Chapter 3

I awakened when the kids came in from school. Of course, they could not comprehend the concept “work nights, sleep days”, and therefore tore into and across the house like a thundering herd. I rolled out of bed, creaked my way through some stretches, and beelined for the coffeepot, there to await the steamy mug o’ wakefulness. Chaos roiled around me.

I managed to settle the boys down, and get them changed into jeans and out of school clothes. I directed them to pick up their rooms, and then they were out the door, to tear around the neighborhood and our yard.

I powered up my computer, and entered the screenshot of “Lance” into a reverse image lookup program. Unsurprisingly, his face turned up on Facebook. I reviewed his life, and was unhappy, but not surprised, to learn that he was Annie’s boss. He lived in the next town over, and had been employed at the company for a dozen years, holding several managerial positions. He was married, and, seeing the flattering picture of his wife, I was puzzled at him stepping out. Her smiling cute face seemed open and happy. Dressed modestly, she nonetheless appeared to be trim and feminine. Strictly as a man-pig, I didn’t see cheating on her. Unless, she was a manikin in bed.

I saved the results of my reconnaissance, packed up my laptop, and started dinner. I packed my lunch, got showered and dressed, and summoned the kids. By the time Annie whirled through the door, I had dinner on the table, kids washed up and waiting, and we were ready to go.

We adults exchanged casual conversation, and Annie brought me up to date on the latest office intrigues. Dinner finished, I pecked her on the cheek, gathered my stuff, and set off for another night of Fighting Disease And Saving Lives.

When things go well in an emergency department, you don’t really have any drama, at all. Folks arrive for their sinusitis, their sprains, their asthma, and you triage them, record their vitals, administer meds, provide discharge instruction, and wave goodbye. And, when that works out, it is really pretty pleasant. When it doesn’t, well, that’s when you earn the big bucks. (notwithstanding the fact, that you do NOT get paid “big bucks”).

So, for some reason, tonight was The Festival Of The Leaves. In rural Michigan, that’s when all the smokers, asthmatics, obese, diabetics, and generally unwell, decide that they cannot sit still another minute, without raking up, bagging, and hauling to the curb all those 40-50 pound bags of leaves. As you might imagine, not everybody celebrating this festival is any sort of aerobically fit, and a few of them are one squat away from rupturing an aneurysm, or sending one last little particle of cholesterol or clot off on a voyage, to plug that last little opening remaining on one coronary artery, or another. Alternately, for those whose karma is a little more in order, they simply find that the ability of their heart arteries to supply blood, is just about up to the task of perfusing (feeding blood) to the myocardium (heart muscles), if and only if, they are spread out on the couch. Once these souls begin to labor in the yard, their myocardial oxygen demand goes up, up, up, and the ability to supply this demand, well, in their situation, being static, if does NOT go “up, up, up”. This produces a demand/supply mismatch, and THAT, boys and girls, is why cardiolgists’ kids go to nice colleges! It turns out that heart caths both save lives (YEAH!), and cost a considerable amount of money.