Tag Archives: tale

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On guard

My nurse’s breath catches. “Oh, no,” she says.

I am new here. Less than a year. “What?” I say.

“We have Janna Birchfield on the schedule.”

“Who is Janna Birchfield?”

Tonna leans back in her chair at the nurse’s station, a high set desk that runs behind the front office. We have new glass barriers along it to make it more hipaa compliant. It is also more claustrophobic. She throws her pen down. “She’s one of the most hostile people here. She’s known for throwing a brick through her second doctor’s plate glass window.”

“Ah,” I say.

“She was Dr. M’s patient but apparently she and Dr. K got in a screaming fight in the hallway. She is banned from that clinic. So we are the last clinic in town.”

My nurse knows the local stories and she has seen a lot. She doesn’t have a lot of unconscious monsters. Yeah, there is some impatience and some anger there, but she’s pretty good. No real fear, nothing cringing at her feet.

“Hmm. Let me talk to Marnie.” Marnie is our office manager.

Marnie and I talk. I read the last notes from Dr. M and an account of the screaming fight with Dr. K. I call Dr. K. I don’t know of anything that scares her and she is tough. I rather enjoy envisioning her yelling back at this patient.

The day arrives and Mrs. Birchfield is put in a room. Vitals are done. I go in.

Janna Birchfield is big. She weighs about twice what I do, and it’s muscle rather than fat. She looks solid. Not like a body builder, just strong. She tops me by nearly a foot. She looks sullen and unfriendly.

And I am looking at her monsters. Three are guarding a fourth, at her feet. Fear is there, anger is the biggest and posturing, like a body builder, in front. The third is morphing back and fourth: envy and hostility. The fourth is in a stroller, guarded by the other three. Asleep? Unconscious? Well, yes, duh, but it’s not often that a monster is so undeveloped that it is still an infant. Not good.

“Hi, Miz Birchfield. I am Dr. Gen.” I hold out my hand, moving slowly and smoothly. Her monsters alert, fear flinching and anger ready to punch. I stand with my hand out. She eventually touches it, glaring.

“Hi,” sullen.

“We need to talk about the clinic rules first.” I say calmly. Anger puffs up and her shoulders rise as the monster swells and takes control, her elbows rising and hands are fists. Her eyes don’t turn red, but nearly. “I have heard about your argument with Dr. K.”

Furious voice, “She screamed at me. She’s a horrible doctor! She got me thrown out!”

I am smooth and calm, “I am not going to discuss Dr. K,” I say. Honestly, it’s even more fun to think of Dr. K taking this on and not budging an inch. Dr. K is my size, small. “In this clinic, I need you to understand that you are not allowed to yell at anyone at the front desk, in the hallways or on the phone.” Anger flees immediately, small again and she looks confused. “You may not yell at the staff, at the other patients, or at anyone on the clinic property.”

“Why would I agree to that?” she says. She is mostly confused because I am not scared or angry. I am not behaving the way she expects, the way most people behave around her.

“If you are upset, the only people you can yell at are me or the office manager and you need an appointment.”

“They are rude to me!” Basically she means everyone. “You can’t make me do that!”

“Take it or leave it.” I say. “You need to agree and keep the agreement, or we will discharge you immediately. If you say no, leave now, and I won’t charge for the visit.”

Her monsters are confused. Anger has shrunk back down and they are conferring, heads together. Confusion has shown up as well, morphing though different colors and stripes, stars and paisleys. She stares at me, frozen hostility. I just wait, sitting in front of my laptop, serene. This is going well. She isn’t yelling and she hasn’t left.

“What if they are mean?” she says.

“You will make an appointment with me or the office manager, and we will help you.”

“Ok,” she says. The monsters are still surrounding the carriage, but really, now confusion is in charge. We work through the rest of the visit, as I get to know her a little. She has had a hard, hard life.

I let the front office and the nurses know the rules. The office manager and I let them know that this is a contract with the patient and she has agreed. They feel protected. They feel protected enough that they are nice to her. She behaves and starts, infinitesimally, to relax. She is still angry and hostile in the exam room but it’s not directed at me. It is directed at the entire world, the rest of the world outside the clinic. I try to help her medically but also let the monsters have their say. The visits start with anger and hostility but tend to subside into confusion. I am not getting at the fear or whatever is in the stroller. It is one of the large old fashioned ones, heavy, navy blue, where an infant can lie flat. Clearly it does not fold up to go in a car or anywhere else convenient. There are no toys hanging from the top or across it, no stuffed animals. Only a form under the blankets, always still.

I may reach that form, or not. I do not know.

For the Ragtag Daily Prompt: paleontology.

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Honey and the ants again

The next two times Honey feels the ants biting from the inside feeling are also on obstetrics.

Both times it is a VBAC. Vaginal birth after cesarean. The woman has has a cesarean section in the past and is trying for a vaginal birth.

Both times, Honey gets the biting ant feeling. There doesn’t seem to be anything wrong with the woman in labor, the nurse is relaxed, the fetal heart monitor looks ok.

With the first one it is the younger male obstetrician who is on call. He is a big man. He sits and peruses the monitor strip outside the room, taking his time. “There were some decelerations back here, but the heart rate looks fine now. Do you really want me to consult?”

Honey can’t stand still, the ants feel so bad. She tries to sound professional and calm. “Yes, this is a VBAC. I would like you to go in and meet her.” She is trying not to shoo him towards the room. He shrugs and gets up, not quite slouching towards the room, Honey trying not to jump up and down in impatience behind him.

In the room, he introduces himself. Again, Honey has not told her patient. The obstetrician says, “Dr. B. asked me to stop by since you have previously had a cesarean section, but everything looks fine.” Two minutes later she and the nurse and the obstetrician all alert as the the fetal heart rate monitor chirp slows, dropping from the 120s down to 60. THERE IT IS! thinks Honey. It stays down, they have the mother roll on her side and pop oxygen on her. It comes back up, but that is that. Off to the operating room. Again, they don’t have to do a crash cesarean. This time it is not clear what was wrong, but everything comes out well.

On the third round, it is the older male obstetrician. He looks at the strip and is calm and goes right into the room. He introduces himself and everything looks fine. Honey is wanting to dance from foot to foot from the ants. Again the fetal heart rate drops, right as the obstetrician gets up to leave the room. The nurse has the woman roll to her side and adds oxygen. The calm obstetrician gives Honey a look and has the nurse get the surgical consent. The heart rate is back up and off they go.

Honey wonders. Ants? Little voices? She knows that we all pick up information from body language and information that is not conscious. That could be a scientific explanation. Information that is not quite conscious. Honey decides that she really does not care what the ants are. When those voices speak, she listens. Who cares what it is, as long as it works.

______________________

What is the word? “Fictionalized”, from fallible, friable memory.

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Honey and the ants

Honey is in her second year working. She escapes clinic because she has a labor patient. In the daytime! Not on a weekend or at 2 am! Hooray!

She has to hang out, because this is baby number five, so it could come really really fast. Everything is cool. The mom has more experience than she does, nearly. Well, Honey has done more deliveries, but has only had one baby.

Honey starts to feel itchy. Agitated. It’s not skin at all. Something is bugging her. She goes in and out of the room. The nurse seems totally unperturbed, but Honey feels like ants are attacking her, from the inside. She goes out the room and studies the rhythm strip, the baby’s heartbeat. There is a printer feeding out in the central nurses station.

Screw it, thinks Honey. I make look stupid, but I don’t care. She calls the obstetrician. It’s the woman who is on. Honey is a Family Medicine physician. They are in rival clinics. “Hi,” says Honey, identifying herself, “I need a consult on this woman.” She reels off the medical details, Gravida 5, Para 4, all vaginal deliveries, no complications. “I just feel like there is something wrong. There isn’t anything really bad on the strip. But I need you to come.”

The woman obstetrician comes. She sits and studies the heartbeat strip. Honey still feels like ants are biting from inside. The OB puts the strip down. “There is nothing on this that would get you in trouble. But you’re right: something is wrong. Come on.”

Honey has not told the patient that she’s calling the obstetrician. The patient might be annoyed. They go in the room. The obstetrician introduces herself. “Dr. B called me to consult. We have a bad feeling. We want to do a cesarean section.” Honey is sure the patient will say no. She is wrong.

“Me too,” says the patient. “Do it.”

They do the paperwork and move quickly to the operating room. Not a crash cesarean, not an emergency, so spinal anesthesia, not general. Honey assists.

They are in. There it is. The umbilical cord is wrapped four times around the infant’s neck. It has not tightened down. Honey has goosebumps as they gently unwrap the cord and do the delivery. The baby is fine, no problems, apgars of 9 and 9. They complete the surgery, mom is doing fine too. Honey still feels rattled but the ants have gone away.

The mother is relieved when she wakes, glad they did it, glad to hold her fifth child. The obstetrician is in charge of post operative and Honey is managing the baby. They don’t really talk about it, everyone acts as if it’s all routine. If the cord had tightened down, everything still could have been ok, but it would be a crash cesarean section, general anesthesia, more risky for everyone. It could also have not been ok.

Honey is relieved to go home, adrenaline draining away and leaving her very very tired.

Honey decides that she will listen to those ants, that feeling, any time it shows up.

______________________

Based on a true story, at least, on memories, that are unreliable. Aren’t they?

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A tale of no tail

Yesterday on our early morning walk, Sol Duc rushed up a driveway, all fierce hunter, and attacked the pile beside a garage. Not our garage. I wondered if it was a mouse? Nope. She lost interest once she’d flushed the prey. The tailless prey was quite relieved.

For the Ragtag Daily Prompt: tail.

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The cover of a book

“The cover of a book is only skin deep.” -Malcolm Kenyon Ottaway

My father came up with that one. It sounds like it makes sense until you think about it a bit. He and my mother did tons of wordplay and they would conflate adages. That’s “Don’t judge a book by its’ cover.” and “Beauty is only skin deep.” (I don’t agree with the second. The complex interiors of people have their own beauty. We just don’t have pageants for small intestines and hearts and brains.)

Don’t burn all your bridges, look before you leap and we’ll cross that bridge when we come to it. We morphed those into Don’t burn your bridges before you cross them. Another I’ve heard is this:

The older we get, the more we learn
which bridges to cross, which to burn

Honestly, I am terrible at burning bridges. I think it comes from being passed around as an infant and feeling abandoned or a sense of loss and grief. I am practically incapable of really burning a bridge. At most I can put up a guardhouse with a tollbooth. Not that anyone ever tries, really. People mystify me and apparently that is not going away ever.

I love this old adage, too:

Make new friends, but keep the old
One is silver and the other gold

For the Ragtag Daily Prompt: adage.

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A yarn about paper

On Friday in the morning I took notes on paper. I was attending a conference on diabetes on Zoom. There are three new things added to the diabetes guidelines. It is now impossible to do a visit about diabetes and actually talk to the human being who has diabetes. We’ll be too busy doing the stupid checklists.

The personnel person stopped by. I said I was taking notes. “On PAPER? You are killing me!”

“Ok. I will use yarn this afternoon.” I drove home and got my knitting and worked on a sock in the afternoon. All the clinics were having a slow day. I guess the kids are getting out of school and everyone is feeling good. Or panicked.

I retain as much information knitting as I do taking notes. Tactile-auditory learner and the controlled fidgeting of knitting helps me stay awake, retain information, and produce socks and others items. I wear the socks more than I reread the notes.

I still like paper. I keep a paper journal. I wanted notes from the most complex lecture. The new medicines are jockeying for position but right now there are different indications for each one, so it’s rather confusing. They said that Type II Diabetes takes two hours daily to manage “correctly”. And that Type I and Type II on insulin take 3 or more. We are supposed to check for Diabetes Distress, which is not depression, exactly. I think I need to be checked for Guideline Distress and Contact Diabetes Distress, sigh. At least the Diabetes Distress speaker thought we should talk to the patient, though I think the talking should have been long before that. Medicine in the US is a mess.

I used the back of the clinic schedules for notes. I do print it out daily. It’s to try to run on time. What time am I supposed to see the patient, but they can be up to 7 minutes late and then the medical assistant still has to “room” them (yes, room has been verbed). Then I can go see them. So the theoretical starting time and the actual starting time can vary quite a bit. I don’t feel bad about being twenty minutes late if I didn’t get to go in the room with the last patient until twenty minutes late. Maybe a no show will let me catch up. Or not.

Anyhow, I still like paper.

For the Ragtag Daily Prompt: paper.

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Story morph

I’ve been seeing some embroidered stories. They are based on a true story, but the details are wrong or exaggerated.

One is an old friend of my sister. He notices a chair in his garage and contacts me. Now, my sister died in 2012. He says the chair is from Grandmother Tessie and that my sister told him “It’s the only thing I have left from my grandmother.” He wants the chair to go to my sister’s daughter and he may be willing to have it recovered for her.

He sends me photographs. Touches your heart, doesn’t it?

Except that Tessie was not our grandmother. She was my maternal grandfather’s mother, so my great grandmother. I have never seen the chair before and it would have to be late 1800s or bought late in her life. It does not look that old, though it looks chewed. Also, we all got boxes of stuff from my maternal grandmother Katherine, to the point where we all agreed it was ok to get rid of some of it. We offered it to each other first. Seven cousins and I got two pitchers. I asked my mother, “Why two pitchers?”

“After your uncles and I picked what we wanted, we lined up seven boxes. Then we went pitcher, pitcher, pitcher, pitcher. There were enough to send everyone two.”

Oh. My grandmother was a serious packrat. I got a silver plate pitcher and sugar bowl that look like they are from the 1930s, art deco. I had never seen them before they came in the box. So they are not attached to my memories of my grandparents at all, but I like them very much.

I send the chair message on and I don’t know if my niece will want the chair. Nor do I know if it was great grandmother Tessie’s chair. I had an enormous box of tablecloths and pulled thread doilies and so forth after my parents died. I would bet money that there was something from Tessie Temple in there. I offered it to both my children and my niece. They each took one tablecloth and napkins. I kept a few and got rid of the rest.

The other day I noticed that one cloth that I kept is signed Margaret White. She was my maternal grandmother’s oldest sister. I have Margaret’s small leather sewing kit as well, made in Germany and stamped with her name. I’ve had that since my teens and used it until the leather corners are wearing down. My mother said that my grandmother found her sister Margaret difficult, but I don’t know if that is true either.

At one point I emailed with a family member found on Ancestry.com. This is my paternal grandmother’s father’s half-sister’s descendant. She said the family rumor was that they were related to John Philip Sousa. I said, “My great grandfather, Fredrik Bayers, played saxophone in John Philip Sousa’s band.” She said, “Oh, that must be where that story came from.”

Are these stories benign or not? With social media and the ongoing trials of various people from both the government and investment schemes, the stories seem less benign to me. If my niece wants the chair, I think that is very kind of my sister’s friend to make the effort to get it to her, but the story was rather garbled. It makes me want to be careful with the stories I tell.

Peace.

The photograph is from 1965 or 1966, of my grandmother Katherine White Burling, me, and my sister, Christine Robbins Ottaway. I would guess that my grandfather took it.

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Love tale

An older couple comes to me in clinic. She is losing her memory, they explain. They are looking for a doctor who will respect her wishes. Once she goes in the nursing home, no intervention. No antibiotics, no shots, no iv, no hospital.

Yes, I say.

It is about a year before she goes in to the nursing home. I do my regular visits.

After a number of years I happen to meet her husband in the hall. “She is talking about her twenties.” he says. “She lived in an apartment and ran errands for her uncles. I am hearing all sorts of stories I never heard! I go home and type them and send them to the family.”

“That is wonderful,” I say. He visits daily.

I go on to her room. She says, “That man comes to see me. He says he’s my husband. I don’t remember, but he is such a nice man!” I think she falls in love with him again daily. He visits and is where she is in her memory.

Some time later the nursing home calls me. “She has a fever of 101 and has not eaten for two days.” I go visit and call her husband. “Should I do anything?”

“No! She’d kill me!”

“Ok. She might die.”

“I know.”

She doesn’t die. The fever comes down and she gets out of bed and is thirsty.

There is a year between my years at the hospital and setting up my private clinic. We send out postcards, trying not to send them to anyone who has died.

Her husband comes to the clinic opening. “She died last year,” he says.

“I am so sorry! We tried not to send postcards if people had died!”

“It’s ok,” he says, “I wanted to come and thank you.”

He dies about a year after she does. I hope they are together again.

For the Ragtag Daily Prompt: true love.

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Tendrils

He likes to be the smartest. She doesn’t care and anyhow, people don’t like smart women mostly. Men show it off. Women mask it. She can only partially mask with her professional degree.

He’s pleased to walk on the beach with her. She is withdrawn, down. He can feel that. He does not ask why, ever. She slides neatly into the space his wife’s dementia left. His wife who was also depressed. He does whatever he wants, he’s not available, he won’t be trapped. Control.

She is withdrawn, down. She has a difficult task in a year that might kill her. Closing the clinic and working elsewhere. Maybe she only gets pneumonia when a loved one dies. Or maybe COVID-19 will kill her. There, the range is from make a lot of money to dying. It is hard to explain and people don’t believe her.

Tendrils from her time in the ocean brush him. Then they are longer and lit in the sun. They wrap around him, very slowly. The first after a year. Where the tendrils touch, he has scales.

Neither sees. They are too busy laughing. They are small children, wordplay, in the woods, on the beaches, talking, singing.

She thinks her mermaid self is separate, her dream self. She is safest in the ocean. Her microbiota, gut bacteria, are all from the ocean. Symbiotic. He has land bacteria, at least, he starts with them. They change the longer they are together. He says, β€œI can read your mind!” But he can’t read emotions, since his are locked away. They bang on the dungeon doors howling but his heart is locked there too. His head can’t hear, can’t feel. Only when the small child is out playing.

He is slowly turning green. Now he has a few small leafy tendrils too.

She goes in the sea, the ocean, the unconscious, daily. Unworried, free, happy, healed.

The year goes by. The clinic closes, she has a job.

β€œWhy are you afraid?” He says.

β€œI am afraid I’ll get sick,” she says.

He has tendrils running all over from her. Half his skin has designs, stripes and patterns. The earliest ones have thickened and spread, rooted wherever they touch him, scales edging the roots. She is fully scaled, with the tendrils from fins and tail and hair. She smells of the sea.

She goes to work and is sick after two months. Very very sick with all it entails.

“You didn’t tell me about this!” he says.

“Why would I?” she says. “No one believes me.”

“I am watching and I don’t believe it.” He hates that her mind is unmasked. “I can follow you and it makes sense but you jump topics so fast!”

She shrugs. “Well.”

He tries to cut ties. Once. Twice. He can’t see the tendrils, so how can he cut them? But now she looks from the ocean and sees. The third time he tries, she grabs a shell and slices through the tendrils and dives deep. He could come in the sea. But he will have to choose.

He chooses not to. He thinks she is calling him from the sea. Every day he drinks a little more, smokes a little more, trying to drown the call.

But it isn’t her. The tendrils are his, now. The dungeon is flooded and the monsters and the small child swim in an ocean, fully scaled. They call him daily, to open the door, to let them out, to join them.

To join them in the sea.

________________________

For the Ragtag Daily Prompt: symbiotic.

Sea of love.

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Bear with me

Merle is in his tiny cabin. The cabin far away in the woods. He is holding his guitar. When he realizes where he is, he puts down the guitar, carefully.

He hears crashing outside right away.

He looks. Bear. It rises onto it’s back feet. It is a sow, with cubs! Three!

No, thinks Merle, two cubs. And: “Kurt!” he yells, “Run!”

Kurt just looks at him and turns back to the cubs. The sow is looming outside. This is wrong, why isn’t she attacking Kurt? Kurt is pushing and wrestling the cubs, who are large.

The sow knocks on the cabin wall. “Merle?” says the sow.

Merle doesn’t say a word. This is all wrong.

“Merle?” says the sow bear. She is talking in bear noises but it’s also words in his head. “Well,” says the sow, “you said you could read my mind.”

Merle does not answer. He shakes his head. “Kurt.” he whispers.

The sow bangs on the wall again with a great paw. “You said you’d always be my friend. I miss hiking with you. The rest of it, forget it. Phone, texting, the other stuff. Let’s just hike.”

Merle remains still.

The sow drops to all fours and then sits, her front paws on her back paws. The forest is greening at the tips of the conifers. The grass is electric green from the rain. Kurt and the cubs roll around. Kurt looks ok, really.

“I gave it 50/50 from the start,” says the sow. It’s a meditative growl, if that can be imagined. “I thought you could choose. It was a lie that you could read my mind. You read what you wanted to read. I let you. I thought you’d either keep your promise or break it. I thought you could choose, but maybe I am wrong. Maybe that’s the thing about trying to control other people: if you realize that they are not controlled, you never speak to them again.” The bear rocks forward and back a little. She does not look cute. She looks lethal and smells like bear.

Her mouth opens wide and tongue lolls. “After all, I think people can change and you think they can’t. If you change, then I am right.” She coughs. Merle realizes that it’s laughter.

One of the cubs barrels into her, rolling. She swats it away. Kurt is right behind the cub, but she catches him. She sets him aside, standing up.

“Up to you,” says the bear. She turns towards the woods to the north. Kurt gives a wave and he and the cubs scramble after her.

Merle struggles out of the dream like a diver coming up from the deepest possible dive. “Kurt,” he says, “you said you’d come back and tell me the truth.” He shudders and gets up.

I took the photographs in June 2017.