The Cobra

We who work in the medical field know that we may deal with unpleasant realities on any given day.  People don’t usually come to the doctors’ offices or clinics or hospitals to prove that everything is right in their world.  In fact, most of the time the reverse is true.  As a result of this hard truth, we medical workers develop an odd sense of humor in order to deal with the stress, much in the same manner as law enforcement agents or military personnel or others doing those jobs that most people wouldn’t want to do.  Some call it ‘gallows humor,’ and I suppose that is as good a description of it as any other.

But underlying that humor, we medical workers remember that we’re working on flesh-and-blood people; people who have lives and histories, families and connections and, probably most important, simple human worth.  We will work like fiends possessed in order to snatch a patient back from the grip of death, and if death has just been dealt too strong a hand we will sometimes cry and pound our fist against a wall when The Reaper wins the table.

It is with all of that in mind that I will now share a story from my medical career of over forty years.  I have no intention of making light of a person’s health crisis, and will refrain from stating the patient in my story’s age, medical diagnosis (which I never knew anyway), location, or anything else that could possibly identify this person or cause harm or pain to him or any living relative or acquaintance.  This is meant simply as a bit of humor; the humor that I and many who do work like mine use in order to keep our sanity.

This story is entitled ‘The Cobra,’ and it is with reference to the spitting cobra that is found in Africa and Southeast Asia.  It began when I was called to perform an ultrasound study of the abdomen on a patient in the Intensive Care Unit at a hospital where I worked years ago.  As usual, I loaded gel and linen on top of my ultrasound machine and pushed it to the room where the patient lay.

Outside the door was a cart with gowns and masks and bonnets which are usually provided when the patient has some disease such as MRSA, Clostridium difficile, E. Coli, or any other such highly communicable disease.  As I was gowning up, the patient’s nurse came by and I asked her “What nasty bug am I protecting myself from today?”

“Oh” she replied.  “He doesn’t have any infectious disease that we know of.”

I looked at the cart and bright yellow gown that I was wearing and then asked the nurse “Then why am I wearing all of this?”

“He spits” she said.

“Pardon me?”

“The patient spits.  It’s a neurological thing.  We don’t even know if he’s aware that he’s doing it.  He isn’t aiming, as far as we can tell, and you’ll only get hit if you stray into his line of fire.  He just spits constantly, so this is for your protection.”

I had never heard of any such thing, and so with a mix of caution and doubt I pushed my machine into the patient’s room and set up to go to work on the right side of the bed.  I quickly sized up the situation.  The floor was indeed a swamp of spit.  His bedding had recently been changed, so there was only a general dampness to the sheets and blanket that covered him.  His head was turned to the left, so I plugged in my machine, pulled up my chair, lowered the blanket and raised his gown, and then began to scan according to my abdomen protocol.

“Left lobe of the liver; four pictures in the transverse plane, including the portal vein.  Now three views in sagittal, trying to capture the caudate lobe framed by the left lobe and the inferior vena cava.”

Just about as I snapped that last picture The Cobra, which name I gave to the patient as a part of the coping mechanism that I have explained above, began to slowly move his head from his left to his right, where I was sitting.  “Pffft!  Pffft!  Pffft!”  “Oh crud” I thought.  “They’re right!  He’s spitting and he’s turning toward me!”  

In Vietnam I had seen things coming my way; things that I had little or no ability to prevent.  In such circumstances I had to focus on survival, and so it was on this day.  “Think, Durden.  Think fast!”

The Cobra’s face passed the 90 degree mark and his liquid missiles were beginning to arc onto the right half of his bed.  My peril was undeniable and my reason nearly failed me.  At the last minute however inspiration broke through and took charge of the situation.

“Look” I said, pointing to the wall near the left side of his bed.  “What’s that?”

Gradually, by microscopic increments like slow motion on barbiturates, The Cobra’s head stopped its starboard progress and reversed course, and like a supertanker making a U-turn he began to roll his head to port in order to investigate whatever it was that I was pointing at, spitting all the while like a fireboat at a Fourth of July celebration.

I resumed my exam with a new sense of urgency.  Pancreas: Bam! Done!  Aorta: Bam! Done! Gallbladder: Well, sort of like a Bam!  Those things just take a little more time.  Then on to the right lobe of the liver, with many segments and structures, veins and ducts and such to evaluate.  The liver will slow you down, and time was not on my side.  Sure enough, before my last liver image was taken the fount of saliva began to once again track back to the right.  This time, however, I felt like I had a handle on the situation; it was that or I was cutting the exam short.

“Look” I said again, and with greater urgency this time, just in case he was catching on to me.  “What’s that?”  Again I pointed to the left and again, after almost getting my outstretched right hand spat upon, his head returned to a leftward arc, dousing that side of the bed, the floor, and the wall with a saliva rain.

Now I knew that I had this one in the bag.  I finished the liver and right kidney and began to shut down my machine.  This process didn’t take long and before The Cobra could turn to anoint the right side of the room I was outside, peeling off my isolation gear safe and dry and feeling pretty good about myself.

“How did you manage that?” asked a nurse as I snugly dropped my dry gown and gloves into the appropriate receptacle.

“Manage what?” I asked, being a confirmed and determined smartass.

“How did you stay dry?  Nobody else has done that.”

“Hey, no problem” I replied.  “Desperate times, desperate measures.  I used a decoy.”

I left the nurse scratching her head as I descended to our department to develop my film and show a pretty good study to the radiologist.

The Price of Vanity

As I sit in a chair on my driveway in the afternoon shade while watering my lawn and shrubbery, I look down at the healing wound on the inside of my right heel and the blister that is scabbing up on the back of my hand.  To do this I must peer over the pale flesh of my abdomen; flesh that has passed many a month since it has seen the face of the sun.  The condition of these three parts of my body, hand, heel and belly, is intimately connected.  The pale flesh of the belly, untouched by the rays of the sun for so long, is my belated attempt to avoid further damage to my skin; damage exemplified by the recent biopsy of a mole on my heal and the freezing of the remnant of known squamous cell carcinoma on the back of my hand.

If you grew up in San Diego as I did in the middle of the last century, you had a high regard for the sun tan.  In fact, after the explosion of the surfing culture around 1960, the degree of one’s status and social attainment was greatly assisted by the quality of their tan, and I did everything that I could think of to get a tan.  One of my personal favorites, as I reflect, was the application of baby oil while I would lay under the open sun at Pacific Beach or some other sun-drenched spot where I could properly cook myself.

Baby oil, we teens were guaranteed, was the magic elixir that would turn even a melanin-challenged northern European like me into a bronzed god.  I do not remember who it was that issued that bogus guarantee, but their sales pitch was effective to the utmost.  I would roll over every so often, basting myself anew each time.  The only guarantee that was fulfilled was the unspoken one that I would cook myself like a Thanksgiving turkey.

“The West Coast has the sunshine, and the girls all get so tan – – -“ goes the lyric in a well known Beach Boy song, and the girls did their best to imitate art with their lives.  Twenty years later little had changed.  “I can see you, your brown skin shining in the sun.  You got the top pulled back and that, radio on baby.”  At least three times in that song Don Henly mentions his wayward lover’s brown skin, and unless she is derived from an more melanin-rich lineage than mine (or Don’s, to judge from when I have seen him on TV) that suggests that the girl spends a lot of time working on her tan.

But I’ll not point my gnarled finger only at the beach culture.  One fine day while enjoying a burger and coffee in a roadside squat-and-gobble restaurant somewhere west of Albuquerque I heard a waitress tell a regular customer that her affections would be reserved for a man with that “weathered look.”  Several ranchers and truckers in that joint filled her description to a tee, their tough, brown-to-red skin dried out and creased by deep wrinkles that looked eerily like the gulches and dry arroyos of that sun-blasted land.  The Marlborough Man had as much to fear from the sun above him as he did from the carcinigous death sticks that he liked to suck on.

But let’s bring this story back to my favorite topic:  Me.  As I stated earlier, I tried desperately to get my uncompromisingly white skin to take on some color.  I would broil under the sun at the beach all day, or roast in the desert at Yaqui Pass, Tamarisk Grove, or any of a score of unnamed (as far as I know) springs that could be found up valleys and ravines on the east slope of the Laguna Mountains, in search of the elusive tan.  My record of “success” tended mostly to a glowing redness that never quite matured into that coveted bronze tan.  Rather, it frequently evolved into full blown blistering.

Usually those episodes of trying to imitate a bratwurst on a tailgater’s grill would result in peeling that made me look like a snake shedding its skin.  Perhaps that was my body’s way of getting me to put on some protection.  Clothes applied to cover up my pseudo-leprosy also sufficed to block the next round of damageing sun exposure.

San Diego was not the only scene of my crimes against my own epidermis.  In Texas, Vietnam, northern California, New Mexico and the Pacific Northwest I chased that unreachable symbol of sun-blessed health.  It wasn’t until my third round of biopsies and freezings and lectures from my dermatologist that my addled brain at last allowed the thought that this might not be in my best interest to squeeze through into my consciousness.

So here I sit, writing this sad tale.  However, it’s not really all that bad.  Yeah, my belly’s white, but I’m sitting in the shade on my driveway, drinking some wine, watering the shrubs, and staring at the grass which I currently abide above instead of below.  At long last I understand that life is worth more than a tan, and I believe that I would like to stick around for a little while longer.

Proverbs 5

PROVERBS 5

     I have been pondering Jake’s sermon on Proverbs 5 and Wisdom for a couple of weeks now, chewing on it and trying to put it into a context that I can deal with.  Here’s where I stand in this endeavor at this point.

I was instantly bothered by the format of a father warning his son to stay away from the adulteress who was seeming lurking around every corner.  It sounded like little Shimron could hardly walk to the 7-11 to buy a couple of fig cakes and some new wine in a new skin without at least a couple or three adulteresses hitting him up on the way home for a little hanky-panky.

What I couldn’t help feeling is that it would probably be far more necessary to issue such warnings to daughters than to sons, when you consider the precarious position of women in that patriarchal society.  Now to be fair, women enjoyed far greater status in Hebrew culture than they did among the surrounding peoples, from being declared to be created in the image of God in Genesis 1, to gaining legal rights in Numbers 27 (the Daughters of Zelophehad) to being treated equally with men by Jesus.

Still, nobody can reasonably say that women were likely to be the sexual aggressors in Israel in Solomon’s day, or for that matter anything like equal.  So that issue bothered me from the beginning and perhaps distracted me somewhat from the main points of the sermon.  That left me to fill in my own gaps, which is always a dangerous thing.

But I did just that, and this is the result.  So far.  My first move was to put down my twenty first century lenses and stop trying to view the Bible as if I was a twenty year old sophomore  at Harvard fleeing to a safe space.  Proverbs 5 was written at the beginning of the last millennium before the birth of Jesus and the Middle East was then, as it continues to be to this day, a male world.  So if it sounds a little androcentric, like, duh!

What struck me though, once I began to consider the book for what it is, is that the woman who really counts is Wisdom; Sophia.  She is wise, she is ancient, she is almost omnipresent, if not indeed omnipresent.  She was present at the creation of things and danced with joy as God the Father did Their work.  Wisdom is calling to you, ready to give you insight that will benefit you in every way if you will only come to her.  In fact, it seems as if she is more likely to waylay you on your way to the 7-11, and try to knock some sense into your head before you buy any of those hot dogs that go round and round in the little countertop ovens. You know, maybe she should be called She; She is sort of like a feminine Jesus, but I don’t know about my theological foundation on that one.

What I’ve decided, however, is this:  Chapter 5 of Proverbs is providing a contrast; the Way of Wisdom and the way of folly.  Both ways are presented in a female form; it’s not like “Be like the Smart Dude and stay away from the Ho.”  No, to me its more like “Take the smart road and not the stupid one,” and nothing more than that.

Something I haven’t quite sussed out for myself however is whether or not God used the feminine gender for His portrayal of both wisdom and folly in Proverbs 5 in order to hint to the very masculine culture of the day (and just about all succeeding cultures to this day) that their androcentric views might be off of God’s tracks a little bit.  In that chapter both the Way of Wisdom and the way of folly are female; there’s no Great Male Way offered.  Was this an early act of God, pressing forward the process of reconciling men and women in equality and respect, a process that is taking a distressingly long time to bear fruit?  I don’t know.  I’ll have to think about that some more.