Last week and friend of mine and I were having a discussion in the infusion room of a certain clinic in a nameless hospital in the beautiful city of Minneapolis. To protect his privacy I shall call him Pat. You see Pat and I had both gone through umbilical cord transplants and are now navigating our way through the worst part, the most difficult part...the healing process. Once in a while, more for him, we need to go to the clinic and get a tune-up of sorts. The big scare after a transplant, besides getting cancer again, is our graft attacking us the host, graft versus host disease, gvh, for short. Gvh can rear its ugly head in a multitude of ways...Its favorite ways are by attacking the skin or the gut (any and all places in the gut). Pat and I were laughing about the fact that they put us through these horrendous tests (tubes going up and down places they shouldn't; lips severed and glands removed; skin one-hole punched out, etc...) that are almost always ambiguous and they end up putting us on the drugs to combat Gvh anyways.
That night, I ended up reading several relevant passages from a book I was reading and have now finished (anyone following the reading list??). These are from White Noise by Don Delillo. I highly recommend this book. Very well written and takes many cool and irreverent turns. Nevertheless, here are the passages. To set up the main character believes that he has been exposed to what was termed an "airborne toxic event".
I decided to take another physical. When the results were in, I went to see Dr. Chakravarty in his little office in the medical building. He sat there reading the printout, a man with a puffy face and shadowy eyes, his long hands set flat on the desk, his head wagging slightly.
"Here you are again, Mr Gladney. We see you so often these days. How nice it is to find a patient who regards his status seriously."
"What Status?"
"His status as a patient. People tend to forget they are patients. Once they leave the doctor's office or the hospital, they simply put it out of their minds. But you are all permanent patients, like it or not. I am the doctor, you the patient. Doctor doesn't cease being doctor at close of day. Neither should patient. People expect doctor to go about things with utmost seriousness, skill and experience. But what about the patient? How professional is he?"
He did not look up from the printout as he said these things in his meticulous singsong.
"I don't think I like your potassium very much at all," he went on. "Look here. A bracketed number with computerized stars."
"What does that mean?
"There's no point your knowing at this stage."
"How was my potassium last time?"
"Quite average in fact. But perhaps this is a false elevation. We are dealing with whole blood. There is a question of a gel barrier. Do you know what that means?"
"No."
"There isn't time to explain. We have true elevation and false elevations. This is all you have to know."
"Exactly how elevated is my potassium?"
"It has gone through the roof, evidently"
"What might that be a sign of?
"It could mean nothing, it could mean a great deal indeed."
"How great?"
"Now we are getting into semantics," he said.
"What I'm trying to get at is could this potassium be an indication of some condition just beginning to manifest itself, some condition caused perhaps by an ingestion, an exposure, an involuntary spillage-intake, some substance in the air of the rain?"
"Have you in fact come into contact with such a substance?"
"No," I Said.
"Are you sure?"
"Positive. Why, do the numbers show some sign of possible exposure?
"If you haven't been exposed, then they couldn't very well show a sign, could they?"
"Then we agree," I said.
"Tell me this, Mr. Gladney, in all honesty. How do you feel?"
"To the best of my knowledge, I feel very well. First-rate. I feel better than I have in years, relatively speaking."
"What do you mean, relatively speaking?"
"Given the fact that I am older now."
He looked at me carefully. He seemed to be trying to stare me down. Then he made a note in my record. I might have been a child facing the school principal over a series of unexcused absences.
I said, "How can we tell whether the elevation is true or false?"
"I will send you to Glassboro for further tests. Would you like that? There is a brand-new facility called Autumn Harvest Farms. They have gleaming new equipment. You won't be disappointed, wait and see. It gleams, absolutely."
"All right. But is potassium the only thing we have to watch?"
"The less you know, the better. Go to Glassboro. Tell them to delve thoroughly. No stone unturned. Tell them to send you back to me with sealed results. I will analyze them down to the smallest detail. I will absolutely pick them apart. They have the know-how at Harvest Farms, the most delicate of instruments, I promise you. The best of third-world technicians, the latest procedures."
His bright smile hung there like a peach on a tree.
"Together, as doctor and patient, we can do things that neither of us could do separately. There is not enough emphasis on prevention. An ounce of prevention, goes the saying. Is this a proverb or a maxim? Surely professor can tell us."
"I'll need time to think about it."
"In any case, prevention is the thing, isn't it? I've just seen the latest issue of
American Mortician. Quite a shocking picture. The industry is barely adequate to accommodating the vast numbers of dead."
I thought this passage was poignant at the time? What do you think?
Master J^2