Copyright is held by the author.
“Lines heavy today?”
“Not so bad, no. What’s with the smock?”
I ran my fat palms down it. “Nostalgia, I guess.”
“I hear you, man. All our kings are in pieces.”
I worry about becoming a crack-up, too. Harvard medical degree, ass-kicking-hard and expensive to get, and I work 12-hour days, like most doctors you’re probably thinking, but in in a call center, most of my colleagues nonwhite men. Ravi gave me shit about my attire every day. My guess is he doesn’t have a lab coat ’cause he never worked in an actual doctor’s office even once. He came to LA after medicine, at least in the big cities, reorganized itself into more profitable nodes. He thinks this is how the States have always been.
I’ve barely got my headset on, I’m typing in my login permissions, when First Room tosses me a call.
“Good morning Cadence Medical Outpost may I have the name of your insurance carrier?” I flail to get a new window open, my mic goes up my nose and I wonder if the caller can tell.
“Okay, and your date of birth? Your current location? And your name.”
Juni from Calgary has a UTI. The first of many today. Your mom may or may not have treated these with cranberry juice and a stern “suck it up.”
I talked John the Cancer Patient in London through an IV placement after he got dizzy in his garden, tripped and yanked it. More UTIs — Sydney, Christchurch, Glasgow.
I wait for a lull from the other side of the cube wall. “You getting a lot of mis-routes, Ravi?”
“What’re your patients’ complaints like today?”
Ravi blows his nose sloppily. “Low-level, routine stuff, mostly.”
“Aren’t we the wrong room for that?”
Why does no one except me think divisions of labour, even if nominal, matter? It’s not worth explaining to Ravi that the First Room is supposed to screen all calls and triage: the mom wringing her hands over her toddler’s sniffles should go to Cotton Room, gunshot wounds to Jump Room. People in non-life-threatening pain go to High Room. If you call wanting hypothetical advice but aren’t in the middle of an actual situation, someone in Seek Room should be talking to you shortly. Follow-ups are for the 50-ish of us in Celebration Room. That’s the only name you don’t see an immediate connection to, right?
“Nothing unusual about my callers today.” Ravi soaks another tissue and grabs a call.
Yeah, it’s not unusual to have half the English-speaking world riddled with pain during pissing. Not at all.
My final call of the day is from Spain: a 12-year-old boy whose older sister doesn’t speak English but may be having “contradictions.” That’s either the Mommy Room or the Mad Room, I need more information. I forgo obtaining an interpreter; my Spanish should still be good enough from when I served on a medical team for four years in Chile instead of getting married and producing grandkids for my dad and stepmom. Should only be a few questions.
With Rosária on her merry way to the Mad Room (she does not have a big belly and she keeps telling her brother he needs to “save himself”), I pack up and start the walk home. It’s muggy as a fever out, but my six 12-hour days a week don’t afford me a car.
I like to fly fish. Up to my knees in river, I can think about what I’ve done. For instance, I married a man dying of depression because I needed to be loved by someone who had failed. He was raised on a dirt road outside Calgary where more than hearts beat. His only pets were the small turtles he caught and released into the toxic creek that ran past the wastewater treatment plant the last summer before the marsh gas made it all the way down to the border. The first actual date, he ordered “eggs benediction” at Porky’s (we were in high school — well, I was, still.) Holidays with his family, who mostly all lived within a ten-mile radius of each other, were tensely informal. There were many problems from the start, and we even knew it in the moment, but we also liked peeling oranges in one swirly strip, battling in the personas of Kierkegaard and Marx or Jesus Christ and Warren Buffet on aimless subway rides and staying up past midnight on school nights meticulously planning how we would create a network of billionaires to counteract that of the Koch brothers (we’d definitely need our own data storage and virtual private networks). Maybe you’d get convinced you’d never meet anyone else like this guy, too. If you were me.
He didn’t want to want to die. Like my best friend, who decided to become a chemical engineer in order to solve the energy crisis even though she’s a damn poet, I decided med school was the way to solve my pet mystery: how do you keep from deciding that time is too empty and too heavy to take more of it?
Fly fishing is neat because you can replay conversations to the tune of eddies around your Wellies or the hiss of your reel or nothing at all if you damn well choose. You can recast any particular conversation as many times as you please, too, until you find that sinker. Like when, a year or so after our divorce went through (a year or so after our marriage went through, which was not while either of us were still in high school), we happened to board the same train car and he pretended not to know me. First, I waved. Then I assumed he didn’t see me, so I called his name. Then, when he looked right at me and then totally turned his back, I glared at his rad orange hair.
Then, last week, I finally settled on what I wished I’d said. I won’t argue that it’s the perfect thing to say, but it’s the thing I wanted to have said loudly on that godforsaken train: “Hey, Jonathan David Hadley. Remember me? We once shared an email server and snacked on enlightenment as we rode the train through the capital of Hell and the rest of the country of no meaning.”
Say what you want. The next cast, I caught my first fish of that season.
Most of the doctors on Team Cally, one of our center’s few chronic, long-term, patients, were here overnight last night. They’d wanted to catch one of Cally’s “flare ups” in action — by catch, I mean be told the blow by blow over the phone. They hadn’t gotten it together enough to even diagnose her currently until last month – her mother did describe some pretty weird symptoms in her four-month-old, to be fair. Malformed big toes, painful lumps on random parts of her body that were hard like bone, not compressible like tumors. None of the doctors went home last night. None of them slept.
Ravi thinks they’re heroes. “Just you watch, they’re gonna cure this girl,” he says, as something tall and human crashes in the men’s bathroom. Dr. Rains, manager of Team Cally, emerges, shaking himself like a wet dog and rubbing his baggy eyes. He can’t walk in a straight line back to his desk.
“The tired-drunk doctors are going to crack the most difficult case we’ve ever had?”
Ravi nodded. “Sleep is for pussies.”
“Five and a half hours of sleep is equivalent to a blood-alcohol content of .1. That’s .02 BAC units about the legal limit. What’s it going to take for us to think safely?”
Ravi. “Have an open mind. Some people need less sleep than others.”
I am getting a bit hot under the collar but a) it doesn’t take much and b) I just don’t fit into the current world since I actually value sleep. So I inhale for four, hold for seven, exhale for eight and say calmly, instead of spitting it, “Having an open mind is no excuse for an empty one.”
I sit down before I shake my head in disgust at Ravi. Have an open mind? Maybe he just wanted to use another common phrase. Whatever. The masses are not asleep, they’re sleep deprived, and The System is not a nightmare because nightmares actually wake you up. (Clinical difference between “mares” and “terrors.” Look it up.) Patients being able to do that sort of shit now is why I have one of the most expensive medical degrees and work in a call center. But you are what you put up with, I guess.
The thing I like to do when it’s too cold to fly fish is make wire trees. You mold colored craft wire into tree shapes and string beads along the way wherever you want; if you hang them on the ends of the branches, it feels like Christmas every time. There’s nothing rational about this, why it’s helpful. That the human is a rational animal is the most irrational thing I’ve ever heard.
I’m at the store for more beads because it’s more convenient to go to a physical store when you want your thing right now as opposed to having to wait for it to be shipped. Also, online pictures lie through their shiny, little teeth. I normally don’t buy wire; I just use extra fishing reel (“extra” is in the eye of the beholder), which holds shapes well enough for my purposes. The organic beads are prettier, truer to their color, but more expensive than the nonorganic beads. What the hell even are organic beads? Little specks harvested from plastic that wasn’t sprayed with Roundup?
“Vote with your dollars.” I jump and almost knock over an elderly woman looking over my shoulder. She tips her hat to me, nods to her own basket — full of organic yarn, of course, and waddles to the checkout. Organic yarn actually makes sense, but ‘vote with your dollars?’ There’s that irrational thinking again. Trying to solve capitalism’s problems by voting with your dollars is like asking a fire how to build a house.
Once I’m safely back at mine, I allow myself to fall asleep in the middle of a purple willow tree. I’ve still got about a month — so that’s four days off – before the niece’s birthday. My brother doesn’t buy his kids “those patronizing hunks of plastic detritus stores have the gall to call toys,” so I thought, ‘why not some pretty plastic? In the shape of a tree? Kid’s got to be exposed to at least the image of a tree, if not the real meal deal.
“My brother has itching of the skin and does not have himself,” the poor woman on the other line says for the third time. “Fevers is also common.”
“Are there headaches with the fever?”
“They have started occurring currently.”
“Maybe the last few days.”
“Concurrent with the other symptoms or later onset?”
“Did the headaches start at the same time as the rest of him got sick or did they come after?”
“All together at the present.”
“Are you with him now?” There’s shuffling and yelling in German I think. Dutch, maybe. Danish? “Are his lymph nodes, uh, is his neck swollen? Hello?”
“Yes, yes. Swollen neck.”
“What happens when he tries to walk in a straight line?”
“Nothing like he’s fine with that?”
“Yes, he can do it. But he does not cool down.”
“I’m sorry, where are you calling from again? City and country?”
An explosion of whoops and high fives and rolly chairs hitting the ground as people jump around covers up the woman’s answer. Team Cally is losing its shit; celebration co-opts the whole room.
They start chanting “FOP, FOP” as they form a conga line in preparation to spread their celebration around the office. When the conductor of the insane train gets close to my desk, he waves me to join the back.
“FOP is what you’re celebrating?”
He pumps his fist and makes a train whistle sound that sounds more like a honk. “We can stop prescribing chemo! We finally know what’s wrong with Cally!”
“FOP?” I’m asking the third, now fourth person in the train. “As in, the currently cureless, one-in-two-billion musculoskeletal disorder that slowly paralyzes its victims by growing a second skeleton and locking their joints down?” Everyone’s nodding and acting like this is a rock concert. “That’s what you’re celebrating?” But all that happens is that the celebration passes me by and my fretful caller has hung up.
I peek over the cube wall. Ravi’s sitting back in his chair like he just got hit with a stun gun.
“Not joining the victory train?”
He shakes his head slowly for a long time. “It seemed like not many truly joined it.”
“What do you mean?”
He looks up, rubs his eyes. “There is supposed to be life in the parties, yes?”
I nod. “Something like that, sure.”
“I did not see it anywhere in this one.”
I fall asleep again before the willow’s done. My dream could have happened. A tall man is walking driveway that is three years long. He struggles to stay awake during the day and has a hideous time sleeping at night. His stumbling worsens but he finally is able to get some sleep. When he doesn’t move for three dream days, my dream self knows he’s never going to wake up. There is a woman who I can’t see in the dream and she tells me that this is my fault.
Okay, this part couldn’t have happened: I leave the place I’m standing as I watch the man die and head to the river where I catch more fish than I’ve ever caught total in my eight years of fly fishing.
When the random cold days in spring retreat from the summer sun finally, I hit the river. The willow’s a day’s work from being done and I’ve got one more before the birthday. My reel sounds like a grossly huge fly but I take three fat fish.
“Yes,” the German woman says, “I spoke with one who asked could my brother walk straight?”
“I remember. That was me.”
“Yes, he says his hands hurt like arthritis and sore muscles like a marathon runner.”
“And I’m sorry, where are you calling from? City and country?”
“Itchy skin, amnesia, enlarged lymph nodes, fever and now balance issues, correct?” I read as I type the last one.
“Okay. Is the itch all over? Centralized in one location?” I ask calmly with the strings attached to the corner of my mouth pulled up and tight.
“Um.” There is a long pause filled with German conversation between the woman and a very tired man. I don’t speak German but tired is a universal tone. It’s also basically universal.
I realize about five minutes into the hold I’ve been put on that, if I wanted to, I could learn the parts of the body in German. And also the word for bug bite. So, there is a Käferbiss.
“Can you describe the nature and location of the bite? Swollen or raised at all?”
“Is there a lump where the bite is? How did you identify where the bite is?”
“Circles of red and bruising and there is a little dot in the middle and white is around it.”
My computer screen flashes orange three times, which means high volume of urgent
calls. They’ve got it set up that, in Celebration Room, there are allegedly no urgent calls, so they feel okay about putting a timer on each call – you have to diagnose and prescribe a treatment before the call disconnects automatically in seven minutes and you’re on the phone with a new patient. I start talking about Calamine and Benadryl, anticipating the language barrier and she is spirited away just as she understands.
The niece’s party theme is sunset colors. Weird kid. Maybe my brother’s personal offense at the existence of toys has more side effects than he’d thought about. I showed up with a hot purple willow tree because five seconds ago, that was her favorite colour. She shrieks with disappointment in front of everyone else who gave perfect gifts — a red ball, a yellow teddy bear, pink rain boots, pajamas with suns on them.
“Thanks for the warning, Pete.” I jammed an elbow into his side when the tears and public shaming were over for that particular moment.
“Hey.” He shoved my elbow hard back at me. “Signs are all around if you’re paying attention.
I take that as my sign that fly fishing is a better choice that social gatherings. Screw trees, also.
A month later, the German woman is back. “Yes, I spoke with one who asked could my
brother walk straight?”
“Yes, I remember. That was me. May I have where you’re calling from, please?”
“He cannot walk straight now.”
I’m not screwing around this time. “One moment, please.” I start dialing the translation service on the phone screen. While I’m on hold a German interpreter, I cover the receiver and lean over my cube wall.
“Hey,” I say when I see that Ravi is playing Solitaire not on a call. “Itchy skin, amnesia, enlarged lymph nodes, joint and muscle aches, insect bite and now balance issues all fit African sleeping sickness except the amnesia, right?”
“Yes, in that order, too. Except the bug bite would have come first.” He drags the final king in place. Cards go wild on his screen.
“Well, and that the caller’s not calling from rural Africa.”
Ravi turns from the digital jubilation. “Where are they calling from?
“Hello? Yes, German, please.”
“When did this woman start calling?” Ravi stands.
I cover the receiver with my hand. “Isn’t it more relevant when the symptoms started than — hello? Yes, Cadence Medical Outpost.” I run down the symptoms and join us all party-line style.
My, oh my, how the German flies. It’s like they don’t need me at all.
Until, “Doctor, you said amnesia?”
“Yes, that was one of the first reported symptoms.”
More German. Then, “Did the patient actually say amnesia?”
My stomach drops a little. I scan over my notes without seeing the words several times before slowing down. My brother has itching of the skin and does not have himself. Confusion. Not amnesia.
“Okay.” German for a long time.
Even if I hadn’t fucked that up, I’d ruled out sleeping sickness. The tsetse fly is only found in rural Africa. That’s the only place warm enough for it to live.
“Rav.” I don’t even bother to cover the phone. He’s not moved. “Replace amnesia with mental confusion, and what do you get?”
“Death within three years, usually. But,” he pumps a fist. “That’s without treatment. They’re in Germany, right? They should be fine.” He does a disco move and spins back around to his computer screen, littered with cards all funned out. Sunset slings through the half-closed blinds, colors everything failure to see the signs.
“Yeah,” I said, more into the phone than at Ravi. “The dude who got African sleeping sickness in Germany is going to be fine.” Cue the pandemonium.