Saturday, September 11, 2004

Let's Do Lunch

It was one of those small awakenings.

It had been a chaotic morning in the clinic. Charts and lab reports and patients were everywhere. The exam rooms were full, and the waiting room was boiling up toward insurrection level. I'd been rushing about like a madwoman. Was I wrong, or were the day's patients even more inarticulate than usual ? First there had been the 90 something woman who'd signed in with a "sore mouth" who suddenly was describing waking at four AM with burning chest pain that radiated to her arms. OK. Swell. Cardiac work up. No problem.

Then there was the dizzy man.

Tell me about your dizziness, sir.

Well, I was sitting there, and, well, suddenly I felt, uh, you know, dizzy.

What did the dizziness feel like ?

Umm, well, my head, uh, it was really, really -- dizzy !

Can you describe the dizziness ?

Uhh, it was, you know, uhhhh, I was in the kitchen and I'd just had my cuppa coffee, and I was talking to my wife, and all of a sudden I, well, it was sort of like I suddenly got really, really ... dizzy.

I found myself pacing back and forth in my office eating lunch.

But it was less "eating lunch" as the civilized world construes it than trying to see how fast I could push a jam sandwich into my mouth. I was chewing the first quarter, wondering how few chews I could get away with before I could swallow and push the next quarter in. Without needing a Heimlich. Chew, damn you, chew ! I admonished my jaws, impatient, grinding, gulping, reaching for the other half sandwich, pacing all the while. Crumbs sluiced down my white lab coat. A red dollop of strawberry jam clung to the corner of my mouth. Still chewing, I wiped it away with the back of my hand. I pushed the third, then the fourth quarter in.

I'd pounded down that sucker in under a minute, I'm sure. I was a veritable eating machine.

Suddenly I had an insight. A disgusting one. I'd put that sandwich away as if I were in an eating contest. I thought of voracious fairground contestants pushing hot dog after hot dog into their mouths, or rooting, face down, in a bluberry pie. I'd always stared at films of such events with a mixture of revulsion and fascination.

The only difference was that I had no more strawberry jam sandwiches. If there'd been a pile of them on my desk would I have, like an insatiable automaton, kept shoveling them in ?

The thought made me dizzy. As in spinning -- we're talking true vertigo, doc -- on the edge of a sheer cliff.

I sat down and took a breath.

I remember once thinking, after a similar lightning lunch, that it would be much more efficient simply to have a large-bore feeding tube hitched up directly to my stomach. Right through the abdominal wall. Bypass the mouth totally. I could probably inject a blenderized jam sandwich through one of those things in 10 seconds, tops. While talking on the phone and signing lab reports.

Something was seriously out of balance. And it wasn't just the dizzy man.

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