Syracuse, NY 13210
Volume 6, 2006
Sunday’s at noon Mrs. Stern lies on her side facing the hall, her silver hair cropped short like a boy’s, her spindly legs drawn to her stomach. She looks old and weak, and her eyes are shuttered. She moans as the psychiatric ward nurse enters. Her face has lines like a fishing net, with slits for her mouth and eyes.
“Mrs. Stern,” the nurse says. “The on-call doctor has come to see you.”
“Finally,” Mrs. Stern says, her eyes still closed. “Well, what does he say?”
The nurse advances to the bed. “Dr. Rubens wants to ask you some questions.”
“No,” Mrs. Stern says in her raspy smoker’s voice. “I want to ask the doctor questions. Two hours I’ve waited. Where is he?”
“I am here, beside your bed.” Rubens replies in a calm tone. He glimpses her untouched lunch—tuna salad, juice, and steaming coffee. His stomach growls. “What is the problem, Mrs. Stern?”
“I have terrible pain. No one listens to me. Why?”
“Tell me what sort of pain you have,” Rubens asks.
“You don’t know?” Mrs. Stern’s eyes stay shut. “Did you speak to the nurses?”
“Yes,” Rubens says. “I did.”
“Did you read the chart?” Mrs. Stern’s eyes open.
“I wanted to see you first,” Rubens says.
Rubens has not read the chart. He feels remiss; he knows nothing about Mrs. Stern. When the nurse first tells Rubens about Stern’s complaint, he is distracted. Now, at the patient’s bedside, Rubens struggles to recall the nurse’s words. Rubens is light-headed, dreamy. He has seen many hospital and emergency patients today. He has had one cup of cafeteria coffee for breakfast. He has slept poorly all weekend, and his sciatica has worsened. He recalls a single fact about the patient-- Mrs. Stern is 68.
Rubens thinks his grandmother who died at 92 looked younger than Stern.
Mrs. Stern looks to be closing in on one hundred.
It is the lines on her face and neck. Lines like mesh, like crossword puzzles intersecting without letters, graphs running over her forehead, her lips.
She is the oldest looking woman he has seen all weekend.
She looks old enough to be in the British Museum.
Momentarily Rubens rocks on his feet, asleep, feels a dull tinge of back pain, and awakens, in a curious mind-fog. His eyelids flutter. He hears the nearness of the nurse and patient beside him.
He smells Mrs. Stern’s steaming coffee. He dreams of childhood.
When he is nine, his mother buys him a Superman outfit, the red tights, the blue body leotard, the red cape. She gets him red sneakers to match the uniform— it takes months of haggling—his dad, the pharmacist, is anti-Superman—the TV program, the comic books, the outfits. Superman gives kids the wrong idea.
“No son of mine is going to dress like an idiot in tights.” His dad points to their black-and-white TV. “See his wires? See how the wires keep him up? It’s a cheap trick.”
“Dad, please,” Rubens says. “I want to be Superman. What’s wrong with that?”
“Plenty. Superman can’t fly. He’s a goddamn phony. He lives in a comic book.”
“I want to play weekends like the rest of the guys. Everybody has an outfit.”
His dad marches to the window. “Show me one kid dressed up as Superman.”
Rubens stares at the playground across the street. Kids play cowboys and Indians, cops and robbers. There are basketball and street hockey players. There are two boys skipping rope with the girls.
But there is no Superman.
In his new outfit Rubens rides his bike. His cape catches on his pedals nearly decapitating him. He practices running at break-neck speed from the second floor to dive headlong into the living room, cape flying, leaning forward, in semi-flight.
He receives nosebleeds, back spasms, sprains, and withering stares from Dad.
“Go ahead. Jump. I swear, if you break your leg, I’ll personally bust your head.”
Undaunted, Rubens wears the uniform under his clothes to school. He has a crush on Esther Gold, the girl four rows ahead. Rubens hopes to prove his special powers yet is too shy to take off his shirt. At night he practices beside his mirror and makes muscles.
“Look,” he says, “up in the sky—it’s a bird, it’s a plane, it’s Superman!”
Rubens’ eyes open to the present.
Rubens is 51, married, with three children—yet a primal part of his mind still believes he is Superman. He has flying dreams and tries to levitate furniture. He shares the fantasy with no one, not colleagues, not his wife, not his second analyst. The idea is preposterous, psychotic. It hides in dreams and is his dark side—his Hyde.
He directs his positive energy towards patients.
“Dr. Rubens?” the nurse says.
He tries to re-focus. He struggles to remember what the nurse told him. Is Stern the ulcer lady? Is she the patient who fears the FBI followed her from Miami? He has seen too many patients—faces in a crowd that blur and fade from view. His stomach growls, his sciatica gnaws away. He is too weary for hospital on-call.
Tides of sleep wash over the back of his eyes.
Mrs. Stern has an air of antique majesty. She rotates, faces Rubens, and points a scepter-like digit. Her eyes are battleship gray with white flecks that look like gun smoke.
“What are you going to do, doctor?”
“First,” Rubens says, “I have to ask some questions.”
“Here it is, all over again,” she jabs a trembling, irate finger in air. “I am in the hospital dying. Nothing happens. You doctors are incompetent. If this was Russia, you’d be shot. I need stronger pills, something to take the edge off pain.”
Perplexed, he leans to the nurse. “What awful tragedy befell this poor woman?”
“I told you before,” the nurse whispers, “Mrs. Stern has constipation.”
“Constipation?” he mutters aloud. Constipation.
Rubens tries to straighten his back. The nurse passes him the chart. His memory ebbs back, like brackish water. Stern is the patient with chronic constipation. She has seen GI people, surgeons, psychiatrists, pain experts, naturopaths, and criminal lawyers.
She has been constipated longer than most of his patients have been alive.
He feels light-headed, his eyelids twitch. He slips into reminiscence.
When Rubens turns 12, his grandmother, Masha, moves into the spare bedroom.
She is from the old country, walks with a cane, and has a thick Polish-German accent. Stewed prunes, apricots, All-Bran, Dulcolax, mineral oil, stool softeners—she has rituals with hot tea to stimulate her sluggish bowels. Mornings are the key to success.
“Believe me, it is no joke,” Masha says. “Wait ‘til you get old and constipated.”
Rubens smirks. Her line-up of dried fruit, bananas, and laxatives is hilarious. He juggles apples. He makes apricots vanish. He produces prunes from his nose. He slips bananas in his sleeves and hides All-Bran. He dreams he is Harry Houdini.
“Wake-up! Stop your games,” his father yells. “Life has no cheap tricks.”
“But look dad! Where did the banana go? Look! Show me where.”
“Here.” His father grabs Rubens’ sleeve, and finds the banana, squashing it to a pulp.
“What if,” Masha says, “what if the only difference between you and me is our age? One day you will get old and sick.” But Rubens feels like a master of the universe.
In school he takes Esther Gold’s quarter and turns it into a silver dollar.
“I want relief. I have terrible pain.”
Mrs. Stern places a fist over her abdomen. Rubens inspects her lace of scars and warms his stethoscope. He places it gingerly over her umbilicus. He takes her vital signs.
“You have good bowel sounds down there, Mrs. Stern,” he smiles.
“Nothing passes,” Mrs. Stern snarls like a customs agent. “We are blocked.”
“What sort of medication do you use for blockage?” Rubens checks for the chart.
“Percodan tablets,” Mrs. Stern says.
Rubens adjusts his glasses; he turns this way and that to read the chart. He needs stronger lenses. It doesn’t help that the resident’s notes are illegible. He reads that Mrs. Stern’s husband has died a year ago; her daughters live out west. Her husband ran a shoe store, sold the business, retired early. Six months later he drops dead—a stroke. She has had constipation all her life, but now it is intractable and constant in her mind. Her GP puts her on Elavil. Her depression worsens. She loses weight. She is admitted to psychiatry, 20 pounds thinner. She remains in her room. She refuses to talk. She demands to smoke. She holds court and gives ultimatums. Rubens prepares himself for a breakthrough.
“Do I get my Percodan now, or do I call the head of the hospital?”
“We will get you some relief—we will try to make things better.” Rubens shifts his weight--another sciatic twinge. He finds her GP’s letter. Six Percodan daily; yet there are no chart orders. He writes a Percodan order hoping to wean her off narcotics.
“Mrs. Stern, you grieve your husband; you miss your children; you are alone,” he says. “Percodan worsens depression and constipation. Let us start a new antidepressant.”
Her lip twists. She cries, “Don’t take away my Percodan. ”
Rubens pats her hand, confident of victory. “I know, I know the drug comforts you. Let’s talk of the setbacks, your husband, the children--the feelings deep inside--”
“My feelings?” Mrs. Stern rubs her eyes. “What is the good?”
“Can we talk of what happened before you came into hospital—your losses?”
But she cuts him off. “Listen doctor, I have pain deep inside. It doesn’t leave. Talking doesn’t help. Antidepressants don’t help. Doctors don’t help. Percodan helps. Now leave me alone.”
Rubens lingers at her bedside. The trouble is he wants to cure everyone. If only he were Houdini, he could perform a trick. He sees it clearly. He places Mrs. Stern into a big wood box, locks it tight while his comely assistant shoves in swords from all sides. He waves his hands. There are flames, a puff of smoke, a loud explosion, and presto! The box levitates. The depression and constipation lift. Mrs. Stern emerges, beaming, cured. Rubens watches the audience mesmerized by his magic powers. But someone stands up in the rear, then flies forward, hands waving, shouting, screaming. It is his father.
“Do I have to yell from up here? Son--get it through your thick, idiotic head.”
There is a hush. Rubens looks up. He sees in the swirling dark universe of dreams his tormented weary father. “Listen,” his father yells. “For once in life, will you listen? Stern does not want to get better. You can’t play magic tricks on her mind.”
“Dad, what do you mean? What do you want?”
“She wants to stay a patient and keep her anger and pain. She won’t let go. Life has no cheap tricks. You can’t win. She won’t let you. Stop your hocus-pocus.”
Rubens listens. Perhaps, he thinks, his father has a point.