Fat (15 page)

     I just kept rubbing her back in small circles.  His death was a real surprise.  He was so young.  Albert, that is.

     He left a good looking corpse.  Albert ran five miles every morning, was a Whole Foods health nut, and saw his doctor as recommended every year, always receiving a clean bill of health.  I think the last time he ate a trans-fat was in high school.  He gulped down a glass of red wine everyday after dinner in a single swallow like he was taking medicine just for its cardiac benefits, never considering savoring its more enjoyable qualities.   A heart attack is not the way he should have gone – collapsing during an early morning run through the park.  Though it does say a lot to what too much stress can do.  This guy was a workaholic, a real type “A” personality, and loved chasing money.  He could have retired comfortably with Kate years ago, but he loved the drive of making a buck.  A hundred hour work week was just a normal week by Al.  Take that grind times thirty some years and you’ve got the makings of a Heart Attack Jones.   

     “Hi, Dr. Grant.” 

     I looked to my left and it was Xander, coming towards me in a Rascal.  He looked like a garbage bag overfilled with dirt being pushed down the street in a motorized wheelbarrow.  His banding looked like it was failing terribly.  He was much bigger.  And had a poorly kempt beard.  With cookie crumbs stuck in it.  He must eat like Cookie Monster, with more crumbs spewing out than being swallowed.  There was an
US Weekly
and a
OK!
magazine in the rascal’s front basket.  It looks like this guy was now consuming processed trash down both the gullet and into the noodle, regardless of occasion.  His motorized approach did end Kate’s hug, and she started wiping away her tears and trying for some composure.

    “Hi Xander.”

    “Thanks for coming, Dr. Grant, it is good to see you.”

    “I am so sorry about your dad.  He was a good guy.”

    “Thanks, Dr. Grant, I really appreciate it.”

     Silence.  Kate sniffed.  I heard Xander’s stomach growling.

     “So, what is the deal with the Rascal, are you hurt or something?”

     Xander let out a soft laugh.  “Even here you’re worried about me.  You are one of a kind, Dr. Grant, one of a kind.”

     “I thought you’d be running marathons by now.”

     “I thought so too, but a few weeks ago, I thought I was ready to run a mile, but after a few hundred yards, my knees said no way.  It hurts to just walk now.”

     He lifted up his right pant leg and showed off an elastic knee brace.  Fat and skin squeezed through the circular kneecap opening at the center of the brace, looking like a just-about-to-pop pimple.  His leg skin looked like he had been wearing a tourniquet for days -- a purple mess of venous insufficiency.

     He continued, “And then my dad died, so I pretty much spent a week in front of the TV with frozen pizzas on a sheet pan, a pizza cutter in my left hand, and my right hand going sheet pan to mouth.”

     Kate added, in a tattling tone, “And he ate about a million Reeses Pieces.”

     “No mom, it was regular M&M’s in a jar of peanut butter and a spoon.  Get it right.”  Then Xander laughed.  The suspension on his Rascal creaked with his heaving guffaws.  “I was actually doing great for a while.  I got under three hundred pounds for the first time since high school.  Don’t worry, I’ll get back.  Just like the people in these magazines.”

     Unlikely.  Xander was now in the classification of a failed surgical intervention.  This guy was put under anesthesia, incised, had a camera and some rods poked into his abdomen, then had a silicone strip placed around the top portion of his stomach to create a change purse for food, and he still couldn’t keep off the weight.  And now He was on a Rascal, using external  energy and engineering to do the equivalent of walking.  Of course it was shocking that Albert had beat Xander to death.  Though, with the way he’s going, it doesn’t seem like it will be by that much.  My bet is that tomorrow, Xander’s going to be cruising on his Rascal, sloppily eating an Italian beef with sweet peppers, then suddenly slump down into its soft leather seat, his Italian beef falling to the sidewalk, dead of a heart attack as the Rascal slowly rolls into the front door of a Krispy Kreme.

     “I am sure you will get back, Xander.”

     Kate was still tearing a bit, so I gave her a half hug with my left arm over her right shoulder, which she leaned into a resting of her right temple against my shoulder and staring off into nowhere. 

     Xander looked over at his dad’s casket.  “Being fit sure didn’t help him.”

     I looked down at Kate on my shoulder.  She was spaced and didn’t hear Xander.  The comment made some backward sense.  If a healthy guy like Al can die of a heart attack so young, why even try to get healthy?  Why should someone deprive themselves the joys of butter and sugar when eating nothing but twigs and berries still might not matter for longevity?  Because even though fit people can die early and obese people can live a long time, being healthy is about reducing risk, not eliminating it.  No one can eliminate all risk.  Albert still had his stress.  If I were pulling playing Russian roulette, I would want the minimum number of bullets in the chambers as I could negotiate.  If one is the minimum, then one is what I would want.   Zero would of course be better, but then it wouldn’t be Russian roulette.  Eliminating all risk would make life not a life.  I can sit inside a sealed bubble getting tube fed a slurry of calories, vitamins and minerals and live to a hundred and fifty, but then, why am I even here?  You have to eat some bacon, or dig into a good chunk of chocolate cake, or eat way too much at a buffet once in a while.  Food is meant to be enjoyed.  But, swimming every day in a sea of bacon cheeseburgers and chili fries and chocolate milkshakes doesn’t make much sense either.  Who wants to play Russian roulette with six in the chamber?  That’s just suicide.  Xander has had six in the chamber for a while now and all that was left was for death to pull the trigger.

       Xander nodded and then rolled his Rascal towards Albert’s casket.  I steered Kate towards a chair and sat next to her as she started crying again.  She was using my dress shirt as her personal tissue.  Bad idea to go with my best white dress shirt today.  Just as Xander reached the head of the casket, he looked back at us and smirked – his mom’s head was burying deeper into his old pediatrician’s chest at his dad’s wake.  Xander just stared at Albert for a while, until some random family member interrupted his condolence to offer their own condolences. 

     Xander was looking at the tip of his downward spiral in Albert’s pale corpse.  Accelerating life turned rotting meat.  Albert went much too soon, Xander was living on borrowed time, but he was treating his rental like he didn’t care because he didn’t own it, playing whiffle ball with his RedBox DVD.  He was still young enough to change, but he was also old enough to have started setting his behaviors into a lifestyle.  The opportunity for change was slipping quickly as hardening concrete.

     The condolences to Xander from passing friends and family were initially made in quiet earnest, but there was a moment in each exchange when their words became parsed in escalating awkwardness at the realization that Xander reeked of death. He was tinged gray, diaphoretic, in mild respiratory distress and emanated fungal gas. Standard wake prepositional rhetoric of “at peace” or “in a happier place now” was just as applicable to mean death would be the only relief to a young man left to motor on a scooter from gross mass grown during a life of over-consumption.    

     Kate’s body heaved deeper into my chest.  She felt fragile, as if a whiff of breeze would send her to the ground.  I gave the top of her head a little peck.

     Then the carpet matting trembled with a bang.  Albert was still resting quietly in the casket.  The Rascal was empty and decelerating driverless down the center aisle.  A rush of dark dress formed a large semicircle around the heap of flesh.

     “Is he having a heart attack?”

     “He’s still breathing, I think.”

     “Get him some water!”

     “His blood sugar might be low, grab some cookies!”

     “Is there a doctor here?”

     Kate’s head lifted and she gave my thigh a squeeze, nodding in Xander’s direction.  I ambled over with Kate.  By that time, Xander was already sitting up and trying to get up.

     “Hey, buddy, are you all right?”

     “Yeah, Dr. Grant, I’m okay.” He stood up with a grunt.

     “What happened?”

     “I tried standing up to give my uncle a hug and I felt dizzy and hot then blacked out.  Maybe my blood sugar is low?”

     Someone instantly handed him a cookie and he chewed it down.  It sounded like a simple vasovagal episode, just his heart rate and/or blood pressure dropping temporarily from triggered brainstem activation and nothing to do with blood sugar, but I didn’t feel the need to give some lengthy exposition to these strangers on his correct diagnosis and why the blood sugar theory was incorrect, especially since he was recovered now.  I just shrugged at his question.

     “I better get something to eat before this happens again.”

     One of the onlookers brought the Rascal back to Xander. He huffed his was back onto the seat and motored out the front door towards the buffet.

     Kate mouthed “thank you” and gave me a peck on the cheek.     

GOLF

     I play golf.  A lot.  As much as I hate the stereotype of the doctor distractedly rushing through patients to get to the golf course, I got bit by the golf bug early in my childhood and just kept on playing.  I’m a golfer that became a doctor, not the other way around.  I love the immediate consequence for any given action, the never-ending battle with the defeatist mind, and the perpetual search for elusive perfection amidst a sea of failure.  Makes me wonder why I went into a profession where I deal with patients who don’t care about consequences of stroking out at age fifty as long as they can eat their hamburger and fries today, parents that believe they need no more information to engage their minds because they equate surfing a few random blogs for a few hours on par with a lifetime of medical training, and patients that expect perfect health in perpetuity regardless of the fact they just spent their failing health sucking Marlboros and Bud Light in between bites of deep fried anything while lying on the couch day to night.  Now that I am retired, what else is there to do but forget about medicine and play the greatest game every day?

     So I am here at the club this morning, like I am almost every morning, ready to get in a quick 18.  Today, I’m waiting for Xander.  Ever since he got well enough to get out of his Rascal, Kate has been begging me to take Xander out to the course, to get him active and exercising in something, even if it is the slow burn of golf.  I usually like walking my round, sometimes with a caddie if I’m feeling tired, just to maximize the physical aspects of the game.  No caddie for me today, though.  Xander rolled up to the first tee today in a cart.  He was already sweated through his XXXL polo, his wrinkled ballooning shorts cinched on with an belt that bulged oddly at the buckle form the extra holes punched into it, and he looked badly out of breath.

     “Hey, Dr. Grant, ready to crush some rocks?”

     “Sounds good.  Are you going to walk or take that cart?”

     “Cart, for sure.  Do you want to get in?”

     “No thanks, Xander, I am just going to walk it.”

     This was working out okay.  With him in the cart and me walking, I could at least get some sporadic separation and concentrate on my own game, instead of him being in my ear all day, a foot away from me.  Ninety percent of golf is getting to your next shot, so if we shared that cart, even in a quick four hour round, it could’ve meant over three and a half hours of face-to-face time with Xander.  Not the way I want to play my golf.  Plus, maybe with the cart I wouldn’t have to resuscitate him on the third green.

     The first hole is a short par four that doglegs a little to the left, and the tee shot landing area is guarded by a couple of bunkers on either side of the fairway.  Most people lay up short of the trouble, about a 240 pop to a wider fairway, but I like trying to cut the corner with a driver, and this hole fits my standard draw, so I always take a good rip.  I only successfully cut the corner about thirty percent of the time, of which today was thankfully one of those three in ten.

     Xander stepped up to the box with his driver too.  He used to be a good golfer back on his high school team, when he was in the midst of his slimmer phase, and even got to the state finals one year.  He now took a cut at the ball looking like he had never played before.  His swing was now a series of compensations to get around his massive chest and belly.  His setup was further away from the ball than should be, and he had hunch of a bend in his posture, to accommodate the extra mass resting on thighs and hanging between arm and ball.  The takeaway was round and flat and stopped short, with a slow weight shift, then quickly to a big over-the-top move, getting the club in front of his belly with a glacial lateral shift of weight back towards his left foot, with just a hint of a proper forward turn.  He did use the ground for leverage well and did a proper post-up to his left leg, but his swing was a supreme digger, always leaving two divots: a rectangular one from his club into ground, and a circular one under his left shoe from twisting all of his weight onto his left foot, as if an elephant stamping out a cigarette butt.  Xander’s hand-eye coordination was impressive that he could even make contact with the ball with all of his moving parts.  Even if he caught it flush, I doubt it would’ve made it to the bunkers.  He duck-hooked this drive low and left, just into the rough short of the left fairway bunker.