The Stroke Artist

Genre
Equality Award
Book Cover Image
Logline or Premise
Young Dr. Choate had it made. At thirty-five, he had survived medical school and a long residency and had come into his own as a legitimate surgeon.

Then, the music stopped.

He had suffered a life-threatening stroke. His self-penned story, ‘The Stroke Artist’, speaks to all who have at one time or another faced life’s tragedies. From fighting to survive, to negotiating with an unhinged drug dealer, The Stroke Artist doesn’t disappoint.


First 10 Pages

The following is a 2435-character excerpt from The Stroke Artist. Prior to this point, I had suffered a massive stroke and underwent 3 brain surgeries. While on the ventilator in the ICU under heavy sedation, I lived a dark reality I call The Vivid World, completely foreign to my previous life. Unbeknownst to me at the time, I was living in a world created by the deepest fears of my subconscious. Perhaps because I was abused as a child by my mother, this deep fear manifested into a character known as La Madrona: the New Mexican psychopathic drug queenpin who coerced me into the black market organ trade.

Chapter 12: Office Hours

As advertised, la jefa told me I would be rejecting her workers’ disability and workman’s comp claims by falsifying medical reports and saying they were good to get back to work. At that point, she would usually fire them. Most injuries were as follows: falls on a kitchen floor slick with aerosolized fry grease or inhalational injuries from cleaning supplies. I was just as mad at the old cow’s workplace negligence as I was at the workers for letting it continue. I mean damn. Change the record already.

I returned to this Vivid World nightmare and found myself in my clinic on a Saturday morning. I was seeing ten patients who were employees from the hotels or restaurants. Some had driven hours to see me. La Madrona forced me to hold office hours for workman’s comp and disability evaluations on Saturdays. It was also a sort of general walk-in clinic for her employees. Most of them were Spanish-speaking patients with terrible or non-existent health insurance. My copay happened to be zero dollars for restaurant and hospitality workers. As a result, I ended up seeing a few walk-ins from one of the city’s rival underworld firms.

La Madrona didn’t seem to care that I saw them, as turning people away might have raised some questions that she nor I wanted to answer. They were mostly henchmen without documentation or eastern Europeans that their Italian boss Vito Catoni owned and employed. His legitimate business was a speak-easy-themed restaurant. Talk about hiding in plain sight.

Mr. Catoni was a portly Italian with a large head, sausage fingers, and cheeks like an English bulldog. I had eaten at his restaurant in my previous life. Albuquerque doesn’t have many restaurants worth writing home about. I remember thinking way back then what a kitschy caricature of an Italian place it was. The food was so-so.

I always liked seeing these eastern European underworld types though. They were fighters who had overcome quite a bit of circumstance with nothing more than an eighth-grade education and two fists. They were mostly men between the ages of eighteen and thirty and dressed like they came out of the nineties. They had all broken their noses at some point and they all wore mullets: business in the front, nineties democracy in the back. They looked like movie extras in the filming of the Berlin wall’s destruction.

Chapter 13: Tears of the Salt Mine

That same day I saw a Panamanian woman named Griselda. She had come to America sixteen years ago and had recently married a Mexican man named Santos who ran a backhoe for a developer in Rio Rancho. He was naturalized some years back. She was around forty years old. “Dime lo que pasó,” I said, “Tell me what happened.”

She said she was cleaning up a room at the motel in Chimayo when she dumped her used chemicals in the bathtub as she always had before. She returned to the room before heading out to confirm it all drained. It had not because the stopper was engaged by the previous occupant. She went to pull up the stopper mechanism and a deep breath sent her to the floor coughing and retching. She had clearly mixed some ammonia with a bleach-containing product inadvertently and inhaled the chlorine gas byproduct.

She could barely talk she was so short of breath. It would be a long time with a lot of pulmonary rehab before she would ever work again. I reviewed her most recent x-rays. Her lungs looked bad. The “read” from the radiologist said something like parenchymal shadows with bilateral infiltrates and patchy interstitial markings. That’s radiologist-speak for “looks like dog shit.”

I felt for her. I knew that even on two incomes they were struggling to get by. The school system in Burque was rough. They were plenty religious but also wanted better for their kids and thus they were sent to a private Catholic school. A lot of people in Albuquerque did this out of necessity. I couldn’t write a fake note.

I put in her medical record the appropriate findings. She didn’t deserve any worse. She was a really good person. The following day I came clean to La Madrona. I told her what I did. I figured she wouldn’t mind a blip on her insurance premiums. Boy was I wrong.

She unloaded. Apparently, she didn’t like her pocket doc scribbling outside the lines. The last time I saw rage like that was when I spilt Jell-O on a Hispanic kid’s new white socks in ninth-grade gym. She let me have it. She hit me with every cuss word in the book and put me in my place. The sad thing was that she was pretty well right.

I had grown too big for my britches. She reminded me that she bought me and still pays the EPD monthly to keep me in a white coat and out of a strait jacket. Nonetheless, her obstinacy hit me like a solar flare. I wanted to kill her. I wanted real freedom. I wanted to get back to my real life. Talk shows and social justicing would have done if the first option was off the table. I just wanted out of this seemingly inescapable hell. She made me retroactively alter Griselda’s chart to deny her claims and dispute the findings. I felt sick to my stomach. I had no choice.

Chapter 14: Clinical Espionage

The following Saturday, I held my usual office hours and saw mostly Vito’s Iron Curtain outlaws. No less than four of them had gotten into fights the night before and needed someone to sew up their eyes, chins, or mouths. It was a fun morning. I enjoyed getting my hands bloody. They said it was the MS13s or some other equally unimportant group of Rhodes Scholars. It was all too exciting for these East block goonies. They wouldn’t shut up about how good they whipped up on them.

The last guy I saw was named Janus (Yah-noose). He was a regular. He always wanted antibiotics for a sinus infection. He was a tiny Jewish hypochondriac in a Strongman champion’s body. He was, for all intents and purposes, the leader of the ruffians. Janus had a speech impediment and a poor command of the English language which made the fact that he was a chatty-Cathy even funnier.

I love walking ironies. He must have been in his late twenties and was from somewhere like Latvia or Azerbaijan. He was a “wild and crazy guy.” He was a good dude despite his day job.

Janus and I would usually talk soccer, or exchange secrets about La Madrona. He was always pumping me for information on the bitch, probably on Don Vito’s behalf. In answer to his probing questions, I gave him the same vaguely inconsequential “not much” every time. I was her property, not her priest. I knew probably less than he did. He asked why I looked so tired. I told him I couldn’t sleep.

He kept asking me oddly specific questions about La Madrona’s health. Like if she had been to the hospital lately and when she had gotten out. Rather than question him, I just sort of played along. I made up some dates, times, and fake diagnoses. I said she was hospitalized for a pneumonia for about four days. He said, “Neh-oo-monia? I thot it vuss her kitneez failink?” I corrected myself and countered with an “oh yeah, you’re right.” I made up something about how I confuse patients all the time and that it was another of my patients that had the pneumonia.

I told him I hadn’t had my coffee this morning. No sooner then I muttered this worn out expression, I realized he wouldn’t get it. He didn’t. I continued this pleasant disinformation game with Janus and learned that La Madrona was diabetic. From the history provided by my glib friend, I pieced together that she was a Type 1 diabetic. Even better.

I hadn’t known this about my vile captor. Different from the much more common type 2 diabetes mellitus, type 1 diabetics usually require injectable insulin to manage their blood sugar levels. Many have trouble keeping their blood sugars tightly controlled with insulin even in the best of circumstances, and they often develop chronic end-organ damage. Common end-stage damage tends to affect organs like the heart, kidneys, and eyes.

Apparently, her kidneys were taking a hit. Even if she developed fulminant kidney failure requiring dialysis, she still might live another three to ten years without a kidney transplant. I didn’t have that kind of time.

Chapter 15: Tipping Point

That night I had gotten home to my trailer park abode, living quarters that I was given as a prior courtesy of La Madrona. Most of her “help” lived in this park. Her goons lived amongst us to keep tabs. At least I had a double-wide with cable and internet. The door was slightly ajar.

I always locked it whether I was inside it or not. Disturbed, I cautiously snuck in and opened every cabinet and closet in the tiny dwelling to confirm no intruders. I had my pocket-knife out in stabbing position. I didn’t find anyone.

On my kitchenette bar, I found an unsealed manila envelope. I opened it up in a frenzy. It contained some photos that I dumped out onto the plastic countertop. The first three were pictures of Eleni pushing a shopping cart in a parking lot. The last two were pictures of my dog. She was dead and lying on her side with matted blood covering her neck and ears. She had a bullet hole in her side. I couldn’t think. My vision went red and I wanted to burn the world to ashes.

I wanted every living thing on Earth to be dead. I wanted to rain fire from the sky. Those were pictures of my wife. That was my dog. I was ready to kill and ready to die. When I would get this way in my previous life, I would need to beat my punching bag until I felt real pain or completely tired myself out. I punched four holes in three cabinets before I was cool enough to think.

I grabbed a bottle of Irish whiskey from the fridge and finished the last of it. I told myself I wasn’t a pathetic cretin. “You’re a fucking wolf,” I yelled as I beat the counter with my fists. I belted out a curdled yell until my vocal cords felt like blood and glass. One of the goons rushed in and told me to shut my mouth.

I pretended like I wasn’t fazed and told him thank you for stopping by. I then went into a flow state of focus. Enough was enough. I went to sleep that night half-drunk and maybe slept an hour before I was yanked out of bed by three large goons with pistols. They ordered me to get dressed. I demanded they hit the START button on the coffee maker.

It wasn’t worth the pistol whip to the side of my head. That woke me up. Regardless, I grabbed a twenty ounce to-go mug full of black coffee and chugged it down. They drove me to my clinic office. The lights were on and there were three trucks parked in the lot. They walked me in, prodding me in the back with the muzzles of their pistols.

The oldest one, Lalo, asked me if I was ready for surgery. “What are you talking about?” I asked.

I was tired of these “men” pushing me around. I grew up in San Angelo, Texas. I’d seen how Latin men were raised. Most of them were coddled mama’s boys.

Somehow, I oughtta be able to take advantage of this and overcome. I was thinking to myself what I was going to do. Did they mean they were going to cut on me for my recent transgression? I calculated an escape. There were now five guys with guns in the room. No way I was getting outta there without a bullet in my back, then head.

When I saw what was awaiting me in the procedure suite, the pieces all suddenly fell into place and I knew what was going on. There was a dead man lying supine on a metal table in the procedure suite. He looked to be a medium-build, short Hispanic man in his mid-fifties.

I knew the bitch wanted a kidney and this was probably a relative or someone that died and had a directed-donation advanced directive to her. At least that’s what I told myself. I was being ordered at gunpoint to harvest a dead man’s kidneys by the Vatos Locos.

Every one of them had a gun pointed at my head. They told me to hurry up and I heard mutters in Spanish that La Madrona was prepped and already under anesthesia. Much to the goons’ astonishment, I checked for breathing and pulses and confirmed he was dead. I was not going to be an accessory to murder in addition to a black-market organ harvester.

As I unzipped the dead man and entered his abdominal cavity, I could hear the cocking of four pistols and a pump-action shotgun. I worked feverishly. “Apúrate! Apúrate güero!” they shouted. I opened up the chest, vented the right atrium and cannulated the aorta to slam in the UW solution. UW solution is the liquid used to preserve human organs for transplant, developed at the University of Wisconsin; which is why it’s called UW solution. They had all the necessary equipment for this procedure, oddly enough. I was impressed. La Madrona had more connections than I gave her credit. I took down the white lines of Toldt and entered the retroperitoneum. Within twenty more minutes, the kidneys were out and in a cooler.

“Bien hecho puto,” one of them said. Two of them left with the goods and boarded a helicopter outside. The men in the room had tattoos from tip to toe and had probably killed scores of people, but a few of them nearly lost their lunches looking at the tableau of viscera I created. I was glad that these assholes would have the pleasure of cleaning up my abattoir.

I was satisfied with the kidneys’ vein lengths and artery patches. It’s probably a surgeon thing, but it’s just not in our blood to do bad work. At least someone else would probably get a kidney out of this ordeal. At least that’s what I told myself.

Comments

Bevan320 Wed, 13/03/2024 - 17:53

At 35-years-old, I suffered a life threatening stroke. After three massive brain surgeries and a tracheostomy tube, I somehow survived a month-long stint in a COVID-stricken ICU. I came into the hospital a successful surgeon, and left a young man with a shaved head and a walker.

After a seemingly endless and arduous climb to the top, I was somehow back at the bottom. Well, below bottom. Subterranean. For months, I struggled desperately to cling to any hope I could. Though highly determined, I still battled immobilizing depression. Initially, my appearance, gait, and station drew the attention of curious onlookers. I am sure it was incongruous to see a seemingly young healthy man skulk around with a walker at a restaurant. The attention made me bitter and full of shame. Through months of intense rehabilitation, my gait and strength improved. My outward appearance was no longer lacking, but I lost my ability to operate in an OR, dance, or play sports. My injury had become invisible, though I still felt grief-stricken and generally sad. Like many stroke survivors, the invisible injuries are often harder to reconcile.

Through some divine serendipity, a colleague urged me to write a book about my experiences. This started as an exercise, and flourished into something of meaning. I thought, "I've been on both of sides of medical catastrophe. I might be able to help some people with this book and my medical knowledge." I began getting involved in the stroke and brain-injury community. I found a new community of people who, although marginalized at times, are some of the most resilient and grateful individuals I have ever met.

When I was circling the drain on a ventilator and fully sedated, I did not meet angels or see any tunnel of light. Instead, my subconscious pushed me into a vivid new reality of darkness and deep-seated fears. I went to war.

I later understood this to be only what my mind had known at the time. Why should I have seen angels or fond childhood memories if I never allowed myself to develop these aspects of life? My whole life had been an egoic fight for accomplishment, achievement, and deranged martyrdom as the "self-less surgeon."

Well, you cannot give what you do not have.

This poignant realization has changed me completely. I am thankful for the stroke. Thankful for its inertia. Thankful that I have a second chance to live life on life's terms. Medicine will always be there and I can continue to give it my best. But it certainly will never again define me. I am now much more interested in the love I develop with my family. The ability to be able to help a young stroke survivor battle through the lows. The world, my soul, and others now have more meaning to me than ever before. Art and palette knife painting.

Disabled people with brain injuries are a small portion of the population but are easily overlooked. They have so much to offer. I will continue working to help and reach those of similar fates to share in experience. The message is simple. Surviving a stroke cannot be the end. It is a milestone and through a community of similar individuals, much can be gained.

Bevan320 Wed, 13/03/2024 - 17:56

For an audio performative adaptation of the story excerpt above, please listen to episode 666 "The Dark" performed by me on the Risk! podcast.