Royal Pains

by D P Lyle

  “I told you, nothing is silly. If you’re worried, I’m worried.”

  It took a couple of minutes to hook up and record Ellie’s EKG.

  “Looks good,” I said. “Except for a few of those PVCs. You’ve been taking your beta-blockers every day, haven’t you?”

  Another mischievous twinkle. “I might have missed one. Maybe two.”

  “Didn’t I tell you not to do that? That you’d have more symptoms?”

  “Yes, dear, you did. I’ve just been so busy with all this.” She waved a hand toward the wall of windows.

  When I first came in, I hadn’t noticed the half dozen workers shoveling dirt and pushing wheelbarrows around. One of them hugged a large shrub to his chest and moved out of sight to my left.

  She saw my gaze. “They have to dig up part of the garden, I’m afraid. To put in a dance floor for the wedding.” She sighed. “I’m sure it will rain and Nicole and her friends won’t get to use it.”

  “Bet it doesn’t.” I smiled.

  “The usual?” she asked.

  “Sure.”

  We shook on it.

  Ellie loved little bets, a dollar only. Laughed whether she won or lost. We’d wager on all kinds of things. The weather, whether the Dow Jones would be up or down the next day, the winner of some sporting event, college football with her beloved Longhorns being her favorite. I was never much of a gambler, never saw the fun in it, never had the money to lose, but this I considered part of the service. Laughter is good medicine, a great stress reducer, so making Ellie laugh was part of her care.

  “Promise me you won’t let this wedding drive you crazy,” I said.

  “It’s not the wedding. The party part anyway.”

  “Then what?”

  She sighed again. This one longer and deeper. “I wish she was marrying someone like you and not that . . . that . . . I can’t even think of the proper word.”

  “I thought you were happy she was getting married.”

  “I am. Just not to him.” She shook her head and her gaze dropped to her lap. I could see the stress lines in her face deepen. “I mean Robert’s a decent enough fellow and he seems to adore Nicole.”

  “Then what’s the problem?”

  “Unfortunately he’s a clone of my son-in-law, Mark. A Wall Street lizard. Robert even works for Mark. Both of them are too wrapped up in money and status.”

  “Hard not to be around here.”

  “Doesn’t mean I have to like it.” Her shoulders relaxed and she laid her head back on the sofa cushion. “This wedding is just too much.”

  “No, it’s not. I know you. This is what you live for. Putting on better parties than anyone.”

  She raised her head and smiled. “I do, don’t I?”

  “Yes, you do, and I’m sure this one will be no different.”

  My cell buzzed. I checked the screen. Divya. I stood. “I need to take this.”

  Divya Katdare, my physician assistant, is pretty and smart. Too smart to be working for HankMed, the name my brother, Evan, gave to my practice. Divya had the smarts to do anything she wanted, but for some reason this seemed to be her passion. Not that her family agreed. They’re old country. Think she should attend polo matches and charity events, not serve the huddled masses. Divya saw things differently, so she joined HankMed. Not that I had a choice. She didn’t so much apply for the job as create it. When I said I didn’t need a PA, she ignored me and jumped on board anyway. She doesn’t accept no easily.

  Before I could even say hello, Divya began talking. Rapidly. Not making much sense, but here’s what I got: Ben Kleinman, the fourteen-year-old son of one of my patients, and three of his friends tangled with a swarm of jellyfish. Stung from “top to bottom,” as she put it. Ben had called asking her what to do, so she drove to the beach to check him and his friends out.

  The real problem? Evan came with her and now he wanted the boys to pee on one another. He was ranting about something he had seen on TV that suggested urine would take the sting out.

  Did I mention that my brother is an idiot?

  “Get down here and stop him,” she said.

  “Okay. I’m leaving right now. Tell Evan not to pee on anyone in the meantime.”

  I glanced at Ellie as I closed my phone. She raised an eyebrow.

  “Your life is so exciting,” she said.

  “And with a brother like Evan it can be trying.”

  “Evan is sweet.”

  “Not exactly the word I would use about now.”

  Ellie laughed. “You run along. I’m fine.”

  I gathered up the EKG machine and medical bag. “Call me if you have any other problems.”

  As I started toward the door, she said, “My granddaughter and her best friend, Ashley, are driving out from the city today. They’ll be staying here until the wedding. We’re having a little welcoming party tonight. Nicole’s invited some of her Hamptons friends over. I want you to come.”

  I hesitated. “I’ll try.”

  “Don’t just try. Be here. It’ll be fun.” She laid one hand over her chest. “Besides, with all the stress of entertaining I might have more palpitations. I’d feel better if you were here.”

  “Okay. What time?”

  “Say seven. Bring Divya. I haven’t seen her in a while.”

  “I’ll ask her.”

  “And that beautiful young lady of yours. What’s her name? The hospital administrator?”

  “Jill.”

  “That’s right. I don’t know why I can never remember her name.”

  “I’ll ask her, too.” I started toward the door.

  “And Evan and his girlfriend, of course.” She shook her head. “I must be getting old. I can’t remember her name either.”

  “Paige,” I said. “I think she’s leaving town today. Or maybe it’s tomorrow. I’ll ask Evan.”

  “Bring him regardless.”

  “I will.”

  Chapter 2

  I found the boys on the beach, just below Panama Joe’s Crab Shack, a local restaurant famous for its fresh seafood and Mexican beer. They were sitting on towels and seemed very uncomfortable. Jellyfish stings will do that. Evan was still extolling the benefits of urine.

  “Yes, it does work,” he said.

  “No. According to The New England Journal of Medicine , there is no evidence that it has any benefits whatsoever,” Divya said. “Except perhaps to humiliate the victim.”

  “You’re a PA. That’s with a little p for physician, and a big A for assistant.”

  “It would seem that in this case I know more than you.” Her chin jutted toward him.

  “You two knock it off,” I said.

  They both turned toward me, finally noticing I was there.

  “Tell your brother that this is a medical issue and not a CFO problem,” Divya said.

  Evan is CFO of HankMed. A position he gave himself. I’m still not sure exactly what he does to earn the title, but it’s better to let him have it than argue.

  I raised a hand. She fell silent. Evan adopted a smug look. I turned to him.

  “Are you crazy? Trying to get a group of fourteen-year-olds to urinate on each other?”

  Divya stood with her arms crossed; the smug look had now migrated to her face.

  “It works,” Evan said. “Joey and Chandler said so.”

  “Who?” I asked.

  “Joey and Chandler. Friends. Remember that show?”

  “Of course I know the show, but what does that have to do with this?”

  “In one episode Monica got stung and they said urine was the treatment. Joey’d seen it on the Discovery Channel, so it must be true.”

  “Let me see if I understand you correctly,” Divya said. “You obtain your medical knowledge from a sitcom?”

  “And the Discovery Channel.”

  Divya rolled her eyes. She can say more while saying nothing than anyone I’ve ever known. A look, a glance, a roll of her eyes, a fixing of her jaw, and it’s impossible to miss
her point.

  “No more about this,” I said. “No one is going to pee on anyone.”

  I knelt next to Ben. “Let’s see what we’ve got.”

  I peeled away the towel he had wrapped around his leg, exposing an area of acute erythema—a bright red splotch—the size of my palm just above his left knee. Several equally erythematous streaks spiraled downward, around his calf, reaching his ankle. He had contacted the jellyfish’s body and its tentacles had latched on. He had apparently managed to kick it free, but it left behind its angry red calling card.

  I examined the other three boys. Each had similar splotches and streaks of angry flesh.

  “Looks ugly,” Evan said.

  “And it stings like crazy,” Ben said.

  He started to scratch one of the streaks, but I grabbed his hand. “Don’t do that. It’ll get infected.”

  “But it itches and burns.”

  “I know. Just give me a minute and we’ll take care of it.” I turned toward Evan. “Here’s what I need. Some baking soda, a knife, a small bowl, a bottle of water, and some vinegar.”

  “Fresh out of all that. Got plenty of urine, though.”

  Stubborn. Aggravating. Exasperating. There are so many words to describe my brother.

  I nodded toward the restaurant. “Why don’t you ask them? I’d bet they have everything I need.”

  “You want me to go get that stuff?”

  “I can’t leave you here. You might pee on somebody. Yes, go get it.”

  I looked at Divya. “Do you have any one percent hydrocortisone cream in your SUV?”

  “I’ll get it.”

  While waiting, I called Ben’s dad, Mort, a big-time investment banker, and told him what had happened, assuring him that Ben was okay, just uncomfortable. Mort was in the city and said he’d deal with his son’s stupidity later. He thought it might do Ben some good to hurt for a while, but he did give me permission to treat the poor kid. He also said he knew the other fathers and that they would want their boys treated as well. I hung up.

  “What were you guys doing?” I asked.

  “Racing out to the buoy and back,” Ben said. “We’ve done it before.”

  “Water’s pretty cold.”

  “Not that bad.”

  “Who won?” I asked.

  “Jerry.” Ben nodded toward Jerry, a redhead with pale, freckled skin. On such fair skin his welts appeared even angrier than those on the other guys.

  Evan and Divya returned and I went to work.

  I mixed some baking soda with water in the bowl until it made a white paste. I smeared this on Ben’s wounds. I then took the knife and gently scraped the paste away.

  “What are you doing?” Divya asked.

  “Jellyfish tentacles leave behind little venom-filled capsules called nematocysts. The paste locks in the ones that haven’t yet released their toxin and the blade scrapes them away.”

  “Clever.”

  “Then we wash it with the vinegar and apply some of the hydrocortisone cream. All will be as good as new in a few days.”

  “Good,” Ben said. “Because I want a rematch.”

  There is nothing more stupid than a fourteen-year-old boy. All that testosterone and no brakes. It’s like having a Formula One car without a driver’s license. I was sure Ben’s father would tell him not to pull this stunt again. I was sure Ben would listen attentively, agree it was stupid, and swear he’d never do it again. I was also sure Ben and his buddies would indeed have a rematch. It’s a guy thing. We simply can’t walk away from a competition.

  Testosterone is a dangerous drug.

  Chapter 3

  “The urine would’ve worked just as well,” Evan said.

  “No, it wouldn’t have,” I said. “It’s mostly water.”

  After we returned the bowl and knife to the restaurant, we decided to stay for lunch. The manager, Will, a young man with tousled blond hair and a year-round tan, thanked us for helping the boys. Seemed that Ben’s dad, Mort Kleinman, owned Panama Joe’s. I’d been his doc for a year and I never knew that. But since Mort owned everything from strip malls to high-rise office buildings, I wasn’t surprised.

  Will gave us a prime umbrella-shaded table on a weathered, wooden deck that extended out over the beach and told us lunch was on the house. Not a bad deal.

  Evan would not be deterred. “Chandler said the ammonia in it would kill the stinging.”

  I couldn’t believe he was still on this. Wait a sec, of course I could. We’re talking about Evan here. He gets something in his head and he won’t let go. Been that way since we were kids.

  “Somehow I don’t see Joey Tribbiani and Chandler Bing as medical authorities,” I said.

  “Those TV guys research this stuff,” Evan said. “They wouldn’t put it on the air if it wasn’t true.”

  “You actually believe that?” Divya asked. “Do you not see the flaws in that logic?”

  “They have a staff that digs up all this stuff.”

  “Perhaps you should watch less TV and read a few medical texts,” Divya said.

  “Do you have any of those?”

  “Of course. I’m a trained professional.”

  “Maybe I could borrow some of them.”

  Divya frowned. “I doubt you would understand them.”

  “Sure, I would.”

  Divya smiled. “Really? What is amyotrophic lateral sclerosis?”

  “Something bad, I’m sure.”

  “It’s Lou Gehrig’s disease,” I said.

  Evan’s brow furrowed and he hesitated a beat. “What did they call it before Lou Gehrig?”

  Divya shook her head. “What do you think?”

  “That amyo-thing.”

  “Like I said, you’d never understand them.”

  “Okay, Ms. PA,” Evan said. “What’sa P and L statement?”

  “Profit and loss. It’s a measure of a company’s past performance and helps investors project future cash flow.” She leaned back, crossed her arms over her chest, and aimed her chin at him. See what I mean? A gotcha without saying a word.

  Evan stared at her, apparently at a loss for words. Finally he said, “That one was too easy.”

  “My father taught me finances at a very young age.”

  Evan was saved when our waitress appeared. She was blond and tanned. Could have been manager Will’s twin sister except her eyes were bluer and her smile was brighter. She wore jeans and a brilliant yellow Panama Joe’s T-shirt. Her name tag read: HELLO. I’M MIRANDA.

  “Will said you’re the guys who helped Ben and his friends,” Miranda said.

  “That’s right,” I said.

  “He and his buddies hang out here all the time. I heard it was jellyfish.”

  I nodded.

  She winced. “Been there. Hurts a lot.”

  “They’ll be okay,” I said.

  Evan jumped in. “Miranda. That’s a beautiful name.” “Thank you.”

  “Evan R. Lawson,” he said. “CFO of HankMed.”

  “HankMed?” she asked.

  “My brother’s concierge practice.” He nodded toward me. “This is my brother, Dr. Hank Lawson.”

  Miranda smiled at me.

  “This is Divya. Our physician assistant,” Evan said, accent on assistant.

  Divya raised an eyebrow. “Our?”

  “Our,” Evan said. “HankMed’s.”

  Miranda pulled a pad and pen from her hip pocket. “What can I get you?”

  Evan and I ordered steamed clams, Divya a chopped salad.

  Evan unzipped his backpack and pulled out his laptop. He cleared a spot on the table and booted it up.

  “What are you doing?” Divya asked.

  “ESM,” Evan said.

  “Emergency staff meeting? I thought this was lunch.”

  “It’s called multitasking. You know, doing several things at once.”

  “I know what multitasking is,” Divya said. “In your case it would consist of having lunch, conducting a quasi staf
f meeting, and suggesting dubious medical treatments.”

  “I was just trying to help Ben and his friends.”

  “I’m sure you were. The problem is that sitcom medicine doesn’t work so well.”

  “Sitcom? Joey or Chandler, I forget which one, said they saw it on the Discovery Channel.”

  “Let me make sure I understand you. Two fictional characters talk about what was most likely a fictional documentary and you buy that as fact?”

  Evan stared at her for a minute but apparently had no comeback.

  The computer finished booting. Evan tapped a few keys and then turned the screen toward Divya and me. A picture of a gray building with two brightly colored vans angled nose to nose out front filled the screen. The sign that crowned the single-level structure indicated it was Fleming’s Custom Shop. Evan tapped a key and we were now inside the showroom, where three more vans were on display. Each more colorful than the last. Each with fancy wheels that were worth more than my Saab.

  We were being treated to one of Evan’s slide shows. He loved PowerPoint. He loved productions.

  “What is this?” I asked.

  “The future of HankMed.”

  “A van?” Divya said.

  “Not just a van,” Evan said. “A mobile clinic. A chariot that brings health care right to your door.”

  “We already do that,” Divya said.

  “No, you bring yourself and a little black bag. Your SUV is too small. I’m talking about a full-service vehicle.”

  “What are we going to do?” I asked. “Open-heart surgery in the back?”

  Evan hesitated as if considering that possibility, and then shook his head. “Not that full service.”

  Evan tapped the return key. Now a bright blue van, side doors open, appeared. A young attractive brunette stood next to it, smiling at the camera.

  “Who’s the girl?” I asked.

  “Rachel Fleming. Her father owns the place. She does all the custom designs.” Evan moved to the next slide. This one a view of the interior. “These guys can do anything. We can have one tricked out any way we want.”

  “Tricked out?” Divya asked. “Sounds like a rolling brothel. With mood lighting and a bar.”

  Evan raised his hands, palms toward her. “Okay, we can have it suitably equipped for our needs. Is that better?”