Bloodletting and Miraculous Cures (15 page)

Counter-transference, thinks Sri. That's the word that's been tickling at him. They have been taught to beware of counter-transference, the emotions a physician has in reaction to the patient. No, not to beware. They are taught to be aware. He can almost hear Dr. Miniadis saying, It cannot be avoided, but must be channelled.

The top buzzer. There is the third floor, the alleged poisoners. Sri presses the top button. It is a fine day on Crawford Street, which opens into Trinity Bellwoods Park, a park that has its quiet heart low down, tucked into a ravine. Sri decides that if no one answers the door, he shall not magnify his concern, but will urge himself to feel relief, and will walk down the pathway toward the ravine, stirring leaves with his feet. He will have the freedom of having followed his uneasy feelings about Winston, of having tried every reasonable method to return the numberless page, and of having completely discharged his duties without any answer at the phone or the home. Sri tells himself, with a firmness to counter his sense of worry, that if no one answers, he will not pursue Winston any further than this doorstep, and he will simply wait for the situation to come to him again, if it does.

He is about to turn when he sees a woman's face at the door. She hesitates. The door makes a hollow sound as it opens.

“Can I help you?”

“I'm Dr. Sri,” he says. In such situations, it is important to use the title. “Winston's doctor.”

“Come in.” But she doesn't move. She leans forward to Sri and whispers, “He's been talking to himself all day.”

“You are his…”

“Upstairs neighbour. Adrienne. These old houses, you can hear everything. Did Winston call?”

“In a way.” So there's an Adrienne.

Still whispering, “Winston keeps to himself. Past few days, he's acting strange. What's wrong with him?”

“It's hard for me to say.”

“What do you think?”

Sri whispers, “I can't tell you. Doctor-patient confidentiality.”

Adrienne looks slightly offended, and then unsure whether she herself has given offence.

Sri says, “I understand you had a party.” He tries to say it casually, socially, the way one says,
Oh, a party—how nice!
but it feels unfair to ask a question after saying that he can give no answers.

“Yes, there was a big party.”

So there was a party.

She says, “I've been out of town.”

“Halloween?”

“I was in Montreal. But I think the first-floor apartment had some people over. The recycling bin was full.”

“May I come up?” Was there a harem girl? he wants to ask.

Up the stairs, dark inside. Both of them stand at the second-floor landing. Sri knocks.

He says, “Winston? Winston?”

Behind the door, silence.

Adrienne says, “It's the doctor. Your nice doctor here to see you.”

Sri says, “I got your page, but I couldn't call you back because I didn't have the phone number. I tried to call, but you didn't pick up. And I was in the neighbourhood, so I thought I'd drop in.” Sri feels obligated to fill in this picture, to justify the steps by which he has arrived at this second-floor landing with Winston's upstairs neighbour. “Good news. Your drug tests are negative.”

Winston says through the door, “Why did you decide to kill me, Adrienne?”

Adrienne's expression is completely unchanged—the way that someone who is really shocked often does not have it within their repertoire to actually twist even the smallest facial muscle, or is it the way that someone who is not surprised is simply not surprised?

Should he ask how she went to Montreal? Car? Train? Maybe catch her out. That's going too far, Sri decides.

Sri says, “No one wants to kill you, Winston.”

“You're in on it, doc. I thought you would pick me, Adrienne. Didn't want to murder Claude, but if that's what you want, I'd do it. Really would do it. But why do you have to kill me? Forget the whole thing. I'm sorry for listening. Honestly very sorry.”

“Are you taking those pills, Winston?” asks Sri.

“Oh, very nice. Your poison. The blue-drink poison, and the tea poison, and the pill poison. You think you'll get me somehow.”

“Can we come in?” says Sri.

“Stay away!” he screams.

“Who's Claude?” whispers Adrienne.

“Claude isn't your husband?”

“I have a roommate, Claudia. I barely see her, I work nights.”

Does she have a harem girl costume? Or maybe is she sort of…masculine? Sri wants to ask, but stops himself. The facts are shadows of themselves. Behind the door, Winston is howling.

Sri says to the door, “You paged me, and usually when people page me, that means they need help.”

They hear scraping, and a thump against the door. Scrape, thump.

Sri whispers, “He's barricading the door.”

Adrienne says, “Don't do that, Winston. If you scratch the floor, Mrs. Brooks will make you pay. You know how picky she is.”

“We could have had something together, but then the poison. Did you think I'd trust you after the poison?”

Sri asks Adrienne, “Can I use your phone?”

 

Sri tells the police that his patient is psychotic and has been having thoughts of murder. He is aware that Adrienne hears him, and it only seems fair that she
know something about the situation. They will send a squad car, they say. Sri calls Dr. Miniadis, who seems unsurprised to hear that her resident is calling from the upstairs apartment of the alleged poisoners of their psychotic patient.

Adrienne appears with a tray. “Tea?”

“No thanks.”

“Freshly steeped.”

“I'm good, really.”

She pours tea for herself. A little cream, three sugars. There is an empty cup. Crashes and howls shake upward through the floor.

Adrienne says, “You like being a doctor?”

“It's great.”

Teacups and saucers sound so dry, clicking on each other.

“I can make herbal if you prefer. Mint, rosehip, or camomile.”

“Really, I'm fine. I had a cup just earlier,” he lies.

They sit in the sunny front room, which is all plants and books and light. No siren, no slam of car door or chatter of police scanner. It is a beautiful and quiet day, except that Winston has begun to scream,

“Don't! Don't! Don't!” pierces the house.

Sri thinks that he should have emphasized the unpredictable nature of his patient, the possibility of sudden calamity, the need for the immediate appearance of officers. Despite the screaming and smashing from below, Sri feels much better now that he has
decided that Winston is psychotic, and at least Winston is still alive and has done no one else any harm. Sri wishes to go for a walk in the park, and then feels guilty at this thought, which competes for mental space with his feeling badly for his patient. Adrienne pours herself another cup.

“Are you sure?” She gestures at the empty teacup, saying, “It's
not
poisoned, you know.” This is meant as a joke, and Sri smiles as if complicit. Then he feels that his poor reciprocity of humour makes the subsequent silence, and the dull clinking of the spoon in her cup, more acute. She pours tea in front of Sri. He can see why Winston finds her attractive.

A cup of tea would be ideal on this afternoon before the onset of snow. No, better not. He reminds himself that if he believes it to be truly not poisoned, and he feels like having tea, why should he not take a sip? Can he not see that Winston is psychotic?

The teacup handle is warm, and the porcelain body of the cup scalding. A steaming sip, perfect. It is at this moment that he sees it. Very briefly, but long enough to make a definite impression on his retina. It is outside the window, and pauses for a moment on the brick ledge, pecks at a strand of ivy, seems to hunch (if birds actually hunch), then darts upward into the air. Adrienne sips with the self-consciousness of a host to strangers.

Sri says, “Um…was that a purple bird? Just out the window.”

“I didn't see it.”

Are there purple birds? Here? Maybe a nest. He has never heard of a purple bird. Maybe from a pet store. That happens all the time, tropical creatures escaping and living in sewers and eating cats. Sri reminds himself that birds do not live in sewers or eat cats. Downstairs, there is screaming and the creak of wood breaking, thud thud thud as Winston thrashes.

“I was just imagining things. A strange light.” Sri smiles hesitantly, offers a pleading grin as if they should both be accomplices in this little joke. He tells himself, firmly, that there are no purple birds in Toronto. The tea has a wonderful aroma but he resolves to ignore the scent, and places the cup delicately but securely on the saucer.

 

ELI

THE POLICE HAD THE MAN IN CUFFS. WRISTS BEHIND
his back, arms twisted high between his shoulder blades. He cursed them.

“Behave,” said the female officer.

Blood ran down his face. Thick, opaque over his neck, it soaked his shirt collar.

“Hey doc, how long?” called out the male officer. They were in the hallway, waiting to have their prisoner registered at the front desk.

“Lot of people here. Up to the triage nurse,” I said,
not breaking stride. Wait your turn, I thought.

The officers, one short man, one tall woman, were speaking to the emergency triage nurse. I knew what they would be saying: We're short staffed tonight, we're stretched thin, tons of calls, help us get this done. The nurse would be saying: We've got chest pains, belly pains that have been waiting for hours. The police wanted to get in quick. In and out. Feet are built to move and standing is more tiring.

 

Volumes were rising at this time just after dinner, a few hours before midnight. We speak of volume as numbers of patients, the way they fill our fixed space. It is also the volume of noise that we actually hear. The crying of the child, the belligerence of drunkenness, the thin whine of a failed suicide. The noise and presence fills the waiting room, a condensation of the city's private screaming made public.

Several minutes later the triage nurse asked me, “Doctor Fitzgerald, can you see this patient?”

“The one with the cops? You want me to see him first?”

“He'll be a quickie,” she said. “He's in the quiet room.”

The quiet room—our euphemism for the screaming, struggling, calm-down-or-we-tie-you-down room; also the actual name of the room.

The two police were standing outside the wired safety glass door, which could be locked and unlocked
from a control at the central desk. Inside that room was a panic button on the wall that triggered a silent alarm.

“Got a live one for you, doc,” said the male officer, badge 1483.

“Glad he's alive,” I said. Through the glass, I could see the man twisting on the stretcher. “This your prisoner? You got him in quick.”

“Thanks for seeing us fast,” said the male officer. “We only got three cars on the road.”

“We've got thirty in the waiting room,” I said. “Funny night.”

“Well, you've got to know how to laugh,” said the female officer, badge 6982.

Police stand and talk and lean on things as if they belong anywhere. For most people, there's a distinction between a place that is theirs and one they are visiting. Cops—you see them with their sidearms jutting out, their elbows resting on diner counters, parked in no-parking zones, using the staff washrooms in the hospital. Their hats hold in their hair, tidy.

“Tell me about your man here,” I said. The bed rattled as he lunged though held down by cuffs.

“Not much to tell,” said the male officer. “Fell, cut his head open. We need him fixed.” Some fall. Forehead split open, bleeding a red curtain. He shouted obscenities, shook his head. Not even a scrape on his hands. People put their hands in front of them when they fall.

“Fell, huh? Clumsy guy,” I said.

“Eli has very poor coordination,” said officer 6982.

“What made him so clumsy?”

“You see, Eli is a bad man, and we find that many such people are accident prone,” said officer 1483.

The game is supposed to go like this. The police give the precis: Look doc, this guy did such-and-such, and we caught him, and now this-and-that has happened so we brought him to hospital. Maybe they say what they think the diagnosis will be. The officers usually imply what they think should happen to the prisoner. They can't say it outright—'course, you're the doctor, they must say in conclusion, as per protocol. Then the physician can respond to this play: Well, officers, I need to do test A, procedure B, and check for problem C. If A turns up normal, B works out well, and C is absent, I'll pronounce your prisoner, my patient, healthy and you're good to go. All with a wink and a nod.

I was irritated that these officers seemed to want to play a modified version of the game: You do your thing and we'll do ours. This is sometimes the case with more serious charges, and all the more reason for me to play carefully. Cops and robbers and doctors. It's a game where mostly everyone can be happy if we all play nice. The police are surprisingly kind to the prisoners, as long as they're docile. They treat them like younger siblings, showing them where to sit and filling in forms for them. Just like an older brother, the police turn nasty in an instant if the prisoner becomes difficult.
You better settle down.
Benevolence and cruelty are
separated only by a veneer of whim which, in medicine, we understand.

I opened the door, went in. His smell grabbed me and twisted my stomach so I had to force down the urge to vomit.

“Hi Eli,” I said.

“Get me out of these,” he said.

“I'm Dr. Fitzgerald, the emergency doctor. What happened?”

“They're fuckin' nuts. Get me out.”

“I am Dr. Fitzgerald,” I repeated. In medicine we pretend that our names may be enough to control a situation.

“Breathe,” I said. I sat on the edge of the stretcher, next to Eli's cuffed ankle.
Always sit down with the patient,
I was taught.
It makes it seem like you've spent more time and that you care.
In a chair, on the stretcher.
If you give this impression
(this is the subtext)
then the patients will do what you say and leave quickly.
I liked the stretcher, since sitting on the edge of the bed is what everyone's parents once did.
Where is it sore, dear?
“Speak–slowly. How–did–you–cut–your–head?”
Speaking slowly and loudly transcends both agitation and language barriers.
Another clinical pearl.

“Set-up. It was a set-up.” He pulled and rattled at the metal bands tight on both wrists.

It was nauseating to breathe, with the closed-in smell of piss and sweet-sour human stench. I pulled on gloves, flexed and extended my fingers so that the latex was tight on my skin.

“Pain anywhere?” I asked. I felt inside Eli's split-open forehead, ran my finger over the warm smoothness of skull. It was a straight gash from the hairline to the top of the nose. The blood flowed hot, an anxious stream. A man can bleed to death from the scalp, but not the forehead. Cuts in the face look worse than they are. I explored with my finger, to feel for smashed fragments of bone.

“Shit man, stop that,” said Eli. He swung his head.

“They say you're clumsy.”

“Fuckin' cops playin' drums with my head say I'm a killer gonna make me pay some shit.” Eli kicked against the cuffs on his ankles, which rang out on the stretcher's chrome frame. I stood. “Fine bitch cop there, huh?” said Eli. He winked at the female officer through the window. Her expression did not change, but she enclosed her right fist in her left hand while looking at Eli.

I left the room, took a big breath of clean air. The clatter of Eli's rage drifted through the wire-strung windows. The child in the next stall was crying.

“What's the deal here?” I said to the two police, who were leaning on the nurses' counter.

“We need him fixed,” said officer 6982.

“Right,” I said, and did not move.

“That's the deal,” said officer 1483. He turned toward the quiet room and smiled at Eli. Officer 1483 had a fresh haircut. The nape of his neck was raw from a razor.

“And his head split open? Like that when you got him?”

“Fell. And banged his head getting into the cruiser,” said officer 1483. “Already filled out an incident report.”

“Did he pass out?”

“Nope.”

“Vomit?”

“Nah.”

“Something about being a killer,” I said.

“When you're done, we'll take him to the station,” said officer 6982. “Get him out of your hair.”

Cops. They want to get seen first. Put them at the front of the line but then they won't talk. None of my business, they figure. They were responsible for his legal ailments, but I was now liable for his medical misdemeanours. It would be awkward for me at the inquest if the Crown said, Doctor, tell us a little more about the head injury that led to Mr. Eli's demise. The police records state that all circumstances were explained to you. The doc holding the chart last has to explain everything.

Maybe Eli needed to see a psychiatrist—a name after mine on the chart. Was Eli psychotic? Could be. I'd better find out. Police inquests are tedious, nitpicky, and it's lonely being the only physician on the stand. I went back into the room, into the thick piss smell. His pants were dark. Can't blame a man for that when he's scared and cuffed. Acid—that's what it must smell like inside a pelvis.

“Listen to—”

 

“Get me out doc get me out I gotta get out.”

“Shut up. Listen to—”

“Ya fucking, you're not a doctor, ya fuck.”

Now both of us shouting: “Listen to me. I am your
“Last month I'm minding my own business, this guy
doctor. Are you hearing voices? Are you seeing things
comes up he says he's gonna shoot my dog unless I give
that other people don't see? Is someone out to get you?
him some names. See, I love my dog, she's all I got, and
Are you receiving radio or telephone messages? Do you
I don't got the names he wanted so things got a little
want to hurt someone? Do you have a psychiatrist?
outta hand and anyhow how's I to know he's a cop? He
What medications are you taking? Do you feel that
hit me first, sucker punch. I hit him back. Betcha he's
people are plotting against you, out to get you, that
banging that bitch cop there. Fuckers they said my
there's a conspiracy of some kind?”

time's up now they got me.”

 

Then both of us stopped talking. In the sudden quiet, I stepped back and wrote in the chart for a little while. Then, “What can I do for you, Eli?”

Eli paused to consider his situation, and then said, “Why don't you suck my cock?”

I tried to breathe shallow, but the urine smell was so insistent I thought I could taste it. Outside the window, the officers watched and grinned. The female officer said something to the male officer, who laughed. When he saw me looking, he turned the other way.

“You're right,” I said to Eli. “They really are fuckers—just like you.”

I went into the hallway. “What's so funny?”

“Talking about something else,” said officer 6982, smiling.

“You seem to think me and your prisoner are pretty funny.” Cops, backwards garbagemen, always bringing
in
the trash.

“There's something I don't understand here.”

“You should watch yourself,” officer 6982 said.

“That a threat?” I asked. If these cops wouldn't play the game right, I'd look for a new game. I wasn't going to be the last doc signing the chart.

“Watch yourself with Eli,” she said. “He's quick. Watch yourself.”

“And he's mentally ill. We'll keep him here.”

“Whaddya mean?” she asked, her voice now less relaxed. “We gotta get him back and book him.”

“After our psychiatrist sees him.”

“When's that?”

“Tomorrow morning.” It was ten at night.

“What makes you think he's nuts?”

“Eli told me about someone threatening to shoot his dog, trying to get information from him, punching him,” I said, and felt the first nervousness of enjoying this. “It's funny, he said it was a cop. That would be coercion, police brutality. Can't be true. So, Eli must be paranoid. Psychotic.”

“You can't believe these things,” she said.

“Not for a second, but I have to document what he told me, right here on the medical record,” I said. I showed her the chart on which I had transcribed Eli's statements. “Must be delusions, poor Eli. He must be imagining the police punching him and so forth. Although I guess he's not psychotic if it's all true. You know anything about this stuff?”