Rewards

 I wheel into the office and plop onto the chair in room one. Jean takes my scooter and unwraps my bandages and is joined by Jenny, who says she’ll be working on the floor more now that the two newbies are fully trained. “I really miss it out here,” she says. She keeps calling Jean what sounds like “beezhawn,” and sure enough, when I squint at his name tag it reads BJON. What the hell kind of name is Bjon? Not Bjorn, or Bijan, which is Persian for hero. 

“Drainage on the right wound is scant,” he says. Scant. What a beautiful word. I feel a tiny worm of hope try to inch its way to the surface.

Jenny is very chatty and we talk while we wait for the doctor. She tells me about how the kittens got into a bag of sponges and now that’s all they want to play with. I tell her about being on antidepressants. She says she wishes her husband would go back to therapy. He’s never been the same after his father died in 2006. Incredibly, both their fathers died within two hours of each other. 

Dr. Thompson comes in and asks how I’m doing. She’s wearing a new cap with little green and brown blobs on it. I say not bad, and ask how she is. “I’m in trouble,” she says. “I’ve been walking on my foot too much.” When she comes closer, I see what the blobs on her hat are. This Black woman doctor who has flown jets in the Navy and worked in the emergency room and as a reconstructive surgeon, who rides a motorcycle and plays the saxophone, is wearing a hat covered with Baby Yodas. 

She is chatty as well, and talks about reading music. “I’m terrible at memorizing things,” she says. “I’m better at problem solving.” She tells me about a cellular biology exam she took in medical school. The first essay question was about a patient who had suffered severe burns. “Everyone was freaking out. We hadn’t covered burn treatment at all. But then I realized, it’s all just cellular biology, and I got an A.”

She says the wound on the left foot looks good, even though it’s a little bigger because she cut so much of it away last week. The foot on the right, however, is almost completely healed over. “This is good news,” she says, and that little worm of hope breaks through the surface and wriggles around for a moment before diving back under.

Bjon or whatever his name is puts on a new soft cast. Jenny just watches, answering his occasional question. “I’m just going to do a banana fold here, right?” When I get home I find that my foot is wrapped so unevenly that I can hardly walk on it without twisting my ankle, and I realize that he forgot to put the outer layer on. 

On top of that, a sign taped to the door of the elevator reads

ELEVATOR WILL BE OUT OF SERVICE

FOR THREE WEEKS STARTING OCTOBER 1ST

WE APOLOGIZE FOR THIS REAL INCONVENIENCE

They had warned us that this was coming, but it’s still irritating. But they’ve removed the “no dumping” sign, so maybe they changed their minds about that at least. Or maybe they’ll put it back up. I understand that change is part of life, but why does it always seem to be for the worse? And why do I foolishly want some sort of reward for all this hardship I have been through? I know it doesn’t work like that, and yet I still feel entitled to some huge piece of good fortune.

But I’m looking forward to my eye exam on Saturday morning; hopefully now that I’ve got the retina problems addressed, we can go ahead with scheduling my cataract surgery. 

When Saturday comes, I roll out to catch the streetcar up to the eye clinic. The usually-teeming office is nearly empty. I wheel up to the lone receptionist and comment on how quiet it is. He just stares at me until I tell him I’m there for my 9:30. 

I sit in the waiting room. The building is all odd angles with a high ceiling crisscrossed with beams. Everything is gray. Eventually a woman calls me and says “Before we go back, I need to ask why you’re seeing Dr. Foley instead of Dr. Danh?” I start to tell her this was the soonest appointment I could get but she cuts me off. “It doesn’t work that way,” she snaps. “You need to see your usual doctor. Besides, Dr. Foley is scheduling cataract surgeries out for six to nine months from now. Dr. Danh will be able to do it sooner. I will have Martin reschedule you.” She storms off and I’m left with the dead-eyed receptionist, who tells me Dr. Danh can see me in two weeks. 

It’s a perfect day but my mood is sour as I roll along the bold, uneven sidewalks of Northwest. That little squiggle of hope has shriveled to a dry husk. It’s so fragile. Six to nine months? What if Dr. Danh can’t do my surgery until months and months from how? I’ve already waited so long. I am so tired of this blurry world. 

I figure since I’m in the neighborhood, I may as well stop by the hardware store and get a bike lock for my scooter; there’s a bike rack on the ground floor. The leaves are starting to drop and so are acorns and buckeyes and sweetgum seeds, and I can no longer speed blithely along. 

I ask a guy at the hardware store where the bike cables are. They’re secured to pegs, so I ask another guy to unlock one for me. I have a padlock already, the one I bought to secure the U-Haul when I moved across the country. I haven’t used it since. The cashier asks if I’m a member and I say no. “You get rewards,” she says. I don’t answer, just swipe my card and wheel on out to face the next obstacle. 

The Race

        The new Shawn opens the door of the clinic and tells me I’m in room one. “Time for the baby birds to fly on their own, huh?” I ask. 

        “Something like that,” he says. “Shelley will be watching over me to tell me how badly I’m screwing up.” 

        He unwraps my right foot and cuts off the soft cast on my left. “These both look smaller,” he says. As he’s cleaning them up, Dr. Thompson surprises me by sticking her head in. She stares in my eyes like she’s looking for something. I say hello. She glances at my feet then says she’ll be back. Shelley comes in and sits at the computer while Shawn measures the wounds and takes pictures. One has indeed shrunk by a third, the other by half. I was not expecting such good news, and though I’m afraid of getting my hopes up, I find myself feeling a little perkier. 

        One of the other nurses asks Shelley to talk to a patient on the phone. “You know Mr. Stuart better than anyone,” the nurse says. 

        “Me? I’ve only seen him once,” she says, but she leaves to talk to the man. “I’ll be back, Jean.” Jean? All this time I thought they were calling him Shawn. I look at his tattoo sleeves, his crew cut. He doesn’t look like a Jean. While we wait, we make small talk. Noticing his thick twang, I ask where he’s from. He says Oklahoma, the oldest of eight kids. I don’t ask him if they all have French names. 

Shelley returns, followed by Dr. Thompson. The doctor asks how everything is going, and I tell her not great. She asks how work is, and I tell her how challenging it’s been working with so many law enforcement types. “I don’t exactly fit in,” I say. 

            “I feel very fortunate,” she says. “We really are like a family here. We all get along. There’s only one of us who…” She doesn’t finish her sentence. I wonder who the one problem nurse is. 

        She says she’s seen a big change with the hospital security as well. “They used to just be mall cops. Now they’re all decked out in Kevlar and riot gear.” As we talk, a voice over the loudspeaker announces a Code Gray. She shakes her head; Code Gray means a disruptive person. 

        She does a lot of work chopping away my callouses. I ask how her foot is doing. “I’m following doctor’s orders,” she says. “And apparently so are you. These look wonderful.” She puts down her scalpel and hobbles out.

        Shelley arranges the materials for the soft cast and stands by to watch Jean work. Karen, the other new nurse, comes in and observes silently from the corner. Jean wraps the bandaging around my foot and leg and Shelley tells him what he’s doing wrong every step of the way. Eventually she takes it away from him and does it herself. “You enjoy this, don’t you?” I ask. She giggles. 

Finally I’m all wrapped up again, and Jean brings me my scooter. On the other side of the curtain, Dr. Thompson is perched on her own scooter. It looks much more solid than mine, and has brightly colored streamers and a pink bell on the handlebars. I remember being told that she rides a motorcycle. She rings the bell. 

        I wheel out of the office and she follows me into the elevator. A floor down, a woman gets on, carrying bags full of blankets.

        “Lot of babies today,” the doctor says to her. 

         “Lots of babies,” the woman agrees. She points to our scooters. “You race?”

        “You bet,” I say. “Who do you think will win?”

        She looks at Dr. Thompson, then at me, then back at the doctor. 

        “She win,” she says. 

        The doors open on the ground floor, and Dr. Thompson speeds off down the hall, her lab coat flapping around her.

Artificial Tears

At the last minute, they are able to change my wound care appointment to early Friday morning so I can squeeze it in before my visit to the retina specialist, after which I intend to speed on down to work a half day. It's going to be hectic. 

Thursday night I receive a message saying my dear friend Teddy died Tuesday night of a heart attack. My own heart feels like it’s breaking at the news. It had been over a month since we’d talked, and I had meant to call him over the weekend. Sunday night someone had left an anonymous message on my latest blog entry:

If pain and suffering had a sense of humor, it’s laughing. Sean, thanks for giving me courage and confidence to face the unknown with flare and deep glares, as all great artists do.

It was obviously Teddy. But... face the unknown? I was told he had a heart attack, but did he actually kill himself, like he often said he would? Or did he just have a premonition that he was going to die in a few days? Ted had been saying he was going to die since I met him twenty-five years ago. He was always juggling a number of ailments, and had suffered one heart attack already, as well as a stroke. He ate like shit and smoked steadily his whole life so it was a wonder he made it this far, really, though it doesn’t make his death hurt any less. 

I email work to say I won’t be in at all on Friday. My boss tells me he’s sending healing energy my way. 

The next morning I get to the clinic as it opens, and am happy to see that Jenny is my nurse. We chat the entire time about our cats and the recent presidential debate. I tell her about losing my friend and she’s as kind and compassionate as ever. I ask her how KC is and she says still not dating anyone. I feel my stupid heart flutter for a moment, stupidly.

Jenny takes off the cast and says the wound looks really good. So does the one on the right foot. She measures them and takes pictures then leaves for the day; she has a doctor appointment herself. Dr. Beaumont comes in, followed by a godlike warrior of a man. “This is Dr. Thompson,” she says. She looks at the wounds and does a bit of scraping at the callouses, explaining to the other doctor what she’s doing. "A callous is like having a rock in your shoe," she says. He watches without a word. 

“These are both coming along beautifully,” she tells me. I ask her what the next step is, if I should schedule surgery. “Well we might not need to,” she says. I’m confused. 

“I’m confused,” I tell her. “I thought it was a foregone conclusion that I was going to lose it.”

She seems confused about my confusion. “I said you had three choices,” she says. “You can go back in the chamber for forty days. Or you can have it removed. Or you can stay off it as much as possible and see if it heals up. Which it seems to be doing.”

"I didn't realize there was a third choice," I say. “Isn’t the bone infected?” 

“It may or may not be,” she says. 

“What about the MRI?”

“The MRI isn’t conclusive.” 

“But what about the wheelchair?”

“Didn't your primary set you up with one when you saw him?” I tell her that my session with him had basically been a psyche evaluation and that he hadn’t mentioned any wheelchair. 

“Well, I talked to him about it,” she grumbles. “Look, I’m not going to say you have to be in one. It’s up to you to decide. It will speed things along. But the way things are going…what you’re doing seems to be working.” 

My head is spinning. I know I should be relieved and happy, but I’m just bewildered. 

Jenny has left for the day, so Shelley comes in to reapply my soft cast. She chatters on about her kids as I sit there staring at the curtain printed with words like Hope, Love, Gratitude. I want to rip that curtain off its fucking rings. 

I catch the bus with a minute to spare, and head across town to my retina appointment. I wait for a while then get called by a young man with a thick Russian accent. He is awkward and angular and I feel bad but I have to ask him to repeat every other sentence. He says "You're doing great" over and over, like it's a recording. He checks my eyes then dilates my pupils and takes me into another room to do another retina scan, just like last week. 

After the scan he leads me to a cramped waiting room apart from the main one. It’s crowded with patients and their spouses. We all sit there a long time. Occasionally is one of us summoned and the rest of us watch in envy. 

Finally a different assistant calls my name. When we get to the room, there are already people in there. “I thought you were done,” the assistant says, and sends me back to the waiting room. I try to read a magazine but can’t concentrate. I send texts to a few friends about Teddy. I don't know who knows yet; he had gotten more and more isolated over the years and I was one of the few people left who kept in touch with him.

Finally the assistant comes for me again. She sits me down and says she’s going to inject me with red dye to take pictures of my capillaries. “Your vision will be pink for a while afterwards. Let me know if you feel nauseous and we'll stop,” she says. I rest my chin in a little frame and she shoots an intense flashing light into first one eye, then the other, then back, over and over again, for five full minutes. I wonder if they torture prisoners this way. Afterwards, it’s back to the waiting area, which has been freshly painted pink. 

After another half hour I’m finally led down yet another hallway to yet another tiny room where after yet another wait the retina doctor meets me. This plaze is like a labyrinth.

Dr. Wong surprises me by not being Asian. He asks me about the laser surgery I had done years ago and where I had it. I tell him Allentown, and he says he went to college in Philly and that his wife was from Allentown. He tells me her name, as if I'm supposed to know her. 

He says he could do laser surgery again but would prefer not to, because the damage is right in the center of the eye and it’s much riskier. He says there’s medicine that is much safer and just as effective. “We inject it directly into the eye once a month for a while, then we taper off." I ask if I will have to have these shots for the rest of my life and he says probably. I feel like I am going to be sick to my stomach. He says that after the first injection, I'll be able to go ahead with scheduling my cataract surgery.

I tell him that sounds like my best option.

“Great,” he says. “I’ll have the nurse give you the numbing drops.”

“Right now?” I ask. 

“You bet," he says. “Look, if you wait, you’ll be up all night worrying about it. This will take  ten seconds and won’t hurt a bit. I perform forty or fifty of these a day. But it’s totally up to you.”

I’m getting tired of having to make all these choices. I just want someone to tell me what to do.

“Let’s do it,” I sigh. He looks delighted and says he'll send the nurse in. 

The nurse sits down and reads off a list of things I should look out for and be concerned about –the biggest risk is infection- then has me sign a release form. She says if I have any discomfort, I should use artificial tears. I try to come up with a joke about preffering the real thing but my mind isn't working. She puts a lot of numbing drops in my eye and leaves the room as I dab the excess with a tissue. 

Teddy will laugh his ass off at this, I think, forgetting for a moment. 

Dr. Wong returns and puts more numbing drops in and says, “Now to let that simmer for a while.” He’s gone a long time and I start wondering how long the drops will keep my eye numb. I've been in this place three hours already; it's good I called off work. 

When he finally returns he puts more drops in my eye. 

“Does that burn?” he asks. I say no. All I can see hovering above me is the tip of the eyedropper. “Does that burn?” he asks again. I say no. “Okay we’re done,” he says. It wasn’t the eyedropper at all; it was the tip of the needle. It had taken less than ten seconds. I hadn’t felt a thing. 

for Teddy, without whose encouragement I wouldn't be writing

Motion Artifact

 The door of the wound care clinic is locked when I arrive. I’ve never been here first thing in the morning before; they adjusted my appointment to be closer to my other appointment. The Widder has generously offered to shuttle me around. 

Caitlin ushers me in; I haven’t been in her care in ages, though she’s always flittering around in the background. I ask how she’s been and she says her life revolves around the lab/terrier mix she rescued in the spring. My wounds look slightly but not substantially better. I ask her if what I’m going through is unusual, and she says it happens more than I might think. “Especially with people who have to work,” she says. “It’s hard to take the time off you need for these kinds of wounds to heal. If we could make you hover in the air, you would heal up in no time.” 

“I guess the wheelchair will help,” I say. She says definitely, and that I will be in it for 2 months after the wounds are actually closed, to make sure the skin is healthy and strong and won’t just break open again. 2 months on top of all the other months. 2 months on top of God knows how many months of actual healing. I feel my gray mood darken. No one has told me when I’m actually supposed to get this surgery yet; we couldn't move forward until I got the MRI. The doctor hasn't gotten the results yet.

Dr. Beaumont comes in and asks how I’m doing. I tell her spectacular. “Spectacular, huh?” she asks. Twenty years of living in Portland has made me trade my sarcasm for light irony. “Well, I’m glad you’re seeing your primary right after this,” she says. “I had a good talk with him. They need to get you a counselor, and none of this once-every-six-weeks nonsense.” She writes something down on a business card. “That’s my cell number. If he gives you any excuses, have him call me.” My usual self would crack a joke about calling her in the middle of the night for advice on how to properly marinate Cornish hens, but I’m not my usual self. I notice that she’s wearing a different African cap than usual, with brightly colored blobs that look like they could be flowers or cartoon animals but they’re probably just blobs. I want to ask her about it but instead I just ask how her foot is doing.

She cleans up my wounds and Shelley assists her. They talk about how dangerous the world has become, about getting bitten by dogs, about how you can’t let your kids play outside anymore. “When I was a girl my mother left me at home alone once,” the doctor says, “And one of her friends stopped by and I wouldn’t let her in because my mother told me not to open the door for anyone.” 

“My kid’ll open the door for anyone,” says Shelley. “I know because when I leave the house I circle back to test her and she always just opens the damn door without even looking.”

I sit silently with my eyes closed the whole time. The doctor says she’ll see me next week and wishes me good luck with my appointment. 

Caitlin comes back to put on my new soft cast and I start crying. I feel like a building being demolished to make way for a superhighway. Caitlin is kind and lets me cry a little, then tells me about a movie she watched called Zombeavers, which is about zombie beavers.  

I text the Widder when I’m done and she drives me to the medical center at Lloyd Center. I’m led into the office by a young woman named Maggie who, if I ran into her on the street, I would assume was attending middle school. When she takes my blood pressure, I notice that her tiny fingers seem deformed. She gives me a depression checklist to fill out and says the doctor will come by in fifteen minutes. The checklist goes from 0 to 4, 4 being the most often or severe. My page is all threes and fours. 

As I’m sitting there, I get the results of the MRI. 

“Impression: Motion artifact is present which degrades many images limiting detail,” it reads. Then it goes on to repeat everything I already knew from the x-ray. At first I think motion artifact may refer to the foreign object, but it’s just a term for “patient moved around a lot.” Artifact is such a strange term. There’s no mention of the foreign object at all, probably a victim of the motion artifact.

Finally Dr. Tran comes in. He’s subbing for my regular GP, who Dr. Tran lets slip is on extended leave. I'm not really sure what this visit is for; I just talked to my GP last week. I expect him to talk about getting the wheelchair, but all he wants to know about is my mental health, so I let him have it. 

He takes in the torrent of invective-laced highlights of my past year in wound care. When I've exhaused myself, he looks over the depression checklist I filled out. asks if I’ve ever been on antidepressants. I list them as best as I can, along with the shitty experiences I had with each. He says he would like me to consider trying Cymbalta. I instantly start to protest but he addresses all my arguments with such cool Vulcan logic that I am soon exhausted into agreeing to give it a try. I feel a twinge of relief at giving in, though I know not to expect anything from this new drug but disappointment, along with dry mouth and excessive sweating. He says he wants me to talk to a psychologist as well but they won’t have one in the office until next month. I wonder if I should give him Dr. Beaumont's card.

He leaves and sends Maggie back in to draw blood and give me my flu shot. She has trouble finding a vein, despite the fact that I can see them bulging all over the place. She goes to get her supervisor to reassure her and the two talk in Spanish for a while, then she draws my blood without any trouble. She apologizes and gives me my shot, and by the end of the visit we are laughing and joking like old friends. 

She leads me to the restroom so I can provide a urine sample. The restroom latch says VACANT and when she knocks no one answers, but when she opens the door, there are two large women inside. She makes a face of horror and leads me deep into the building to another restroom. She knocks three times and cautiously opens the door. There is no one inside, but there is a sign over the toilet that reads Reclaimed Water: Do Not Drink.

“Damn, and I was really thirsty,” I tell her, reaching for one of the sample cups piled on a cart.

“Make sure and lock the door behind you,” she says with a smile. 

“Don’t tell me what to do,” I say, and break the seal on the cup. 

Tumbling E

The ophthalmologist’s assistant has long fake lashes. She gives me a form to fill out then checks my eyes but the only letter I can read is the big E. I try to engage her in small talk but she’s not interested. She puts drops in my eyes and hands me a tablet and leaves the room. The tablet talks to me in the doctor’s voice to educate me in the basics of cataract surgery. I know most of the information already; I’ve had a number of friends go through it this year. Everyone tells me it’s a weird but painless experience. “You may see flashing lights and colors,” the doctor’s voice says. I’m nervous but impatient to get it over with; the world has been a blur for six months now. Though I detest eye exams, I've actually been looking forward to this appointment, seeing it as a step toward normalcy.

The doctor comes in with a different assistant. She shines a light into my eyes from various angles, telling me over and over to look at her ear. She gives me more drops and has me sit back in the chair while she shines another light into my eyes, telling me to look in every direction. Upper left. Left. Lower left. Look at your feet. It’s extremely uncomfortable and seems to go on for a long time. The doctor seems irritated but I may just be paranoid.

When she’s done, the assistant with the lashes returns and leads me into a tiny room where she does a retina scan. I rest my chin on a frame and stare into an eyepiece at a brilliant blue orb. A red line sweeps the orb from top to bottom and then we do the same with the other eye. It looks like a graphic from a space movie from the eighties. She leads me back into the first room to wait. The doctor pops her head in and asks if I mind if she sees another patient first. I have seven hours before my MRI so I tell her to take her time.

While I sit there, I look up why they always use a big E instead of some other letter. The most common eye chart was developed by the Dutch scientist Herman Snellen in 1862. The E’s horizontal bars help show if people can tell black from white. He also made what is known as the Tumbling E, for children who can’t read. The E is shown in various positions and the child tells the doctor which direction it faces. 

I have a sudden memory of one of these charts. I had an eye exam when I was young and was given a wooden E to hold in the position of the each one the doctor pointed to. I can picture the room where the exam is being held in; it’s in the basement of my elementary school. I remember being fascinated by the eye chart; I can see it clearly in my mind. I find this memory suspect, however; did they really do eye exams right there in the school? All I know for sure is, I was seven when I got my first pair of glasses. 

The doctor returns with printouts of my retina scans. She shows me the left eye, which looks fine, and then the right, which has a bulge on the retina due to diabetes. “I need you to see a retina specialist before we go ahead with the surgery,” she says. I feel my stomach drop. Is nothing in my life ever easy and straightforward?

“What will they do about it?” I ask.

“They’ll either do laser surgery, similar to what you had years ago, or they may just give you medication to make the swelling go down.”

I had wanted to ask if she’s ever seen the film Gray’s Anatomy, in which Spalding Gray describes his attempts to cope with his eye issues –the way he says the words “macular pucker” makes me chortle- but she brusquely says goodbye, so I just wheel out to the front desk and make an appointment for next week. The sunlight is hard on my dilated pupils and I can barely see. The world at the edges of my vision crackles and disintegrates. 

I stop at Safeway for a few things; the other grocery stores are on strike. The only lines open are self-checkout lines. The machine doesn’t give me the sale price on my cheese and I tell the attendant and he charges me the wrong price. I’m too tired to argue so I just mentally add the six bucks to all the other money that wretched store owes me. 

I take the streetcar home and eat lunch. I try to do some work online but my internet connection has been so spotty lately that I can only work in seven minutes bursts before I get booted off. 

A few hours later it’s time to head across town for my MRI. I almost miss my transfer because the first bus driver misses a turn, and instead of just circling back, he has to call dispatch so they can reroute him through his GPS. On the second bus, the driver gets in a fight with a woman who accidentally told him she needed Stark Street instead of Sandy. She apologizes but he is furious with her for some reason; maybe they’d had some conflict before I got on. 

I get to the hospital and check in at the desk and head down to the bowels of the building, where they do all the diagnostic imaging. 

I fill out a three page form and wait for twenty minutes until they’re ready for me. The tech asks if there’s any metal in my body I forgot to mention on the form. There is potentially metal in my body but I didn’t mention it on purpose. The mysterious foreign object in my foot didn’t disrupt the last MRI I had six months ago, so I figure it’s probably fine. 

The tech is a bald older man who, like everyone I’m encountering today, turns out to be impervious to my attempts to engage him in friendly conversation. He tells me not to move my foot and I tell him that the last time my foot twitched despite my best efforts to relax. He slides me into the machine and it starts banging and screeching. Ten minutes later he pulls me out and says my foot twitched. He wedges some padding around my foot and slides me back in, obviously irritated. 

When I get out, the sun is going down. This was my favorite time of day before my eye problems; now, the dusk is hellish, filled with indistinct forms and shadowy figures. The sidewalk is covered with invisible obstacles, and I roll slowly across it so as not to overturn my scooter. Two men are sitting in the bus stop smoking fentanyl. 

On the way home I get a text from the eye specialist, asking me to leave a review. I delete the text and sit with my head in my hands. I have two back to back doctor appointments tomorrow morning. I feel like I am in free fall, my broken body tumbling through space, too tired to scream, praying that solid ground arrives soon.