A Baptist in Baton Rouge since birth, the family genius at Tulane University since early acceptance at 16, and a born-again cynic after trying to treat his first Cancer patient at 24, Stewart Williams, III, MD believed in two things. Results, and procedure. Both were well worked into the program at the Klajburg Nursing home, the last resting place for Long Island elders who had outlived their usefulness to their ‘youngers’, and overqualified physicians who had outlived their usefulness to themselves. The pay was good, the hours short, the schedule reliable, and the patients were ‘manageable’ unless you objected to the smell of urine or had problems dealing with patients who were not themselves. Indeed, the patients who were their ‘younger’ selves were, all things considered, not so bad off. Though the calendar said it was 2005, four years after 9/11, a decade or less away from the next and perhaps final crash on Wall Street, to most of the white haired, or no-haired, patients at Klajburg it was the Roaring Twenties, the golden homecoming months after V-J day, or those quietly-prosperous times when Elvis was King and Marilyn Monroe was queen. Even to the Mr. Weinstein in room 235, who found his way into Mrs. Lazanska’s dresser draw again, sauntering around the common ground like Queen Marylyn. The ‘whys’ of it didn’t matter anymore. Mr. Weinstein was probably visiting those times when his mother, wife or mistress weren’t home again, thinking that the other patients in the hallway were shoppers at the mall who were actually fooled by his impersonation of the opposite gender. If he really ‘passed’ then, or could pass now, was immaterial. With Parkinson’s disease progressing faster than expected, added to his diabetes, added to his nearly deaf ears, ‘Doc Stew’, as Mr. Weinstein whispered in his ear seductively, didn’t mind the old man’s eccentricities, or even the touch of the old geezer (or geezerette’s) hand on his thigh. The main issue at hand was what was still on the night table next to his bed.
‘Your pills,’ Williams sighed, looking straight into Mr. Wienstien’s mascara covered eyes. “We talked about your taking your pills. And you promised me that you—“
“—I DID take my pills,” Weinstein interjected.
“Your Parkinson’s pills?” Williams said, looking at the bottle of medication he specially ordered and titrated, having been untaken for the third day in a row.. “The L-Dopa.”
“I’m no dopa, or doper, Doc,” Weinstein insisted. “I read an article on where those things come from.”
Williams took in a deep breath, prepared once again to defend the pharmaceutical companies with the pre-rehearsed and repeatedly needed lecture about how the drugs from drug companies were carefully measured and researched. That while there were risks with everything, taking that little white, blue, green or no-colored pill was better than playing Russian Roulette with Nature or ‘natural’ herbal products that caused so many un-studied side effects, even when the patients could read the labels. But before he could get through the first “I know you heard many things, and that some pharmaceutical companies are out for money first” qualifier, Weinstein smiled, pulling out a vial. Empty this time. With the physician’s name on it, ‘P.D.Q., M.D.’
“What was in there?” Williams grunted as he grabbed the vial, smelling its contents.
“I don’t know,” Weinstein said, walking over to the CD player, with a gait that was better than he was supposed to have. He turned on the ‘record machine’, ‘Summer Winds’ from Sinatra gently flowing from its speakers. Lifting up a fold of Miss. Lazanska’s skirt, revealing legs he had freshly shaved last night, Mr. Wienstein extended his hand to Williams, without tremor. “Shall we dance, Doctor?” he asked.
It was all Doctor Williams could do to hold back his stutter. That stutter that came out of his mouth when an Intern interrogated by an Attending who demanded to know an answer he didn’t have. That stutter which he learned to control when he had exhausted his source of medical knowledge. That stutter that said in a helpless way ‘I don’t know’ from a man who was bred, educated and paid to know everything. Why was is that Weinstein was able to move so gracefully? Something in the music? Something stimulant creeping up from the smelly-soled pumps he stole from the lost and found? Something from the bottle from Doctor PDQ, the mystery man who had visited more than one of his patients in the last few weeks.
“Well, Doctor?” Mr. Weinsten asked again, after doing a pirouette that left him standing, and smiling. “Shall we dance?”
“Eh…eh….eh…” Williams replied, backing up towards the door as Mr. Weinstein turned more ‘Marilyn’ with each step towards him.
“Later,” Williams said, seeing help just behind him.
“Yes, later, Marylyn,” Nurse Erica Freedman said, presenting Williams with a clipboard. “Doctor Williams has an emergency to deal with now.”
“Eh…yes, I do,” Williams said, grateful for this ‘save’ from Erica, yet one more time. This time, it was with a sense of humor, the ‘get out of listening to an Old Timer’s story’ clipboard containing the a fax from a Travel Agent boldly displaying the dates for a dream Hawaiian vacation affordable on a real-life Bensenhearst budget. And if that didn’t do the trick, something else.
“Dream Mate Escort Service?” Williams commented as he accompanied Erica down the hall. “Isn’t the idea of an escort service to hook onto someone who is NOT your mate, and doesn’t need to be one?” he mused.
Erica seemed disappointed. Williams knew that she had designs on him, or wishes, that went beyond ‘coffee’, ‘drinks’ or even ‘breakfast after a sleepover’. But this time, she was mad at something else in the Louisiana-bred Doctor who lost all traces of Southern gentility, grace and diction since moving up to the Big Apple. “That joke is old,” she slurred from the side of her mouth as she smiled to Mrs. Jackstein, Mr. Stone, and, as he preferred now to be called for reasons even the shrink couldn’t figure out, Father Rabinowitz. “Old like you’ll be some day,” she said, causing a defensive shrug from Williams. “Old and useless,” she continued, finally causing him to stop dead in his tracks.
“Useless!” he protested her, and asked of himself.
Erica put a quarter into the coffee machine, kicking it in the right place so that it would cough up two half-dollar cups of java. “Nature takes care of animals, God takes care of fools, and—“
“—Doctor PDQ is taking care of everyone in here better than either of us did,” Williams muttered softly enough so as to not be heard by the patients walking, dancing and singing around the hallway like they were something more…People. Most of them were living in their own world, but those worlds were happier than seen in previous weeks, and movement within them more negotiable. Mrs. Carlson’s myasthenia gravis was improving, the throat that had a hard time swallowing now able to carry a conversation, and even an off-toned show tune. Mr. Verowskoff walked with a cane now, his walker gathering dust in his room as he chased after Mrs. Carlson. And the keys to the drug cabinet kept becoming missing, and re-appearing again.
“Any idea who he is?” Williams asked Erica.
“Or SHE?” Erica noted, her attention pulled away by a crash of a tray from a room in hallway B, the indigent scream of an elderly patient, then a cry of what seemed like a baby from the same location. “Mrs. Mahony,” she smiled in a concerned maternal tone, walking down the hall to treat the mother who bore the first of her nine children when she was 16, now a child herself, finally.
Williams noted the new crop of Fourth Years and Interns turning the corner, two of them having that ‘terror’ for the aging, most of them carrying with them the ‘this is going to be the easiest rotation ever in their upstart eyes. There were many questions in Williams’ mind always on guard to snatch an answer. “Why does leukemia kill children?” “Why does a quarter of the world wake up and go to bed hungry?” ‘Why war?” “Why aging?” “Why death?” “Why did my ex-wife go off and have an affair with MY mistress?” But for now, one inquiry catapulted up to the top of the A list, lingering there over all others. “Doctor PDQ,” he found himself thinking and saying.
A nudge came from his right, or was it his left? “PDQ?” a gravely voice echoed into Williams’ ear. Turning to see the source of the terror, ‘Doctor Stew’ bent his head down, noting a 5 foot 6 elderly once-gentleman who stood barely five foot with the hunch which now had become part of his bent back. “PDQ”, he slurred from one side of his mouth, the other paralyzed with Bell’s Palsy or some other neurological complication that came and went. “It means Fast. Doctor Fast, on the button, on the ready, on the—‘
“—I know, Mister Ignitowski”, Williams slurred through eyes that hadn’t gotten a good night’s sleep in as many nights as he could remember. “I know what PDQ means.” Doing a once-over on Mister I, or ‘Mister Me’, as he often liked to be called by the nurses, Williams sniffed the ulcers on his elbows.
“They’re getting better.” Mr. I said.
“Because you’re taking your insulin,” Williams stated, and asked, hoping that his best, and underneath it all, heartfelt, efforts were not offered in vain.
Mr. I smiled with all the effort he could exert. “You look tired, Doctor Stew. Maybe you should go home and get some sleep.”
“But who would take care of all of you?” Williams said, believing the BS which started as PR then became reality after he found himself part of the dysfunctional Klajman Hospital ‘family’.
Mr. I considered the matter, stroking his chin with the hand that should have been amputated weeks ago, according to everything Williams learned as a student at Tulane, a resident at Columbia and an attending at Johns Hopkins. The assuring laugh from the on-and-off-again Mr. I afterwards was certainly not in the textbooks.
As Mr. I hobbled down the hallway to his room, and new box of old books delivered by his daughter, Williams felt like going home. One couldn’t say that patients at Klajman were ready to go home to their families, or the world outside the doors of the ‘Senior Living Center’, but they were doing better than expected. Someone was taking care of them with some special brand of medicine no one was talking about? Was it Erica? One of the new Interns who was a closet Einstein? Maybe God had finally waken up from His, or Her, lunch break. But whoever it PDQ, MD was, he, or she, was moving fast making William’s something he feared most…useless.
Looking at the schedule for the next day, and the now excess staff available to fill it, Stewart Williams decided it was time to go home. Erica recommended it as well. Besides growing into a chronically-tired pain in the ass to the nurses, he seemed to be having lapses of judgement himself, having to be corrected on at least three occasions on miscalculating drug doses for patients. The first time he said it was because the hospital should hire nurses who can read a physician’s handwriting. The second time, he blamed it on a new label from the pharmaceutical company with splotches between numbers that looked like decimal points. Thankfully, the ‘three check’ system was in William’s protocol, read the bottle before you open the tip of the syringe, again when you load it, then again before you inject it. But it was taking three checks to catch him now, and perhaps others would catch him soon. Erica was the protector he feared most. Watching his every move, thought and feeling, she could read him like a book, and it was not reading like a success story.
Forty-something on ninety Williams could see himself in every over-something over aged patient who came into the door. It was loss of function for the muscle between the ears that he feared most. It wasn’t anything visible to the eye. He still had all his hair, teeth, testacies and appendages. But he saw it every time he looked in the mirror. The young man who was really old, and whose days of ‘retirement’ would come sooner than he thought. The stats said that 10% of all patients, and people, before 65 developed ‘Altzimer Dementia’, and his family history was filled with forgetful, 90 year olds who started to die by their fiftieth birthday, too depressed to commit suicide. A sin in the eyes and the Lord, of course, who still haunted him, particularly on the “Come Live with Jesus” billboards he saw on his way home every night. “Go back to Alabami!” he screamed at the happy and lifeless faces of the multi-colored congregation painted on the billboards, and the seemingly manipulative blonde, blue-eyed, bearded overseer in the long white robe and halo. “Show yourself in MY world, or go back to your own!” he screamed at the billboard that did nothing except smile back at him sadistically every night.
But this night, the Billboard had something else to say. Noting another detail on the board, another rise in the number of New Yorkers converted into Evangelism boosted by the New Life Ministry, he raised his third digit in anger, noting that with each defiant gesture expressed on behalf of a tortured humanity, his wrist shook with even less control. Then, his arm, then, this time, his foot. Two screams, yelps, and prayers to Whoever might be listening later, Williams woke up in a ditch.
The view of the South State Parkway from behind broken glass seemed psychedelic. Yellow lights. Green traffic signals. White lights from cars too distant to notice him. Red tinge on the glass, probably, he intuited, his own.
“Help?” he asked the sky. But instead of bright light, it was dark. Still dark and silent. The stars seem to laugh at him. The planets didn’t care. “Help…right,” he sighed, resigned to facing his own demise, thankfully with his sense and perspectives still intact. “Help” he muttered again, closing his eyes, offering his Soul to God, hoping that He, She or It existed, or could be brought back to life in service of humanity by his sacrifice, and/or offering.
“PDQ, Doc,” he heard from a gravely voice. Looking up, he DID see the bright light, flecks of shining hair behind a head that moved closer in to him, revealing eyes that were bright blue, wide open, kind and…very human. More human than he ever imagined possible. In a face that he found himself recognizing.
“Mister Ignitowski?” Williams said, not believing his eyes. “How did you get out of—?“
Mister I shh’d him, taking a stet scope out of a three-decade old, scuffed and hole-ridden medical bag bearing his name, “Ed Ignitowski, MD. PDQ Doc.” Behind him was a familiar vehicle, an ambulance from the ER, from the Klajman Medical Center. Its operators were apparently busy, with another patient, a driver on the side of the road walking around his car, smashing it to pieces with a crow bar. The person most certainly was about to become a patient, perhaps because of the bleeding left arm and limping left leg, or the way he was so boldly and effectively destroying his own vehicle, resisting help from the Paramedics.
“Who is that…?” Williams said, opening the door, pushing his way out of the car with as much strength as he could.
“Situation under control,” Doctor I said in voice that seemed coherent, connected to medical instincts and abilities as great as any Williams had seen, or learned, at Tulane. ‘Patient’ Ignitowski’s method of pulse diagnosis, neurological exam and that touch that combined maximal proficiency and compassion made Doc Williams feel secure, and cared for, for the first time in a long time. Still, Williams needed the kind of medicine that helped him most—-to be needed. “I have to help that patient out there!” he said, noting the straight jackets being taken out, the thorazine taken from the special compartment of the Emergency Vehicle, ready to inject into the unsuspecting patient’s arm, perhaps the right medicine, perhaps not. “I have to help!?
“Physician heal thyself,” the Elder PDQ said to the younger MD in an assuring, and stern tone. Mr. I, formerly Doctor Ignitowski, handed Williams a jar of medicine from his bag, simply labeled ‘Two pills a day, as needed, PDQ’. Losing no time, and with the quick rhythm of a man half William’s age, Doc Ignitowski’s hands whipped the lacerations in William’s hands and head back into shape, giving him injections of antibiotics, anti-inflammatory, and anti-psychotic drugs. Some Williams noted as being from the Klajman Hospital Pharmacy, while others weren’t, writing on them faded, in red script from a time before computer print outs or perhaps even typewriters.
Williams sniffed the special PDQ pills, then tasted them. “Sugar pills!”
“Maybe, maybe not,” Ignitowski said, cutting the last remnant of excess stitching from William’s forehead. “But one thing is for sure.”
Williams looked into the mirror, noting the repaired scar on his forehead. “That my ex-wife will say I finally got the lobotomy I needed, and deserve?” he mused.
“No, my lad, boy…man,” Ignitowaski smiled. Putting his hand on Williams’ shaking shoulders he leaned into the car. “All well motivated patients get better.”
“People” Williams said. “All patients are people. And all people are patients. And if I forget about that tomorrow at work, I want you to—“ Doctor Stew turned to Doctor Ignitowski, finding him walking back to the Emergency Vehicle, the erect six foot tall healer becoming a hunchbacked patient, losing an inch with each step.
“You okay Doc?” the Head Paramedic said to Patient Ignitowski.
“No problem,” he Dr I nodded as he took his seat in the cab, strapped into place by the Assistant Paramedic.
“What were you doing out in the woods?” the Assistant asked. “We asked you to stay in here. You’d get into big trouble with your family and we’d get shit from our boss.”
“A sick animal needed my help,” Dr I replied.
“What kind of animal would that be?” The Head Paramedic asked respecting the man, ignoring his stories.
“One that is…okay now,” Doctor Ignitowski replied, turning to the car that the Paramedics didn’t even notice, the Doctor inside of it who was not cured by a patient hardly suspected of being his biggest problem, and ultimate solution.
Williams scratched his head, opened the door, and trudged through the woods that hide anything more than ten feet from the highway from the driver’s perspective. As expected, thirty cars passed him without noticing or stopping. As unexpected, he found a cell phone on the pavement, a note from PDQ saying to press ‘redial’. Following doctor, or patient’s instructions, he did so.
“Hello…hello…” came from the other end, the voice confused, then angered.
Smiling, Williams knew what the good doc wanted him to do, and the treatment he needed to follow up on for a long time. “Hello, Nurse Erica, this is Doctor Stew.”
“Doctor Stew?” she inquired. “You hate it when patients call you that.”
“Well, a lot has changed since then.” He walked down the highway, continuing the conversation. “Which I wanted to relate to you over a late supper at my place…. and breakfast.”
“Where are you?” she asked, concerned.
“A better place than I’ve ever been,” William’s reply as his 90 dollar loafers sloshed through another pile of highway mud, a semi throwing ten gallons of oil-soaked rain puddle onto his suit and he felt the droplets of blood on the stitched lacerations on his arms, reminding him, for better or worse, that he was finally…alive.
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