Dude, Where's My Stethoscope?

by Gray, Donovan

  Braveheart lay back down reluctantly. After a couple of minutes of scraping I was able to get the metal fragment and its accompanying rust ring off his cornea. It wasn’t easy, though – his eye kept watering and he wouldn’t stop blinking and squirming around.

  Boy, they sure don’t make mechanics tough like they used to, I groused to myself when he finally left the department.

  At 10:15 on Saturday night I was sitting at the ER desk when the phone rang.

  “Hello?”

  “Hi doc, it’s me, Mike the mechanic.”

  “Hey, Mike. What’s up?”

  “I was just wondering how long it’ll be before I can see normally again.”

  “What do you mean?”

  “My eye’s not as sore as it was before you took that piece of metal out of it, but now everything looks pretty blurry.”

  “Well, it usually takes a couple of days for the scratch on the surface of the eye to heal.”

  “Oh, that’s good to know. Thanks a million, doc. One last thing – about how long will it be before that black circle in the middle of my eye goes back down to normal size?”

  “What?”

  “Right now it’s way bigger than the one in my right eye. Is that okay?”

  “Your pupil is dilated? That doesn’t make any sense. Maybe you should come back so I can have another look at you.”

  Mike returned to the hospital. The ophthalmology room had just been used and needed to be cleaned, so I took a quick look at him out at the ER desk. Sure enough, he had a hugely dilated left pupil. There was no good explanation for it, unless… . I went back into the eye room, pulled on a pair of gloves and did the wastepaper basket equivalent of dumpster diving. After a brief search I found the discarded tetracaine tubes I had used on him that morning. Unfortunately, a closer inspection of the labels revealed they weren’t tetracaine at all - they were homatropine. Homatropine is used for dilating pupils. It has no topical anaesthetic properties whatsoever. I sifted through the tetracaine box in the cupboard and was only mildly surprised to discover both tetracaine and homatropine tubes in it. True to Murphy’s Law, the tubes are almost identical in appearance. My best guess is that the last person to stock the medication cupboard accidentally tossed a handful of homatropine tubes into the tetracaine box. No wonder he’d had such a hard time staying still – he’d been feeling every single scrape and scratch as I worked on the inordinately sensitive surface layer of his eye! The mere thought of it made me want to ralph. I squared my shoulders and went out to face the music.

  “Um, Mike, there’s something I have to tell you… .”

  655: Dead, But Dreaming

  (Trapped on Jacob’s Ladder)

  "As I lay dying, the woman with the dog's eyes would not close my eyes as I descended into Hades."

  - The spirit of Agamemnon speaking to Odysseus in Homer's Odyssey

  * * *

  “Is all that we see or seem

  but a dream within a dream?"

  - Edgar Allan Poe, A Dream Within a Dream

  The highways of northern Ontario can extinguish your life in the blink of an eye. One minute you’re humming along with the pop star on the radio; the next you’re an ugly red smear across a rock cut. Graffiti in flesh and blood. Carrion for the haruspex and obit scavengers. Did you hear about that horrible accident on 655 last night? What a shame, he was such a nice man… .

  Highway 655 is a 60-kilometre strip of desolation that runs between Timmins and the northern branch of the Trans-Canada Highway. Due to chronic staffing shortages, the provincial police have pretty much given up on trying to rigorously enforce the speed limit on it. As a result, 655 has become immensely popular amongst the 18-wheeler crowd. Some days the endless convoys of transports blasting by can make keeping your car out of the ditch a real white-knuckle adventure.

  Oddly enough, some nights on 655 you can drive forever and not encounter a single soul. Whenever that happens, my mind has a tendency to wander off and leave my vacant shell steering the car. Although this state bears some resemblance to the automatism that sometimes manifests during minor medical procedures, one key difference is that zombie-driving isn't nearly as closely monitored. As I autopilot down the highway at well over 100 kilometres per hour, a host of half-forgotten memories drift around aimlessly inside my head. Sooner or later my primordial fugue is interrupted by an urgent message from the sector of my neural network tasked with keeping me alive: Wake up! When’s the last time you checked the road? I usually awaken from my drooling stupor just in time to cringe as a semi passes within a few millimetres of my car. You’d think close calls like that would make me more vigilant, but they don’t. Most times I decay back into a torpid, near-REM haze within minutes. It’s not that I have a death wish or anything sinister like that – it’s just that I’m so tired I can barely keep my eyes open. Sometimes it almost feels as if there are pennies resting on my eyelids.

  Strange thoughts seep into my mind at night when I’m in a daze and there’s no one else on the highway. Am I really here right now? How can I be certain I didn’t fall asleep at the wheel and wrap my car around a tree a few klicks back? Maybe I’m actually pinned under a filigree of twisted metal, coughing up blood and imagining I’m still cruising along a chimeric 655. Could my current existence be nothing more than the terminal hallucinations of a dying brain? Can anoxic neurons spin threads of life out of fear and hope?

  Do the dead dream?

  Time Flies When You’re Having Fun!

  Mrs. Charon is in for a routine checkup. I’m running through a review of systems with her.

  “Any change in your bowel habits?”

  “No.”

  “Any chest pain?”

  “No.”

  “Shortness of breath?”

  “Yes.”

  “How long have you had that?”

  “For a while.”

  “How long is ‘a while’?”

  “Oh, a few months, maybe. You did a test on my lungs around the time it started. I had to blow into a machine.”

  “That was probably a pulmonary function test. When did you do that?”

  “Sometime within the past year.”

  I leaf back through her chart. 2003, 2002, 2001… . Not a pulmonary function test in sight. Nothing. Nada.

  “Are you sure it was less than a year ago?”

  “Yes, doctor.”

  2000, 1999, 1998… . Zilch. Bubkes.

  “When did you say you had that test?”

  “It was about a month after that time I got really sick and you put that tube down into my lungs and transferred me to Toronto.”

  “Mrs. Charon, that was over 10 years ago.”

  “Goodness! Where did the time go?”

  PART THREE

  There and Back Again: Return to the Big City

  Should I Stay or Should I Go?

  Originally when I moved to northern Ontario in 1991 my plan had been to stay for a few years and then hightail it to a warmer latitude. A year later I got married. The following year we started having kids… . One amazing decade later Jan and I realized we were approaching a major crossroads in our lives. If we stayed in the north much longer, we’d probably never leave. We had a beautiful home, a great circle of friends and satisfying careers. When she wasn’t busy being an elementary school principal Jan took courses, participated in church activities and directed the local community choir. I cycled, snowmobiled, snowboarded, went on canoe trips and wrote. Our daughters were happy with their school lives and extracurricular activities. Why on earth would we ever want to leave? Three words: our extended family. Both sets of parents, as well as Jan’s only sister and her family, lived in the Winnipeg area, and we missed them. We wanted our girls to be able to spend more time with their grandparents, aunt, uncle and cousins. We also wanted to be around to assist our parents as they grew older and began meeting new life challenges. In the end, after much soul-searching we decided to pack up the homestead and point our wagons west. But the little
town with the polar bears and swans will forever hold a special place in our hearts.

  “We Put the K in Kwality!”

  July 13, 2004

  Dear Kwality Mooovers,

  Greetings from Winnipeg. As you know, recently your company moved my family’s belongings from northern Ontario to Winnipeg. Although I’m sure Kwality Mooovers usually does stellar work, unfortunately this particular move did not go so smoothly. The following is a list of some of the problems we encountered:

   I suspect your employee Billy-Bob (“Moooving Consultant”) didn’t take his Ritalin the day he came to survey the contents of our house, because he certainly didn’t appear to be paying attention to anything. Nevertheless, his quote of $7,738.01 was better than your competitor’s so we awarded the contract to your company.

   Rather than being packed on June 28 and moved on June 29 as I had stipulated when I booked the move, we were erroneously scheduled to be packed on June 29 and moved on June 30 instead.

   The “packing crew” sent to our house on June 29 consisted of one 67-year-old woman who had been sweet-talked out of retirement. She had been given instructions to pack all of our breakables in the morning and then drive to a home in another community to do their packing in the afternoon. She took one look at the number of items in our house and immediately telephoned to cancel her afternoon assignment. Despite putting in a solid day’s work she was unable to finish the job because it was simply far too much for one person. My wife and I had to work well into the night in order to complete the packing.

   On June 30 the moving team arrived more than two hours late with a semi-trailer that was already half-filled with someone else’s furniture. It therefore came as no surprise later in the day when they ran out of space in the trailer for our belongings. As your company was unable to procure any other vehicles that day, they had to cram the overflow into our garage. While they were busy doing that, one of the movers (a jolly fellow with no shirt who spent much of the day drinking beer) broke our most expensive lamp. Several other items got badly scratched, dinged, and stained during the transfer process. After the crew finally departed, a subsequent tour of our home revealed a host of overlooked articles. My wife and I had to move these items to the garage ourselves.

   Although we had been promised the movers would be finished by 1:00 p.m. at the latest, they in fact did not leave until after 9:30 p.m. This forced us to alter our travel plans and forfeit the hotel reservations we had made for Thunder Bay. We also had to ask the new owner of our home to postpone his possession date, which was a nuisance for him.

   Due to the various delays our July 1 Canada Day plans with family and friends in Winnipeg were ruined.

   Shortly after our arrival in Winnipeg I was notified that Billy-Bob had underestimated the weight of the shipment by approximately 4,000 pounds and we would have to pay $11,841.44 on delivery instead of the $7,738.01 originally quoted. This represented an astounding 53 percent markup! I immediately contacted your head office about this mind-boggling discrepancy and was told the only way the driver would release our furniture would be if we paid him the previously agreed upon amount plus an additional 10 percent. I was also advised your company’s CEO and I would have to “work out the difference.” When I called your chief executive about the matter he said (and I quote) “Don’t worry about it – we just want you to be happy!” Bobby McFerrin much?

   Instead of arriving on July 3 at 9:00 a.m., the moving truck didn’t show up until July 4 at noon. This was highly inconvenient because my wife had to leave Winnipeg on the morning of the 4th to attend a course, so she was not able to be present for the initial unloading and unpacking.

   Only two people were sent to do the unpacking. One was an elderly man and the other was a teenager. They worked from noon until 1:00 a.m., and it would have taken them an additional four or five hours had I not been carting boxes and hauling furniture right alongside them. I even had to assist in carrying our grand piano up the front steps because the young apprentice would almost certainly have been crippled for life had he been forced to continue lifting his end of it all by himself.

   More than 40 boxes had not been tagged by the team in Ontario, so the check-off process was grossly inaccurate. In addition to that, a number of articles that arrived safely (e.g., our washer, dryer, fridge, stove) were not even recorded on any of the inventory lists as having been sent. Had they not arrived, I would undoubtedly have had a difficult time getting them replaced because your Claims Department labours under the delusion that if an item is not listed on the manifest then it doesn’t exist.

   Although it was supposed to be a “complete unpack,” when the unpacking “crew” left there were still more than 30 unopened boxes scattered throughout the house. They said they’d return within a couple of days to dispose of the empty boxes and advise me of the final weight (no one seemed to have a hot clue as to the actual weight of our load), but I’ve seen neither hide nor hair of them since.

   I am now in receipt of an invoice from your company soliciting the balance of the $11,841.44 you claim I owe you. With all due respect, I don’t think so. Have a nice day.

  Sincerely,

  Donovan Gray (“Moooving Victim”)

  Where’s Waldo?

  “It is astonishing just how much of what we are can

  be tied to the beds we wake up in in the morning,

  and it is astonishing how fragile that can be.”

  - Excerpt from Coraline, by Neil Gaiman

  Last year our family moved from northern Ontario to Winnipeg, where I’ve been working part-time in an emergency department as well as in an Urgent Care centre. I return to Ontario one week per month to do clinic and ER locum tenens work. This means I currently have three jobs in two provinces. My shifts in Winnipeg are a screwball mixture of days, evenings and nights. Most are eight hours long, but some are 10. In Ontario my stretches of ER call are anywhere from 24 to 72 hours in duration.

  Human beings are not well-equipped to work irregular hours for prolonged intervals. This is in part because shift work wreaks havoc on our natural circadian rhythm. As a result, over time the perpetual flitting between the various shift categories exacts a heavy physiological toll. Diet, sleep, fitness levels and even relationships often develop significant fault lines as the tectonic plates of our professional and private lives crush against one another. For those of us who practice the art of mending broken bodies, night shifts are universally acknowledged to be the most difficult to adapt to. I can handle two or three consecutive graveyards without incurring too much additional stress, but anything more than that starts to make me feel like I'm about to join the ranks of the undead. Whenever I finally revert to regular daytime hours after a long stretch of nights I always half-expect to burst into flames the moment sunlight makes contact with my skin. Perhaps I've read ‘Salem's Lot one time too many… .

  On a more scientific note, I recently came across a study that suggested shift workers suffer higher rates of accidents, heart attacks, strokes and depression than people who work more conventional hours. Based on what I've seen over the years, I'd say there's probably a lot of truth to that theory.

  Where I sleep prior to starting a shift depends on my schedule. If I’m working days then I’ll sleep my nights in our bedroom upstairs. If I’m scheduled to work nights I prefer to siesta in the basement, because it’s usually quieter down there. If the kids are raising Cain and preventing me from banking a few hours of sleep before my night shift, sometimes I’ll drive over to my parents’ house for some shut-eye. When I’m working in Ontario I stay in the locum house or apartment if either one is available, but if they’re already occupied then I bivouac in one of the local motels. Lastly, all three hospitals have designated quiet rooms that can be used for late-night catnaps when things settle down. If my count is correct, that’s nine different pillows my head makes contact with on a fairly regular basis.

  Sometimes I’m gently shaken awake by Jan or
one of my daughters. More commonly, I’m resurrected by the wakeup chirp of my Pocket PC or the buzz of an alarm clock. In Ontario the nurses usually telephone when they need me to come to the ER at night, but occasionally they get in touch with me via my pager. If I’m dozing in one of the hospital nap rooms my réveillé tends to be a knock on the door.

  Once in a while I’ll wake with a start in a darkened room and have no idea where I am. Am I at home? My parents’ house? The locum apartment? A motel? One of the hospitals? Which one? As I fumble to get my bearings, a second tsunami of questions hits. Am I on call? What time is it? Did I sleep through an alarm? Am I late for something? What the hell is going on? It’s hard to describe the feeling of complete disorientation. I suspect it’s analogous to what a golem experiences the moment it becomes sentient. Shift work. Not for the faint of heart!

  Gyne Stretcher at Midnight

  G1

  P0

  20 weeks

  Cramping

  Bleeding

  Passing a large clot

  Not a clot

  A fetus

  Dead

  Not dead

  Stirring

  Pink Cronenberg mass

  Legs now kicking

  Thin arms reaching

  Instinctively trying to return

  Reenter the womb

  Sanctuary

  False hope

  No hope

  Dying

  Slowly

  Mouth opening

  Silent scream

  I stare

  Frozen

  Helpless

  Powerless

  The horror

  The horror… .

  Lost Soul

  Arun was my organic chemistry lab partner back in pre-med. I didn’t mind the organic chem course work, but I sure hated the labs. As far as I was concerned, pouring foul-smelling hydrocarbons from one beaker into another for three hours every Monday morning was sheer torture. During the first month students worked solo, but after that we were partnered up. Fortunately for me, I got to work with Arun.