic resident hovered over his sternum, her scalpel poised and waiting for the go-ahead from the 'gas-passer'; another resident was swabbing the kid's sweaty, mud-caked skin with saline and Betadine. There wasn't enough time to get the kid upstairs to an O.R.
This was Tanner's second year as a general surgery resident, his third six-month rotation through the ER. He couldn't remember ever having done anything else in his life. He could barely remember his parents anymore -- they seemed like abstract constructs in an anatomy class. Girlfriends: who had time? Jenny so-and-so, a waitress one night, and Macy last summer -- they had come and gone, had fallen into the general blur of life at the hospital, just another blur on the past-passing landscape. Everything he had once thought important, girls, cars, even maybe getting married someday -- all these things belonged to a past that was so far away it wasn't recognizable anymore. Everything he ever wanted to do was gone now, his memory wiped clean by drunk drivers and irate husbands.
'Everything... but this goddamned ER,' he told himself from time to time...
An orderly rushed into the room: "Can one of you break free? We've got a big bleed in five!"
The Chief looked up at the orderly, then at Tanner. "Go!" she said when she made eye contact.
"Right." Tanner walked down the hall and ducked into another room and shuddered to a halt: "What the hell?!" he said in wide-eyed astonishment.
"He got his arm caught," a paramedic began explaining, "in this machine, they grind hamburger in..."
Tanner looked at the mess: male, forties, calm... sitting up on a fire department gurney, his right arm -- almost up to the elbow -- had been pulled into a large metal meat-grinder; there was a fireman holding the machine up to keep it from pulling the man's mangled arm from his body. Paramedics had applied a tourniquet at the scene and started an IV; every time they released it on the ride-in massive blood loss resumed.
Tanner walked to the man's side. 'Why isn't he in shock?' he asked himself.
"How'ya doin', doc," the man said. He still had his white butcher's coat on. "Sorry about this."
"Can you feel anything?" Tanner asked while he bent over to examine the "hamburger" that had come out the spout on one end of the machine.
"No, not really... it hurt like a son-of-a-bitch while it was happening, but not much since."
"Nerves are completely severed," Tanner mumbled. "Nurse, get me some saline, and let's get some light down here." Someone handed him an opened bottle of saline and he slowly poured half of the liter bottle over the wounded pulp; Tanner pulled a lamp closer, looked at the mangled mess. "And start some ringers," he added.
"You gonna have to amputate?" the butcher asked stoically while he watched Tanner probing the mess.
Tanner kept looking at the mangled remnants while he poured saline over the tissue, looked at hidden structure with the metal probe in his gloved hand. Every now and then he made little clucking noises with his tongue and his head moved from side to side but other than that he seemed completely absorbed with the problem at hand...
"Does this machine come apart? There?" Tanner asked the butcher as he pointed at the main body of the grinder.
"No, not the chute," the butcher said, "that's solid aluminum, doc."
Tanner moved, looked down into the machine's feed chute, from the uninjured side of the man's arm. "What about those blades in there? Do they reverse?"
"No, doc. The gears just turn one way." Tanner studied the machine for a moment, then stood up:
"Nurse, call someone in maintenance and have 'em bring down a metric socket set and some vice-grips."
"What?" the nurse said. "What did -- you want...what?"
Tanner turned to the nurse. "Metric socket set and vice grips, and Stat!"
"What are you gonna do, doc?" the butcher asked again. "Amputate?"
Tanner looked at the man; his eyes were full of fear. "What's your name?"
"Jake. Jake Bushman. Sorry I can't shake hands."
"Well Jake, I'm going to disassemble this grinder and remove whatever is keeping those gears from going into reverse. Then we're going to turn the gears slowly -- in reverse -- then we'll pull your arm out the way it went in, try not to mess up any more tissue than we have to. Once we get that done we'll take you up to an operating room. We'll try to reassemble the structure, repair the veins, and see if we can't save this hand."
"You gotta shittin' me!" one of the paramedics said.
Tanner looked up, scowled at the paramedic: "Nope. Piece of cake."
"Fuck! I thought for sure I was gonna lose my arm!" Jake said.
"No guarantees, Jake. But we're gonna give it our best shot. Okay?" He turned to a nurse, ordered some blood chemistries and a couple of surgical trays, then pulled up a stool and began looking at the machine.
A janitor walked into the room with a toolbox, looked at the butcher and the surgeon, then at the gleaming machine and the pulpy mess of arm hanging from the spout, then passed out and fell to the floor like a sack of potatoes.
Tanner left the hospital a little before noon the next day; he got in his ancient BMW and drove out of the physician's lot and headed down to the marina, parked and walked out to his boat. While he walked down the pier he looked at his feet, tried to ignore the world around him. When he got near his slip he stumbled to a stop, looked at the suitcase on the deck by the cockpit; he saw Macy sitting in the shaded cockpit and sighed.
"Ah, the ghost of girlfriends past," he mumbled as he took a few more steps. "It must be Christmas already." They'd broken up last summer, a spectacularly uneventful parting of the ways. Still, she'd been nice...
"Hey Doug," the girl said when she saw him. She seemed upset, not like the Macy he remembered.
"Hey yourself." He climbed on-board and ducked into the cockpit and unlocked the companionway, lifted the boards and walked below. He went to the breaker panel and flipped on the air-conditioning, checked a battery monitor and flipped a switch to cycle the bilge pump, then walked to the little fridge in the galley and pulled out a Coke. "Want something?" he called up.
"Whatever you're having."
That was vintage Macy, alright. She must have been a telepath! Never ask for anything, never want anything, but she resented the hell out of you when you didn't give her what she wanted. He grabbed another Coke and walked up the steps into the cockpit.
"To what do I owe this honor," Tanner said as he popped the top and took a sip.
"I'm pregnant," she said. She was looking him in the eye, daring him to say something smart.
"Oh? Really?" He met her eyes.
"Don't worry," she said; she looked down at her hands. "You're not the father."
"Great, but I'm missing something." She seemed to be hovering over plains of a great despair. "I mean why are you here? Why me?"
"I lost my job. I need a place to stay."
Jake looked at her, lifted his hands and shrugged. "And... what? You suddenly remembered good ole Doug and decided to come on over, move in?"
She smiled unevenly, laughed a little: "Yeah, something like that." Then she looked at him again, more closely this time. "I didn't know what else to do, Doug. I had to move out of my apartment last night."
He nodded. "What about the father?"
"Nada. Threw me out when I told him."
"Sounds like a nice guy. Real father-of-the-year material."
"You have to go back in soon?"
"Nope; got 48 off."
"Think we could go out?"
Tanner sighed, looked at the sky, thought about his berth down below and how much he wanted to sleep. "Hadn't been planning on it," he said, but what the hell. Looked like a nice breeze out there and maybe he could figure out what it was she wanted from him.
"Please," she said. "I used to love going out, with you..."
"Well, why don't you put your stuff up forward, give me a hand with the lines..."
He raised sail and the boat slipped out the cut from Dinner Key, pointed toward Key Biscayne across the shallow, blue bay, downtown Miami off the port beam. It was warm, in the hi-60s, a typical mid-December day. There was no one out on the bay mid-week; it was like they had the whole ocean to themselves. The boat knifed gently through the water, the wind little more than a breeze. Macy took the wheel and Tanner went below for more Cokes and to make some sandwiches. They ate in silence; Macy seemed to bask in the sun for a while, then she curled up in the cockpit and fell into a restless, twitching sleep. Every now and then she moaned.
Tanner watched her, jibed the boat slowly and pointed the boat south, toward Homestead; he set the auto-pilot and put his feet up, regarded the girl while she slept.
A gust passed through the sails, the boat heeled a little and dipped through a wave.
"Penny for your thoughts," he heard her say.
"Why me?" he said.
"Because you are who you are," she said openly. "I know you... you'd help."
"Why's that? Because I'm the biggest sucker you know?"
She shook her head. "You're not a sucker, Doug..."
He looked at her, looked at her tiny belly. "How far along?"
"Macy? Have you seen an O.B. yet?
She laughed. "Maybe." She turned her face into the building afternoon wind, her hair streamed past her shoulders.
"No foolin', Macy! You been gettin' check-ups or not?"
She shrugged. "I can't afford it."
"What... what happened? I thought you were pretty high on the seniority list."
"Not high enough. They let about three hundred of us go."
She'd been a flight attendant with a major carrier for years but everything seemed to be falling apart this year; the only real growth industry in Dade County seemed to gunshot wounds and drug overdoses.
"I'm sorry," he said. "I didn't mean to pry; I know it's been a bitch all over. But don't you have Cobra, or some kind of policy?"
She nodded. "Yeah, but the premium's are pretty steep, the co-pays... there's just not enough to go around."
He nodded. "It's been tough for a lot of folks." he said. The ER was awash with these new, cruel realities -- he sutured-up the grim truth of this reality day in and day out.
He looked at her a long time, tried to think of what to say, or how to, then:
"So right, feel free to stay aboard if you want. 'Til you get your feet back under you." He looked at her, looked at her gentle smile. Maybe that was all he wanted out of life, he told himself; to see people smile, see them get a fair shake every now and then.
"You see, I told you."
"You're... you know... you're the most decent human being I know, Doug."
He laughed, blushed, looked away. "Right, that's me. The very soul of perception..."
"Why do you always put yourself down?"
"Habit," he said.
Tanner eased into the slip just as the last of the sun's light faded away, as the sky slipped from purples and oranges into sinking waves of cobalt, then on down to the hazy amber-black of an urban sky. There were no stars out, there never were, not here under layers of bright city haze. Tanner chopped the throttle, jumped onto the pier and made fast lines, hopped back aboard with power cords and hooked them up. He squared away all the "stuff" that went along with sailing, went below and switched the ships systems back to shore power.
"Man, you got some sun today!" he said when Macy eased below. "You're gonna burn, there, on your shoulders."
She reached up, felt her skin: "Youch!"
"I'll get some aloe..." he went to the fridge and got out a pump bottle. "Sit you down; let's get some goop on that..." She sat, he rubbed. He remembered the way she felt now, while he touched her, like his skin on hers unlocked some vital store of memory. He thought of her, of the months they'd spent together, and he had to admit the memory was good. He rubbed her shoulders, the tops of her arms, then up her neck... he felt the downy hair on her neck and remembered the way it used to smell when they made love.
"You're still in love with me, Doug, aren't you?" he heard her say as he slipped away in shades of gray.
He heard her words, shook himself back into the present, stood and put the aloe away. "You hungry?" he asked.
"Actually, I'm not sure. I feel, maybe, well yes..."
"Me too." He slipped into the aft cabin, grabbed his shower things and walked up to the shower building. He enjoyed this marina despite its size; once upon a time it had been a Pan Am flying boat terminal; now it was a huge marina full of live-aboards, overflowing with herds of South American pilots and families with kids and retired people off to see the world -- and taking a time out. He showered, walked back to the boat, saw a mother and her crying daughter waiting by the boat. The little girl was crying...
"High Amy," he said to the freckle-faced girl as he got closer, "what's wrong?"
"Oh Doug, she picked up another splinter, a real biggie, playing a while ago," Mary Ann, the girl's mother, said. The little girl looked at him stoically and held up her hand. He bent over and squinted in the darkness.
"Youch! That's a biggie alright." Tanner said. "Well! Let's see if we can't fix you up." He jumped below, heard Macy barfing in the forward head while he got his bag out; he walked forward and knocked on the door: "Morning sickness?"
"Oh boy oh boy am I gonna chop off the next dick I come across!" -- she said before she retched again, followed by a deep moan... "I swear to God I'll never touch another fucking penis as long as I live..."
"Uh, right... I'll be back in a second, got a splinter to remove..."
"Right..." More retching sounds followed. He shook his head and went to the panel, turned on the cockpit lights and went back up into the cockpit.
"Is Macy back?" Mary Ann asked. The marina was like any other small town -- news traveled fast. Her husband was a pilot for AirTran and gone all the time...
"Lost her job and her apartment," he said while he opened the cockpit table and laid his tools out. "Okay Amy, let's see that honker!" The girl held her hand out and put it on the table and he bent over and looked at it. "Well, doesn't look as bad as I thought. You want to be a brave girl and tough it out or do you want me to use some Novocain?"
"Is that a needle thingy?" a wide-eyed Amy replied.
"Yep. But that's a real big splinter, Amy. If it was in my hand I'd want the shot."
"Okay then. If it's what you'd do." Not too long ago Mary Ann had told him her little girl had a crush on him.
He got to work, cleaned up the wound and bandaged it, gave her a tetanus shot and sent them on their way; he went below, found Macy on the v-berth up front lying in a pool of sweat.
"You're burning up, kiddo," he said. He returned to the galley, got his bag and a cool washcloth and went back forward, put it on her forehead. "You hurt anywhere?"
"Here," she said, pointing to her lower left quadrant, "and here," now at her mid-groin.
"How bad?" he asked as he reached down and palpated gently.
"Bad!" she moaned when he touched her.
"Okay. If you think you can walk we'd better go to the ER; if not I'll call an ambulance."
"Not sure," he lied. "Better check out some things and make sure the baby's okay." He was concerned she might have an ectopic pregnancy; he needed to keep her calm. "Can you walk?"
"I don't think so," she said. "I don't think I can move."
"Right." Tanner walked back to the chart table and got his phone, called 911, gave the operator directions to the boat, went back and took her blood pressure, wiped more sweat from her face.
He heard the ambulance a few minutes later, went topside when he heard the paramedics getting close, helped them load her in the ambulance and rode with her to the ER. He called a social worker while they worked her up; he wanted to get Macy set-up with Medicaid before the bills got out of hand. He went back to check on her but they had already taken her upstairs. Then he remembered he didn't have a ride back to the marina. He looked at his watch; three in the morning.
"Great!" he said.
"Hey, doc! How's it going?"
Tanner turned, saw one of Miami's finest, a good-natured cop everyone called Mannie. "Hey yourself. What are you doing down here? Krispy Kreme not open yet?"
"Ha-ha! I don't eat them hi-dollar donuts, Pachuco!"
"Yeah? Looks like you're eatin' 'em somewhere, Mannie! Whoa, dude, you're packing on the pounds!"
Mannie Hernandez looked down. "Yeah, I know," he said quietly.
"You on duty?"
"Overtime. Came in with a big MVA, a DUI homicide. Headed back to the station."
"Good, you can give me a ride home?"
"Yeah, sure, no problem," the cop said.
"Thanks. Now, what the fuck's wrong?"
"Oh, man, it's my old lady..."
They stopped off for a couple dozen donuts on the way...
He spent the morning with Macy, and the other half of his day cleaning the boat; he had finally put his feet up in the cockpit and opened up a book, had just started reading when an old couple walked up...