Authors: Andy Siegel
“Hand me that plastic bag,” she says, indicating the one she wants. I do as I'm told. She looks in it, nods, then hands it to her new friend. “Here, take this.”
He complies and looks in it. His eyes light up. He reaches in with his grimy hand and takes out a roll, resting it on his dirty lap. Then he takes out two more, a shiny metal knife and five butter packets.
“Really, Mom?” I question. “Rolls, butter, and a knife. Really?”
“It was for my bum. But this guy's a good sharer.”
“Your bum?”
“Yeah, near my apartment.”
Lastly, he takes out a small white vase with a red carnation in it and sets it down on the sidewalk. He proceeds to butter up his roll as Mom enjoys her cig. They both seem pretty satisfied.
A moment later, we're distracted by a distinctive hearty laugh in the close distance but coming our way.
“Oh, shoot,” Mom says, “oh, shoot. Wheel me that way, quick!” She takes a long last drag and tosses the cig. It lands next to the bum. He picks it up, puts it into his mouth, and takes a hit while still chewing a chunk of buttered roll.
“But we're heading this way.”
“Turn me around and wheel me that way! Now!” I look to see who's approachingâit's a trio of nurses.
“I said turn me around.
Now
!”
I slowly begin turning her, making sure the nurses can get a glimpse of Mom.
“Faster,” she demands. “Faster!”
I get her pointed in the other direction. Then she barks another order. “Push!”
I obey.
“Adele! Adele, is that you?” It's the hearty voice.
“Push!” Mom says. “Faster!”
I stop. “But that nurse wants to talk to you. Maybe she wants to say good-bye.” I know for a fact by the tone of that nurse's voice she clearly does not want to say good-bye.
“She's annoying,” my mother responds. “Push! Hurry!”
“Not a chance. You think everyone's annoying, so there's something else going on here.”
The nurses reach us, and I pull a one-eighty. Mom looks up.
“Well hello, Adele,” the nurse says snidely. She's a large black woman, over two hundred pounds, and she speaks with confidence and authority. Mom must love her. She loves health care providers with high self-esteem.
“Hi Anita. How was your lunch?”
“Don't give me that, Adele. You can't play me. Now, did I see you smoking a cigarette?”
“No.”
The big nurse offers a stern look. “Are you sure I didn't see you take a big puff just a few seconds ago and toss it down to Montgomery over here?” she asks, nodding to the bum who looks up upon hearing his name.
“Wasn't me,” she responds.
“Was!” They give each other a momentary stare down.
“Big deal,” Mom finally says, breaking the tension.
“It is a big deal, Adele. You heard what the pulmonologist said.”
“Yeah, I heard what he said. I have twenty-four percent of my lung capacity left and, as far as I'm concerned, that's plenty.”
The big nurse rears back and squints her eyes. She's mad. Then she turns to me.
“Who are you?”
“I'm her son.”
“Oh yeah, the lawyer with the bossy wife and rhyming name.”
“Tyler Wyler,” Mom offers. “Ridiculous.”
“Yeah, Tyler Wyler,” the nurse repeats. “I heard about you. And her.”
I look at Mom. She shrugs.
“Well, you ought to know better than to let her smoke,” Anita chides me.
“It makes her happy.”
Her face softens just a bit. She gets it. “Well, turn her around,” she orders. “Wheel her back inside.”
“The hospital?” I question.
“Yeah, the hospital, dummy. That's where she came out of, right?” The two other nurses with her giggle at this.
“Why would I do that? I'm taking her home.”
“Oh, you are?”
“Um, yes.” Somehow though, I'm not so sure of that answer.
“Nobody discharged you mother. She played you for a fool. Step aside. I'll wheel her back in.”
My mom gives Anita the look one gives when their big getaway plan has been foiled.
“Mom, don't ever do this again, understand?”
Cough, cough
. I keel over and churn out three more deep, painful coughs. On the last one I see lightning bolts flashing inside my head. Leaning back, I try to conclude my reprimand, but it's lost its force by now. “You understand?”
“No promises.”
“I can tell you this,” Anita says to me. “You sound like you should step inside, too.”
“I'll be fine.”
Just before she wheels Mom back in, she pulls me aside to explain what it's all been about. The woman in the bed next to her died unexpectedly last night. It freaked my super-brave Mom out, and that's hard to do.
At this point, Robert's still exactly where I left him. Still straddling the horizontal bar of his bike, book open. I walk over to say good-bye. I love this kid.
“Hi, Robert.”
“Hi. There're no pictures in here. I don't like books without pictures.” I'd say he's three-pages deep.
“Me, neither. But did you find what you're looking for?”
“I think so.” Suddenly, my vision becomes blurred, then doubled. Robert's helmeted head rises above itself.
“Are you okay, Mr. Wyler? Why you looking up like that?”
“Robert, how tall are you?”
“Five feet nine plus one inch.”
“Do you mean five foot ten?” I ask, as my focus returns.
“No. Five feet nine plus one inch.”
“I understand, Robert. Why don't you just go home now and come see me in twenty days when your check's ready, like I said? You bring your process server's license and I'll accept service.” He doesn't need to be standing there all day. But it's no use. When I start walking away, he resumes his scrutiny of the process server's manual. Best to let Robert be Robert.
I walk half a block to the subway on 77th Street across from the hospital but don't go down. My chest is on fire, my head is throbbing, and my lungs are filling up with green gunk. I lean against a building, looking at a hot dog cart across the street. Since I don't want a dirty dog, something must be seriously wrongâdespite the opinion of my internist.
My phone vibrates. It's Mick.
“What's up?”
“Been out of state lately?”
“I think you know the answer to that.”
“How's your head feeling?”
“Killing me.”
“How are your joints?”
“Achy.”
“Your chest?”
“Getting worse.”
“Got any neck pain?”
“Recent onset.”
“Your vision?”
“Was blurred and doubled just a moment ago.”
“Your culture came back. You're positive for something that you couldn't have been in contact with.”
“No kidding. Go on, I'm listening. What do I have that I haven't even been exposed to?”
“Cocci, buddy. You need to get to a hospital. Pronto!” I look across at Lenox Hill.
“Hold on. You're way ahead of me. What's cocci?”
“Coccidioidomycosis.”
“What the heck is that?”
“It's a fungal infection.”
“Like athlete's foot?”
“Hardly. Listen, I'm ninety-nine percent sure that's what you got. But you need a particular blood test that evaluates your serum to see if your body has produced the antibodies to this specific antigen.”
“All right,” I say in a tentative tone. “But can you tell me why exposure occurs outside of New York?”
“Sure. Because Coccidioides immitisâwhich is the mold that causes the fungal infectionâonly resides in the soil in the southwest.”
“Then how did I get it?”
“I don't know how you got it, but typically the mold has long filaments that break off into airborne spores. Your infection was caused by the inhalation of those particles. That's about it.”
“I see. Could my sputum culture be a false positive?”
“Could be if you had some other fungal disease, but highly unlikely in your case.”
“Why?”
“You got all the classic clinical features. You also need a chest X-ray.”
“Just had one. It was negative. How does that factor in?”
“I want to see the film, that's how. I very much doubt it's negative, given your constellation of symptoms. Who read the film? A radiologist?”
“No, my primary-care guy.”
“He wouldn't know what to look for.”
“How do you know about this condition?”
“My training in Tucson. Some of the convicts from the local penitentiary would come down with it from time to time. Our hospital provided medical services to the inmates.”
“Okay.”
Cough, cough
. “I'll get to a hospital.”
“Go now,” he insists.
I look at Lenox Hill Hospital for the third time. Pedestrian traffic into the ER has been light since I started monitoring it.
“Hey, you're worrying me. It's a fungal infection, right? You spoke about antibodies, so there must be a treatment for the condition. Am I correct on that?”
“Yes, there is. But the way yours sounds is troubling me.”
“I'm listening. Go on.”
“Your cocci presented as a pulmonary infection. That's why you're coughing so much. But it sounds like it's also disseminated into other systems. Your joints hurt, your head hurts. These are bad signs. Signs of an advanced disease. This could lead to a brain insult if you don't get treatment soon. And by soon I mean, like,
now
.”
“What are you talking about? A brain event, from a fungus?”
“That's right. I've seen it. When it gets to the brain, there's a high risk of mortality if not promptly treated.”
“You're freaking me out. I don't feel like I'm about to die. All I've got is a bad cough, plus achy joints and terrible headaches that come and go.”
“It's the etiology of the headaches that poses the risk. This fungus has disseminated through your systems and into your head. It causes inflammation of the tissue layers that surround your brain, meningeal disease with hydrocephalus being the most disastrous complication.”
“You've got to be kidding me, right? Hydrocephalus?” I'm stunned. “Water on the brain?”
“Well, it's not water, it's cerebral spinal fluid.”
“I know what it isâso, please, spare me your corrections. How do these spores cause it?”
“It's a combination of factors. Overproduction of fluid is the main culprit, coupled with obstruction of the drainage routes. The fluid's overwhelming your brain's absorption capacity and the buildup of CSF is causing increased pressure inside your head. That's what's happening. This is serious stuff. You got a bad case of Desert Fever, buddy.”
“Okay, okay. I get ya.”
“No. I don't think you do. Listen! And listen carefully. You need to understand the seriousness of this. The spores of C. immitis were being developed as an agent for chemical warfare at one time. That's how serious this is. Now get yourself to a hospital right now! No, better yet, where are you? I'm coming to pick you up.”
Mick's words resonate in my fluid-filled head. I'm formulating and assessing, and, although my concentration is off, my executive function is off, and my recallâyeah, that's off, tooâI quickly realize this is not about me.
“You there?” I hear Mick ask. “You there?”
Holy shit!
“I gotta go, Mick!”
Click.
SOME NO-CONTACT DIRECTIVES REQUIRE DIRECT CONTACT
As I scramble-scroll through my phone, thoughts flash across my pounding head. The MRIs showed no evidence of a surgical injury at C4 that could be responsible for the backflow of CSF ⦠no one ever came up to their apartment ⦠Major and his father both worked on chemical agents out west ⦠dry desert plants confined to Cookie's separate bedroom. Ones I knocked over. Exposing myself.
Major is poisoning her!
The guy's a psycho. He's inducing the overproduction of fluid and creating the false need for repeated and emergent spinal taps. Setting up a dependency, so he can keep his dancer prize to himself. Who'd ever believe it?
I hit the
call
button. Come on, Cookie, pick up, girl.
“Hello?”
“Cookie, it's me, Tug Wyler, your old attorney. Is Major there?”
“Um, uh, I don't think I'm supposed to talk to ⦠um, no, he'll be back in a few. I'll tell him that you ⦠to call you.”
“No!” I shout. “Don't tell him to call me! Listen! You've got to get out of there! Now! Major's poisoning you! Do you understand me?”
“Not really.” Justifiably, I have to say. “Um, I like you and all,” she continues, “but I'm pretty sure you're not supposed to call me or contact me in any way since I switched back to Chris. I mean, he just got the file back, and they've offered him two million dollars.”
Oh, man! This is no time to set the record straight.
“Cookie! You have to listen to me!” Some no-contact directives require direct contact. And this is one of them. “It's not about your lawsuit. I promise I know what I'm talking about. Major may be manipulating Chris, too. He could even be part of the fraud scheme.”
“Fraud scheme? What are you talking about?”
“I was contacted by an investigator, from where I'm not sure, but while I was handling your case a fraud investigator approached me. A little fish named Minnow.”
“A little fish named Minnow?”
“Yes, listen, I'll explain everything to you. I promise. Wait a minute, Minnow's not actually an investigator. I mixed it up. Pusska said she couldn't find anything on him. Oh, that's not the point. Anyway, right now, it's you I'm concerned with. Your health and well-being. I'm on my way over. It won't be long. I'm close by. Meet me across the street from your building. Hurry!” I add with a sense of urgency, “Please! This is very real. And stay away from your plants!”