Waiting Room
Before he was text, he was a physician. I examine Dr. Orville J. Pennington on a cold basement floor next to the straitjacketed water heater and the Saturday morning shoppers clawing lamps and carnival glass. He sells for five dollars at an estate sale. He is long dead, but soon enough he is a private show of patient accounts, appointments, marginalia, and news scraps in a rotting Smirnoff box.
There is No Death promised the poem tucked in his Special Edition Laird & Lee’s Webster’s New Standard Dictionary of the English Language.
He wrote his sister Now for godsakes get this into your pate + these cases never die until they wear out the whole family. Lizzie might live for another four or five years + might outlive you.
Prescription
Before this man was my confidant he was a physician. He sits across a desk and drinks fair-trade coffee from a Viagra cup. He scribbles on his Depakote clipboard. He urges me to slow down. His Prozac pen can't dance quickly enough to map the geography of my hysteria.
I suspect physicians lust for the body in a museum of the static, each organ isolated from the next, each lung or kidney a sterile fetish.
I am the seductive brain. This is his fetish. I take in his flying fingers. There is the curious charge of the inner self in stirrups. There is the attractive calm of his accessories: those diplomas, that photo of a beaming, reedy wife.
Clinical Characteristics
Complaints are often colorful or exaggerated but lacking in specific factual information. Patient commonly "doctor shops" leading to numerous ongoing treatment efforts. Patient often has a history of multiple diagnostic procedures, surgeries, and hospitalizations. Patient frequently reports chaotic life aside from complicated medical history. Somatization disorder associated with high rates of iatrogenic illness.
or
The treatment of hysteria demands great tact and firmness on the part of the physician. The moral treatment is all-important. In severe cases, removal from home surroundings and isolation are essential, in order that full benefit may be derived from psychotherapeutic measures. Occupation, or be it rather said want of occupation, is a prolific cause.
Gynecology
I want to know the patient named "wife." She sometimes pays in laundry. Sometimes she pays with checks. Sometimes she scrawls We are hard up now and ain't got nothing but what we earn and work. We had run back and ain't got nothing. Have a little paytents.
Wife shows up on almost every page, delicately tucked under the wing of her husband's name. On April 18, 1911, she had a miscarriage. It cost $12. She is birthing and dying, fetching nerve pills, swallowing tonics, cleaning the doctor's floors.
Medical Records
Madame Armstrong, Palmist and Psychic Reader. One visit with Madame Armstrong will save you many dollars in untold worries. She has helped thousands. White and colored are Welcome. See her today, tomorrow may be too late.
Old Doc Pennington saved her ad.
Patient History
He was my physician. I don't know why I was stripped out of my Kelly green bell-bottoms and kanga shoes and spread open on the table. The wooden tang of the tongue depressor imprinted my mouth. His hair was white as his coat. He smelled of Old Spice and peppermints. His nurse was blond and thick, wearing a polyester dress, holding down my arms. My mother sat on a chair in the hallway, huddled into herself.
Pediatrics
My discovered physician tucked a photo of Shirley Temple in one of his account books. Near her image: Boston, Nov. 16, 1923 -- It's the girls who are sowing wild oats nowadays. And what's more, they are leading boys astray.
Examination
You are a physician. You slide your hand up my turtleneck to feel the thrum of my heart.
Shall I undress for you? Shall I leave my jewelry on? My black jeans, my red bra rest under the chair now, and I am stripped to a medical gown and sagging socks. I am rearranged in a complication of stirrups. The nurse flutters, reassuring as a pigeon. Slide down. Relax: re -- lax --- I will let down my thighs. I will bite this tongue through before I remind you that you are the only person whose hands can spelunk me without even the smallest nod of seduction.
"Nice estrogenic effect." Do you spend late nights cataloging the taxonomy of these parts - plump, shriveled, sad, longing for their estrogenic tattoo, virginal, episiotomied?
I take your latexed fingers. You are pressing me: your hands are eyes: your hands see unseen parts of me. I want to cry with your hands in me. I can't remember how you got here.
You insert your speculum. This whole world stinks of rubbing alcohol and formaldehyde. Everything is off-gassing. Everyday you dump these archives of plastic, latex, needles, spent blood and dioxin-ed cotton. You dump me. I am disposable, an estrogenic effect, a symptom, a fume. I dump you. You are disposable, a white coat, a stethoscope, a pad of paper laced with code for chemical moons.
My imagination can hear you droning the story later among the manila folders and Merck manuals: 29 year old female, nice estrogenic effect, fussing over the idiopathic. . .
Symptomology
Pain. Burning, searing, swelling, embroidering, needling, tatting, ripping, flaring, intricate, clumsy, vulgar, rare pain. Pain thinking about pain. Each nerve sings its painful little tune, the nerves sing together in a chorus of pain. Rare pain, dear pain, pain as history, as expectation, as memory. When there is no pain, there is a ghost of pain, hovering in the corners. When there is dull pain, it is the pain of counterpoint, balancing any melody of pleasure, of concentration.
Hysteria
Somatization Disorder
DSM IV 300.81
Pattern of recurring polysymptomatic somatic complaints resulting in medical treatment or impaired daily function. Usually begins before age 30 and extends over a period of years.
Psychiatry
Gynecology, Urology, Emergency Medicine, Pain Management, Uro-Gynecology. Psychiatry again. Specialists bobble up and down my weeks like notes on a staff.
Diagnosis reveals itself as a melody, hidden under discord. A few simple forgotten tests, the crescendo. There are only cruelties. There is the overlooked: a missed pregnancy, ridding itself. There is the revealed incompetence of hurried doctors: a missed culture, an untreated infection. There is the exotic: the minor keys of vestibulitis, rolling off a specialist's lips. There is nothing good for this, she assures me, only cruelty -- violent surgery, immune suppressing drugs, palliative psychopharmacology.
Nerve pills. Tonics. The blue missile of the Zoloft sinks my pain with its chemical fire, its subtle con, its interceptions. I have been cured.