Bloodletting and Miraculous Cures

by Vincent Lam

  “Of course…well, he has no active homicidal or suicidal ideation so I suppose that is wonderful…in its own way. My differential diagnosis includes thyrotoxicosis, and a poisoning syndrome.”

  “Marvellous case presentation. I am pleased, Dr. Sri. Very pleased. You paint a good picture: a descriptive summary, appropriate inclusion of diagnostic impressions, and just enough detail to make it alive.”

  “Toxicology is not my strength.”

  “Hmm.”

  “But I can’t think of an agent that would produce these symptoms.”

  “Agent? Ah, the poison issue. Dr. Sri, I admire your open-mindedness. Youth, with the magical new experience of clinical pathology. You’ve heard that the sound of hoofbeats implies the presence of horses? It is true that we must look carefully for zebras, but for the most part we expect to find horses.” A grand smile.

  “So…what should I do?”

  “What, indeed? You are fortunate. A fine, fine case. Fascinating. You could wait years to see such a rich, exciting clinical picture. The mind—a force to behold. And so. What should you do? Examine carefully. Drink it in! Take full advantage of this educational opportunity.”

  “It seems like a psychosis, then?”

  “Amazing, isn’t it?” says Dr. Miniadis.

  “Should I consider neuroleptics?”

  “Remarkable drugs. Read up on the atypicals.” Dr. Miniadis taps the journal in front of her.

  “What about…. Well, the patient insists we test him for poisoning.”

  “Naturally. Zebras. Always, people are drawn to zebras.” She taps her fingers on the headphones.

  “Then I’ll send for a TSH, lytes, and a tox screen? The patient insists,” says Sri, almost apologetic. “It will satisfy his questions, and build trust.”

  “This is the dilemma, to build a rapport, to allow the legitimacy of experience, but never to speak of what is not real as if it were.”

  Sri is hesitant, sheepish in asking, “Dr. Miniadis, is there a drug that causes this?”

  “Causes what?”

  “What this patient has experienced—the temporary amnesia, the sleep disturbance. A new synthetic substance, maybe?” Winston had pressed Sri on this point, and because Sri was not certain in an absolute way, he had deferred the question, saying that he would ask his supervisor. “It is striking that the patient has insight into the disrupted nature of his thought process, but believes it is the result of poisoning.”

  She smiles, raises her hands as if to frame her face like flowers in a vase, and says, “Our world is mysterious. You’re doing well, Dr. Sri.” She places the headset on her ears, leaving Sri no choice but to exit the room.

  Morning crept up slowly, sneaky, until suddenly it was day.

  Winston had not slept since Halloween. He wrote in a scrawling, angry hand.

  November 4

  Claude goes to work so early? So chipper! Energetic!

  He drinks coffee, maybe. Coffee from grounds, grounds from beans. The beans are red before roasting, who told me that?

  That’s it, coffee. Shall you drink coffee?

  No, I need sleep. No coffee for me.

  Cigarettes, the calm. You’re out. Their noise, all night. Chitter chatter chipper chapper.

  The red car left a snake-trail of exhaust in the lane, which slithered its belly into the ground. Winston felt the shocking cold of the chair leg on his ankle. He curled his foot around the metal.

  The sheep jumping, that’s what I forgot. The jumping part. You forgot the jumping. Each part is crucial, evidently. So what if I sleep? Then what? So what?

  It’s not safe.

  THAT’s why I haven’t been sleeping, because it’s NOT safe.

  Sleep is an illusion of the happy, vulnerable people.

  Listen to those feelings, the inner leading voice.

  No. No. No. It’s perfectly safe, sleep is the safest thing, what am I thinking?

  It’s NOT safe.

  Who put that thought into my mind?

  It’s just NOT safe.

  No, it’s safe, who put that thought there?

  Where has slumber gone?

  Sleep is the escape that has escaped.

  Adrienne hummed. These soft morning throat-sounds were as close as if his ear were against her neck. Instead, they came through the ventilation grate. Winston crawled across the floor, heard Adrienne twist one knob of the faucet and then the other, the water rushing circles around the tub. He heard the shuffled thump-slap, thump-slap, thump-slap of her heel touching, followed closely by the ball of her foot. He crawled to the couch, took a pillow, placed it silently next to the grate, and lay there with his ear against the layered paint that smelled like rain falling on dust. Winston decided that it was okay, that there was nothing wrong with it, that he had been kept awake by Claude and Adrienne all night for three nights, and so there was nothing at all wrong with what was essentially the private pleasure of listening to her bath.

  In the clinic washroom, Winston produces urine for the drug screen, tucks himself in, and zips. The vial is warm in his fingers, his arm hot-achy from the bloodletting, staunched by a tightly taped cotton ball. The sign says 1: OPEN DOOR, 2: PLACE SAMPLE ON TRAY, 3: CLOSE DOOR SECURELY. This little square door in the wall is just big enough to allow a hand to enter. Winston opens the door. In the passage, there is a small plastic tray for the urine sample. Winston sees the latch of the door on the other side of the wall, and wonders whether the door was closed before he pissed, or whether he might have heard this little door open while he was pissing. Could someone peer through here? He should have watched the actual door while he was standing, legs apart, in front of the toilet, though aim would have been an issue. The latch could probably be popped from the other side with a strong thumb. Clever, how they put it behind where a person stands, so you don’t necessarily see if someone peeks. He could try to open it from this side, but then they would see him checking it out, and if someone had peeked, they would know that he knew. The thing to do is to pour. Yes, to use the sample vial to pour a thin stream into the toilet and see if, at the moment when someone might presume that he is turned to face the toilet, the door clicks open. Winston thinks of opening the vial, of pouring his urine into the toilet while watching the door. Except his bladder is now empty; they will be suspicious if he is too long in the bathroom, and maybe it is safer to play along. He places his vial on the tray. Closes the latch. Goes back to the doctor’s room, sits nonchalantly as if everything is just fine and above suspicion, waits for Dr. Sri to return.

  Winston had not slept since Halloween, and with the desperate, grating morning came the shamed anticipation of Adrienne’s bath, a further embarrassment. Claude’s feet descended the two flights of stairs, accelerating in a drum roll. Winston wrote.

  November 5

  I confront them today.

  This may be deliberate.

  They must know that I hear.

  Last night, their sounds were strange. The baths: Adrienne hears me listening. She knows. Should I speak to Claude? Maybe Claude, but if she heard me and she told him, then he will kill me. It’s just bathing sounds. The sound of water soothes me, I’ll tell them.

  He is bigger than me.

  They’re talking. They know.

  Winston sat at the kitchen table, which was covered in a green faux-marble surface and rimmed by a gleaming chrome band. It, and the chairs, were part of a set. Winston watched the departure of the red car. The window was rolled down and Claude’s left elbow was perched on the door.

  It should be Claude that I speak to. No. Better to speak to Adrienne. She knows, of course. What will she say?

  How would she know?

  Know about the talking or about the baths? Maybe she wants me to hear the bath, could that be? No, NO! That would make it wrong, make her ugly. This is about the talking. You need to discuss. Focus and discuss. Talk about the noise. Yes, thank you, talk about the noise at night. Really, it’s a noise issue. The bath is separate, but if sh
e knows I hear the talking she will know about the bath, but that is nothing.

  Yes.

  It’s a shared house, which should be quiet. A noise issue, yes—primarily one of late-night quiet. Crucial for sleep.

  Later that morning, on the third floor where there is no landing but only the stairs leading abruptly up to the apartment, Adrienne opened the door.

  “Hi, Winston, come on in.”

  “I shouldn’t.”

  “You’re going to stand there?”

  “It’s just something, a little thought I wanted to sort of mention quickly, so I shouldn’t come in.”

  “What is it?” she smiled, which made him feel very badly but also glad and a little bit hopeful about lying there next to the ventilation grate each morning.

  “It’s about the house really, it being an old house and everything and you know how old houses weren’t really designed to be separate apartments so some things are a bit wonky and haphazard like the air ducts and noises and plumbing and I’m a light sleeper so if noises are an issue it’s really an issue, so I—”

  “Step inside? I made tea. It’s steeping, and there’s a cup with your name on it.”

  “Sure.”

  Adrienne brought Winston’s tea the way he liked it—a drop of cream and three sugars. They sat across from each other in the living room, and Winston had the anxiety of desiring comfort, of knowing that Adrienne was one of only three people in the world who knew how he liked his tea, the others being his mother and himself.

  Adrienne looked at him as she did whenever he dropped in, which was as if she had known all along that he was coming, and she saw exactly what was in his mind, and she understood precisely what would make him happy but was forbidden from telling him because to do so would deprive him of an important challenge.

  “Did you have a good time, the other night?” she asked.

  “What?” he said, always startled when she asked an opinion of him. It was his favourite tea—Earl Grey. She must have known that he would be coming upstairs.

  “Halloween—ghosts are so classic. Especially with flowery bedsheets.” She raised her teacup slightly to Winston in salutation of his superb costume choice, blew the top layer with a long breath, and sipped.

  “I had a great time. Thank you.”

  “Everyone said you were so funny. You were all right in the morning? I guess you don’t normally drink that much, but there’re nasty drunks and there’re funny drunks, and everyone loved you, said that you are definitely in the funny category. How did you feel the next day?”

  “About the same.” Winston remembered the first drinks, the pitcher of blue fluid with cherries floating in it, and then the next morning waking up in his own bed. He wished he remembered being funny and loved, just like she said.

  “You had to be put into your bed, hope you didn’t mind.”

  Winston was about to ask who had tucked him in. Was it her? Or her and Claude? Or the partygoers as a group? Or Claude alone? Or her alone? Instead he said, “I’ve had difficulty sleeping.” He now suspected that she had noticed that he had observed that she was not wearing a brassiere. Perhaps she saw that he had reddened, or at least he presumed this from the heat on his cheeks. She didn’t cross her arms or turn to the side despite any attention of his that she may have become aware of. He looked into his tea.

  He sipped. The tea was perfect.

  “I used to have that,” said Adrienne. “Is it because you’re excited about something, or you just can’t let go?”

  “Neither.” Now Winston realized that he could not blurt out that his state of insomnia was fuelled by her and Claude talking through the night. Sheep or no sheep. Perhaps he had heard facts that he should not know, ideas that would be dangerous. He had not been able to detect the actual words. He did not understand why he could not make out the words, but he couldn’t, so maybe there was no danger? However, they spoke softly, mumbling-like, certainly of dark secrets next to which his life would be of little comparative value. He had come very close, too close to revealing himself, and with a sudden panic he jumped, spilled tea on his knee. “Something urgent. Important. I remembered. Have to go.”

  “Are you all right, Winston?” she asked.

  He tumbled downstairs, locked the door of his apartment behind him. Sat behind the door, a narrow escape. Could not remember if he’d put the teacup down, or if he’d spilled it on the floor and owed an apology.

  Sri pauses outside the door of the examining room. Of course Dr. Miniadis is right, he assures himself. Horses. Winston jumps when Sri enters the room, and Sri is unsure whether this is a startle of suspicion or optimistic anticipation. Sri sits, wonders if he should have googled “recreational amnestic.” He becomes aware that Winston is waiting for him to speak.

  “You should come into hospital,” says Sri. “A specialist will take care of you.”

  “A poisoning expert?”

  “An expert in your type of situation.”

  “In poisoning,” says Winston, satisfied.

  “Your kind of experience…we find is best addressed on the psychiatry ward. They are concerned not only with poison but with the mind.”

  This is unnecessary, says Winston in a rush. With the test results, can’t they simply administer the antidote? The poison, he says, keeps him from sleep, slows the mind, disrupts the form of his thoughts. Sri chooses his words carefully, speaking in the third person. He explains that situations similar to Winston’s are carefully examined on the psychiatry wards. Winston says that he is not crazy, not loony, not bonkers, not asking for a miracle but only for a cure, which is what any poisoning victim wants. Sri speaks in low, measured tones, asks him if he will take a medication. Sri feels his own heart pounding, remembers that they are taught to speak in the mood they wish the patient to absorb. Winston says that this, at long last, is what he has come for: the antidote. Sri writes on a prescription pad. He tears off the prescription, holds it in front of himself like a peace offering.

  Before Sri can explain the prescription, Winston says, “That little door in the bathroom: the inside door opens from the outside, right? Who watched me take a leak?”

  “What door?”

  “I’m not saying you, or any specific person specifically, although if you did need to watch me pee for a bona fide medical reason I suppose that’s cool but you should let me know about it. I’m not freaking out or anything—I’m just telling you I don’t appreciate it.”

  “Didn’t you close the door, Winston?”

  “Don’t play dumb. The cubbyhole door, where you put the pee.”

  “The passageway for the urine sample?”

  “Naturally, it concerns me, as it would concern anyone, that someone watched my urination.”

  “No one watched you, Winston.”

  “I’m trying to be polite about this.”

  “What would you do if you found out someone were watching you?” asked Sri. He thought of the criteria for admitting someone to hospital against their will: danger to self, danger to others, failure to care for self. “Do you feel so frightened that you might do something…physical…to protect yourself, for instance?”

  “I need to protect myself?” says Winston. “Am I being watched all the time?”

  “I’m not saying that. I’m asking if you feel a need for self-defence?”

  “How should I defend myself?” says Winston.

  “That’s not what I’m suggesting, but have you thought of it?”

  “You know, Claude and Adrienne live just upstairs.”

  “I know,” says Sri. “Do you think they watch you? Would you defend yourself against them?”

  Sri listens for a clue, some indication of an impending debacle which will allow him to keep Winston involuntarily. He feels guilty, as if he is circling Winston with a lasso.

  “So I am watched, then.”

  “I want to know what you would do if you were really convinced that someone was watching you.”

  But then, what does
one do with a horse that thinks it is a zebra? Sri throws the lasso wildly, saying, “Are you so scared that you would try to kill yourself, or maybe someone else?”

  “Kill myself?” says Winston, alarmed. “Are you crazy? The surveillance is worse than I thought. So just tell me, what’s the big deal about seeing how I pee?”

  “I can attest that no one watched you in the bathroom, but—” and he thinks of leaving aside the issue of the cameras, but to hide something now could lead to problems later. “Someone is viewing us right now, of course, but that’s different. We have a camera system…anyhow, you know about that, don’t you?”

  “What?”

  “Cameras. Not in the bathroom, but all these rooms are, let’s not say watched, let’s say monitored.”

  Winston looks around quickly, realizes that he is seated far from the door, that they are on the third floor, that it is too high to jump out the window, that the architecture has trapped him, and that he is correct. He knew that he was being watched.

  “Then I have to be careful,” he says, whispering to Sri, already half-standing to leave.

  “Didn’t you read the signs in the waiting room? This is a teaching facility, so there’re cameras running. But it’s not someone ‘watching’ you in the sneaky way you feel that someone is watching. It’s a routine, normal part of our teaching institution. It’s a person, a real person. Dr. Miniadis is the supervising physician today, so she can see all the rooms. There’s the camera.” Sri points at the one-way mirror that shields the lens. “It’s a physical camera, with wires, and it’s really there, but not the way you think someone is watching you. You know what I mean?”

  “That’s exactly what I feel, that someone is really watching me.”

  “Now, to be honest, often Dr. Miniadis doesn’t watch.” Sri says this in complete confidence that she never turns away from her headphones and her music, and therefore does not hear him give this explanation.