by Barbara Ebel
“Since Friday, you’ve done fine. I ordered that postoperative angiogram yesterday to make sure the surgical clip I inserted completely treated the aneurysm. It did.” Danny beamed.
Garret nodded’ he’d had faith in his surgeon and Dr. Tilson had delivered.
“You haven’t had any strange movements,” Danny continued, “like a focal seizure or a headache or a drastic problem with your speech since I saw you yesterday?”
“No,” he said pleadingly as if begging to leave.
Danny smiled. “I’ll be happy to write your orders and you’ll sleep in your own place tonight.”
“You don’t say,” Garret said. “So when can I …?” He seemed to lose his thought like pollen in a breeze.
Danny waited. He believed Garret’s thought process was the same preop as it was now postop. And if he hadn’t had the surgery - if the aneurysm had ruptured - his mind would have been much worse; perhaps like a post-stroke victim with a very bad outcome.
Mr. Archer tapped his fork. “The most important two things. When can I ride my motorcycle again and when can I go to the gym?”
“Here’s the deal. I don’t want you to do either. Not yet, anyway, because I’m sending you to a neurologist for a work-up. Your preop radiology exams showed an irregularity. Don’t worry, your surgery went fine and I’m not hiding something like a diagnosis of cancer or anything like that. I want to consult her, that’s all. We’ll put our heads together and then I’ll see you back in my office.”
Garret made a face and pouted his lower lip as if he was twelve years old. “Jeez, doc, you’re taking away my art of living.”
-----
At the nurses’ station, Danny wrote discharge orders. He contemplated his next step because he missed the neurologist he had worked with for a long time; the old man had retired but had been a valuable member on Danny’s team regarding the awful organism responsible for a pandemic a year ago.
Making a decision, Danny called the operator to patch him through to the newest neurologist’s practice.
“This is Dr. Tilson,” he said when someone picked up. “May I speak to Dr. Banks?”
“She’s between patients so, hold on, I’ll hand her the portable phone.”
“Dr. Tilson,” said a perky voice with a slight Boston accent. “I’ve been here a few months and we’ve come and gone at meetings, but we haven’t had the opportunity to cross paths on patients.”
“So true,” Danny said after she left a quiet gap. “I think that’s about to end.”
Although he’d heard about her already as new doctors’ credentials always preceded them, they still had to prove themselves even if they’d done stellar work somewhere else. No newcomers were given a pass. Danny knew this was her second practice; she’d left the first because she’d asked the head partner for more money. Apparently, another male neurologist in the group was making more so, when they didn’t pay up, she left.
Penny Banks said, “Please go on.”
“I’m calling about a patient named Garret Archer. He’s fifty-one and he came in with symptoms from a large aneurysm of the anterior cerebral artery right at the medial portion of the frontal lobe. He’s postop day four from a successful aneurysm clipping and I’m sending him home.”
Danny continued, “But there are more physical findings. Distal to the aneurysm the artery basically died out without further distribution to that area of the frontal lobe. Like a deer who can’t regenerate its antlers. So here’s where you come in. That area not being fed by an artery, not surprisingly, is suffering from brain atrophy.”
“And you’d like me to test Garret Archer’s speech, motor skills, social behavior, spontaneity, impulse control, memory, problem solving, language, and more?’ Dr. Banks asked.
Danny laughed. “Yes, do a neuropsychological evaluation.”
“So we can correlate the physical with the functional?”
“Absolutely.”
“Send me everything you have,” she said. “You know you’ve heightened my curiosity.”
“I was hoping you’d say that. After you look at the arteriogram and see him, I wonder if you’ll be as perplexed as me. A fifty-one year old health nut with a dried up anterior cerebral artery. What caused that?”
Chapter 12
Horrified, Rachel stared in front of the mirror. If the surgeon had successfully put her face back together again, there was no evidence of it. Prior to her surgery the night before she wore purples, blues, greens and yellows, but - this morning - they were richer than any rainbow she’d ever seen and her facial aureate brilliance didn’t look becoming either. Rocky Balboa never looked this bad.
Secondly - as far as the swelling – Rachel knew about the exact organism she now mimicked. Oh, yes, she knew all about pufferfish. They could ingest huge amounts of water in their elastic stomachs to turn into a huge ball multiple times their normal size to outsmart their fishy predators … she was now a human with a pufferface.
Thirdly, the right side of her upper lip looked half as big as it should be. What did the doctor do, whack off part of it? In addition, what felt totally weird was the inside of her mouth between her gum and upper lip. She rolled her tongue along a mound of tissue which either grew there or was put there.
Lastly, where did all the feeling go in her face and upper lip? Unless she was still under the effects of some local anesthetic, she was number than if she’d been held hostage in a freezer!
The only saving grace she saw in the mirror was her aqua eyes. But since everything else looked so bad, who would notice them anyway?
Rachel heard noises outside the bathroom door and pushed it open.
“Good morning, Ms. Hendersen.” Her oral and maxillofacial surgeon, Dr. Pain, gave her a smile and his nurse stopped their rolling cart which carried patients’ charts.
“That’s easy for you to say,” she sneered and said. “You have a lot of explaining to do. Why do I look worse instead of better?”
“Please, sit down,” he said softly. “You should know from your operating room experience that the bodily colors we sustain from major trauma take time to get better.” He looked pleadingly at her. He’d been having a good morning and he didn’t want grief from some previous ‘beauty queen’.
“The good news is that your facial nerve and its branches looked intact. I know because I peeled up from the inside of your mouth to put several titanium plates there to secure your maxillary bones. I went further up on the right side closer to the orbital rim than I’ve ever done with any patient. Other fractures will heal as best as they can. However, you may not have much integrity to your sinuses the rest of your life.”
The doctor was soft-spoken and kind of cute with sun-streaked, straight brown hair. So Rachel held back on a total tirade and shook off her thoughts as now wasn’t the time for spinning men into her web.
“What about this fleshy bubble I have under my lip?” She half-heartedly pointed to it.
“Since that’s where I had to go in and up, that’s where I had to bring the tissue back together and suture. It’s a frenulum. Once you get feeling back, we can see how much that subsides and if it’s too bothersome for you. Also, it will take time for the damaged nerves to rejuvenate.”
“So I’ll be numb for weeks?”
“Probably more.”
He smiled and took the chart from his nurse. “The good news is that I’m discharging you today. I’ll see you back in my office in one week and then once a month, probably for two or three months. You’re on medical leave from your job until I give you clearance. Any questions?”
“You don’t have an office in Knoxville, do you?”
-----
As soon as her surgeon and the nurse left, Rachel picked up the phone. She didn’t have a choice.
“Officer Parks,” she said when someone answered at the sheriff’s office. The call was transferred and she was greeted with “Parks here.”
“Evan, good morning. It’s Rachel.”
“Ho
w are you? I was going to call today to check on you,” he said rolling back from the desk, putting distance between him and an overdue report.
“I had surgery last night. I’m doing so well, they’re discharging me today.”
“That’s good to hear. I put faith in your Dr. Tilson that he would find a good surgeon for you. He seems like a decent man.”
She caught her breath from his remark. “As you know, I don’t have my car.”
“I understand. I get off at three o’clock. The earliest I can be at the hospital over there is around five. If you have to leave earlier or have another mode of transportation, I’ll understand.”
“I can’t think of a safer way to be escorted home or by anyone more courteous than you. I’ll see you later, then.”
-----
It wasn’t easy being discharged with nowhere to go. Per hospital rules, they had to put Rachel in a wheelchair and roll her to the front entrance. She insisted her ride would be there shortly, got up and sat on a sofa in the front lobby. However, she still had almost two hours to wait before Evan showed up.
A call from Danny preoccupied her for at least a few minutes. “Have you been discharged?” he asked.
“Yes, and I’m sitting in the hospital twiddling my thumbs waiting on Evan to bring me to Knoxville. I didn’t think I could arrange a short visitation with Julia.”
“That’s true. So say hello to your policeman friend and, if you want to see Julia when you have your postop appointments, give me advance notice.” He felt bad enough that she couldn’t have killed time in his office with their child but he’d done enough in the last day or two; his family needed to see him more than Rachel did.
Rachel hung up. Waiting was hard enough but the stares from people walking by were despicable and she wondered about her status with Evan. Was he simply going to provide transportation or were things going back to the way they were?
-----
Evan pulled the car up to the front entrance and held the car door open. As the late rays of the sun caught his blonde hair and mustache, she thought he grimaced while contemplating her face. Once on the road, the heavy traffic leaving the city slowed them down and Evan barely said a word until they neared Knoxville.
“I spoke with Leo Ramsey’s prosecuting attorney yesterday. He will be calling you or me about your testifying - anything you might know about the defendant’s history of date rapes and, of course, he’s going to consider your daughter’s plight as well.”
“Great,” she mumbled. She looked over at him, appreciating his boyish dimple which made him look younger. He hadn’t changed out of his work clothes either. Perhaps it was true that women prefer men in uniform.
Small talk wasn’t one of Rachel’s gifts and she floundered to fill in the silence as they approached her apartment.
“I hope you don’t mind, Rachel. The way I see it is that we should be friends from here on in. I’m not interested in any romantic entanglement at this point in my life.”
She plugged her tongue into the area her surgeon called a frenulum and sucked on it; apparently she wouldn’t be sucking on anything of his anymore. Oh, well, his loss. She recovered quickly.
“Thank you so much for the ride, Evan. That was a lot of trouble for you. Take care, now, and don’t do anything I would.”
She grabbed her bag off of the floor and opened the door before he got out. As she pushed it closed, she didn’t bother to smile. She looked like hell anyway.
-----
When she got into her apartment and unpacked her few things, Rachel rustled through her DVD collection. She picked out “Rocky” and then went into the kitchen and lined up the only soft food she had. When she got comfortable with the movie playing, her situation was worse than she thought. She could barely eat a thing with the soreness and puffiness, along with the pain she experienced in her teeth. Using a straw helped out with liquids but yogurt would barely slide from the spoon into her mouth. Great, she thought. She hadn’t planned on dieting anytime in the near future.
Another concern popped up. She probably had limited medical-leave pay and - on top of that – those medical bills had to be paid and they’d surely be hefty.
As the evening unfolded, the darkness settled in on her apartment and Rachel didn’t feel like turning on lights. Her relationship with Evan Parks had been going along quite nicely until now and she had counted on living with him in a few months; she hadn’t planned on it ending.
Anger welled up in her stomach and she wished it could be vomited up like she’d done with the blood from her guts two days ago. As her temper subsided, Rachel took a downturn into despondency. She curled up further into the couch and turned up the volume to keep from focusing on her own thoughts.
She was glad she did. As she honed in on Sylvester Stallone’s accent and dialect, Rocky got ready to deliver one of her favorite scenes and she listened to every word:
“The world ain't all sunshine and rainbows. It is a very mean and nasty place. It will beat you to your knees and keep you there permanently if you let it. You, me or nobody is going to hit as hard as life. But it ain't about how hard you're hit, it is about how hard you can get hit and keep moving forward, how much can you take and keep moving forward. That's how winning is done!”
Rachel could have kissed the Philadelphia boxer where it mattered most.
-----
Danny and Casey parked and walked along the tree-lined street until they arrived at the nondescript glass front of Serious Gyms. Danny pulled open the heavy door and the two of them entered to the expending energy of the after-work crowd as they sweated all over the equipment.
“I called before we came,” Casey said, “to check if the personal trainer would be available. You did look a little wimpy on the bike the other day. Maybe you’d like to work with him; tailor a program to your one or two visits a week and he can gear it to a beginner. You’d be starting out on the right foot, doc.”
Danny lifted his head after signing in at the counter and gave a hearty chuckle. Casey never called him that.
“You know best. This is all your idea anyway.”
“His name is Rob King. He’s right over there,” Casey said, waving.
“Great,” Danny said when he saw the trainer. “I’m going to be Superman’s pupil.”
“I’ll be here,” Casey said as he walked off to the cardiac machines to warm up before doing some serious weightlifting.
Danny extended his hand to Rob. “Danny Tilson. How about working with me on a limited basis since I need a game plan on aerobic and anaerobic fitness?”
“I would be happy to,” he replied in a deep voice. Deep enough, Danny thought, that the trainer may drink testosterone.
“Let’s go over here. Today, I’ll evaluate you to gauge your strengths, weaknesses, and your fitness level.”
Danny estimated King to be about thirty-five years old; with a long face and a pointed nose, his 200-pound frame had a broad neck and sloping shoulders like many body builders, a look he didn’t desire. Not that he’d ever have it anyway.
The two of them sat down at one of the tables. Rob had a packet of papers and asked Danny a series of health questions; then, he marched him back to the equipment. Rob showed Danny how to use certain machines but also tested his muscle strength and conditioning.
Danny was impressed at the thoroughness of his new trainer but, finally, put his hand up as a signal for a break. He picked his water bottle up and took a big swig while Rob took a long drink from the tall can. Then, Rob grasped two dumbbells with different weights.
“Start with the smaller and let’s see how heavy you can go. Do one after the other of these,” he said, demonstrating. With one arm, he did a biceps curl and with the other, a triceps extension. He wore a sleeveless, gym logo shirt, and Danny noticed the bulk of his muscles.
“Your turn,” Rob said, egging Danny on after he’d replaced the weights on the rack.
Danny’s surprise registered on his face. “Besides the good c
ondition you’re in, that was impressive from a neurophysical perspective.”
“How so?” Rob rolled a fitness ball a few inches, sat on it and propped his sneakers on the exercise bench.
As Danny’s eyes widened, he responded, “There was a twenty-pound weight difference in those dumbbells and yet you grasped both of them as if they were identical and proceeded to do a different work out with each arm. Normally, people can do each task at one time with one or both arms, but not two separate arm tasks so smoothly at the same time … especially with two different weights.”
“In other words,” Danny said, “your grasping and manipulating of objects or your motor and visual skills - are amazing. Looks like your spatial awareness, balance and coordination are stellar, too.” Danny laughed. “Can you teach me all of this?”
Rob shrugged his shoulders. “Comes with the territory. Here, do one task at a time,” he said, handing Danny the dumbbells. “Biceps curls.”
-----
“Take your time,” Danny said. Casey was working his abs on the floor mat doing three-quarter sit-ups as moisture accumulated between his tee-shirt and the waistband of his shorts.
“I wish my abdomen looked that good,” he mumbled walking towards the table area. He filled his bottle at the water fountain and sat down as a familiar face came in the front door.
“Isn’t this unexpected providence?” Varg Dagmar exclaimed with a grain of salt and held out his hand.
Danny laughed. “I’m sweaty,” he said, turning his palm over.
Varg grasped his hand anyway and gave it a hearty pump. “I wouldn’t guess this to be a stomping ground of yours, so I bet you are here because you need a luxury lakefront getaway.”
“Funny you should say that,” Danny replied.
Without missing a raindrop in a downpour, Varg said, “I will personally develop a tailored list for you and screen every single place myself. Your time is precious, Dr. Tilson, and I will not waste one millisecond of it.”
Casey swallowed from his water bottle as he stepped up to their table.