by Mark R. Brand
“This frigging thing.”
Frost knew without looking that Mary had gotten blood on the hemocrit analyzer lens again. She started pulling out drawers at the nurse’s station looking for a box of individually-wrapped alcohol pads. This wasn’t as easy as it sounded. Some of the other nurses, and especially the medical assistants, loved stealing them and hiding them. The stock room guy was a blatant slacker and he just nodded like a bobblehead at the office manager’s suggestion that they only keep on hand the supplies they’d need at any given moment.
This of course meant that there were never enough of three-dozen random things at all times. Some days there’d be disposable gowns but no needles, other days there’d be five times as many bottles of peroxide as they could use, and if he wanted sterile gauze he’d need to barter half a box of iodine swabs for it with one of his associate’s staff members.
The supply black market was an unforgiving quagmire of ugliness and the instant a shipment of replacements came in, they’d vanish to wherever everyone was squirreling them away. They hadn’t had enough alcohol pads to go around for about a week and a half and nobody had extras to beg, borrow, or steal.
The hemocrit analyzer had a lens on the inside that was meant to read a little plastic disposable slide with a drop of blood on it. The chief flaw of this was that if jiggled even the slightest bit while inserting the slide, the blood droplet would contact the convex lens and smudge, rendering the machine useless.
“We going to get that reading?” he asked, just trying to light a fire under her a little. She pursed her lips but didn’t frown.
Three drawers later, Mary began hauling shit out and tossing it onto the desktop. Old versions of intake forms and script pads with one or two sheets left on them, loose drug samples on their cardboard blister cards, the caps for eighteen disposable pens that patients had wandered off with in their pockets and purses, and a seemingly bottomless pile of high-quality marketing materials shoved at them endlessly by the drug reps that haunted their office during clinic hours. After un-bending the last of these, Mary thrust out her hand silently in triumph. Behind all of this detritus she had found a dusty, forgotten box of alcohol wipes. An entire box! They were rich.
“Got it,” she said, busy using a slide to push the alcohol pad into the tiny space beneath the lens and swab it clean. Minutes passed. Finally it was ready. She grabbed her tackle box, took out another lancet and a fresh slide, and set off down the hall. Frost could hear her voice come muted from the other room. “Okay, Mrs. Healy, we’re going to have to jab you again, sorry about that.”
Mrs. Healy was a good sport, hopefully. He heard a beep and the analyzer flashed up her hemoglobin count. Frost hadn’t seen Mary return with the blood. He glanced up. There were still lights on in the rooms, but all was silent.
“Mary?” he called. No response. He walked back toward the rooms at the far end of the hall and found them empty.
He picked up the phone and dialed the office manager’s extension, thought twice, hung up, and dialed the extension for Greenstein’s nurse.
“DiLeccio,” she answered.
“Kelly?”
“Mmm hmm…is this…?”
“Doctor Frost.”
“Oh, hey Dr. Frost. I didn’t know you were still here.”
“Hey. Listen, do you know where Mary went?”
“Pretty sure she hit the road.”
“Really?”
Silence. He glanced at his watch. It was an hour past their last scheduled patient.
“Umm…”
“Right, sorry,” he said, choking on the awkwardness. “Have a good one.” He hung up.
*
X-ray machines consist of a large power generator that converts wall current to high-voltage output, a stabilizing arm, and a cylinder shaped like a large beer can. This cylinder contains an electrical anode and a rotating tungsten cone inside an airtight bath of coolant oil. This is the “tube.” The tube is encased in lead, except for the small aperture where the x-rays escape and travel at physics-class speeds through flesh, organs, and bone, finally striking a photosensitive crystal screen that imprints a negative image of the patient’s anatomy on a piece of multi-layered emulsive plastic. The rooms are generally lined with a layer of lead sandwiched in the walls to contain the photoelectric ionizing radiation that occurs when various milliamps per second course from the anode to the tungsten cone, creating a God-like arc inside the tube. All this happens in darkness, as most feats that harness the power of the building blocks of the universe do.
The doctor bounced a golf ball off of the tube in the x-ray room while the radiographer scoured the table beneath it with a disinfectant so strong it came in a glass bottle rather than a plastic one. The room smelled vaguely of feces.
“Do you get much Sleep?”
“About three hours, usually,” Andy replied. Andy had a kid at home, he knew, and another on the way. A girl named Stephanie and an unborn fetus named I Will Never Again Own a New Car. “Sometimes I get two and a half, but I don’t like cutting it quite that close. If I don’t get the full three hours, I just don’t feel right. Pretty soon I’m going to have to start Sleeping here because of the baby.”
“That sucks. You ever take naps?”
“Shit,” he said, looking sideways at the doctor. He stacked up x-ray films on a desk and started marking left and right on the corners with a black Sharpie.
“What?”
“You’re a lazy motherfucker.” He could always count on Andy for the truth. “Just turn up your Bed. Try maybe three and a half hours. You won’t be able to sit still after that much Sleep. You’ll be bouncing off the walls.” The golf ball continued to bounce off the x-ray tube.
The doctor wanted to tell him that he’d already thought of that, but didn’t. He picked this little strategy up at some conference or another in Arizona in the middle of the winter. A study was done by some focus group of vicious, slobbering medical office managers who had been let out of their cages long enough to compare notes about squeezing the last ounce of productivity out of their underpaid drones. They discovered that if the support staff think the boss is ignorant or empty-headed, they tend to work harder, a motivating force not unlike that of a child overcompensating for their well-meaning but chronically helpless parent.
He missed a catch and his golf ball rolled under the generator. He didn’t go after it. He had an entire bag of miscellaneous golf-related shit in his locker that his patients had brought him. Someone even gave him a putter shaped like a foot with a laser pointer attached to it. He didn’t know what was more insulting, his patients assuming he had time to play golf or the fact that they thought he was a bad enough player to need a laser-guided putter.
*
At some point, he realized he was in the middle of surgery on what used to be a young woman who had been dragged on a chain behind a sport utility vehicle over a mile and a half of gravel back-road.
“I think I’m hallucinating,” he said to no one in particular.
“That’s what she said,” came a reply from someone in a mask and scrubs. He gestured to the woman, whose anesthesia had sunk in enough that she could barely manage a whimper.
“Fuck you, I’m serious,” he said. His face shield fogged slightly when he exhaled.
“So is she, apparently.”
The unfortunate ingénue of that evening’s tragedy let out a “huhnnn” that was less than heroic as he scrubbed flecks of gravel out of her rectus abdominis muscle, which was open to the air given that the flesh of her torso above it had been taken off as if by a belt-sander. Cleanliness, right next to Godliness.
“What’s the time loss threshold for narcolepsy?”
“Huh?”
“It can’t be that, though. No cataplexy…”
“Focus, man.”
Frost wheeled on him, snake-like and covered in blood from sternum to knees. Whenever challenged, escalate.
“What the fuck did you just say?”
“Hey,” Dr. Nobody said, hands coming up, “I’m just here to help.”
“What are the risk factors for hallucination?” He had forgotten the patient on the table entirely. He picked up an emesis basin full of flesh and blood, intending to fling it at the resident if he flinched. Evidently the kid had been in operating rooms full of flying metal before, though, and held his ground.
“Uh… psychoactive drug therapy, alcohol and drug withdrawal, dementia, sleep deprivation, head trauma…”
Frost glared at him for another moment and the corners of his eyes flickered. Something like minutes went by. “That’s what I thought,” he said at last. He handed the resident the emesis basin and headed for the door, pulling off his mask as he went. Blood sloshed onto the floor, but he ignored it.
“Where are you going?”
“I need a nap,” he said over his shoulder to no one. As he hit the door he looked up to see another door. He opened this one into an identical hallway with another door at the end. And another, and another.
*
“Hi – this is Sandy at St. Augustine’s. We’re calling to make sure everything’s okay with our favorite doctor! Call us back when you get a minute. I’ve got a few messages for you.”
He thought he had turned the phone off, but he didn’t really remember. He had a vague vision of putting the key into his condo door and hearing it grind loudly as he turned it, and then soft blackness. Apparently he’d been unconscious for hours. The inside of his mouth felt like indoor/outdoor carpeting, and he had urinated on himself while he slept.
He hadn’t missed a day of work in seven years, twelve if you counted residency. He thought they’d be a lot angrier than they sounded. Sandy seemed nice. He made the call to the hospital and told them he’d be in later.
“Oh, that’s fine. Dr. Greenstein covered for you. He did leave a message that you should try the office Bed next time, whatever that means.”
“I know what it means.”
“You feeling okay?” she asked.
“Sandy…”
“Lisa.”
“…you’ve been more than helpful.”
He hung up. For all his lack of good taste in music, Greenstein didn’t miss much.
Every nerve cell in the human body consists of a long cable with a synapse at each end. The cable part of the cell is made up of fatty membranes that conduct electricity in the form of tiny, single-electron currents called action potentials that occur between sodium and potassium. When the current reaches the end of the cable, it jumps to the next strand by secreting a chemical that helps the current flicker across the gap. These chemicals have familiar names like serotonin, dopamine, epinephrine, and acetylcholine. When these currents jump to muscle fibers, you get a contraction. When they jump to a gland you get secretion. When they jump to your brain cells you get a boner, and so forth.
In the end, he thought, that’s all we are. Just electricity sizzling down cables made of fat and squirting across a little space between. This was another of those cases where knowing things didn’t improve on an otherwise blissfully ignorant life.
Tony Barker had this thought well in hand when he positioned the first TMS patient’s pre-frontal brain directly between the poles of an MRI electromagnet. Barker was doing this in the ’80s, so he was very progressive that way, but not so far removed from the old days that he flatly dismissed the gains made by psychiatrists in the ’50s and ’60s, when similar treatment modalities involved plugging people right into the wall current and putting a rubber block between their teeth so they didn’t snap them off. This was a kinder, gentler era. MRI was safe, as far as anyone knew. TMS was just a little current change. Hardly noticeable. The first two letters of MRI stood for Magnetic Resonance, and that’s exactly what TMS did. It caused the electrons on a molecular level to resonate. Instead of blowing the fuse entirely, the TMS just flipped the breaker on and off, on and off, thousands of times per second.
All Dr. Sid Merriweather did was discover the frequency, the note played across what amounted to a two-million-dollar electric guitar string, that reset the right sequence of synapses. Do Not Pass Go – head directly to Stage-4 REM sleep.
*
“There were a few pieces of ferrite dust on the magnet’s face, but not enough to throw off the cycle.”
“What is it, do you think?” Frost asked the repairman on the phone. He disliked people being in his apartment when he was not, but this could not be avoided.
“Hard to tell. You may want to just try another Bed if you have access to one.”
This bit of diagnostic wisdom was becoming tiresome, he thought while hanging up. He considered that it might be a while still before he went all the way over the high side, but he could feel it coming. Mary, prescient soul that she was, had started hiding his car keys. “Where the hell are they?” he asked her.
“What, doctor?”
“My keys.”
“Haven’t seen them.” As she walked away, the pocket over her left tit jangled.
“Mary,” he said, rubbing the blur out of his eyes, “I believe in the sanctity of the workplace and all that high-minded bullshit, but there’s only so much a professional can take.”
She shot him a look that pretended she had no idea what he was talking about.
He grabbed a random chart off of the wall and headed into the adjacent room. “That lung has to come out,” he announced firmly while walking in. There was no point being wishy-washy with these people. He gave them the straight news. The ten-year-old boy on the exam table looked up at him in terror over the cast on his leg. His mother, a woman who inexplicably wore yellow eyeliner, looked up from last April’s issue of TIME and gave him a shitty look.
“Excuse me for just a moment,” he said. “Mary!”
A medical assistant that he was firmly against hiring from the start looked up from a handful of used needles as the doctor passed him. He tried to scurry out of the way, but was too slow. The doctor grabbed the front of the assistant’s white coat and shoved him into the nearest room. The sound of hard muffled scrabbling against the shallow carpet was the only sound the kid made, as he attempted to keep his feet and failed. The doctor didn’t as much as look back. If you can’t stay out of your own way, at least stay out of mine.
The hallway overhead fluorescents started to pulse with his heartbeat. “Mary,” he bellowed down the hall, “the doctor needs you!”
She rounded the corner in a pretty flourish of professional crispness. The clean lines of her uniform threw her figure into maddening shapelessness. Only he knew that she had not taken her scrubs home to wash in over two weeks. Her filthiness was mildly arousing.
“I wonder about those armpits of yours,” he said.
She gave him a smile that said he was one charming dog. “Is there something you need?”
“I need my lung. Where did he go?”
“She.”
“Where did she go?”
“Room ten.”
“No,” he said, putting an arm around her shoulder. They walked toward room ten and on the way she walked him straight into a wall. He backpedaled awkwardly. It was a long hallway suddenly. “I was just in room ten, and my lung was definitely not in there.”
“Try again,” she suggested, helpfully. It was hard not to notice how round she was in her scrubs. Even with a lab coat on top. She made him think of a mesh bag of oranges shifting around in a big white grocery bag. She had enough smoke scent on her to keep her from ever smelling clean, but freshness wasn’t everything.
He took a deep breath and pulled down the lever-action door handle. Hospital door handles are regularly cited as the filthiest surfaces in the building. “That lung will have to come ou…” Sitting at a card table were three large greyhounds counting a stack of money. They peered up at him with lively, suspicious eyes. The one on the far left gave him a look like he might owe the dog a favor.
“Pardon me,” he said, closing the door quickly. Mary arched her eyebrows and her hair seemed to straighten and re-curl in front of his eyes. “Did you do something different with your hair?”
“Room ten is at the end of the hall.” Mary motioned with a seven-inch index finger. Lids with an unbecomingly cheap brand of eyeliner flicked up slightly.
“We’re going to have to have a talk about your bedside manner,” he told her as he proceeded onward. Suddenly, the medical assistant sprung on him like a trapdoor spider.
“Sorry doctor, I have Dr. Neely on the phone for you…”
“TELL HIM TO GO FUCK HIMSELF!” he screamed, buffeting the little bastard about the head and neck with a clipboard. He smiled as he walked away, secure in the effectiveness of his intuition. The escalation principle had once again steered him clear of time-consuming negotiation.
***
Mark R. Brand is a Chicago-based science-fiction author and the online short fiction editor of Silverthought Press. He is the author of three novels, The Damnation of Memory (2011), Life After Sleep (2011), and Red Ivy Afternoon (2006), and he is the editor of the collection Thank You Death Robot (2009), named a Chicago Author favorite by the Chicago Tribune and recipient of the Silver medal 2009 Independent Publisher Book Award (IPPY) in the category of Science Fiction and Fantasy. He is the producer and host of Breakfast With the Author and lives in Evanston, IL with his wife and son.
As It Ought To Be 