Postcards from Sri Lanka

I roll into the office and see Dr. Thompson behind the counter. “You’re back!” I cry. I’m happy to see her, and I can’t wait to hear about how Sri Lanka was. She stares at me without a word. 

I wheel back out and sit down next to an obese old man who is watching his phone with the volume turned up. A man is talking very fast and in an unnatural tone of voice, so that I wonder if it’s AI. It is very difficult to make out what he is saying; something about talking to his father-in-law about hedge funds. It is one of the most boring monologues I have ever heard, but the old man watches with rapt attention until Shelley mercifully comes to get me. 

In the far room, she takes my vitals and says, “Your blood pressure is only one point above what it was last time. Isn’t that bizarre?” She fires up the saw but after she has cut three inches down my leg it sputters out. She looks at me. It starts up again. She continues to cut and a few minutes later it cuts out again. She unkinks the hose and bends down to look at the machine, giving me the saw to hold. She turns it back on and finishes cutting the cast without any problems. 

“Not much drainage,” she says. “It doesn’t look that bad.” She takes a picture and measures it. “A little bigger. Not much.” She pokes a Q-tip into it. “A little less deep, but it’s kind of boggy. You know what I mean?” I say no. “Boggy. Like mushy. So it’s deeper than it seems. Not too bad. But really boggy.” I ask her what causes that and she says unhealthy skin and slough. “I’m not too worried,” she says perkily. “So you shouldn’t be either.” I tell her I’m not. After all, this is only my second visit to this exciting new office, and I trust all these nice strangers to take good care of me.

She squirts some Lydocaine onto a pad of gauze and presses it onto the wound, then pinches the cord they all keep their necks and says, “Call Russ Morgan.” 

“Calling RUSSELL. MORGAN,” the cord says. 

“Ruh,” A man’s voice grunts.

“Russ, this is Shelley in wound care.”

“Herm.”

“I’m having issues with our saw and I wondered if you could look at it. It kept pulling to one side the whole time I was using it, and it went dead a couple of times.”

“Up,” the man says. 

“Thank you Russ!” She disconnects and starts talking about how boggy my wound is. I wish she would stop saying the word boggy. “Oh, and Judy the nurse practitioner will be doing your cast,” she says. I’m surprised; I thought only doctors could do those. 

She leaves and I listen to a woman talking to Karen in room two. “The one healed up but this other one has been there for years,” she says. “I don’t want to lose my foot.”

“We don’t want you to lose your foot either!” says Karen. “Now have you heard of something called debridement?”

“You mean when you die?” the woman asks, alarmed.

Karen laughs. “No, that’s bereavement. This is debridement.” The woman laughs too.

A few minutes later Judy comes in, wearing paisley purple Crocs. Behind her is Dr. Thompson, in ordinary scrubs with a plain blue cap on. 

Judy asks how I’m doing, if I used that app she recommended. I tell her no, but that I’m feeling okay, though things have been up and down. She looks concerned. 

“Sometimes it just helps to talk to someone about things,” says Shelley. 

As Judy adjusts the chair with the pedal, she puts her hand on my shoulder, which seems odd. I excitedly ask Dr. Thompson how her trip was.

“I didn’t go on any trip,” she says, sounding confused and a little annoyed. 

“Oh, they told me…but you were gone…”

“It was a staycation,” she says in a dead, flat voice. I suddenly feel uneasy. I want to ask more but my gut tells me to keep my trap shut.

Shelley hands Judy a scalpel. As she unseals the plastic, Judy exclaims, “Oh I forgot to record. Do you mind if I record this?” I say no, even though I do, and she sets her phone up on the computer stand.

“Beginning debridement of wound,” Judy says. The doctor watches Judy as she slices at my calluses. 

“You have good circulation down here,” Judy says, dabbing at the blood. 

“See how boggy it is,” Shelley says.

“That’s the top of his metatarsal there,” says Judy, poking.

“I don’t think so,” says Dr. Thompson.  

“What about all this bruising?” Judy asks. 

“I… think that was there before,” says Shelley. She looks at the computer screen. “Yeah I think that was there.” No one mentioned any bruising before.

“Well it looks like it’s healing up,” Judy says. She grabs her phone and they leave. As Shelley wraps my leg back up, she tells me about the car accident she got in last week. Some woman plowed into her at a four way stop. I ask if she’s biking to work. “No, I wanted to use a jetpack but I was afraid ICE would shoot me down.” She giggles. It’s the first time I’ve heard her reference current events, but I don’t feel up for getting into all that. 

Perhaps distracted by thinking of the car accident, she doesn’t put as much padding on as usual. “The cast went up pretty high last time,” she says. “Did that work okay for you?”

“It was fine,” I say. 

“I better go up higher then.” She cuts an extra length of padding and wraps it just below my kneecap. Perfectionist that she is, she has never had to do this before. Now it’s way too high.

“You’re not done?” Dr. Thompson asks Shelley when they return.

“I’m just finishing running the water.”

The doctor turns and addresses me for the first time.

“How are things at the museum?” I tell her things have calmed down now that the renovations are done, and encourage her to come check it out. “I haven’t been there in years,” she says. I want to ask her what she saw last time she was there, but Shelley turns off the faucets and lugs the bucket of water over.

Judy is the only one wearing a paper gown; she’s apparently going to do the cast herself, which surprises me. I thought only the doctors did those. 

Dr. Thompson looks at how high the undercast is, thentouches the skin of my knee, which is red and shiny from the scooter. 

“He wanted it that high,” Shelley quickly says. “He likes it. He said it was really comfortable.” I shoot her a look but her focus is elsewhere.

As Judy clumsily wraps my foot, the doctor stands to the side, watching. An oppressive tension fills the room like a cloud of noxious gas. Shelley plops the rolls into the water and occasionally  helps Judy smooth out the Fiberglas. My yellow leg is covered in dancing blue gloves. The doctor offers an occasional comment or question. “”I like to alternate back to front to keep it even. You don’t want it to soak that long. Are you going to leave it like that?” 

After the third roll, Judy lowers the chair and asks me to stand on the cast. Neither of the doctors have ever asked me to do that. I place my foot flat on the floor and she says, “No, put all your weight on it.” I hold onto the chair’s flimsy arm and she rubs the cast, then has me sit again while she applies one last layer. Doctor Thompson wanders off without a word before she finishes. 

“Does that feel tight?” Judy asks when she’s done. It does, but I tell her it feels fine. It’ll only be on four days anyways.   

When I roll out of the office, I find that the handicap restroom in the waiting area is out of order, so I use the tiny one next to it. Once I squeeze in, I have to get off my scooter and rearrange it so I can close the door. I feel shaken by my visit, by the sudden change of climate in the office. Why did everybody tell me Dr. Thompson went to Sri Lanka, of all places? Why not just say she’s on vacation? Did she have a health scare, or a mental break of some sort? It’s all so strange. While I guess I should be grateful to have the monotony shattered by a whiff of mystery, instead I feel deeply unsettled, like when someone you trust reveals some ugly impulse.

When I get out, Shelley is in the waiting area telling a tiny woman, “They just called a Code Gray. If you feel you need to be somewhere safe, just press that blue button and you can hang out with us.” The woman stares at her, uncomprehending.

“My mother’s in there,” a man sitting nearby says. “What’s a Code Gray?”  

“It’s when someone is having a really bad day, and gets upset,” Shelley says, as if she’s talking to one of her kids.

I head downstairs. I don’t see anyone having a bad day in the lobby or at the bus stop or during the ride home. But as I’m waiting for the walk signal across the street from my building, a wide, scantily-dressed woman is screaming in a baritone voice at a dumpster a few feet away from me. Dance music blasts from a speaker slung from their shoulder. There is no one else in sight.

“You shut your fucking mouth, nigger,” they scream. “You shut your fucking mouth. Tell me to turn my music down nigger? I’ll turn my music down nigger. Do I look like a can of paint to you? Do I look like a fucking can of paint? Fucking nigger.” 

They turn their attention from the dumpster and start to lumber towards me, still screaming. 

I decide to brave the rush-hour torrent and cross against the light. 

The Sun King

             I overdid it with my insulin –or underdid it with my lunch- and by the time I reach the hospital, my blood sugar is well below the level I need it to be to allow me to function normally. I'm dismayed to see that the stanchions have been removed from the metal detector and its green lights are beckoning. A man sits leaning on the conveyor belt. I roll up to him and he says, "Oh I don't work here, I'm just waiting for a ride." I roll off before any guards materialize. 

Fortunately, my appointment is later than I thought, so I have plenty of time to roll into Starbucks for a box of apple juice. As I sit in the waiting area upstairs sucking it down, Bree dashes out of the office with her coat on. 

“Done for the day?” I ask. She says yes and I ask if I should tell them I’m here. “Oh I told them,” she says, though I don’t know how she knew. Does she have a surveillance camera in there?

An old man shuffles out of the office with a cane. When he presses the elevator button he releases a loud, wet fart. 

    Bridget comes out as well, pushing a wheeled contraption with a series of straps and buckles dangling from it.

“Ooh, is that for me?” I ask.  

I throw out my empty juice box just as the office door opens again. 

    “Get in here, you.”

    When was the last time I saw KC? August? I knew she worked Mondays, but I wasn’t sure if I would actually see her this visit. I warn her that my sugar is low. She says she can get me some animal crackers and peanut butter, then leads me to the far room. “We won’t be bothered back here,” she says and as I plop into the chair, she hops on my scooter and speeds away on it. “Whoa, this thing is wobbly,” she says. 

    “If you break it you have to buy me a new one,” I say. 

    She returns and closes the curtain and then it’s just the two of us. I’m the last patient of the day and the office is quiet. 

    “I heard you were talking about how violent I am,” she says, and starts pummeling my arm. 

    “I hope you don’t abuse all your patients like this,” I say. 

    “Only the special cases.”

    “The ones who come here for years and refuse to get any better?” 

    The blood pressure machine bleats pitifully to warn that its batteries are dying. She ignores it. My blood pressure is too high for her liking. I tell her it’s probably because someone’s been punching me. “Try not to think of anything,” she says, her breast brushing against my arm. Between her proximity and my lack of glucose, my head is spinning. I close my eyes and try not to think of anything. 

She examines my foot. I’ve warned her that it’s been looking pretty rough. “It just gets bigger and bigger no matter what I do,” I say. 

“I don’t know, it doesn’t look that bad to me,” she says. “Moderate drainage." She keeps adjusting the paper ruler. "And it’s about the same size as it was last week. Point six, point seven.” 

“I'll take point six,” I say. She measures it again, and then again. I ask how her holidays were. 

“Not great to be honest,” she says. “The whole year really blew. I had to have a front tooth pulled,” -I remember her talking about that months ago- “And it took forever for them to replace it. It was supposed to be eight months but it turned into nine, then ten. But you know how that goes." I ask if she stuck a piece of corn in the space and no one will ever know, vaguely aware that I've made this joke before. New start my ass, I'm already starting to repeat myself. 

She laughs anyways. "I should've carved myself a wooden one! Healing is so slow," she says. "I didn’t leave the house the entire year except to go to work and the gym.” 

“I bet you got a lot of reading done,” I say. 

“Oh god no I hate reading,” she says. 

“What?” I laugh. 

“No really. I just hate it. I listen to audio books sometimes but even then I have to go back and relisten half the time because I get distracted. I mostly spent the time watching shows.” If this has felt like a date up to this point, this is the moment when you have to decide if you’re still going to try to take this person home with you or if you need to catch the waitress’s eye for the check. 

“I rewatched Outlander, and now I’m watching Versailles.” I ask if Versailles is any good. She shrugs. “It’s all about Louis XIV. Everyone dies young because he forces them to move into the palace then when they tick him off he has them killed. And oh God the men are so effeminate, with that long hair and these crazy high heels they clomp around in.” I ask if she’s ever been to Versailles. “No. I did get to Paris but I was only twenty. I’d like to go back.” 

I tell her I’d love to go to Paris for the art, and somehow find myself talking about the series of drawings I did at the end of the year. I tell her about how for a long time I’ve wanted to do pictures of homeless people, especially the ones frozen in place by their cocktails of fentanyl cut with animal tranquilizers. “You’ve probably seen them twisted in all kinds of crazy poses, standing bent over for hours. I wanted to capture that.” She looks at me intently the whole time I'm babbling. I can’t tell if she’s interested or just being polite but I can’t stop myself. This is the most important thing in the world to me right now and it’s all I want to talk about. Even if I’m probably boring the hell out of her. I mean, this sweet, adorable woman doesn’t even read.

“You know, my brother back east goes to a methadone clinic every day,” she says. “Otherwise he’d be back on the steeets.” 

She asks if I’m getting a cast put on today. I say yes, surprised she isn’t already aware of this somewhat important fact. “Okay then I’ll tell the doctor you’re ready for her,” she says. 

“No debridement today,” Vicki says, poking her head. Has she been sitting just outside the curtain this whole time? “Oh, hi Seann.”

“She’s not debriding?” KC sounds confused. 

“Nope, just doing the cast. Thompson will debride him on Thursday.”

“Alrighty then, guess I’ll get you ready to get casted up,” she says. “How long since you had one of these puppies?” I tell her it’s been since October. “What? Why has it been so long?” I tell her about being on vacation and the series of footballs and the holiday and Thompson being on vacation. “Oh yeah I heard something about you needing to wait for permission from work?” I tell her it was a miscommunication with Dr. Baylor. Her face twists in irritation –maybe I’m not the only one who isn’t thrilled with the substitute doctor- but she doesn’t say anything a she starts preparing the undercast. 

“All this news is getting me down as well,” she finally says. “I keep trying to limit my consumption but it’s all just so awful, I can’t look away.” 

“I know,” I say. “It’s horrible. And it’s frying all our brains trying to make sense of it all.”

“It all happened so fast,” she says, and looks like she’s going to cry. 

“Yeah but this has been building for years,” I say. “But how’s Cathy?” 

She instantly lights up. “She’s great!”

“Is Ghost still coming around?” 

“God he’s a nuisance,” she says. “He stops by four or five times a day when I’m home. I mean, it’s my fault, I keep giving him treats. He’s Cathy’s secret boyfriend. She pretends to be annoyed by him but I saw them boop noses just the other day. It was precious.” She takes out her phone but she can’t find the picture so she goes back to wrapping my foot. "I haven't done this in a while, I'm out of practice," she says. I don't take the bait. She goes about preparing the water and the rolls of casting. Bad date or no, I realize we’ve been talking a really long time. I wonder if Doctor Taggert is waiting for us; it’s nearly five.

Just then the doctor herself appears and gets right to work. Instead of scolding me about my wound, she congratulates me that my hemoglobin a1c is so good. I thank her without mentioning that the only reason it’s so low is that I keep bottoming out, like I am right now. But it's still progress. 

“You should be proud of yourself. Look at how far you’ve come since you started here,” she says. 

“You’re right. But I’m frustrated that this is taking so long.”

“Well you’ve got a new cast now,” she says, vigorously rubbing the wet Fiberglas to smooth it out. “Think of this as a new beginning.”

I laugh. “I am! In fact I planned on coming in today and pretending it was my first visit at this new clinic, with a new doctor and her new lovely assistant… what was your name again, young lady? CK, was it?”

KC laughs. Taggert laughs. We all laugh, safe in our tiny curtained room as the mad king’s minions murder people in the streets. The Sun King lived a long life, and died with his head still firmly attached. The powder keg wouldn’t ignite for decades. But KC’s right. Unlike the healing of a wound, or the replacement of a tooth, this is all happening so fast and no one can tell how things will  turn out.

In the meantime, I forgot how heavy these fucking casts are. 

Amnesiac

     Thursday afternoon, a coworker surprises me by arriving early to relieve me so I can leave for my appointment. It's nice not to have to rush down to the bus stop, but once I'm there I find that the bus is running late. 

    Karen leads me in to room two, where Jenny is waiting. I don’t feel any of the dread or despair of last week, despite the fact that my cultures did in fact come back positive for MRSA and another bacterium called proteus miribilis. All day I’ve been nervous about my appointment, but now that I’m here, I exhibit signs of a sort of nihilistic perkiness. 

    “It doesn’t look great,” I warn Karen. The last time I changed the bandage, the wound was huge and inflamed and rimmed with dead white skin.

    “Oh my,” says Jenny.

    “Yep,” I say. “Worse than ever.”

    “I don’t know”, says Karen. “A lot of this is callus. It doesn’t actually look any bigger than last week. She measures it. “Okay, maybe a little bit bigger.” 

    “Yeah I’ve pretty much given up hope of it ever healing,” I say cheerfully. “It’s kind of freeing.”

    “Don't make me smack you,” says Jenny. “She’s right, it really doesn’t look that bad. And it’ll look even better once the doctor cleans it up. And then you’ll get your cast on Monday and things will turn right around.”

    “But it was almost completely healed,” I say. “Twice. And now look at it.”

    “Apples and oranges,” she says. “Think of this as a new beginning,” she says. “We’re starting fresh.” 

    I laugh. “But what about all this time I’ve wasted up to now? All this time on the scooter, coming in here every week, only for it to get worse and worse. What was any of it for?”

    “Apples and oranges,” she says again.

“I don’t know what that means,” I say. 

    I have no more surprise or disappointment left in me so when Doctor Baylor comes in I greet her warmly. She doesn’t seem concerned about the wound or the infection, just cuts the callus -there is a lot of blood- and tells me in a chipper tone of voice that she’s prescribing me a different antibiotic to battle the proteus miribilis. When she leaves I ask Jenny if Dr. Thompson is still in Sri Lanka. 

    “Yeah, she’ll be gone for three weeks.” I tell her it’s already been three weeks. “No, she just left last week,” she says. 

    “But this is my third week with Baylor” I say. 

    “No, she’s only going to be gone three weeks.” 

    "So she'll be back next week."

    "No, she'll still be in Sri Lanka."

    To keep my head from exploding, I ask her how Dave is. She shows me pictures of the lanky blond tomcat. His fleecy fur looks like spun gold in the sunlight. 

    And the sun is shining a half hour later when I roll up the hill to the bus stop. The days are getting longer, if not warmer. So what if the past six months of appointments have been for nothing? It’s not really all just a pointless waste, is it? And even if it is, what good does it do to fixate on that? I’ve done the best I could and it wasn’t enough. The hole is larger than ever, I'm months away from even being close to healed up. And who knows how long that will last. A week? Two weeks? 

    But Monday is a new beginning. I can pretend none of this ever happened, that I’m preparing for my first day of treatment in an office I’ve never been to before, with a brand new team of doctors and nurses to get acquainted with. It’s all very exciting! I will wheel into that office like an amnesiac anxious to learn about this life he has no memory of having lived. 

*

The next day I leave work early again for my eye appointment. I haven’t had one since summertime; what with my weekly wound care visits, then vacation, then the holidays, I just didn’t feel up for it. But I need to get back on the eye-stabbing wagon.  

I sit in the big waiting room until I’m called, then stare into the mirror and recite the diminishing lines of the illuminated Snellin chart mounted on the wall behind me. I open my eyes wide as they check my eye pressure with an instrument the size of a pen. I sit in the waiting room for a while longer, follow the technician into a tiny dark room, gaze into the box at the blue circle and flickering red horizon line. I roll off to squeeze into the tiny waiting room. I could do this in my sleep.

    As I open my sketchbook, a baritone voice rumbles, “Hey, Seann.” I look up and see Mark from the Goose there. I feel vertigo that comes from seeing someone out of their usual habitat. I ask what he’s there for and he says he’s having some issues. He doesn’t elaborate. Mark used to be a submarine captain. I ask him a few questions and he answers them and then I go back to drawing. I can tell he’s nervous. In a few minutes they call his name and I wish him luck. 

    An elderly man sitting across the room takes the chair next to me so a couple can sit together. He watches me drawing intently, and eventually starts making small talk. He is a mechanical engineer from Missouri, friendly enough though not terribly interesting. I ask what kinds of things he worked on and he says he received a patent for a sewer pipe fitting. "It proved quite lucrative," he says. 

    In time they call him, and finally it’s my turn. An assistant administers the numbing drops, then leaves and comes back and administers more. She’s kind of blandly pretty, and when she turns her back I have an urge to grab her ass. After quite a while she returns. “The doctor’s dealing with an emergency, but you’re next,” she says. “In the meantime, I need to give you more drops.” 

    Finally the doctor comes flying in, gives me some more drops, flies away.

    After a long time, he dashes back in and uncaps the syringe and slides it into my eye. A blood-rimmed bubble blooms instantly in my vision. I must make a face, because in a concerned tone of voice he asks, “You doing okay?” 

    “I’m okay,” I say. 

    And I am. I’m alone and miserable and wracked with loss and tired of the endless medical drama and repulsed by all the loathsome acts being perpetrated in this country by all these cretinous buffoons, sick of the cringe and the cruelty and the sheer batshit craziness of it all… but aside from that, I’m doing okay. As I mount my scooter, my trusty wheeled steed with its ragged tires and wobbly handlebars, I look into the mirror at the Snellen chart. When lit, it’s a scrambled alphabet that spell nothing as it shrinks to the point of illegibility. Turned off, it’s just a black rectangle, all its backwards letters lost in the darkness. But still there.

High Levels of Exudate

     As I do every week, I remind my various coworkers that I need to leave early, and once again when two o’clock arrives I have to call over the radio to have someone relieve me. Two of them eventually arrive simultaneously, and while I know it’s not the end of the world, and that I will most likely make it to my bus on time, today I feel something snap inside and I am blinded by rage. 

    I don’t show it, though. I just clock out and speed down to the bus mall. 

    An old woman gets on the bus and sits across the aisle from me. Out of her left sleeve sticks a metal claw. Unlike last week’s unlucky fellow passenger, this woman’s misfortune does not make me feel better about my own. My foot looks like shit and my blood sugar, which has been well-controlled lately, has suddenly zigzagged out of control this week for reasons I can’t figure out. I try to use the training I practice in meditating to stop myself from worrying about this, but my thoughts fly to stress like nails toward a powerful magnet. 

In the waiting area, I feel myself sinking further, and I am too tired to fight it. By the time Shelley throws the door open, I have no energy for niceties. Warm, gentle Jenny is once again waiting for me in the middle room but I just grunt hello and collapse into the wide chair. 

    Vicki had ordered my medical supplies from a company that first calls you, then makes you pay in advance before they ship your order, so unsurprisingly my stuff didn’t arrive until yesterday. When I opened the package I was surprised to find that it contained nothing but a single box of ten foam dressings called Zetuvit Plus Silicone Border. There were detailed diagrams on the outside of the box, and inside was a set of instructions, microscopically printed in sixteen different languages on a thick sheaf of onionskin Though they are basically just fancy Band-aids, requiring you to just peel off the backing and slap them on, the instructions are astonishingly thorough and feature ten headings including Intended Purpose, Indications, Incident Reporting, Contraindications, and of course Product Disposal. 

    Zetuvit Plus Silicone Border absorbs and retains up to high levels of exudate in the absorbent pad and the dressing is able to redistribute pressure. It features a micro-adherent silicone interface and adhesive borders, so no other materials are necessary to secure the dressing.

    Maybe I missed some important step because when Shelley pulls off my sock, the bandage is bunched up and has slid half off the wound. Despite this, it doesn’t look much worse than last week. The foot looks slightly redder than usual though. Jenny asks if it hurts and I tell her yes. 

“That’s odd, you don’t usually feel much pain,” she says. 

    “How is it on a scale from one to ten?” asks Shelley. I tell her three and a half. They exchange looks and Shelley places her gloved hand over the end of my foot. “Temperature seems okay. It really is red though.”

    “Maybe it’s finally time to chop it off,” I say, and I mean it. Let’s end this charade. Let’s stop pretending this is ever going to get better. Time to shed that last scrap of loathsome hope. 

    Karen pops her head in and asks if she wants to see the latest videos of Dolly. I shrug and she shows me the dog wrestling with her doggie best friend, who looks exactly like her. I watch without comment. 

    “Isn’t she the cutest?” she gushes.

    They leave and I hear Dr. Bayliss’ voice on the other side of the curtain and my spirits dip further. I take off my glasses with one hand and cover my eyes with my other, which would be a lot trickier with a metal claw. A moment later the doctor comes in, followed by the new nurse whose name I’ve already forgotten. Helpfully, he name Judy is embroidered on her white coat.   

“So we’re still waiting to see if you can get permission from work to take off so we can put the cast on,” Bayliss says. 

““I don’t need permission, I just need two weeks’ notice so I don’t fuck them over.” Though I’m not sure why I’m worried about fucking them over at this point, when they can’t be bothered to even show up to relieve me even once. “I was waiting for you to call me.”

“Well I guess we had a misunderstanding,” she says, cutting away the callus as the new nurse watches intently. “Hmm, this is red, and a little swollen. I’m going to get you some antibiotics just to be on the safe side. Have you ever had MRSA?” Holy shit, I think, does she think I have MRSA? Why does she think that? I feel like I would know if I did. I tell her yes, I had it once. She tells Shelley to take a culture, and she digs a tube and a long cotton swab out of a drawer. 

“I can’t take any more of this,” I say, a little louder than I mean to. The room is very quiet. Vicki slips in for some reason, and they all stand there and stare at me; Jenny, Karen, Dr. Bayliss, Vicki, Shelley, Judy. I am so fucking sick of all of them. “It’s never going to heal up, and even if it does, it’ll just open right up again. This has been going on for years and there’s no fucking end in sight. I’m starting to lose it.” 

“What does your podiatrist say?" asks Bayliss. "If there’s a spur that keeps growing, they can sometimes shave it down.”

“I know. They've shaved it down so many times that it doesn’t help anymore. I'm not seeing a podiatrist at the moment because none of them seem to know anything. No one has an answer except to never walk on it again. It’s maddening that this is all just because of a tiny hole. I don’t want to do this anymore. Nothing helps. I'm done.”

“Are you thinking about… harming yourself?” the doctor asks. 

    I think about last night in the tub, using the opportunity to finally have my foot unwrapped to take a

rare bath. I kept closing my eyes and picturing that painting of Marat. He looks so serene.

    “No, nothing like that,” I say. 

“Your primary probably has a counselor who visits the office, or else he can write a referral to see a…”

“When am I supposed to see anyone when I’m already coming here every week?” I snap. “I don’t have any sick time left.”

    “Have you tried to get permanent disability?”

“Yes and I got turned down. I know you have to try a number of times but I don’t want it it anyways. I’ll go crazy being at home all the time. I’m already starting to crack. I am so. Fucking. Tired.”

“Can you get people to help manage things?”

“What people? There’s just me. There’s always just me.”

Judy comes and shows me a meditation app on her phone. I don’t bother telling her that I already use one and I actually like it a lot. But it’s not enough. It’s hard to believe that a few weeks ago I felt like I had an okay handle on things. 

“I’m not sure what your spiritual beliefs are,” she says, “But I’m happy to pray with you.” 

    Oh for the love of God.

    “No thanks,” I say. “But that’s very kind of you.”

    “Well I’ll pray for you regardless,” she says. I tell her I think my mother’s already praying too much for me as it is and she laughs politely. 

    No, seriously, I think. Do not fucking pray for me.

Bree pops her head in and asks if I can come in two Mondays from now for my cast fitting. I say okay, and then they all filter out except for Shelley, who tears open a package of Aquacel and a foam dressing.

“Where’s Doctor Thompson, anyways?” I suddenly ask.

“Sri Lanka,” she answers. “Lucky stiff. I can’t wait until I can travel like that but it’s hard with the kids needing things all the time. And they want a little sister really bad.” She tells me about what a disaster her house is, what with the water leak and them having to redo the kitchen. She says her oldest came home from school last week and told her about another outbreak of lice. "She has really thick hair and she throws a fit when I brush it much less try to run a comb through it." 

    How long ago was it that she told me this same exact story?

    “It never ends,” she says. 

    “You can say that again,” I say. 

    No doubt, she will. And I'll probably be here to listen to her say it. And to hear her tell the story of the kids at school getting lice year after year until both her girls are out of elementary school and in middle school, then high school, then college, then having kids of their own to be afraid of getting lice. Year after year I will keep wheeling up here as the doctors and nurses age and retire and eventually die, and then it'll be my turn, passing on without ever having managed to fix that tiny hole that held out until my unquestionably bitter end, sticking to its guns, never backing down, getting smaller and bigger and smaller and bigger but never disappearing completely, exuding various amounts of drainage, my one constant companion I can count on to never abandon me. 

Don't Chase

 I spend July 4th in the apartment, alternating between cleaning and sleeping. I didn’t have too much to drink at the barbecue but I still feel sluggish and worn out. I have a pretty pleasant day regardless, and by evening feel perky enough to head down to the Goose for supper. 

There are Lost Dog posters plastered all over the neighborhood, showing a moppy little mutt with the typical admonition “Dont chase will run.” The Goose is busier than I thought but most of the crowd is settling their bills and heading out to watch the fireworks, leaving only a few of us. 

As usual, nearly everyone on the deck is coupled up, but when I walk over to the water cooler I see an attractive woman sitting by herself. I smile and she gives me a big, warm smile back. Well that’s nice, I think, but she’s probably waiting for someone. But when I go to sit down with my drink, I see her start to talk to a guy sitting by himself a few tables away from her. He has a full beard and a baseball cap. He also has a dog. 

By the time my food comes they are laughing and chatting like old friends. His dog barks wildly at every other dog that approaches the deck. “She’s just saying hello,” the man says every time. I can’t make out much of their conversation but I hear him say that he’s in real estate. She’s new to the neighborhood, and fairly new to Portland. I hear them talk about paddle boarding. They look like a good match. Even if I had a dog, I can’t compete with real estate and paddle boarding, not to mention that beard, which is full and lustrous. I can only hope that the cap is hiding a case of male pattern baldness, though I know that wouldn’t make a difference at this point. 

I take my trusty sketchbook out for company but my heart’s not in it. I tell myself this is a good opportunity to practice not spiraling down into self-hatred and misery about how alone I am, how long I’ve been alone, how the older I get the chances of this changing grow ever slimmer. It’s so easy to chastise myself for my cowardice. I should have gone right up to her when I got my drink, talk to her before that irresistible canine spell could take hold. But I couldn’t do it. I am convinced that no woman wants anything to do with me. While this might not be true, it has been many years since I’ve seen any evidence to the contrary.

“I need to get a dog,” the server says to me.

“Same here,” I say. “But I like cats better.”

“Me too,” he says. “But, you know.”

The new friends order another drink and I finish mine and head back up the hill. In an empty parking lot, a gorgeous young woman and a man who looks like her father are fiddling with an automatic ball-throwing machine that their dog is nosing warily. The girl is twitchy and holding her limbs at odd angles, like she’s on something. Dog toys and balls and various bits of throwing apparatus lie scattered across the parking lot. 

At the top of the hill, the lost dog signs grow more desperate, hanging from every telephone pole. The sky is nearly dark. Soon the fireworks will start and all the dogs I saw tonight will be whimpering under their owners’ beds. I wonder where the lost dog will hide, who will comfort him as the world around him explodes.

Clean Towels

        It’s the day before Independence Day and the second Revolutionary War has been won. After decades of fighting, the noble rich have finally thrown off the shackles placed on them by the filthy poor. For us huddled masses, it’s all pretty disheartening, but I have the day off tomorrow and am on my way to a backyard barbecue. As I sit on the bench at the bus stop, I look at the arrival time on my phone. It keeps leaping around, getting longer and shorter as some unseen force impedes the vehicle’s progress. A man on the corner shows a cardboard sign to the traffic. I don’t bother to read it. I used to be interested in these signs, in all the different ways people ask for help, the various kinds of lettering they use, but I can’t look anymore. 

        A teenage girl sits next to me, thumbs skipping across the screen of her phone. There is suddenly an explosion behind us, followed by another, and another. It seems early for fireworks –the sun is still high in the sky. I turn around to look and see puffs of smoke in the air above the bridge. The booms go on for a few minutes. 

        “What was that?” the girl asks uncertainly. She doesn’t have an accent I would guess she’s Pakistani.

        “Oh, somebody getting ready for the fourth,” I say.

        “But that’s not until tomorrow,” she says, sounding confused.

        Just then there is a crash right in front of us. An old hatchback truck crammed with junk has spilled a pile of metal shelves out of its open hatch. The truck speeds through the intersection then pulls over. Fortunately, the car behind it brakes before it hits the shelves, and I walk out in front of it, holding up my hand up. The girl runs out after me and we both gather up  the shelves. The words CLEAN TOWELS are written on a piece of masking tape on one of them. We carry them to the sidewalk and the driver of the truck comes and grabs them without a word. 

        

        The girl and I sit back on the bench. 

        “Lucky that didn’t go through somebody’s windshield,” I say. 

        “Yeah. Pretty scary,” she says. The bus comes and I gesture for her to get on first then she does the same to me and I insist and she says no then we both try to step on at the same time and laugh. As we drive off I look at the guy on the corner and finally decide to read his sign. He’s crayoned an American flag next to the words WAR VETERAN ANYTHING HELPS. I wonder if he knows that the real war is just beginning. 

The Lew Welch Memorial Expressway

I wake up beside the highway. Above it, rather. Over the past year I’ve learned the rhythms of its traffic the way someone living beside the sea learns the patterns of the tide. The traffic never stops on the 405 and its many arteries, though it does slow down at night. The poet Lew Welch ranted about the insidiousness of highways in a letter he mailed from a house one block from here that a few years later was razed to build this very road. If it was still there, I would be able to see the roof from my bedroom window. Despite all the changes to the city, I like knowing that many of the buildings he would have walked by are still standing, including this one. 

The sun has not yet crept around the corner of the building so I’m a little chilly as I sit on the balcony with my coffee. The sparrows vanished last week; I miss their frantic chirping, though I never caught more than glimpses of their beaks. I do my puzzles and read the news, even though I know I shouldn’t. I should be protecting myself from the constant barrage of horrifying updates to the story of our country’s plummet into madness. It’s  rush hour and the traffic light on the ramp is helping to stagger the traffic speeding toward the tunnel that cuts through the hills. 

Last week my mother and I drove through that tunnel on the way to the zoo. She was in town to visit and she said the two things she wanted to see were my new (to her) apartment and the baby elephant. Tula-Tu is four months old; I’d never seen an elephant so young, and while it’s always depressing to see animals in cages, my mother and I were both captivated. It’s a strange experience to stand next to the woman who gave birth to you and watch a baby elephant tuck her trunk into her own mother’s armpit to suckle. 

We had a nice week together. Growing old has not made her bitter and crabby like it did to her own mother, who never was all that nurturing to begin with. I didn’t plan a lot but we managed to pack in a lot. I dragged her along to a program dedicated to the work of a local video artist, which wasn’t great, and a production of Assassins, which was. Assassins is a Stephen Sondheim musical about the people who killed or tried to kill the president. It’s hard to believe there has only been a single botched attempt at eliminating our current president, but the show repeatedly urges us to follow our dreams.

The production was put on by a small local troupe of self-proclaimed marginalized  individuals, all of whom were terrific. They performed in the black box theater at Reed College. Lew Welch went to Reed, along with his friends and fellow Beat poets Gary Snyder and Philip Whalen. I wonder what they would have thought of the play, its usual carnival barker narrator replaced by an imposing drag queen Lady Liberty. 

We spent a few days at the coast, staying in a motel in the sleepy town of Rockaway Beach. It was shabby, but it was clean, and it was right on the beach. We had lunch in Manzanita, which is a bustling metropolis by comparison, then went to my favorite spot on the entire coast, Short Sand. I don’t get there often because you need a car. From the parking lot you follow a creek for a mile through old growth forest, where trees sprout from other trees, their roots forming twisted structures that look like portals to the faerie kingdom. It all looks otherworldly. The path ends at a gorgeous cove rimmed with pines and beloved by surfers. 

Welch famously disappeared into the California wilderness with a rifle when he was 44, leaving behind a note.

 

I never could make anything work out right and now I’m betraying my friends. I can’t make anything out of it – never could. I had great visions but never could bring them together with reality. I used it all up. It’s all gone.

 As I sat next to my aging mother, looking out over the Pacific, I felt grateful that she was still in good enough shape to visit me, to drive to the beach, to walk through the woods to get to this beautiful spot. It has been a hard year, as was last year, as was the year before, as was... The losses keep building up and the planet seems to be spinning faster and faster toward apocalypse. My foot is still fucked up, and as usual I’m aching with loneliness. To cope with it all I’m drinking too much, which, oddly, does not seem to be helping. I’m not ready to give up on this world yet, but if I was, this would be a good place to do so. To let go of this world with the protective arms of the cove encircling us. Juncos twittering in the branches. The sun sparkling on the water. The waves crashing against the sand like the sound of rushing traffic on the freeway.