Patient Be Where

So let’s say you do happen to wake up in that seedy hotel bathroom in an ice filled tub with a throbbing pain where your kidney should be; what’s a guy to do? Well naturally your first thought would be to travel with all haste to the nearest purveyor of compassionate health care; the town doctor, nestled behind his white picket fence in the heart of the community, waiting diligently to tend to the needs of his flock with swift alacrity.   The wise doctor who brought you into this world and has seen you through all the trials and tribulation of life like he were a member of the family. The noble doctor who has only your best interests at heart.

Of course such a doctor no longer exists so instead you direct the GPS towards the nearest emergency room and hope for the best.   The welcoming glow of the ER signs (along with the commercial marketing campaign funded by the conglomerate that owns the hospital) promises a blissful resolution to whatever ails you and beckons you into its safe harbor just behind the sliding doors. Take that first step beyond the threshold however and all of your expectations come to a screeching halt along with your concept of space and time; in your mind you try and make conservative estimates on how much of your life you will be sacrificing to this visit but in this at least the hospital will certainly exceed your expectations.

You shuffle forward to the admissions desk where you are greeted with all the warmth of a frozen pizza. Trained by the palace guards at Buckingham Palace the job of this receiving nurse is to respond to your symptoms with poker-faced neutrality. You could report that an alien probe has dislodged your spleen and get the same regard as if you’d just shown her a shallow paper cut. She calmly takes your information, tags you like a wild seal and then sends you out into the vast ocean of the waiting room where everyone idles about, attempting to make limited contact with people, furniture and door knobs.   You navigate the germ encrusted surfaces, tune out the sounds of intestinal distress and take a seat until called by the triage nurse.

Triage is an important concept in the ER. This is where the nurses try sort the priority of your treatment based on your likeness to croak or to generate a lawsuit before your name can be called. If you have anything about to fall off your body or shoot out of your body you’ve got a better chance of being elevated to the top of the stack. Anything short of that and you get sorted into amorphous categories along with the rest of the wannabe patients. In general the healthier you are (or should I say ‘the less sick you are’), the longer you’re gonna have to wait. One would assume then if you walked into the ER completely healthy you’d never leave.

Put another way, there is a math concept called Zeno’s Paradox that basically says if you needed to reach a destination you’d first have to travel half way across the total distance, and to reach that half way mark you’d first have to travel half of that distance and so on. So if you always had to cross half the remaining distance you’d never reach your final destination since there are infinite ways to repeatedly divide the remaining distance in half. This is what the triage system brings to mind as you endlessly inch ever closer to being “next” without ever actually being called.

Once in this situation, I repeatedly asked the nurse for a status. She informed me that we were “next up in our category”. Apparently this category was “people we’ll call when hell freezes over”. It’s like the waiting room in the DMV or the courthouse where they do the similarly mysterious break down by category; you stare at your ticket with H112 on it feeling pretty good that they are now serving H110. After you see H111 called to the window you breathe a little easier with the knowledge that you’ll be the next one called. And then comes the parade of random tickets from every other possible category; X102, X103, F242, D117, X104, B001, D118,… on and on with no further mention of our precious H group. And so it goes in the ER as time stretches onward.

After several long hours of waiting to be next, you finally get called up to the big league. They announce your name and the thick double doors to the inner sanctum part with an internal glow of healthy radiance. Overwhelmed by the sheer sense of relief to finally be called you forget all about the pain that brought you here in the first place. You rise to your feet triumphantly wanting to pump your fist in the air or thank the academy, or some other display of wild exuberance. Instead you just shuffle on through to the other side and take a seat in a smaller room where you can continue your wait.

Having arrive in your new waiting place, the ER nurse now directs you to strip down and put on one of their swanky hospital gowns. It does not matter what you’re being seen for they just want you to get naked and experience the ass-numbing draft from their rear-opening apparel. Actually there’s an ulterior motive; without the gown they would have no way of knowing who was a patient, who was a visitor and who was doctor or nurse. Uniforms are very important in a hospital and you’re just being asked to play your part.

Another hour goes by. An entire shift of nurses has come and gone since you entered the building. You’ve been poked and probed (though leaving your spleen in place) and shuffled about to get you where you are right now. It’s all built up to this moment when you finally get to see an actual doctor. The selfless doctor that will care for you, empathize with you and cure you with his gentle healing hands. Instead you get the speedy doctor that flies in, assails you faster than a pick pocket groping for loose change, and then flies off again through the curtain like a ripple in the wind.   If you made a pie chart of the time you spent in the ER with the wedge of time you spent with the doctor you would have one very sad and very small slice of pie and the same sense of the lingering disappointment that the doctor leaves in his wake. His parting words are something about waiting for discharge (a horrible choice of words considering the context of your current situation) and the final paperwork from the dismissive nurse (not to be confused with the naughty submissive nurse from the Halloween store). When you have the stack of papers in hand they officially set you free by cutting off your bracelet and shuffling you back towards the big double doors.

The last thing you see as you head out for the parking lot is the collection of poor souls still stuck in the waiting room; some still waiting for relatives that went in before you, some just starting their own long adventures in waiting. You’re struck with mixed emotions, not sure if you should wave a flippant “so long suckers” or pat someone sympathetically on the shoulder. The ER is misery without the courtesy of dignity. Surviving it and the ailment that brought you here fills you with a sense of euphoria. In the big picture everything feels a little better and easier to endure. Maybe living with just one kidney isn’t so bad after all,… beats sitting in the ER.


Dry Run (fiction)

I remember lining up for my first race beneath dark clouds with the promise of rain. “Piano Man” played over the sound system mixing with the energetic announcer who counted down the time until the next wave of runners. I was corralled near the inflatable starting gate with my fellow participants bouncing and stretching to ward off the chill. There was a buzz of nervous conversation and eager anticipation. The annual Folsom Lake “Mud Run” attracted crowds from all walks of life, eager to get down and dirty. I looked around at the faces of strangers and felt a sense of kinship as we shuffled towards the starting line waiting to begin our adventure. Everyone joined in for the final countdown that ended with a long blast from an air horn. We were off.

Twelve years later, there is no place to go. All here is quiet and still. It would have been race time and already the temperature is in the low 80s, promising to be well above the October average of 84. If we hit the 90 degree mark they probably would have issued an evap warning, and cancelled the race anyway. That was just one of the many reasons the race might have been cancelled. I knew the chances of having one last race was slim but I was hoping to end on number 12. I always liked ending things on an even number. It just felt right.

That first race was in 2010 (I liked starting things on an even number too). The Mud Run wasn’t the longest or most difficult race out there. The emphasis was more on fun with a few challenges sprinkled in to keep things interesting. This was more my speed having not competed in anything since high school swim team, and never being a big fan of running in the first place. I was so nervous when that air horn sounded that my mouth ran dry and I almost hyperventilated before the first obstacle, a cargo net climbing structure.   Once I powered through that, putting aside any fear of heights, I was able to settle into the race and set a better pace going forward. Next up was the first of three mud crawls; vast pools of chilled chocolate colored water. I spider walked through the waves it to protect my knees from the gravely bottom, but still emerged dripping wet and coated with a thin layer of diluted mud. I remember feeling uncomfortable with the weight of the water on my clothes and the sticky mud caked to my shoes.

I would grow to miss that feeling more then I knew. The oil based mud they started using in the pits were predictably slimy but were meant to be easily absorbed by the skin leaving just a residue of colored dust. More often than not though perspiration would prevent absorption leaving it to clump in oily rivulets that were difficult to wash off and contaminated what was left of the lake water. Eventually the pits were lined with a gel bottom to simulate the texture of mud though without the muddy mess, or oil slicks in the lake.

If nothing else we knew eventually the Mud Run would have to be moved. After just my second year racing they had already started affectionately referring to this as the Folsom Puddle. The lake levels started dropping quickly as the drought worsened. Each year there was optimism that the rainfall would come to fill the lake and the snow packs would return to keep it stocked. But even the consecutive El Nino years in 2015 and 2016 weren’t enough to make up for the dry years and rising temperatures. By my third year they stopped bringing in the water tankers for the post-race rinse-stations. I remember the decadent use of water prior to that; miles of hoses snaking from a network of pipes, big inflatable structures set up like old car washes that you walked through to get clean under constant streams of liquid water. By my fifth year even the water cups they hand out along the race required purchase of premium wristbands, as well as a deduction of rations two years later.

My friend Luke started running with me on my fourth race. Though he was an avid runner he pretended to “bow to my experience” and let me set the pace. It was good to have the company after my previous solo runs, having someone to playfully mock and challenge along the way also pushed me beyond my own sluggish pace. I fared better with some of the more physical obstacles, such as the sandbag pulley or the medicine ball carry, but he was quicker over the walls and, of course, running between obstacles. Ironically the one destination Luke dreaded the most was the lake crossing. Having the lean runners build he was left with no defense against the mountain snow melt that filled the lake, and back then late October mornings would be chilly in their own right. As we descended down towards the lake shore Luke would begin his ritual of psyching himself out and sprinting in little circles trying to raise his core temperature. It made no difference in the end though, he would still squeal like a little girl as soon as he took that first deep step that submerged him past his private parts.

Each year, the course would adjust as the distance to the lake shore got further and further away replaced by fields of cracked earth broken up by the occasional tire tracks. The boat ramps once filled with recreational speed boats and jet skis were replaced by quads and dirt bikes.   On my 10th run the lake was officially dry. The lake crossing obstacle became the last real mud pit, however since it was covered in plastic to prevent evap it wasn’t much different from the gel bottoms in the other pits. It seemed fitting to make that my final race, and mark the passing of Folsom Lake.

Ironically Luke had a different reaction to the news and after a four-year absence he decided to run again the following year as a way to thumb his nose at the lake crossing that used to taunt him. He was convinced this would make everything better and I felt compelled to join him as long as he promised to do it the following year so I could end even. It was a rather poor performance for both of us as we were feeling our years. My unexpected entry hadn’t left me much time to train properly and Luke’s health issues had degraded his runners’ physique.   This left us with ample opportunity to laugh at each other as we struggled with even the easier obstacles; floundering over the short walls, getting stuck in the crawling tubes and drunkenly stumbling across the balance beams.   We got a better work out from belly laughs then from anything the course had to offer. We had fun doing backstroke in the gel pools and dancing over the fire strips, one of the new obstacles added to replace the mud. It was all well worth the price of admission.

Today was to be our last run. Tickets were just about to go up for sale when we heard about the plans to renovate Folsom Lakebed. They promised the event could continue, though probably by a different name, once the construction was complete. It made no difference; Luke’s doctor didn’t green light him for another race anyway, he thought it would be too much of a strain on his kidneys. Maybe it’s for the best though. The memories we made last year would be hard to match. Maybe that’s a more fitting end to our Mud Run days; to remember the better days of joy and prosperity and be optimistic for the rain to come. An optimism that would be easier if hadn’t ended with an odd number.