A White Coat Is My Closet (23 page)

As she was talking, I pulled Christopher’s chart and looked at his medicine profile. “I’ll have the nurse give him more Zofran now. Hopefully that will calm his nausea some. It shouldn’t take me more than about an hour to check on my other patients. I’ll save him for last and see if I can cheer him up a little.”

“Okay, but I’m warning you, he’s pretty glum. You’re really gonna have to work your magic.”

“Hey.” I smiled though not as confidently as I would have liked. “Why do you think they call me the Amazing Dr. Magic?”

Diane rolled her eyes. “Because you can perform finger puppets with both thumbs up your ass?” She smirked.

“Finger puppets nothing. I can pull a rabbit out of there!” I realized that in my haste to respond with a clever joke, I had spouted off before really thinking it through. I stopped abruptly. I wrinkled my brow and whispered a soft, almost apologetic follow-up. “Okay, that was a little gross. But I guarantee no animals are ever hurt while performing any of my tricks.”

I smiled weakly but inwardly chastised myself. I was close to confiding to Diane that I was gay, but I didn’t want the conversation to occur in the middle of a busy morning, and I certainly didn’t want the disclosure to come out in the form of an anal-sex joke. We had been doing this dance with each other since we were interns together. The intensity of our jobs often pushed us into situations where we found ourselves feeling particularly vulnerable. Invariably, during such times, a lot of intimate information ended up being exchanged. I’d come close to telling her that I was gay, but I always ended up holding back. Partly, my personal shit prevented me from being able to make the disclosure. But the pervasive homophobic attitude in the hospital was also a deterrent. You didn’t have to spend more than five minutes in the same room with Dr. Klein for it to become abundantly obvious that, in the medical hierarchy, gays were ranked somewhere just below the bottom dwellers. In addition to being scorned, they were pond scum. I was hugely apprehensive that coming out would not only jeopardize my reputation, but my future opportunities as well.

I playfully whacked Diane’s shoulder with Christopher’s chart and attempted a partial recovery. “And, contrary to PETA’s accusations, I don’t trick with either rabbits or gerbils.”

I pushed off the counter and started down the corridor to begin my work, knowing that I had left Diane standing behind me shaking her head in bewilderment. She had to figure I was either a genius or I should be committed. Probably the latter.

An hour and a half later, I had reviewed the labs on all of my patients and had been into their rooms to give them cursory exams. I would follow each of them up more thoroughly later in the afternoon. I preferred to see them when they were more awake and when I could better determine if the therapeutic interventions we had implemented were indeed helping. The purpose of morning rounds was principally to ensure there had been no worrisome changes overnight and to verify the plan for the day with my interns. Later in the morning, all the patients on our service would have to be presented to the attending physician in charge. The attendings ultimately had the final say on management decisions and were charged with making sure our plan of care was appropriate. Fortunately, I had earned their confidence, and though I continued to be carefully supervised, they felt secure in giving me a lot of autonomy.

I wanted to make two stops before visiting Christopher. The first was to the inpatient pharmacy. I knocked on the door and was relieved to see my friend Bonnie through the thick security glass. She was my favorite pediatric pharmacist. In addition to being friendly and approachable, when it came to drugs and dosages, she was a walking textbook. I had never asked her a question she couldn’t answer off the top of her head. She pressed a button, the lock on the door buzzed, and I was able to pull it open.

“Hey, Bonnie! What’s shaking?”

“Hey. Zack. I’m good. But you can skip the buttering-up part. If you’re down here this early in the morning, it’s a pretty good bet that this isn’t a social visit. What can I do for you?”

“Oh, Bonnie. You’re so cynical. What’s makes you so sure I didn’t come down specifically to just wish you a good morning?”

She braced both hands on the stainless steel counter in front of her and gave me a deadpan expression. “Because I wasn’t born yesterday.” She brightened with a slight smile but turned to look up at the shelf above her. She began to methodically pull down specific vials in an array of different colors and covered with labels cautioning extreme care. When she continued her reply, her voice maintained a clipped, efficient tone. “I’ve got gallons of chemo to constitute this morning, so if you just came down to say good morning, let me return the courtesy.” She turned to face me and offered a forced, brief, but exuberant smile. “Good morning.” She returned her focus to the counter in front of her. “Now get out.”

“Well, since I’m here, there is maybe one small favor.”

“I knew this was coming.” She didn’t look up, and after conferring with the computer that sat in front of her, she began to arrange the vials in a specified order. “It had better be small.”

“Christopher, our five-year-old with neuroblastoma, is really suffering with the mouth sores. Can we whip him up some of our special concoction? If I coax him through it, I think I can get him to swish it in his mouth and spit.”

Bonnie immediately pulled her attention away from the computer and looked at me. “Of course, Zack. Why didn’t you say so in the first place? You can reserve your charms for when you’re trying to hit me up for some Advil to help your own hangover. As for Christopher, it’s whatever he needs. You’ve gotta watch him, though. I don’t want him to swallow this.”

In pediatrics, one of the recipes to reduce the pain from blisters in the mouth was a combination of three medicines. You mixed 2 percent viscous lidocaine with Benadryl and Maalox. Lidocaine was a topical anesthetic and, at least temporarily, could really relieve the almost excruciating pain from oral cold sores. The Maalox did little more than to thicken the solution, give it a palatable flavor, and make it sticky enough to adhere to the problem areas. The Benadryl aided in reducing inflammation.

The problem was that the concoction couldn’t be swallowed. If a five-year-old swallowed it, their gagging mechanism could be numbed and put them at risk of choking. It was effective and was easily used in older children. However, in younger kids, it could be a little tricky. They really didn’t get the concept of swishing something around their mouth to coat the painful areas but then spit it out without swallowing.

I would have to figure out a way to coach Christopher through it. I was determined to help make him feel more comfortable without using so much morphine that he’d spend his day in a medically induced delirium.

After Bonnie completed the mixing, I thanked her profusely for always being willing to help me out in a pinch, then left the pharmacy and headed for the cafeteria. Hoping to avoid the midmorning breakfast rush, I went around back and entered the main food preparation area through the door reserved for kitchen staff. Ora, one of the shift managers, looked up when she heard me walking through the maze of counters and shelves.

“Dr. Sheldon. What are you doing? You’re not supposed to be back here. You know this area is for kitchen employees only.” Ora was a robust black women. Her skin was the color of polished ebony, and her face was etched by permanent laugh lines. She had worked in food services at the hospital for more than thirty-five years, so I frequently teased her that her labor had been the foundation on which the cafeteria was built. Even her sharp reprimand couldn’t belie her warm, caring smile.

“I know, Ora. I’m sorry. But I need a quick favor, and I knew I could count on you to help me lift the spirits of a sad and sick five-year-old.”

Her expression immediately reflected her concern. She walked closer to me so she could speak in a loud whisper. “Whatever you need, Dr. Zack. You just tell me. I’ve seen you with those sick kids up there and think you’re wonderful. If one of them needs something, you just tell me what it is. If I can get it for you, it’s as good as in your hands.”

She looked at me earnestly. Ora had a heart of gold. I loved it when she called me Dr. Zack. She was old school, and though incredibly friendly with patients and staff alike, she rarely compromised hospital formality. The fact that she would call me Dr. Zack implied that in addition to respecting me as a physician, she also regarded me as a friend. I had huge regard for her too. Through her years working there, she had seen thousands of residents come and go and appreciated those she thought had made a difference. I was flattered to be included in the circle of the ones she thought highly of.

“You happen to have some sherbet hiding around here anywhere? This little guy is going through chemo and has some nasty mouth sores. I figure he might be willing to taste strawberry sherbet, and the cold sensation will help relieve some of his pain.” I smiled and nudged her shoulder. “When it came to finding someone who knew where the dessert was hidden, I knew I should start with you.”

“Child!” A deep southern accent rolled off her lips like thick maple syrup. “You came to the right person. I have me three or four flavors right here in the deep freeze.” She opened the door of the walk-in freezer and ambled way into the back. “Here, take one of each. Let him choose whichever one he wants. Bless his little heart.” She stacked four cartons into my arms and then shooed me on my way. “He wants anything else, you just come to me. Need be, I’ll make him something special. Now, go on. You’re gonna get us both in trouble for being back here.” She closed the freezer door but called to me before I had gotten more than a few feet away.

“And Dr. Zack. Give him a hug for me and tell him I have him in my prayers. God bless you both.” She waved and picked up the clipboard and checklist she had been working on before I had interrupted her.

I went up to Christopher’s room and knocked lightly before pushing the door open. He lay in bed and looked at me from under heavy lids. His pillowcase was covered with hair. The chemo was causing it to fall out, and he had reached the stage where it was coming out in handfuls. Ordinarily we would have just shaved his head, but he’d resisted, so there was nothing to be accomplished by forcing the matter. Might as well let him retain whatever independence he could. I saw no point in making an issue over something that had little clinical relevance. Save the arguments for the things that mattered.

“Hey, my man, I heard you weren’t feeling so hot. What’s going on?

I nodded at his mom as I walked in. If possible, she looked even more tired than Christopher. Her eyes were bloodshot from crying. She cried frequently, almost to the point of becoming dehydrated, but never allowed Christopher to see her. With him, she tried to always appear upbeat and sympathetic. I’d seen it before. His cancer was slowly killing her. But for him, she put up a convincing charade. She tried to offer me a welcoming smile and sound enthusiastic. “Hey, Dr. Zack. Christopher, look who showed up. Dr. Zack is here to visit you.”

I walked over to sit next to him on the bed. In order to get as close to him as possible, I had to dislodge Yogi, his beloved teddy bear, from under his right arm and tuck him securely under his other arm. I pulled the sheet up over both of them and traced my finger over Christopher’s forehead. He hadn’t spoken thus far. I looked at him and smiled as warmly as possible. “So? Tell me what’s up, champ. Maybe I can help.”

He could barely speak through swollen, cracked lips. “My mouth hurts.”

Thinking quickly and remembering that on the day of admission he had been wearing a Superman costume, I looked into his eyes and asked inquisitively, “Really? That’s rough. I’m not sure I’m strong enough to fix big pain, but I thought for sure Superman would have been able to help. What did he say to you while he was in here? Didn’t the Superman medicine that he gave you help the pain to go away?”

My question succeeded in at least getting a little life to come back into his eyes. He opened them more widely, and I was able to appreciate the smallest hint of a sparkle. But it was still difficult for Christopher to talk. “I didn’t see Superman.”

“You didn’t? Really? He was here not too long ago. I spoke to him just before he flew out the window. He said he had come to visit you. You must still have been asleep, and he decided not to wake you.” I nodded as if coming to a sudden understanding. “That must be why he left this Superman medicine with me. He was going to give it to you, but you were asleep. He said that it was super strong and that it was what he used when his mouth was sore.” I looked at Christopher as earnestly as possible. “He said that a long time ago this really bad guy named Atomic Skull tricked him and had gotten him to swallow kryptonite. You know what kryptonite is, don’t you?” Christopher nodded. “It’s a powerful poison and is the only thing on the planet that can hurt Superman. Superman’s mouth must have been really sore when he swallowed the kryptonite.” I paused but continued looking at Christopher and stroking his forehead. “Anyway, this genius scientist”—now I was really improvising—“from Superman’s planet Krypton saw that he was suffering and invented a medicine to try to save him. It’s red, just like Superman’s cape. Superman left some here for you. You want to try it? If it’s powerful enough for Superman, it’s bound to help you. And after all, Superman flew all the way from New York to bring it to you. He was there fighting Lex Luthor but heard you needed some help, so flew right over. Bet he’s sorry you were sleeping. I’m sure he wanted to give you the medicine himself.” I never imagined that there would ever be a professional benefit to having been a DC comic enthusiast. “So, what do you say?”

Christopher looked at me a little warily, but he nodded and in a soft, gravelly voice answered, “I’ll try it.”

“Great, I think that that will make Superman
super
happy. Let me go get it for you.” I stood up and started walking out of the room, then turned around as if remembering something. “There’s just one thing, though. You can’t swallow it.”