The Scream

Munch is one of those artists whose work you want to grace every room -- they have such a welcoming, warming effect. Certainly, waking up to one flashing in the middle of the night, backlit by, say, a lightening strike, is an illuminating experience.

So, it's almost official. German Expressionism has stomped all over the schmalzy poppy fields and brasseries of the lame French Impressionists.

Just kidding.

What is almost official, indeed *is* official, is that a third surgery is planned for my right shoulder area. Philosophical inquiry: When does the area between clavicle and humerus cease to be a shoulder area? [Mine may be the only Hergéveen Manor House in the region in which you will actually discover the sound of one hand clapping.]

You only have to tell me a dozen times, you cross-eyed Physician's Assistant! I get yer everlovin' drift, you emotionless cretin! [There is a storm brewing in some medical bloglets that purports to be about the usefulness of beings such as PAs and NPs. It is when you plomb the depths of the meaning of "usefulness" that the real argument, that is: how much money can Happy and Scalpel legally earn without compromising their liability one red cent? It's a riot. Yawn.] {I am being mean. The argument is interesting, and, as it touches on the nature of things, important to the future of healthcare. *burp*}

She is very nice. She has long, straight, and recently trimmed dark hair. She looks to be about 12 and speaks in a sing-song voice when saying things like, "I know it is hard."

She wouldn't know hard if I hit her.

(This is my new favorite sentence. I am going to enjoy it again: She wouldn't know hard if I hit her.)

Which, of course, I would never do -- I don't have any shoulders.

I may not have mentioned that I may decide to go left-hipless, too. But I think I will save that for when life begins to bore.

"The spacer in your right shoulder is now just a foreign body that is attracting bacteria. It must come out. You are having fevers, pain, and elevated white counts while on intravenous vancomycin. This is not normal. We cannot keep you on antibiotics indefinitely, particularly as we still do not know what we are dealing with -- your cultures are not growing any pathogens."

She has the art of S - V - O down pat. The plan, I see, is to wear me down with simple declaratives and restatements of what they think I already know. Ha! They can never know how little I really know! I should not be misoverestimated.

"But," I whine, "It seems like we are just chasing this from joint to joint, bone to bone, doing one surgery after another. It can't still be an emergency each time! I know I keep saying this but please hear me! I. cannot. do. this."

Note that most of my statements should be issued with asterisks and readily found errata sheets. My écouteurs, and rare interlocuteurs, also ought to be equiped with something like a fly swatter, to manage the pestilence of my punctuation -- it tends to swirl.

That would be pity in her eyes, however briefly -- proof she definitely does not know me. I am quite capable of producing sufficient self-pity, thank you. No matter, her tone of voice made plain her conviction that I had no choice but to play out the scenario that her boss has had her deliver.

He *may* have said the same thing to me last Tuesday. He *may* correctly have concluded that I am not accepting this thing that he sees as a fait accompli. Just because I am fluent in the language does not mean I am the least bit cartesian.

Maybe it wasn't pity. Maybe I poked her in the eyes with speed faster than light. Yeah... that's it. I poked her in the eyes -- yes, both eyes -- with a gnarly stick and was so quick about it that neither one of us saw it happen. Yeah. And where is the thermometer? Fred is hiding the thermometers...

The ID person I trust most is on vacation -- and while she can be equally assertive, she promises an open mind. I find her believable and capable of sustained argument and explanation. I leave her exam room without any still-plaguing worries or questions. Her hair is blond and blunt cut. She is tall and wiry, and wields her wit like a very sharp knife. She gets grossed out by skin ulcers. This I know because we sat together, groaning "grossssss!" at the sight of my nasty foot wound -- it is almost healed, thank goodness (and the Wound Care Center).

We call her Susan because that is her name. Susan doesn't afford me the time to develop a healthy strain of denial. She almost does the Triple Gallic Non, and does do a passable wagging finger. They say she is just a PA, but I suspect that she is the brains behind the outfit. I mean, go figure -- which of their medical staff has managed a two-week vacation at high-holiday time? That's right -- Susan has.

I am trying to understand how the passage from infected prosthetic joint to osteomyelitis means anything. It has significance for these medicos, I can see that. They think it profound, even.

Let's see: same process, slightly different medium. Certainly, once in the bone, any bacteria or what the eff-ever has it made -- I have pre-existing avascular necrosis virtually everywhere. A match made in heaven.

I am beyond depressed. I scared Fred last night -- sleeping fitfully, I kept waking up screaming. You see, as the shoulder area starts to relax and fall backward toward the mattress and the pillows -- well, it sure feels like tissue and schtuff rip and tear -- it is very painful. Horrific, actually. And, if it's my unconscious ruling the roost, I scream. All the care I take to behave well and unremarkably in my waking hours? A complete waste if I am going to scream my bloody head off all night.

Marmy stole my heart away during all that noise, though. As my wailing fades, I see Fred floating in mid-levitation, hair pointing skyward. I see the tip of Sam-I-Am's tail fleeing the scene. Dobby immediately jumps in the trashcan (there is no explaining Dobby). But Marmy? She has come close to me, she is "ack-ack"ing to beat the band, seeking in my scream some hint of syncopation for herself. She came close, she stayed, she did not leave me all night long.

Don't touch my anthropomorphism. It is a vestige of good mental health.

The Boutiqueur and I have a secret worry -- the heart. This breezy and beautiful afternoon, just as we arrived back at Marlinspike Hall, deep, deep in the Tête de Hergé, I had a good five minutes of chest pain. It could not have been truly cardiac -- but I am psychologically primed to fear the be-all-end-all of a "blown" aortic aneurysm.

There is a huge logical disconnect -- but the point, I suppose, is that any note taken of the heart now quickly converts to an internal seminar on what it might feel like for that sucker to really blow. The cardiologist I spoke with on the phone lacked all humor. I asked what symptoms I should learn to recognize. He laughed mirthlessly and said something like: "You won't have time to have any symptoms..."

I don't think that has any relationship with this tenacious infection -- The Boutiqueur is more correctly focused on my crappy aortic *valve* -- its bicuspidness. Bicuspidity? And the chest pain? Well, my heart rate hasn't been below about 110 in months now... Shoot, probably nothing but heartburn or a pulled muscle.

Yeah, Retired Educator! Borrow trouble, you nitwit.

Earlier this evening, I began a reread of The Adventures of Tom Sawyer. I like the transparency of my mind. My memory stretches back to sitting on an old painted bedstead with a very lumpy mattress -- down in my grandparents' basement, reading Tom out loud while my Nana ironed. It would have distressed her greatly to learn that the first "real" book I ever picked for myself, and finished, was Go up for glory by Bill Russell.

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