Leaning on Caduceus

Scott Gilbert

On the morning after the election, as I drove Ben to the hospital, the radio news described a world of uncertainty: Had Bush won Florida, or had Gore? How long would a recount take? Who, exactly, was the president-elect of the United States?

The overcast sky was dithering, too, not yet decided whether the incoming cold front would blow in a flash flood or a clear, cold afternoon. My black tote bag bulged with clothes for either eventuality: three changes, both for Ben and for me, plus diapers, plus towels for cleaning the messes he was likely to make. I expected to spend hours in the waiting room of the pediatric gastroenterology clinic. Ben's general practitioner and I had made nearly a dozen petitioning phone calls before we were granted even a "work-in" appointment. I expected the clinic to be packed, Calcutta-style, with dull-eyed children racked by wasting diseases.

Besides the clothes, I packed Pedialyte, the electrolyte elixir that pediatricians almost always recommend you give a vomiting, diarrheic child. It's designed to prevent dehydration, and because Ben had been sick for so long, I imagined that I could see him shriveling before my eyes. Over two and a half weeks, he'd lost around three pounds -- a lot for a 22-pound two-year-old, so much that his size four diapers were now hopelessly baggy. On Tuesday, after voting, I'd taken him to buy size threes, and while on the Kroger baby aisle, I defensively loaded my cart with almost every Pedialyte product on the shelves, anything to keep him from checking into the hospital for an extended stay.

The hospital's underground garage was full. Searching for a space, I ranted: What evil genius designed the Texas Medical Center? Why is this complex impossible to navigate, impossible to park in, just plain impossible, period? Don't sick people suffer enough already? Through it all, Ben sat placid in his car seat, as peaceful as a meditating Buddha. Two-year-olds are not supposed to be placid. I took deep breaths.

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I found a valet parker and lugged Ben, my purse and the overstuffed tote bag inside the hospital. The receptionist gave me directions to the wrong floor of the wrong building. As I wandered the maze of hallways and elevators, Ben wrapped his skinny arms around my neck and rested his head on my shoulder. It was too much. I felt too weak to rant.

At one elevator stop, a nurse pushed in a preteen girl in a wheelchair.

"What's he got?" the girl asked, looking at Ben.

"I don't know," I said.

"I've got sickle cell."

"Ooof," I said: the sound you make after a punch to the gut.

"You know sickle cell?"

"It hurts a lot, doesn't it?"

"Yeah," she said, almost proud. "They're going to take out my spleen, but not if I run away first."

The elevator stopped. I carried Ben out. I was holding him tight.

My husband, a research scientist, works in a different part of the Texas Medical Center. Paul writes computer programs that piece together snippets of the human genome. When people ask what he does, he replies that he and his colleagues are "decoding the book of life." He says this in a tone of mock grandeur, but it's not entirely a joke. He believes that life can be decoded, that the universe behaves rationally and will yield its secrets to anyone clever enough to ask the right questions and interpret the data.

I believe that too, mostly, and from the outside, our appointment with the clinic looked entirely rational. Our general practitioner recommended that Ben see a specialist -- a pediatric gastroenterologist, she emphasized, not one who treats adults. Pediatric G.I., she said, "is a whole other world," and obviously I needed a guide familiar with its strange geography, someone who could assess Ben's symptoms, fit them into the arcane framework of the field and form a hypothesis. I needed a scientist.

But what I sought, secretly, was an oracle, or maybe a wizard or a god. I didn't want a pretty good guess, or a working approach, or a wait-and-see attitude. I wanted the Truth, please, with a side order of Infallible Treatment.

When I finally found the clinic, its receptionist handed me a clipboard with a questionnaire and directed us to take a seat in a bright-colored waiting room. I was relieved not to find hordes of dull-eyed starvelings. I counted only three other families. My kid looked the sickest of the bunch.

Ben settled into my lap, limp and unusually still. I offered the Pedialyte; he refused. But he accepted a toy bulldozer and clutched it grimly. His eyes were fixed on a wall.  

I watched the room's TV. On the little screen, Bush was explaining that Gore had conceded, then retracted his concession. Bush, Cheney and their sleep-deprived wives sat around a dining room table. There was food, but nobody seemed to eat. They were waiting.

After only a half hour, a nurse called Ben's name and whisked us into the clinic's inner sanctum. I stripped him naked to be weighed, and the nurse held a thermometer under his arm. On a normal day, he'd have fought these insults to his toddler sovereignty. Today he submitted without protest.

Eventually we were left alone in an examining room, and I read the green handout that explained the clinic's procedures. Each doctor worked with a nurse, and if I had questions or problems, I was to call my doctor's nurse, not the doctor himself. Normally I hate such screening, but this indirection made a kind of irrational sense: Of course the high priestess would speak for the oracle; of course I'd ask the Virgin Mary to intercede with God.

With a start, I realized that the entire hospital made this kind of irrational sense. Of course it's hard to get an appointment, impossible to park and frustrating to navigate. Pilgrimages are supposed to be difficult. Wise men live atop mountains, and great pearls always command a great price. I wanted a big thing -- for my son to be healed -- and by design or by accident, the medical establishment seemed determined to heighten the drama of the quest.

Naturally the doctor made me feel like an idiot.

"How do you know that Ben has lost three pounds?" he asked sternly.

Because I weighed him? I thought. Because 22 minus 19 equals 3? No -- that would sound snide. Maybe he wants anecdotal observations?

"He's thinner and noticeably lighter," I said. "His clothes are hanging loose, and we've had to buy smaller diapers."

Wrong answer. "You're gauging a three-pound weight loss by his diaper size?" he asked, incredulous.

No, no, I explained -- I weighed him on our home scales, 22 minus 19 equals 3 -- but it was too late to redeem my reputation, and besides, redeeming it would have ruined the dynamic. If I seemed dumb, then the doctor seemed smarter by comparison. The less worthy the supplicant, the more impressive the oracle.

The doctor offered a hypothesis -- not the word-of-God pronouncement I wanted, but an educated guess: Basically, Ben's original vomiting and diarrhea had been caused by a virus, but by the time his immune system had vanquished the invader, the extra acid had left his digestive tract raw, leading to more vomiting and diarrhea.

The doctor said I should change Ben's diet immediately, that instead of clear liquids he now needed protein and complex carbos, a regular diet so that his body could begin rebuilding itself. Good-bye, Pedialyte; hello, burger and fries.

The doctor prescribed more ordeals for Ben and me: a blood sample, a urine sample, a stool sample. And last, he prescribed a medicine so complicated that I drove to three pharmacies before I found one that could produce it. The pharmacist -- a grandfatherly type, a kindly guardian of the lost art of compounding drugs -- retreated to a back room to mix the elixir. Ben and I waited for an hour. I pictured the pharmacist chanting spells.

Outside, darkness was falling. The weather had resolved itself: cool and clear. The election offered no such certainty.

"Who's gonna win?" a passerby asked the security guard.

"I am," said the guard.

Eventually the pharmacist emerged with a big dark green bottle. Inside it, tiny bubbles slowly rose to the top: visible evidence of powerful mojo. He wrapped the bottle with a block of ice the size of a paperback book, and I reverently carried it home.

As I write this, two days have passed since our appointment at the clinic. The weather remains clear, but little else is. In Florida, the never-ending ballot recount seems like a college exercise in hermeneutics and epistemology. The data refuse to yield an answer.

The clinic hasn't yet called me with Ben's lab results; some won't be available until next week. I can say definitively, though, that his vomiting and diarrhea continue, but at a slower pace. Between rounds of diapering, feeding, cleaning and medicating, he lies on the living room futon, watching PBS, the toddlers' opiate of choice. Sometimes he asks for a hot dog. He never asks for Pedialyte.

He hates the medicine inside the green bottle. Yesterday afternoon, when I removed it from the refrigerator, he erupted into a raging, screaming tantrum. I put the bottle on the counter and held him tight while he writhed and screeched. It was a beautiful, normal tantrum -- a good omen, an encouraging piece of data, a moment, finally, of clarity. I almost cried from relief.

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