Tuesday, February 13, 2024



The patient came to see me for a consultation. He said his doctor had referred him. But he didn’t know why. Just that it was critical that he see me as soon as possible. He wasn’t experiencing any pain. His weight had been steady. He denied fevers, sweats, rashes or catarrh. He hadn’t noticed any bulges, lesions, lumps or viscous secretions. He ate well and trimmed his nails. Drank only occasionally. Most mornings he woke at dawn and worked out. He seemed a paragon of robust middle age health. I had a busy day, many more patients to see and then a couple add-on cases after clinic, but I didn’t want to seem rude. Let’s go back to the beginning, I said. Do you remember the look your father gave you the first time you realized he wasn’t your hero? Do you remember when your mother was young and pretty? Did you ever get your revenge on the neighborhood bullies? Did you peel back all the layers and get into the pulp? Do you think of the life imagined with regret or a sense of relief? Did you get so good at pretending that you forgot what your masks were supposed to hide? Is love, for you, a question of faith or hope? Is hope the remainder when love is taken from faith? Is faith just hope when it falls in love? We made some progress but again I was running out of time. We agreed to end the initial consultation and have him return in a couple weeks.  This became our routine. Every visit advanced the agenda a little further. We worked our way through his life. I knew everything about him. He held nothing back. The closest we could come to an articulation of our common purpose was the heavy silence that hung in the air just before I said well, that’s enough for today, I’ll see your next week and stood to shake his hand. We began to veer into areas that were outside my realm of expertise. I told him as such. I didn’t need to get sued or anything. I even had him sign a waiver. What did I know about how collapsing wave functions, properly shared, represent the utter totality of reality? Who was I to assert that each of us is simply the perfectly vibrating tone the universe has been desperately waiting to hear, all along? How was I to know whether believing it matters or just pretending it did made all the difference? Where did I get off trying to sell him a copy of the self help book I had originally written on a roll of cheap toilet paper? I auscultated, percussed, palpated and looked. I knew every square inch of skin. Every mole and imperfection. I scanned him over and over. We drew lots of blood. No splenomegaly. Pedal pulses palpable. Negative Murphy Sign. He was thoroughly examined. After all, he was still a body. Like me. Somehow a briefly coherent medley of transient loose notes that gave rise to the symphony happening right now. (Next time you look in a mirror you ought to pause. It’s really quite unmooring.) But a body is always changing. The next time I saw him he had shaved his head. He had gotten divorced. Was living in a commune with vegan dwarves. One time he tried to change his name. I told him it would mess up all the insurance forms. He got tattoos and binded his own feet. Had become a shaman for a small Amazonian village.  He began to seem almost astral. Not quite non-human. But different from me. The years passed and I began to feel a sense of shame. I hadn’t helped him at all. We were no closer to the answer than when we first started. But what was the question doctor? he asked. The question, I bellowed, with unequivocal frustration, is: Why are we here? And he laughed and laughed and they brought in coffee and we took a moment to review our respective notes. The last time I saw him he was an old man dressed like a tuna dressed as a man. I brought him some water and gave my old sheepish grin and told him I was out of ideas. I’d retired, in fact, years ago and could barely hear what he was saying. I hadn’t read a surgical journal in decades. I might have been 90 or 99. It’s ok, he said. He was kneeling before me and trying to feed me some lukewarm broth. My tongue felt heavy and numb. I was cold, despite the blankets.  I think it’s time for that operation, I said. He nodded and put down the spoon. I don’t want to go to sleep for it, I said. Just some local. 


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