Monday Mornings: A Novel

by Sanjay Gupta

  Park couldn’t help but think for a moment about the ominous cloud on his own MRI and his dark prognosis, despite how well everything had gone so far. He took a deep breath and continued.

  “From a neurosurgical perspective, Mr. Malchus is asymptomatic. From a psychological perspective, it is a different story.

  “Prior to surgery, Mr. Malchus worked as a welder in a machine shop, fabricating large mufflers for buildings, cruise ships, and so on. I have talked to his wife, and she says he never expressed any interest whatsoever in art.”

  “I thought they were a bunch of pansies,” Malchus interjected. Park ignored him.

  “Mr. Malchus has emerged from surgery with a monomania for drawing. More specifically, Mr. Malchus draws ears. He has drawn them on the walls of his apartment. On canvas. He draws them now.”

  “We need to hear the voices. We all need to listen,” the man said matter-of-factly, still not looking up. The assembled doctors edged forward. Those who hadn’t recognized the shapes before now smiled and nodded to one another.

  “Mr. Malchus sleeps very little. There are times he forgets his meals.”

  “You sound like my wife,” the patient added, now with an edge in his voice. A couple of the junior doctors smiled until they realized Malchus was not joking.

  “Mr. Malchus’s wife has moved out,” Park added.

  “Good riddance,” Malchus said.

  “I add this personal fact because it reflects on—”

  Without looking up, Malchus interrupted. “She doesn’t understand the voices.”

  “The reason I include this in Mr. Malchus’s history is that his wife has suggested her husband be prescribed a neurotropic medicine to mediate these symptoms,” Park said. “I consulted with Dr. Johnson from Neurology, and he agreed.”

  Park placed a hand on the bedrail to steady himself and paused to catch his breath. He tired so easily.

  “Why isn’t he already taking something?” Sydney asked.

  “Wouldn’t that end his neurosis?” asked another.

  “As I said, I have consulted with Dr. Johnson, and Mr. Malchus was offered this treatment option. He has declined any medication,” Park said.

  “We all need to listen to the voices,” Malchus said again. “Can’t you see? I need to help us hear them.”

  “Those ears are beautiful,” McManus said, nodding toward the page now filled with ears. For the first time, Malchus looked up at the doctors who were gawking at him. He stared at McManus, their eyes meeting, his gaze unwavering. He looked at him with such a searing intensity that McManus involuntarily took half a step backward, as though he might get singed.

  “Mr. Malchus is what is called an acquired savant. There are other cases in the literature. Men and women who had no interest in painting or poetry or music who suffered a traumatic brain injury that resulted in a new skill and singular focus,” Park said. He paused again. He was out of breath.

  “Apparently the art world has taken notice. He has a one-man show, Stroke of Genius, at the Marks Gallery next week.”

  “Isn’t that the place that had an exhibit of cow fetuses in formaldehyde?” a small, bald doctor asked.

  “My brother’s an artist. He’d kill for a show at the Marks,” a resident said, almost to herself.

  “That’s not our concern, is it?” Sydney asked. “Aren’t we supposed to be worried about the well-being of the patient?”

  “Isn’t that part of Mr. Malchus’s well-being?” McManus asked. His challenge was friendly. He was smiling and looking at Sydney when he asked the question.

  “You tell her, my friend,” Malchus growled. When Dr. Park asked him to come in for another MRI, overnight observation, the presentation of his case at grand rounds, Malchus had said that as long as they kept him supplied with writing materials, he didn’t mind. He had thanked Park for working with the voices to give him this gift.

  “So it’s okay that he ignores his dietary needs?” Sydney asked McManus. “It’s okay to ignore his wife?”

  “She needed to get her fat ass out of there. The bitch tried to take my art supplies until I ate something.”

  Sydney glared at the patient for a moment and then turned back to McManus.

  “This is what you would call healthy behavior?”

  McManus shrugged. “Isn’t a one-man show at a gallery a sign of functioning in society?”

  “And the rest doesn’t matter? Skipping meals? The anti-social behavior?” Sydney asked. Her voice sounded strident. I sound like a shrew, she thought, appreciating the irony of her taking a stand against a single-minded work ethic. Every time she crossed paths with McManus, she seemed to act in strange and uncontrollable ways. Sydney felt her face go flush—another recurring theme in her encounters with McManus.

  “If anti-social behavior and a propensity to work through meals were symptoms requiring psychotropic drugs, half the doctors on staff would have scripts for Haldol,” McManus said with a wry grin. The physicians laughed.

  “Well, Dr. McManus, I will mark you down in favor of improper and inadequate treatment of your patients,” Sydney said suddenly. McManus looked confused.

  Inside, Sydney was kicking herself. How did she become such a bitch? She heard echoes of herself in third grade, trying to put down any classmate who dared infringe on her role as the smartest kid in the class by answering one of Mrs. Fitzpatrick’s brain teasers. Sydney guarded her role as star student zealously. Now she couldn’t help but hear the childish tone in her voice. This, with a man she found attractive. She was mortified.

  McManus, too, was speechless. After a moment of silence, he turned back to Park.

  “Sorry for the interruption, Dr. Park.”

  Park, exhausted by the effort, finished as quickly as he could, and the doctors filed out of the room in the order they had come in, with Park leading the way, followed by the other attendings, chief residents, senior residents, junior residents, and med students. Sydney and McManus left the room and turned in opposite directions without another word between them.

  Park’s wife was waiting when he reached his office, and she drove him home.

  CHAPTER 38

  V

  illanueva was seated on his stool. Veteran nurse Roxanne Blake stood next to him. The ER was as quiet as it ever got for a Friday night. Even the normally blaring television in the waiting area was off.

  “Is it cold out?” Villanueva asked.

  “Nope.”

  “Big game on?”

  “Not that I know of.”

  “American Idol?”

  “No.”

  “What gives?”

  “You got me, Dr. V.”

  “Where’s the Magnet?”

  “Off,” the nurse answered. The Magnet was a tiny female resident. She’d earned the nickname because she was a vomit magnet. Every night she worked, the whole character of the ER changed with the prevalent theme being vomit, and lots of it. Drunks. Influenza. Food poisoning. It didn’t matter.

  “Too bad. She’s got a streak going,” Villanueva said. “Is Dr. Um-So working tonight? Torturing him is always good in a pinch.”

  “No such luck. He’s off, too.”

  Villanueva surveyed his silent domain. When it was this slow, Villanueva got antsy. He was sure there would be a bus crash, or a fire, or, more likely, multiple shootings. Not that the possibilities worried him. There was an unwritten rule in hospitals. If things were quiet, no one was to point it out, or risk somehow jinxing it. That was not a rule Villanueva cared for. He enjoyed the rush of multiple traumas bursting through the door of the Emergency Department. He liked it better when they were already a little busy, though. It was like when he was waiting tables in high school at a little Mexican place called Guadalajara. He was a much better waiter when he was busy. When the restaurant was slow, he lost his timing. He arrived at tables late or early. The ED was no different.

  “Not even a turkey symptom.” Some patients came in complaining of vague pains, usually in the neck or ba
ck, simply in the hope of getting to a room and receiving a friendly meal—a sandwich, chips, juice, and a piece of fruit. At Chelsea General, it was a turkey sandwich. There was a well-known, almost mythical tale at Chelsea General, of two walk-ins who arrived a few minutes apart, each claiming ailments that were going to get them an X-ray and a sandwich. Through some mix-up, only one received the plastic meal tray. The man with the sandwich was about to take a bite when his fellow patient snatched it and stuffed it in his mouth. In response, Patient Number One threw a right cross that sent the sandwich and a tooth flying. He then picked up his sandwich off the ER floor and put it in his mouth.

  Villanueva and Roxanne looked out over the library-still emergency room.

  “You bored? We got a thripple in five,” she said. The nurse knew Villanueva loved the oddities of the human condition: extra fingers or toes, quadruplets, glass eyes depicting flags or, Villanueva’s favorite, the Marine Corps emblem. He also liked strange or ironic tattoos, like the man with the blue block letters on his calf spelling out the word TATTOO, and odd self-inflicted injuries like the man with his urethra painfully blocked with a peanut who confessed that he and a friend were playing “feed the elephant.”

  The Big Cat slid off his stool.

  “A triple nipple. Why didn’t you tell me?” Villanueva said. A thripple was officially known as an accessory nipple or supernumerary nipple and was surprisingly common. In medical school, Villanueva recalled, Professor Mort Rubenstein mentioned accessory nipples in passing and had asked the anatomy class, “Who here has an accessory nipple?” To Villanueva’s surprise, Frank Braun had shot out of his chair in the lecture hall and hoisted his shirt.

  “Got two,” Braun said proudly. Below each of his regular nipples were very small supernumerary nipples.

  Villanueva meandered over to Trauma Bay 5.

  “How we doing over here, Dr. Wills?” Dr. Deanna Wills knew exactly what Villanueva was up to. She rolled her eyes but played along.

  “Mr. Swanson, here, bruised a couple of ribs falling off his bike.”

  “I see,” Villanueva said, as he conducted a seemingly authentic exam of the man’s chest.

  “A car turned right in front of me. The jerk didn’t even stop.” Having seen what he wanted to see, Gato was already walking out.

  “Keep up the good work, Dr. Wills.”

  Villanueva wandered back to his stool, a small diversion in an otherwise dull night.

  “This keeps up, I’m going to have to order pizza,” he told Roxanne, the nurse.

  “Don’t jinx us, George.” She was one of the few people at the hospital who called Villanueva by his first name.

  The shift ended, still strangely quiet, and Villanueva walked into the cool night feeling unfulfilled. He got in his roadster and drove over to O’Reilly’s. The bar didn’t serve mojitos or frozen drinks, and the only thing that ended in -tini was a martini. No appletini or other cute specialty drinks and nothing that involved ginger or pomegranate juice. The Big Cat found his usual spot at the bar, noticing an attractive woman in her late thirties sitting two stools down. She was well proportioned and slim but not in a gaunt, obsessive way like his ex. The bartender placed a rum and Coke in front of Villanueva.

  “What’s the word, Soup?” Villanueva demanded, while still looking over at the woman. The bartender’s name was Tom Campbell, but he went by the nickname Soupy.

  “Hi, Doc. How they treating you at the hospital.”

  “You know me, Soup, just livin’ the dream,” he said a little louder while turning his bar stool in the woman’s direction.

  The woman glanced over.

  Soupy got the message.

  “Dr. George Villanueva, I’d like you to meet this lovely creature of God, Megan.”

  George reached an enormous hand over.

  “Nice to meet you,” Villanueva said. He was picturing Megan naked.

  “I couldn’t help but overhear. Are you a doctor? The reason I ask is because I just saw something on TV and I’ve been dying to ask if it’s true.”

  “Shoot.”

  “It’s a little awkward.”

  “My middle name, little lady.”

  “All right, is it really true that human beings can smell emotions like desire?” The question alone seemed to crank up Villanueva’s hormones. Easy, Gato, he said to himself. Villanueva tried to adopt a scholarly tone to mask the almost adolescent desire flooding his endocrine system.

  “When people are sexually aroused, they produce specific hormones. Your own Love Potion Number Nine. All vertebrates have a vomeronasal organ to pick up signals like this. I suppose if your nose were good enough, you might be able to smell desire.” Here George abandoned his academic air. “Give me a heads-up if I need to start sniffing!”

  Villanueva let loose with a enormous laugh that didn’t give Megan a chance to be offended. When the eruption of mirth died down, the Big Cat leaned forward.

  “Tell me about you,” he said. Before she could answer, his cell phone buzzed. He did his best to ignore it but the buzz sounded again. Without taking his eyes off the woman next to him for more than a second, he pulled the phone from his pocket and checked the number. The caller ID said NICK.

  “Do you need to get that?”

  “It’s nothing.”

  The phone buzzed again. After a fourth round, it fell silent.

  “You sure you don’t need to get that?”

  “No. It’s all right. I want to know more about Megan. For starters, how did such a beautiful woman wind up two stools down from me at O’Reilly’s on a Friday night.”

  “What’s a nice woman like me doing at a place like this? Really? That’s your line?” Megan tipped her head back and laughed. George was smitten by the spontaneous outburst and her perfect teeth.

  “Something like that.”

  “Soupy and I go way back.”

  “I met this lovely creature of God when I was tending bar at a place called the Oasis on St. Pete Beach.”

  “I guess that makes me a groupie. A Soupy groupie.” Again, she tipped her head back and laughed.

  “One of the pitfalls of the job,” Campbell said and winked.

  “You’ve got great taste in bartenders,” Villanueva said to Megan and then turned to Campbell. “And you’ve got great taste in groupies.”

  As Villanueva continued the verbal dance that he hoped in Megan’s mind would justify a trip back to his small home nearby for an alcohol-fueled romp, he had two thoughts. One: He needed to make a trip to the bathroom to pop a little blue pill he kept on hand for just such an occasion. Two: What did Nick want?

  He was surprised to find himself giving his son’s call a second thought. He would have ignored it completely only a month or so earlier. Nick almost never called, and when he did it was either to ask for money or to get a sympathetic ear about some perceived injustice his mother had committed—banning him from computer games for a week because he had gotten a C in history, for example. He wouldn’t even bother calling back the next day. The next time he went out to see Nick, he’d say there was an emergency at the hospital, or he wouldn’t even mention it. Not that Nick would bring it up. He’d just study his father with his downcast, sullen gaze.

  Now Villanueva was having trouble getting the call out of his mind. If he didn’t hurry up, he risked losing his mojo, not to mention the effects of the pill. Full-blooded lust pulsed through his arteries. The hormones made his vision more acute—offsetting the second rum and Coke now resting on the stained-wood bar in front of him—and his sense of touch more sensitive.

  Still, what was up with Nick? He felt connected to his son in a way he hadn’t in a long, long time, and the call weighed on him. For years, his relationship with his son had been guided by doing the minimum necessary to keep his guilt at being a horrible father down to an acceptable level. He was like the diabetic who reined in his diet just enough to avoid slumping into some sort of hyperglycemic state. There was more to it than guilt right now, though. Villan
ueva was worried something might be wrong. He was worried in a way he hadn’t been since the boy had spiked a 104-degree fever when he was five. Nick might be with a girl himself and need a little fatherly advice. Maybe he was drunk at a party and needed a ride, too embarrassed to call his mom. He might have gotten his ass kicked or been in a car accident. Villanueva tried to put all these worries out of his mind. He had survived his teenage years. Nick would be fine.

  Villanueva downed the second rum and Coke, and Soupy placed a third in front of him.

  It had been a while since he’d taken a woman back to his house, and he did not want to miss this opportunity. What could he say? Villanueva loved women. His lust was equal opportunity: twenties, forties, blond hair, black hair, short, tall, Asian, Latin, African American, Anglo, he didn’t care. He enjoyed women in all their remarkable variety. And Villanueva was already picturing himself undressing Megan slowly with some sexy Brazilian music playing on his ceiling-mounted speakers. Nothing like some sultry samba queen singing in Portuguese to set the mood.

  Tomorrow, his son would still be his son, but the opportunity to hook up with Megan might have evaporated. Villanueva knew he had charisma, which compensated for other negatives: He was forty-eight, overweight, and overworked. Even with the “it” factor working in his favor, he also knew his chances of luring this pretty woman back to his house were directly correlated to her blood alcohol level. His own blood alcohol level was rising fast.

  He and Soupy had a tacit arrangement. No matter how much Villanueva drank, his tab was twenty dollars, and he would toss Soupy another twenty as a tip.

  “Last call, my friends,” Campbell said.

  Villanueva tossed forty bucks on the counter and turned to Megan.

  “I live right around the corner if you want keep this party going. I’ve got this amazing tequila.”

  “Sure, why not?” Megan said. She laughed.

  As they left the bar, Villanueva slipped a hand around her waist to steady her. And then it happened. His phone sounded again. Villanueva wasn’t angry at the electronic buzz kill. He was worried. He took his right hand off the small of Megan’s back and pulled his phone out of his pocket.