I occasionally suffer from diverticulitis. Small food particles become lodged inside pockets which, because I'm old, have formed in the wall of my colon. The diverticules, as these pockets are called, become inflamed, resulting in my bum going on holiday and stomach cramps which can be crippling in severe cases. The worst flare up put me in hospital for three days back in 2015, which was when I learned all about diverticulitis. San Antonio's resident expert on the subject, Dr. Narvaez, admitted to me that diverticulitis is not well understood, and the best one can do is to keep track of what sets you off and avoid eating it because it can be different for everyone. I'm fine with tomato seeds and broccoli, for example, but anything involving peanuts or - to a lesser extent - sesame seeds can be problematic, and granola - or muesli to Europeans such as myself - can be a nightmare. This is annoying because I've always loved muesli, which is probably why I seem to forget what it does to me every fucking time. I chop up chilli peppers three or four times a week and I'm always very diligent when it comes to scraping out the seeds, and yet I just can't remember that thing about granola.
Donna, our neighbour gives us food. Her son brings her boxes of food. She tells us that she can't eat any of it and gives it to us, despite that it's often nothing we're ever likely to eat either. It annoys the living shit out of me, quite frankly, but sometimes it can be difficult to tell someone to piss off or to stick it up their arse without coming across as lacking in neighbourly spirit. This latest unrequested care package contained granola and, as usual, I forgot that I shouldn't eat it. I had cooked pork for two days running, and on the second day I supplemented my pork and beans with a bowl of granola for pudding. I did the same the day after, despite a slight discomfort in my stomach which I had somehow failed to consider as significant.
On the third day, I went back to bed before noon. I'd already been to the supermarket for soup and Milk of Magnesia. The penny had dropped and I'd resigned myself to the usual period of convalescence, because a day or two of rest, laxatives and a liquid only diet usually does the trick before it becomes too painful.
I chugged the Milk of Magnesia, noticing that it was now cherry flavour, specifically that flavour of cherry found nowhere in nature with which everything medicinal is now presented. I went to bed, I slept, and the anticipated bottom explosion failed to arrive. If anything I began to feel worse and worse. I got up around three, went to sit on the bog and nothing came out. I felt hot. I had a cold sweat. I felt faint and nauseous when I stood. I staggered back to bed, resumed the one position which seemed to negate most of the discomfort, and slept again.
'You should go to the emergency room,' Bess says.
'I'll be fine,' I say.
I get up again around six, repeat the unproductive trip to the bathroom, but with more pain to accompany the ensuing nausea.
'Bess,' I croak like an ill person, hoping the desperation of my plea will be enough to carry it to the front room.
'You look bad,' she says.
'I think you were right,' I say. 'I think I need to go the hospital.'
I pull on a pair of pants, a t-shirt, and throw some paperbacks and toothpaste in a satchel, anticipating a spell in hospital. I find myself enfeebled, and Bess has to come around to the passenger side of the car and close my door for me. We drive slowly to Northeast Baptist, which is a relief once I realise where we're heading. I had assumed we would be going to the place I ended up staying three nights back in 2015. I can never remember its name, but it's some way away and I don't feel up to a long journey. I can't get comfortable in the car with the seat folding my middle section into an angle which amplifies the pain - because it is now impossible to deny that it is actual pain. I'm expecting an x-ray to reveal that it's probably nothing critical but they'll want to keep me in for observation, so I'll get lots of lovely heroin to dull the sensation. It probably isn't heroin, but last time they dosed me with whatever it was, it was wonderful and gave me a profound insight into the work of William S. Burroughs.
We enter the waiting room. The receptionist with a wonky eye takes my name and details. 'Is this correct?' she asks, handing me a wrist tag on which my name is spelled Lawerence.
'No,' I say.
She hands me a pen. 'Write how it should be spelled underneath.'
It's about six-thirty in the evening.
She produces a new wrist tag and tells us to take a seat. I think about the Lawerence I once met who has that spelling of the name on his birth certificate because his father was too stupid to get it right.
There are about ten people in the waiting room, maybe fifteen, and the number will rise as the evening goes on.
A woman named Sheryl comes in, followed by a young couple. Sheryl has been bitten on the hand by a dog. The young man behind her, whom I assume is called either Josh or Greg or Caleb or Bubba, identifies the common theme of hand injuries facilitated by sharp objects and shows Sheryl his own recently mutilated appendage.
'I just stuck my buck knife clean through,' he tells her happily. 'I did it on accident. I was splitting some fencing.'
Sheryl tells him about the dog biting her.
'I didn't feel nothing,' he continues. 'I drove all the way from Canyon Lake. I figured it was easier getting to some place I knew rather than look around, so I drove all the way. I didn't feel nothing.'
The line gets longer as another injured person turns up.
'I stabbed my buck knife through my hand on accident,' Josh or Greg or Caleb or Bubba explains to the newcomer.
'I wonder if he felt anything,' I mutter to Bess.
'I didn't feel nothing.'
I vaguely remember Wavis O'Shave on television back in 1982, hitting his own hand with a hammer and gurning felt nowt! I am almost certainly the only person in the entire state of Texas thinking about Wavis O'Shave at this moment, and I want to tell Bess but feel the recollection may require a disproportionate quota of footnotes.
Josh or Greg or Caleb or Bubba now has another interested party, some guy explaining how he did the same thing in 'Nam and just glued the wound shut with superglue.
'I didn't feel nothing,' Josh or Greg or Caleb or Bubba reminds the guy. 'I did it on accident.'
Everybody has injuries, and everybody has had injuries much worse than this one. One guy had his entire upper torso sheered clean off and was just a pair of legs. He'd been skinnin' a cooter with some ol' cracklin' wire. He did it on accident. None of these complete fucking clowns felt a thing.
The television mounted up on the wall is tuned to the news channel. Nineteen elementary school children and two teachers have been killed during a school shooting in Uvalde, the nearest small town to Pearsall which is where Bess grew up. This one is fairly close to home. Greg Abbott, the governor of Texas was apparently addressing the NRA at the time. I'm already bracing myself to weather the outpouring of thoughts and prayers, and how we don't understand why this can be happening, and how it's a tragedy which must never happen again - although clearly it will, because we shall never understand the mystery of mentally unstable teenagers slaughtering toddlers with a legally purchased assault rifle.
What a fucking puzzler it is.
My regard for humanity has been taking a real beating of late.
Josh or Greg or Caleb or Bubba takes the seat next to Bess and myself. He is joined by his wife. They discuss how far he drove and how he didn't feel nothing. We're sat opposite a very old woman in mismatching clothes, including a yellow t-shirt bearing the legend #DREAM #DREAM #DREAM. She is wearing shabby slippers and has a walker in front of her. She's on the phone with the volume turned up so loud that everyone in the hospital can hear the steady string of answering service messages and automatic declarations of numbers having become unobtainable.
'This is Grandma,' she says feebly for the umpteenth time. 'I'm in the hospital.' Somehow it's difficult to imagine her story having a sunny ending.
I'm called in to be seen, but it turns out that this is just the preliminary. A nurse takes my blood pressure, temperature, and pulse. He asks a few questions and then we're back out to the waiting room. It's starting to look as though the anticipated heroin may not be happening. I'm not even asked whether I'm in pain.
The waiting room fills. Josh or Greg or Caleb or Bubba has an unpleasant looking sister who now joins them in the waiting room.
A Hispanic guy sits next to the very old woman in the yellow t-shirt. They talk and their conversation is interspersed with passages he reads out from the Bible he's carrying. I'm distracted by the droning testimony of another guy. He's been yacking away for the past few minutes, something about fishing.
'You see that?' he says, showing his smartphone to a guy in a red shirt who isn't saying anything at all. 'There are eighteen kinds of snapper. Did you know that?'
He wears blue jeans, a camo baseball cap and clearly regards himself as a bit of a character. It's hard to tell whether he knows the guy in the red shirt, or whether the guy in the red shirt really gives a shit about varieties of snapper. He's that twat at work, the one who talks to everyone on the first day, and no matter where you've been or what you've done, he's been there too and done it but moreso.
Inevitably he falls into the orbit of Josh or Greg or Caleb or Bubba, having recalled an incident in which he too once stabbed himself with a buck knife on accident and didn't feel nothing; and Josh or Greg or Caleb or Bubba had no idea there could be that many kinds of snapper.
Bess and I work on not catching his eye.
Someone who has been here at least as long as ourselves wheels his wife back up to the reception. She is folded into a chair which isn't actually a wheelchair but seems to be one of those things used by people who need to keep the weight off one foot. I think she may be crying but the sound is weak.
'So how long?' the guy asks, not unreasonably given that this is an emergency room.
The receptionist mumbles something in response.
'Well, could we at least get a gurney or something.' He gestures to his wife. 'This isn't even a proper wheelchair.'
'I'm sorry,' says the receptionist, which seems unhelpful given that we're actually inside a hospital.
An old black guy is brought in by two cops. He is handcuffed and he's rambling. He keeps saying sorry and addresses everyone as sir or ma'am. He is immediately taken into the treatment room.
I look at my watch. It's after eight o'clock. 'I'm going to see if I can pee,' I tell Bess. 'I've got my phone so call me if anything happens.'
I find the bogs. The guy with the wife in the wheelchair that isn't a wheelchair is in there. He's really not happy. 'How long have you been here?' he asks.
'Since about half past six,' I tell him.
I produce about a thimble's worth of urine. The presumed inflammation of my gut has felt as though it's been pressing on my bladder, meaning I haven't felt inclined to drink much because it's been uncomfortable. So far today I've had one cup of coffee, sixty millilitres of Milk of Magnesia, and a small glass of apple juice probably amounting to about a half pint of liquid, if that.
I return to the waiting room.
'Did you see her arm?' Bess asks.
'Who?'
'The woman who wanted a wheelchair.'
'No. Is it bad?'
'It's terrible. It's all shredded up.'
The fisherman has now latched onto Sheryl. He's asking about the dog that bit her hand, then, 'what's your name?'
'Sheryl,' she says.
'Well, ain't that something,' he declares. 'I got a friend with the same name, although her name is Sherry.'
'So that would be a completely different fucking name then,' I mutter loud enough for just Bess to hear.
Bess is looking things up on her smartphone. 'There's only a ten minute wait right now at Texas Med Clinic,' she says.
'You think we should go?'
It's now half past eight. As it happens, although I'm still in some discomfort, it's nothing like so bad as when we first got here.
We leave.
'Thanks a lot,' I say to the receptionist as she snips the name tag from my wrist, although I doubt I sound particularly sincere.
We drive three minutes along Austin Highway to the Med Clinic. Josh or Greg or Caleb or Bubba's unpleasant looking sister apparently said something about COVID-19 being a hoax while I was in the bogs.
'I knew we shouldn't have gone to that place,' Bess says. She summarises three different horror stories including a miscarriage which occurred in the waiting room and a perfectly healthy limb almost amputated. The woman who had the miscarriage while waiting to be seen was nevertheless charged five thousand dollars despite having received no actual treatment. It's difficult to believe that a service for which one is expected to pay so generously can really be quite so criminally shit, but I've seen it with my own eyes. Both the guy who almost lost a leg and the woman who had a miscarriage are people I know fairly well and have chosen not to name. This isn't some friend of a friend deal.
We enter the Med Clinic. It's a much smaller place and there's no-one here aside from the receptionist. She takes my details, spells my name right, and we take a seat.
Bess and I make a pact. She will try to remember to avoid Northeast Baptist and I will try to remember what happens when I eat granola.
Ten minutes later we're called in to see a doctor.
'Mr. Burton,' he smiles. 'I remember you from last time.'
This strikes me as odd and unlikely, and it will take me two whole days to recall that I have been here before. It was a long time ago, prior to the spell in hospital, and before anyone had even mentioned diverticulitis. They weren't particularly helpful so we went to the medical centre on Broadway where a doctor was able to identify what was wrong with me. We were here for about five minutes which is probably why it didn't make much of an impression.
Right now this declaration of familiarity feels somewhat like part of a sales pitch. The doctor - whom I'll refer to as Doctor Kildare because I can't remember his real name - asks me to describe my symptoms, then interrupts me as I'm doing so. I've described more or less everything relevant as described above, adding the curious detail that I have no discomfort in the lower left of my abdomen - about where the colon swings around in the direction of one's arsehole - which is customarily the most obvious symptom of diverticulitis; so I have all of the symptoms except for that one.
'I think we'll need to take a urine sample,' Kildare suggests.
I remind him that I've hardly had any liquid today, so this seems overly optimistic given that I recently peed out what little urine I had stored up at the previous place.
'Well, we have all evening,' he says. 'You should at least try.'
I trot off to the bog and produce nothing, as predicted.
He keeps going on about a potential bladder infection, and how he's only able to diagnose it with a urine sample. I ask him to run through all the symptoms I would have. The only symptoms I have are those associated with diverticulitis.
'Do you drink alcohol?' he asks.
'Well, yes, but not much.'
Aha!!!, he doesn't actually say, but he's clearly thinking it. He starts on the usual lecture. Drink is bad for you, apparently.
I had no idea.
I really wish someone had mentioned this before.
'I sometimes have a beer with a meal,' I tell him. 'It's not like I'm some boozehound!'
His face lights up as he imagines my daily routine, sat on the curb, burping as I toss a newly emptied forty ounce bottle of malt liquor back over my shoulder, adding to the mountain of empties now higher than the roof of the house. He's also really warming to the bladder infection theme, as though he really wants that to be the problem. I imagine urine samples demanded from patients who come in with an arm missing or old school saucepans wedged firmly on their heads.
'Let's just forget about it,' I say. 'It's not going to happen.'
'Perhaps if you drink some water…'
Once again I trot off to the bogs with my little plastic cup and a glass of water knowing full well that I don't have a bladder infection and that it isn't going to make the slightest bit of difference anyway. I drink the water. I wait five minutes. Nothing happens, and I know that no-one is going to furnish me with either x-rays or heroin this time. Furthermore, even if I'm still feeling slightly ropey, I'm significantly recovered from earlier.
'This is bollocks,' I say to Bess. 'Let's just go home.'
I'm happy to walk right out of the door, but Bess insists I speak to the doctor.
'If I'm able to pee when I get home, I'll be sure to bring it back here,' I tell him.
'That won't do,' he says. 'You see we have to have it here,' followed by some mumbling about sterile clinical conditions.
'Oh well,' I say, and we leave.
Next day I do a nice big poo and feel a lot better. Doctor Kildare calls to ask how I'm doing. Bess tells him I'm fine.
I look forward to the survey in my email.
Satisfied.
Extremely satisfied.
Satisfied as fuck.
