December 13, 2002:

Middle-aged lanky man all-fours on the floor. 2am on, catch this, a dark and stormy night. Rocking back and forth in real pain. Second time in three years: ulcer, or gallstones, or one or another ex-girlfriend's gut-wracking voodoo curse.

"Somebody should really clean this carpet," he's thinking.

Unprepared for emergency. The car's out of gas. Slapstick: soaked to the bone in the pouring rain at a Shell station with pumps open to the sky.

E.R., colorless institutional green. Nobody's home at Reception. "Knock-knock." Delay, then, "Who's there?" "Somebody who needs to check himself in." To her credit she did not reply, "Somebody who needs to check himself in who?"

Helpful, friendly, concerned male nurse. Never caught his name. Very kind and compassionate. Hispanic, mid-thirties, puts people at ease in this of all places. Blood pressure, temperature. Relate the history. Sticks a tap into a vein, parks me in an examination room, where ten minutes or so pass before the doctor is available.

Examination room 9 has a dirty ceiling, including an air vent with dust trailers visible behind its grate. There are dried blood drops on the floor. Shirt and shoes off, gown on, open at the back. Everybody's worried it's too cold, bringing blankets. I feel like I'm on fire. Arms trembling, rocking back and forth on the gurney-bed.

Dr. Buscho is on duty. Fiftyish, middle-height, confident. Apologizes for the delay, which hadn't offended me. Explain the history. His concern is the possibility of a gallstone blocking a bile duct; the pain would be bile reflux into the stomach. Which somehow makes the colorless institutional green seem appropriate. The patient has always been skeptical of the gallstones theory: food sensitivities are wrong. Mint, spice, vitamin-c, tomatoes: these are ulcer sensitivities. I request an H-Pylori screen as part of the blood workup; Dr. Buscho relents, but he's as skeptical of my theory as I am of his.

Nurse returns with a cup of pepto-green liquid. "GI cocktail" it's called. Numbs the tongue and lips, not a comfortable sensation. Long as I'm still breathing I suppose it could be worse. But I'm careful to keep my numb tongue away from my teeth.

One pill: Protonix, which is God's own antacid, and has a name like something Dr. Beverly Crusher would prescribe. Syringe of painkiller into the tap. They're concerned about me driving myself home, so this round isn't the strong stuff. It may become necessary to revisit this decision.

Wait an hour for the bloodwork results. The gurney-bed makes the patient's back sore, including tingling toes. Kids, middle-age bites. Trust me.

Bored, the author looks outside the exam room door for the inevitable clipboard, which, fortunately, contains two sheets of paper labeled "Progress Notes" vertically along the margin. Cool. It would be romantic to say I wrote this piece in blood, but truth is it was a black ballpoint borrowed from the Reception nurse.

Bloodwork returns contradictory. One gallbladder indicator is elevated; a second is normal. Dr. Buscho wants to do an ultrasound, testing for an obstructed bile duct. If positive, immediate surgery might be required. The ultrasound is already very bad news for us struggling writer types, who are, naturally, uninsured. I remember my insurance paying something like $1200 for the previous one, two years ago.

The ultrasound facility opens at 7:30, so there's a wait. I'll take that Demerol now, thanks. The room spins.

More bloodwork results. Low potassium. Same as last time. My GP believes this hospital's bloodwork machine is reporting erroneous potassium results. Nevertheless I drink the cup of bitter orange liquid they bring, washing it down with grape juice.

More E.R. patients. A woman moans in pain, throws up, moans. She's asking for more painkiller, but the doctor tells her the bloodwork is required first. Through the wall I can hear her exhaustion and despair. Later the nurse tells me it's gallbladder night at the E.R.: there are three of us there with similar symptoms.

Female nurse in the hallway has a loud laugh which carries. Goes off every thirty seconds or so for a couple of hours. I know this is petty and mean-spirited, but it begins to seem offensive. There's a woman moaning in pain, to the sound of flippancy. Seems insensitive to her, and I'm offended on her behalf.

Wheelchair ride through the corridors. Kinda fun on Demerol. Ultrasound. I'm first on the waiting list, either 'cause I got there first, or as reward for not complaining, not sure which. "You're going to tell me if it's a girl or a boy, right?" Everybody's concerned it's cold: she covers me in warm towels fresh from the laundry. More pain: she has to press her ultrasound tool pretty firmly into my stomach and sides. Ouch. Results: no obstruction, no surgery. But the gallbladder is full of dozens of good-sized stones which she shows me on her monitor. "I'll name one after you," I tell her. Dr. Buscho says, "This is an obstruction waiting to happen." Obvious implication: yank the gallbladder. Well. Not tonight. As they finish with me, the woman-in-pain from behind the examination room wall is rolled in on a gurney. Young, thirties. On her side, glassy eyes from painkiller. Poor thing. Get well, little sister.

Verdict: gastritis. Scripts for more Protonix, plus some painkiller or other, plus Carafate, a stomach-wall protector. There's a new shift on duty: a different nurse removes the tap. Strikingly lovely female doctor with gray-streaked hair drops by to ask questions about the potassium. Everybody forgets the Demerol: the author is free to drive home. Good. It's only a mile, on a rainslicked Friday the 13th. You should hear the surf, in this storm.