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Patient Safety
Silence vs
White wall
    of Silence
Conflict Of
Psychology of
Nurse survey
Mobbing and
Trust Us
Report Rate
Crime in
Sexual Abuse
Free Speech
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Medical errors

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Thomas Jefferson said that given the choice between government without newspapers and newspapers without government, he would choose to have newspapers.

In medicine we have government without newspapers. Patients cannot find out what they need to know to make informed choices. No one in medicine records or reports the information patients need to know the most. So patients will have to.


Rough Draft / Under Construction

In the library he was handing cards to a librarian to retrieve books when they were interrupted. A second librarian put a card in front of the face of the first librarian and said, "Can you read this?" She stopped and tried but couldn't. The first librarian said, "The book is overdue. How can I send a notice if I can't read the information on the card." Aaron said, "Want me to try?" She handed him the card. He said, "The phone number is legible. Call him up."
"Call him and tell him is book is overdue?"
"Why not?"
"People don't like to find out when they're overdue."
"Want me to call him?"
"You'd call him?"
The second librarian said, "Why not?"
Aaron reached for their phone and turned it around to face himself. He told the guy who answered the phone that this was the university library and they could not read his name on a card the guy had filled out. The guy on the phone said it wasn't him. It must be DeShawn. He hollered to DeShawn and then said, "Just a minute. He's in the shower." Aaron said to the librarians, "It'll just be a minute. He's in the shower." Finally the phone was handed to DeShawn in the shower. Aaron repeated that it was the library and they could read his address on the card. DeShawn recited his address. Aaron then asked him to spell his name and filled out the card legibly for the librarians. The first librarian asked Aaron if he wanted a job. He smiled and she left. The second librarian said they owed him one.

"When a library that loans books for free owes you one, what can you get?"
She said, "Good question, Aaron."
"You know my name?"
"I call it out about twenty times a day."
"I guess that's right."
"I'm Cinto."
"It's Portuguese. It's really Jacinto, but everyone calls me Cinto."
"Nice name."
"Thanks, Aaron."
"So what can I get?"
She laughed. "I don't know. What do you want?"

He smiled and laughed too. She had the biggest eyes. Of course, he had seen her numerous times. She was someone guys noticed. She had long, straight, dark hair that hid her face at times. Now, with her hair out of the way, looking straight at her, it did not occur to him to tell her how beautiful her eyes were. He was too busy trying to think of what to say to keep this conversation going.

"I've pretty well been through the card catalogue and don't think I'm going to find it there."
"Have you tried the reference section?"
"Oh, yes. I'm at the point where, with my eyes closed, I can identify books there by aroma."
She laughed. "You do spend a lot of time here."

Without their noticing, the first librarian had returned and was listening to them. She said, "Maybe he'd like to come to Kevin's."
Cinto said, "That's an idea."
The first librarian said to Aaron, "It's mainly people who work here at the library, and some of their friends, but we're getting together at Kevin's tonight. Why don't you come?"

He was lying on a couch at that party when Cinto and two of her friends sat on him. He thought, "See. Lying down works." She was just being funny. And when she sat on him it seemed she didn't weigh anything at all. The floor behind the desk at the library was higher than the floor the patrons stood on. He had not had a sense of her actual height until this evening. She was yet another woman who was half his size. When standing next to her, the top of her head was about even with the top of his shoulder. She and her two friends sat on him for what seemed like half the evening. It was a good conversation starter. People stopped by to make comments about the seating arrangement. The women sitting on him invited other women to join them and moved to make room at his hips, when they looked at that seat they squirmed and left. He found that odd.

When the other two women had moved on and only Cinto was sitting on him, he started to sit up but she said, "Where do you think you're going?"
"I guess nowhere."
"Damn right. Not without me sitting on you you're not."
"Do you mean that as long as you can continue sitting on me, I can go?"
"How would you go with me sitting on you?"

Lifting her onto his shoulders, he stood up. In high school he had been strong enough to lift her weight over his head with one hand. He wasn't that strong anymore, in spite of how much he was working out, but pressing her to the ceiling with two hands would not have been a problem. She exclaimed that this wasn't sitting. He said, "I know, but isn't this how cavemen abducted their women?"
"Help. I'm being abducted by a caveman." Someone asked if she wanted them to save her. "Hell, no. I've been waiting for this my whole life." Aaron thought, "Now that's a hint, isn't it? . . . Isn't it?" He almost asked. It did turn out to be one. Within weeks he was painting her apartment.

That's when he met her parents. He thought that her parents had come to help, but they wanted only to see who this boy was. Their daughter had been on countless dates before, but never had one stayed long enough to do anything like paint her apartment. If he was doing that, they thought this must be serious. When they walked in, he was painting the crown molding at the ceiling. He stopped to shake their hands, but they urged him to keep working saying they didn't want to interrupt and they were not staying. They just wanted to see how things were going. Later he learned that what they wanted at that moment was to see if what they had witnessed as they entered had been a momentary thing or the way he was going to paint the crown molding all the rest of the way around the ceiling.

Her father was a stone mason who, while his wife was pregnant with Cinto, had built a house for them. To save time and money, he had built it eighty percent of normal size. The ceilings were lower. The doors were shorter. The windows were smaller. They were of short stature and did not want to pay to build or to heat twenty percent more space than they used. To them, ceiling height was wasted space. When they saw Aaron painting the crown molding while standing on the floor, not on a ladder, they were amazed. Back at home for months afterwards whenever anything was up high her father joked, "Aaron would not need to get up from his chair to reach that." It is not a joke Aaron ever could have heard though because it never was said in English.

Cinto's parents were Portuguese. They emigrated here after they got married. Her father had born in the United States, but only had been here for a few weeks after he was born. When Cinto's grandmother was pregnant, the members of their extended family pooled money to purchase a boat ticket to America for her. There was enough money to stay in America only long enough for her son to be born before returning to Portugal. The object was to make him a citizen of the United States. She named him Americo so he never would forget where he belonged. The dream of the family was for this child to have the means and the opportunity to emigrate to America someday. Being born here made him a citizen so could return.

When he grew up, three months after getting married he moved to America without his wife. There were two cities where he had been told stone masons were being hired: Clearwater, Florida and Cincinnati, Ohio. Through family he learned that someone knew of someone in Cincinnati who was from Portugal, so he went there and worked for three years until he had enough money to send for his wife. He never learned to read English. Someone had to read the directions and the warnings on the back of building materials to him, but he also never missed a day of work and worked every holiday if someone would hire him. When his children were teenagers one time they managed to persuade him to take a vacation and take them to North Carolina to a beach. The whole time there he complained that he could be working and earning money. They got so annoyed with hearing it that they never tried to get him to take a vacation again.

At a dinner party one time at Aaron's parents, one of the guests turned to Cinto and said, "Here we are talking about all these people and places you don't know and no one is paying attention to you." Aaron had not noticed that his normally loquacious girlfriend had not said a word in the last hour, but he interjected, "At least we're speaking English. When I am at a dinner at her parents' they don't even speak a language I understand." Everyone laughed, including Cinto, who said that was true, and told them about things that were said about Aaron as he sat at their table without his knowing he was the subject of the conversation.

How are parents to get to know their son's girlfriend when they so rarely hear her speak? At that dinner table surrounded by people talking about sailing regattas and art museums that required getting tickets months in advance, she could not participate. Someone talked about a restaurant in Boston and Aaron asked what they ate there. It turned out that they also had eaten at Durgin Park in Boston. Aaron reminded them of the sign in the foyer that says, "Your grandfather probably ate here" and said that his had and that Durgin Park had been his maternal grandfather's favorite restaurant in Boston. When asked about his favorite, he said, "The oyster stew at the Union Oyster House makes it not only my favorite in Boston, but perhaps in the world. I know that everything about that stew is different than when Daniel Webster ate it. It might be the same recipe, but the cream comes from a different breed of cow that has been fed a different diet. The oysters are from a different location and are grown in water that now has a different composition. The butter no longer is churned slowly in wood and then delivered at room temperature. But still . . . " These conversations might as well have been in a different language for her. When they were with friends at college, he never spoke like this. When she was at his parent's, she didn't speak at all.

So his parents did not have an opportunity to see what he saw in her. They were not present when she was laughing and chatting with friends at school. They were not present when Aaron was walking across campus and was stopped by one of his professors, a man who was only twenty-seven but already had his doctorate and a teaching position, who said to Aaron, without saying Hi first, "On the night of the Giants Browns game you were in Shipley's eating dinner with a woman I have been worshipping for two years. I would trade lives with you any day."
"Is that her name?"
"Nickname. Do you know her?"
"Never met her. Only seen her around campus, but I envy you."

His parents could not ask many questions about her. Asking questions is political. They could not ask how many siblings she had because of what Aaron might think they were trying to find out. They could not ask what her father did or what part of town they lived in. The could not ask where she went to high school because if the name began with Saint, which it did, Aaron would not want to tell them. They could not ask if she belonged to a sorority. They could not even ask what her major was. They had to wait for these things to be revealed. It made it difficult to make conversation with her. Fortunately his mom was great at putting people at ease and doing monologues that amused without requiring people to reveal anything about themselves. However, there were times when they could not help but ask. Like about her name.

"Her father's name is Americo? And her name is Cinto? Like Cinti?" Cincinnatians sometimes abbreviate the name of their as "Cinti" and so "Cinto" seemed to Cincinnati as "Americo" seemed to "America." 

"It's really Jacinto, but when they were younger her brother and his friends made that connection and nicknamed her. In Portuguese Cinto happens to mean belt. But she and her brother don't really speak Portuguese. Although they understand it."

His parents saw no apparent dangers in asking that question so they had asked it. They wished they could ask a few other things that unfortunately did appear dangerous. Like where she was when he needed a ride to the hospital for his wisdom teeth.

St. Virgin

On an excursion to the Natural History Museum with Cinto, as he looked at a display about teeth, he read about the symptoms that indicate when wisdom teeth are becoming impacted and realized that it was a description of something he had been noticing in his mouth. He had just been to the dentist, but returned explaining what he read. His dentist checked, said his wisdom teeth needed to be removed, and asked if he wanted to get them removed there in his chair or in a hospital. In the dentist's office, he could be kept under anesthesia only long enough to do one side of his mouth at a time. In a hospital they could do both at once. Aaron did not ask which was cheaper even though he did not have health insurance of any kind. He heard a choice between two recovery periods or one and chose the hospital. The dentist looked dismayed. He had lost a sale.

Aaron asked Cinto if she could drive him to and from the hospital for the procedure, but she couldn't. So his mother took him to St. Virgin.

As he was lying on a gurney, the nurse who was going to put in his IV strewed her equipment across his abdomen in a way that left a few pieces of it almost on his private parts. She reached to drag them back to where they belonged and he thought that if he were a woman and the nurse were a man this would be harassment. When the anesthesiologist came in, Aaron said that he was sensitive to anesthesia, but they didn't change the dose. It was supposed to be outpatient surgery. The surgery was at six in the morning. His mother was in the waiting room expecting to take him home around nine.

The first time they tried to wake him up a nurse called his name a few times. He opened his eyes. She was leaning away from him over the bed next to his in the recovery room working on something as she told him it was time for him to get up. He sat up.

The next time they tried to wake him up he opened his eyes and saw nurses all around him. Six angles backlit by bright lights. All young. All with hands out to protect him. What more could a young man want? They asked him to sit up again. He lifted his head and saw that rails were up on either side of his bed now. He thought that he must have fallen on the floor the last time for there to be this much attention.

The next time they tried to wake him up, it was the same thing. And the next time too. From their positions he understood that each of these moments were separated by expanses of time of which he had not been aware. He would remember trying to sit up, but the next thing he would know would be an hour later when they were asking him to try again.

Apparently they gave up after four or five hours. That evening he woke up alone in some office off of the recovery room. After lying there a while, he tried sitting up. He didn't faint. After after testing his ability to maintain consciousness for a bit, he slid his feet onto the floor. His pants were on a chair. He hung onto the gurney as he reached for them. He was just zipping them up when a nurse stick her head in the room, turned back to the recovery room and said, "He's got his pants on already."

Later he recounted this to Julie, a friend who was a nurse who said, "Oh, yeah. When a good looking guy is in the hospital, that can stir up the nurses." It had never occurred to him that healthcare professionals during the course of their work would see a patient sexually. And, of course, he had been lying down - his best position.

His mother sat in that waiting room for fourteen hours without ever letting him find out how much it bothered her to be in that place or how worried she was about his being in their hands for so long. This was having more to do with healthcare than she liked. During the next ten days she asked no dangerous questions as she took care of him as he drank through a straw, unable to speak with his jaws sewn together. When he recovered, he and Cinto picked up where they had left off. His mother never asked where Cinto was when he needed a ride to the hospital. Or when he was recovering afterwards. Those were questions that would have been dangerous to ask. So was her next question, about where Cinto was when he collapsed on her stairs calling for help, but they could not help but to ask that one.

Cinto had been right there with him. He had been carrying a wooden shelf up to her apartment. She had wanted shelves so he and Ted had custom built some for her. As he was carrying them up the stairs, he collapsed, his body in convulsions from the waist down. He still had control of his hands and clung to the banister to as he watched the shelves tumble down the stairs. Cinto stepped out of the way. Then she continued up to the landing where she stopped and turned to watch. He said, "Help." She did not move. His torso was jerking his thighs up to his chest over and over. He had no control over them. He didn't understand what was happening. He said, "Help" and reached out toward her with his other hand. She backed away from it.

Getting breath was not easy. Getting control of himself was impossible. He gripped the banister with both hands and watched his convulsing torso for a length of time he would have trouble trying to measure later when asked how long it went on. Several minutes? And then finally there was stillness, but he was afraid to move. He didn't know what would happen if he tried. Would the convulsing resume? If he tried to stand would he fall? He clung to the banister and did not move. He said, "I don' t know what to do." She did not respond. After about ten minutes, she told him that she was going to go up to her apartment and left. About twenty minutes later he crawled on his hands and knees to join her.

In her apartment he dragged himself to her bed saying that his back hurt a lot. He asked her if she could rub it. She did, but so half heartedly and inattentively that there was no point in her doing it. After a while she asked if it would be okay if she stopped. When she stopped she said she was going to the stairwell to get the shelf. It was damaged. She tried to drag it up the stairs without hurting it more. While she was gone doing that, he called his parents and said he was coming home. When he got in his car, his back hurt more than it had hurt at any time so far. He worried about what would happen if he went into convulsions on the freeway. If he thought she would have, he would have asked Cinto to drive him. This felt like being drunk and deciding to drive home anyway. But he never had been drunk and had no experience with recognizing his own weakness and asking for help. So he did drove.

At home his mother rubbed his back. What his mother knew about backs worked well for getting a good back scratch. Since he was little she had told him to choose his wife by how well she could scratch your back. Apparently his father was no good at it. He always had thought his mother was great at it. She always had been, when mere scratching was the request. This called for something deeper and she wasn't reaching whatever it was that he needed reached as she asked him about what happened. "Where was Cinto when you were crawling up the stairs?"
"Back at her apartment."
"She left you there and went back to her apartment?"
Long pause.
"Do you ever think maybe you need to find a new girlfriend?"

He didn't think about that. He thought about finding a doctor. His father's second cousin's wife had run a doctor's office and had spoken frequently about how well-run it was and how competent the doctor was. It never occurred to Aaron that she might have said that to try to overcome his mother's refusal ever to get near a doctor again. He also didn't consider that the last people who could know how good a doctor is are the people on the doctor's own team. Aaron took it as good, insider information and asked who that doctor was. His father found out for him and Aaron made an appointment.

Every time Aaron saw a doctor or nurse or dentist or a hygienist, or even the anesthesiologist before getting wisdom teeth out, whenever they asked if he had any other symptoms or problems they should know about, he said, "I'm getting weaker." Generally they said that we all are getting weaker. He said, No, he had measurements. He kept charts of his exercises. Everyone in the gymn around him was getting stronger, but he was getting weaker. He tried working out more. He tried working out less. He tried working out differently. He studied nutrition. He talked to coaches. He read weightlifting magazines. He tried supplements. It was steady and relentless no matter what he did. He was getting weaker at about the rate at which he thought he should be getting stronger. No one paid any attention to him no matter how strong a point he made about it.

Dr. Ober was going over the forms Aaron had filled out and asking him questions about his health. He asked if the knee problem Aaron had noted was bothering him right now. He did not ask about the shoulder problem. At various times both had interrupted his exercise schedule for extended periods. In one blank Aaron had filled in that he had had Epstein Bar. The doctor asked who diagnosed it. He told about National Public Radio and sleeping for six months. The doctor said, "Self-diagnosis, right?" as he shook his head and erased it from the form. "Anything else?" Aaron said he was getting weaker. "We're all getting weaker. You're getting older." Aaron explained about exercise charts and all the work he had done to get stronger, but the doctor waved him off. The specific problem at the moment was his back. Aaron said, "Well, I don't know if it is related to my back or not, but after I got my wisdom teeth out, my legs tingled for days." This appeared to get the doctor's attention. Aaron talked more about his back and speculated again on a possible connection with the tingling, like if falling out of the bed in the hospital might have had anything to do with it. The doctor raised his eyebrows and said, "No" and told him he was making an appointment for him to see a neurologist.

Where Cinto was when he was at the neurologist was at work in the library. She was a fulltime librarian. The week she graduated from high school she moved out of her parents house and into an apartment with friends who lived near the university. Her friends showed her a bulletin board on campus that listed part time summer jobs. One was in the library. She took it. It paid so little that three weeks of her salary was needed to cover her share of the monthly rent. The rest she spent on food. She ate one yogurt per day that summer. It was all she wanted.

In the fall they gave her more hours of work and she bought new blue jeans. Within a year she was fulltime. A colleague told her that as a fulltime employee of the university, she could take courses for free if she wanted. You get a pay raise if you get a degree. So she started taking courses on the side. No one in her family ever imagined that anyone they were related to would go to college. She had not imagined it either. It just happened.

So she was doing homework when he came back to her apartment from the neurologist with the diagnosis. He had a degenerative nerve condition. He inherited it from his ancestors. It was the largest neuropathy in the country.
"The largest what?"
He explained what a neuropathy is. "More people inherit this one than any other."
"What's this mean?"
"I'm getting weaker and less coordinated everyday and will for the rest of my life."

Over the years he had told at least fifty doctors the symptoms of this condition without a single one of them paying attention to him. It was important to pay attention to this because it turned out that there were medications that were contraindicated. Taking them would be very bad with this condition.

"How did they figure out you have it?"
"Stuck needles into me. Needles about a foot long hooked to electric wires they stick through you skin into your muscles and tell you to make contractions."
"Yeah. Hurts."

It explained so many things. A famous mental image in his family was of his grandfather at the dinner table passing a tea cup in a saucer. His hand shook so badly, the tea cup clattering so loudly on the saucer, that it was alarming. And it happened every time they ate together.

It also explained his father's tennis game. People he used to beat consistently now beat him. Aaron now would be able to tell his father why.

It also explained why, his whole life, whenever Aaron and friends took up a new sport, for about six weeks he would stay slightly ahead of them, and then they would pass him and he never would catch up with them again.

Cinto asked, "So what's going to happen?"
He knew what she was asking. "It does not effect sexual performance."
"Then we'll be okay," she smiled.
He thought, "It really comes down to that, doesn't it? A male without that is alone."

That was something he had worried about when he was a child, not performance, but being alone. When he was seven he was in love with Virgina Kimmler. He dreamt about her a night. He stared at her during class. He tried drawing pictures of her. He had no idea what he would do with her if he got her, but he knew she was what he wanted. But he was depressed about it because he saw no hope of her ever wanting him. She had a girl's body and that was the most fascinating thing on earth. All he had was a boy's body and who ever would be interested in that? At the age of seven at night he laid in bed aching to have her there while thinking that no such thing ever could happen.

There always was someone at school he could not stop longing for. Sleeping alone always had seemed unnatural and lonely to him. He didn't know why it had to be that way. Then AaEeeAh moved into his neighborhood. In the middle of the night, wakeing up desperately lonely, he would sneak out of the house, knock on AhEeeAh's window and whisper to her through the screen. She would put her ear to the screen. He would put his ear to it so she could whisper back. While he was feeling her warm breath in his ear was when he could let his face turn downward and see her body in her night clothes. She did the same to him. Sometimes he was in his underwear there in the dark. When he whispered in her ear she watched to see if he moved far enough from the wall to see if he was turned on. It always ended when they worried they had not muffled their laughter well enough. They laughed so much. She would look toward her door saying someone must have heard that one. She would say Bye and dash to her bed. He would worry her father might come outside so he would sprint away too, leaping high, placing a hand on the chain link fence and catapulting himself over it without making it clatter, dashing through trees and weeds to back home where he would lie down alone again without even having gotten a hug.

He never had a night when he did not wish to have someone in his arms as he fell asleep. With Cinto he finally was falling asleep in a hug. He still was lonely lying there, which he guessed must be rampant testosterone never being satisfied, without wondering if perhaps there were other people who could be better company, but at least there was someone there. But now had been introduced awareness of the fact that if this degenerative disease had effected sexual performance, neither AhEeeAh nor Judy nor Cinto nor anyone else would have been there for him. Companionship seemed more fragile and fleeting and shallow than he cared to think.

She asked what this meant for his back.
"Nothing. It has nothing to do with my back."
"But isn't your back why you went to the doctor?"
"Yes." He still was in pain. It still woke him up at night. It still caused him to squirm during classes. But Dr. Ober had released him on his own recognizance. Ober had offered him pain pills, but Aaron said that they make him stupid and he needed to study. "Pain pills. What good is that?" he said to Cinto. "The problem still is there. All pain pills do is make it so you don't know when you are making it worse. I don't want to be ignorant of it. I want to fix it."

He told her that in fact, the doctor had brushed off his complaints about his back. However, when he said that his legs had tingled for several days after getting his wisdom teeth out, the doctor's eyes had widened and he sent him to the neurologist. It was the neurologist who explained that tingling like that after anesthesia is a symptom of multiple sclerosis, but also can indicate Charcot Marie Tooth, or CMT as they call it, which is something like MS, but not nearly as severe. Like MS it is a demyelination of the nerves.

"A what?" Cinto asked.

He explained about nerves having an insulation around them, just like electric wires, and that it is called a myelin sheath. His condition meant that the insulation around his nerves was deteriorating.

"Myelin sheath? Did you take notes?"
"That's why you are such a good student."
"I'm not that good of a student."
"You're taking upper level classes your freshman year."
"The freshman classes were stupid."
"All the rest of the freshman were worrying about whether they would pass. You tested out of them."
"I tested out of swimming."
"Self awareness is not your strongest point. You don't even know how funny you are."
"Did I say something funny?"
"You don't even know that you are a hunk."
"The doctor said something funny. He asked if I take recreational drugs."
Spontaneously she laughed, "Now that is funny."
"Apparently they could hurt my nerves since mine are not well insulated."
"Does this mean I have to stop sneaking Spanish Fly into your orange juice?"
"Is that why I always want you?"
"Do you always want me?"
"I try not to overburden you with it."
"I can carry that burden. As long as you keep being a hunk."
"Who says I'm a hunk?"
"Let's see. Carla said it. And when she did Terry nodded in agreement. Alice said I should let her know when I'm done with you. But you have to understand Alice. When I told her I was going out with you for the second time, she said, 'Again? Twice? With the same guy? Is this it? Is this the real thing?' It was funny."

He reached around behind his back to try to knead where it hurt. Cinto's never having gone on a second date with anyone else is something he had guessed was true, but now he when it was presented as a fact, it was from the perspective of a friend of Cinto's and carried an awareness of Cinto that was somewhat worriesome.

*        *        *

Two weeks later, he was lifting a carton of milk out of the refrigerator in his apartment when he collapsed. A time would come when he would look back on this almost with nostalgia for its innocence. At least this time when he could not get anyone in medicine to pay attention to his injury, it was unintentional. They plugged him into the system they always plug patients into the system with faith that system beyond their view was working. They followed their routines and managed their careers and their businesses without any real awareness of whether that system actually was healing the patients. But at least they were not intending to prevent his getting help.

A time would come when he would sit in court listening to a nurse and a surgeon and a lawyer lie, even about simple anatomical information, as they sued him for complaining. He would pass notes to his lawyer saying, "How could that artery be five inches deep inside my body? Front to back I am only seven inches thick" and "They are lying. I have diagnoses that prove it.?" The notes were an attempt to get his lawyer to argue a point for which no documents or witnesses had been brought to correct, even though Aaron had asked for them over and over. His lawyer had refused even to learn the facts necessary to argue the points. Aaron was being crushed by lies while thinking this was because his insurance company had assigned him the stupidest lawyer he ever had met. Although that may have been true, Aaron still was too innocent to see worse things than that.

Although it didn't seem like it at the time, being paralyzed on a kitchen floor was a vacation in comparison, one that would become familiar. Since this was only his second collapse, he didn't know what it meant or how to cope with it yet. He was in convulsions for a few minutes. When they ended, he laid still for a bit and then tried to get up. Convulsions started again. They made it nearly impossible to breath. There was a lot of pain, but he never remembered or cared about that. It was the lack of control and the awareness of how life once again was going to become subservient to healthcare. Each time the convulsions came he learned more about what not to do. Using stomach muscles was one thing not to do. He wanted to reach the phone to call for help, but it was a kitchen phone mounted on the wall too high to reach without using stomach muscles.

The milk bottle laid on its side. The refrigerator door was ajar. The smell of the inside of a refrigerator passed after a while, after there was no more cold air to flow out of it. He continued to lay still on the floor for a long time afraid of triggering the convulsions again. Eventually, after enough collapses, he figured out that a limited amount of mobility was possible without using stomach muscles. He figured out that how to kick the refrigerator door shut without lifting his leg from the floor by slowly rocking it sideways to the door. He figured out that he could drag himself by his hands if he kept his body flat on the floor. During this second collapse, it took several hours to work out, by trial and error, how to drag himself without retriggering the convulsions, but finally he dragged himself to his bedroom where there was a phone on a night stand that he thought he might be able to reach. By he got there it was so late at night, and what was anyone going to do? He laid where he was on the floor next to his bed, where at least he was on carpet now, rather than the colder and harder kitchen floor, and fell asleep.

He missed three weeks of classes. Then, within a month, he collapsed again. This time he went back to Dr. Ober. Every time he collapsed the recovery period was longer. And each time it took less to trigger the problem. Getting things out of the refrigerator was particularly dangerous. The freezer was on top. He had to bend down to get anything from the refrigerator. Bending and lifting at the same time became something he could not do anymore. He missed most of that year of school and spent way too much time in doctor's offices.

He learned that lying on bed was a problem. The floor was better for his back. He learned that holding his arm under the small of his back helped his back, but hurt his arm. He figured out what lumbar support was and what was better and what was worse to use for it. He learned how to drink from a bendable straw while lying still without turning his head. He also learned that if he didn't drink anything, he could go several days without having to drag himself to the bathroom, which hurt his back and made him worse.

When he went back to Dr. Ober he was sent to get an MRI. The appointment was made a week in the future. He laid still on his floor for a week. By the time it was time for the appointment, he had gotten so he could move around a little again. Nothing showed up on the MRI, but the trip to get it re-injured him and he had to lie down for another week to get back to where he had been before the appointment. However, he did not yet know that the MRI did not show anything. He had to go back to Dr. Ober to find that out. And that trip re-injured him forcing him to lie down for another week. This was a sequence he would repeat enough times to be able to predict it. He explained it to Dr. Ober. He explained it to the company that did the MRIs. No one would budge. Every time he got injured he tried telling them that an appointment a week in the future was too late. He was injured now. In a week he would have improved enough, as he had before, that they would not be able to diagnose him yet again. No one altered their routines for him.

Dr. Ober also sent him to an he orthopedic surgeon who took care of the ballet and a professional sports team and was supposed to be excellent. That surgeon sent him home with instructions to do a stretching exercise three hundred times per day on each leg, bending over touching his nose to his knee, and to do that several times a day if possible. He did that for the next two years. He kept getting worse. The surgeon kept telling him to keep stretching.

*** After missing most of the next two years of school to this problem, Dr. Ober sent him to a physical therapist. Making small talk as she did therapy on his back, the therapist asked him what happened the first time he was injured. He told the story of collapsing on the stairway. He was telling it to the first medical professional he had spoken to who paid attention to him.

This was a therapist who previously had worked at St. Virgin in their physical therapy department.

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She said, "You slipped a disk." A what? He had never heard of this before. She explained it. Why had no doctor explained this? She told him that the physical therapy they had ordered for him would be of no value and that the stretching that the surgeon was having him do would make him worse with every single repetition. She told him never to make that motion again.

There is no place in medicine to report something like this. The surgeon would never learn from Aaron's loss.

Dr. Ober sent him to a new orthopedic surgeon. This one wanted x-rays and wrote a prescription that Aaron couldn't read. Aaron asked what exactly it said. The doctor said they could know out front. Aaron said he would like to know. The surgeon told him the people out front would explain it to him. Aaron tried again to get information from the surgeon again, but Aaron's three minutes were up. He took the prescription "out front" to the nurse behind the desk who read the prescription and made appointments for him to get a CAT scan and a bone scan.

A bone scan required drinking radio active fluid and then lying still while the radiation emanating from his body exposed film.  He was not happy about having to do this. When they were giving him the fluid to drink they said, "A bone scan for a bad back?" They questioned the patient. He just shrugged. When he was being given instructions on the table the nurse there said, "A bone scan for a back problem?" No one called the surgeon to make sure this was correct. It wasn't.

After that he got a CAT scan that also was incorrect. The prescription was supposed to be for a CAT scan with dye, but because the woman "out front" couldn't read the handwritting, she ordered a CAT scan without dye and a bone scan that has nothing to do with such an injury. When Aaron returned to the surgeon with the tests, he was not able to learn anything about Aaron's condition from the incorrect tests. Since Aaron was paying for this himself, it was not as though the surgeon could not now order the correct tests because insurance would not cover them. He did not order the correct tests because that would make it too obvious he had made a mistake. Instead he suggested putting Aaron in the hospital. Aaron did not understand what that meant and required further explanation. He learned that the surgeon wanted to cut him open to look around to see what the problem was.

How much needs to be said about how disinterested Aaron was in proceeding down that road with this person?

After that second collapse, for the first few weeks Cinto spent a couple of hours with him at his apartment on many evenings. His mom or his brother came other evenings with food. They'd leave things next to him on the floor for him to eat the next day until someone arrived again in the evening. Until he was enough weeks into this to be moved when Ted showed up with a truck and a stretcher. Of course, stretchers can be rented, but Ted didn't think that way. He had built a stretcher. It was a work of art. Wood and canvas, like an antique, but with a post modern sensibility. Ted and a friend hauled Aaron out to a box truck owned by Colorado School District. "Huh?" questioned Aaron. Oh, Ted was doing some welding on the bleachers to make them bend differently for the chorus. Nine hundred pieces of metal had to be cut and re-welded, so he had access to the school's truck to haul tools. "Of course."

Ted's periods of weeks on the floor of his parent's home became routine. Evenings usually were spent talking on the phone for hours with Cinto.

Eventually he stopped seeking medical attention when his back knocked him down. They only made the recovery period take longer. He organized his life around his back, slowly figuring out the things that hurt it. Ted build a stand that held a mirror so that he could watch television lying down with turning or lifting his head. During the day he learned that squirrels have highways. There are specific branches that they use. That's why they are so good from leaping from one to the other. They have made each leap hundreds of times before. They do it everyday. He watched them out the window in the trees around his parents house.

The first few days always were the hardest. The shift from being mobile and active to lying still staring straight ahead took a few days to adjust to each time. The stand his brother had made to hold a book above his head so that he could read without turning his head or moving was one of the pieces of equipment that became a normal part of his life. He was able to get some homework done with it, but he could not take notes or write papers. He only was able to do general reading to help with coursework he hoped to finish someday.

He learned to carry a sweater to use as lumbar support when sitting in a movie theatre seat or on an airplane. He did deep knee bends rather than bend over to pick things up. He never leaned back against seat backs without putting lumbar support in exactly the right place. But he still kept having problems.

Then one day he was trying to drive through McDonald's when there was a traffic tie up in the parking lot. Up ahead some small man in a huge van kept backing up and then pulling forward and backing up and pulling forward without ever managing to pull his van out of the parking space enough to drive away. Finally Aaron got out of his car and asked the man if he needed help. The man leapt from his van in gratitude turning control of his vehicle over to Aaron. Aaron backed it out and pulled it out of the way where it would be easy for the man to drive away. The man said he had just bought it and didn't know how to drive it yet. He was always telling his patients to get vans and he thought he should practice what he preached. "You want you patients to drive vans?" Yes. He tells them, "Get rid of your car and you'll get rid of your back problem."

Dr. Patel was an orthopedic surgeon. He had no children and no need to haul anything, and yet he had purchased the largest van available. If not for this chance meeting in this parking lot, Aaron might never have finished another quarter of college. It turned out that the last thing in his life still injuring his back was his car. He bought a van and after that was able to go half a year without collapsing. Unfortunately, all the deep knee bends put too much strain on his knee.

After a couple of months of limping around and using crutches without its getting better, he went to Dr. Ober who sent him to Dr. Eddie Cantor at Jewish Hospital. "Like the entertainer?" Dr. Cantor was impressed that someone his age knew of that performer. His advice was for Aaron to immobilize his knee except for an exercise he gave him to do. Several times a day Aaron was supposed to stand in front of a couch and, while holding his leg straight, push against it with his foot under it but his ankle being stopped by the cushioned front of the couch. He did this faithfully and returned to Dr. Cantor every three weeks for two years. Sometimes he needed crutches just to walk. Sometimes he didn't. But one thing he noticed was that when he was on crutches, his back gave him fewer problems.

Then one day he was reading an interview with Bob Hope in which Hope told the interviewer about his own back problems. He had gymnast's rings hung and suspended himself from them everyday. It was a form of putting his back in traction to straighten it out. Aaron realized that swinging on crutches was the same thing. If he had not used his crutches for a while, when he first got on them he would hear and feel snapping in his back as the disks slipped back into place. Whether or not his knee was bothering him, he began swinging on the crutches for a minute several times a day. Days when he was not near his crutches, he leaned on counters or banisters or whatever else was available and accomplished something not quite as good, but serviceable enough to get him through until he got to his crutches again. Pain in his back bothered him far less often after figuring out that, as long as he kept the rest of his life organized around not aggravating it.

One thing that concerned him was that no other patients would learn from his experience. He had learned something from Bob Hope's experience because Bob Hope was famous and was interviewed all the time. Bob Hope would never learn from him that something as complicated as gymnast's rings were not necessary to put his back in traction. When Hope was on the road performing, how much trouble did he have to go to in order to find something to hang from when two card table chairs back to back with him in between was all he needed? There was no way for patients to share their knowledge. And no real mechanism for healthcare providers to learn from their patients. None did and he told them what he had learned.

Like sofas. Getting rid of his back problem required more than just getting rid of his car. It required never again sitting in a sofa or any other chair that low and soft. Those were devastating for backs. Most people's living rooms had nothing in which he could sit. He had to sit on their floors and lean on their couches. Which is what he did when he was at Cinto's parent's house. He was sitting on the floor watching Wall Street Week, a television show about investing, with her brother, Juan, one time when Cinto interrupted him to tell him something. It was not much of an interruption to him because there was not much to discuss about stocks with Juan. Juan approached the stock market the way some approach horse racing, by learning everything he could and following the daily movements of its performance. For a living he emptied the change out of parking meters for the city. He lived with his parents so as to save every penny to invest in stocks, but he didn't not have a balanced portfolio. And he did not have enough money to buy more than odd lots. And he traded them so often that commissions overwhelmed any long term gains that might have accrued.

One time Aaron was at a family gathering where Cinto's grandfather heard Juan talking stocks with someone, and her grandfather said to Aaron, "These things are not for us. People like us should save and perhaps own real estate, because we know how to fix things, but not stocks. This is not for us." Aaron believed their grandfather was including him in "us" and nodded in agreement, but did not know what to say.

So when Cinto interrupted his viewing of Wall Street Week, she knew she was saving him from watching a program he did not like to watch anyway. She interrupted to tell him that her mother had just told them what her cousins next door were giving to their five-year-old son for Christmas. The cousins next door had just arrived in this country. Decades earlier when their parents left Portugual, they had gone to Angola where they had opened a grocery store. Political turmoil there forced them to flee the country leaving everything they owned behind. This couple had come here to where relatives had pitched in to put a down payment on a house for them and help them find work. But they had nothing. And could afford nothing. So for Christmas they were giving their five-year-old son a pack of gum.

Aaron said, "That can't happen. You cannot be a five-year-old in America and get only a pack of gum for Christmas." Cinto said, "I know. That's what I thought."

Cinto knew Aaron would do something. Aaron knew Ted would help him. Ted's collection of tools and materials had outgrown his parents' garages. He had rented a shop, about which Aaron had commented, "Who says money doesn't buy happiness?" From Cinto's he telephoned Ted and told him about the pack of gum. Ted said, "What are we going to do?"

"What did you want when you were five? What do you want now?"
"I don't know."
"You have a shop full of tools. Remember learning how to use a hammer?
"Hammers are too awkward for five-year-olds."
"Exactly. And he's in a working class family surrounded by adults who use tools. When I copied our Dad, I stood on a stool with a toy raiser and shaved along with him. Then I packed it in my suitcase to leave on a business trip."
"You did that?"
"Yes. But this five-year-old is going to see stone masons and carpenters getting ready for work, packing up tools everyday. Let's make him tools that would have worked for us when we were five."
"Out of what?"
"Just wood. Nothing he's going to break through walls with, but designed to work. Not like toy tools you can buy. With a workbench and a vise."
"But what's he going to do with them?"
"We'll make lumber out of corrugated cardboard glued up. With wood tools, and wood fasteners replacing nails, he will be able to be join the cardboard like wood. We'll make him a miter saw, and we'll have to figure out how to make cardboard that can be chiseled and planed so his dad can teach him how to make joints."

They spent evenings testing glues on paperboard products. They tested various kinds of wood with various kinds of teeth cut in them for sawing it. But when Aaron cut his first rough hammer out of a piece of basswood and began rounding its corners on Ted's drum sander, conceptually Ted began to see what Aaron saw. Aaron had been thinking about tools and what they should be like ever since he first picked up a hammer when he was five. He had a sense of what a tool should be designed like for a five-year-old. But it was a sense that rethought how they should be designed for everybody. Ted, more used to doing things on paper, sat down at his drawing board and explored through sketches what Aaron explored in his mind.

They redesigned saws and screwdrivers. The most basic tools in any craftsperson's case, when made functional for a five-year-old also were more functional when enlarged for an adult. Ted said, "Shouldn't you patent these before letting even a five-year-old see them?"

"I suppose." But Aaron didn't know how to do that. He knew that if he did, the patents would run out in sixteen years anyway and what would he do with them in the meantime. All he knew to do was keep his ear to the ground until opportunity presented itself.

They never met the five-year-old. They never met his parents. But Cinto said they had a Christmas any five-year-old would love.

Then at a Tuesday appointment, Dr. Canter told Aaron he wanted him to come back in on Friday. On Friday afternoon, he told Aaron that he wanted to operate. He wanted to remove all the cartilage from his knee. From now on he would have to come in for another operation every three years. The joint between the upper and lower leg bones would be bone on bone. Dr. Canter would burr the bone to make it form a smooth surface, but that would wear down and have to be reburred every three years. He was going to schedule the operation for Monday morning. Could Aaron be there at 7:00 AM.

Not knowing how else to deal with this doctor in this situation, Aaron asked how much it would cost. When he was told, Aaron said he had no insurance and couldn't afford the operation right now. Another one of those expressions he never would forget was the look on the doctor's face at that moment: disconcerted, worried. Was it the look of someone who had been caught? Aaron was not sure.

He did not know where to go next for help with his knee. He had gotten no positive results from either of the surgeons Dr. Ober had sent him to, neither for his back nor knee. So he limped around living with the problem for another half a year. Then he was in a frozen yogurt shop with Richard one time when a woman Richard knew from high school limped in. After they said Hi Richard asked her about the brace on her knee. She told her saga of how many surgeons she had been to and how many operations she had had and how finally she had discovered the knee surgeon people went to when all others failed. "Who is that?" asked Aaron.

Dr. Coith x-rayed him and examined him and told him he needed physical therapy. He asked how long Aaron had had this problem and if he had seen anyone else for it and asked what that doctor said. Aaron said that doctor had said something about surgery. "Surgery? You don't need surgery." Coith got out Aaron's x-rays and showed him how even and healthy his cartilage was. Forty years later x-rays still would show that and there still would be no need for the surgery Canter had tried to schedule.

The physical therapy Coith had him start was daily and rigorous. Within six weeks Aaron was walking up and down stairs for the first time in two and a half years. He telephoned Kanter's office and asked to speak to him. The nurse asked what he wanted to speak about. Aaron told him about two years of being immobilized being the opposite of what his knee needed. What he had needed was appropriate stretching and exercise. The nurse said, "Oh, no. You can't tell him that. Because, see, he's a doctor."

There was no way for future patients to be protected from surgeries that did not address their problem and that would lower their quality of life forever. Unnecessary surgery and prior to it treatment that not only did not improve the patient's condition, but that weakened the stability of the knee through lack of use. No other patients would be able to learn that this particular doctor, even though he was the head of orthopedic surgery at Jewish Hospital, was not the best place to go with knee problems. And there was no way for that doctor to learn from his mistakes. At best that doctor had misdiagnosed Aaron and was going to change his life forever in a way that never could be detected once it had been done, but even now could not be demonstrated to help prevent its happening to others. Aaron was extremely unhappy with this state of affairs and complained about it socially for years afterwards. Although one thought he had he did not express to anyone. Was there a chance this doctor had an opening in his schedule and wanted to fill it and wanted to create repeat business that would come back to him every three years for another operation? Why had the doctor not talked about the surgery on Tuesday? Why have Aaron come back on Friday to schedule a surgery for Monday morning leaving no opportunity for Aaron to get a second opinion? He was afraid he would sound paranoid if he questioned that.

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The physical therapy prescribed by Coith required his returning to the physical therapy department every single day to use an orthotron machine. It wasn't the expense that bothered him as much as the time. Traveling there and doing the work consumed about two hours everyday. After about ten weeks of that, he understood that this was going to continue for a long time, and probably intermittently for the rest of his life. So he built an orthotron machine to use at home. When his brother saw it, Aaron said, "It's not a work of art like you would have created, but it does the job. I don't weld and sculpt and have that artistic drive like you do." Ted said, "Are you kidding? Everything you touch . . . Yeah, you mostly are practical and pick quick and dirty solutions, but like those blocks . . the things you thought of with those blocks belong in the Louvre." Aaron's opinion about his home-built orthotron was was aluminum pipe and rail fittings and plywood and belonged hidden in a basement.

Aaron took classes year round, but spent so much time infirm that he and Cinto were progressing at about the same rate even though she took only one class at a time and no class during the summer. He was beginning to despair about ever getting a degree and building a career. People he had started out with were graduating at a time when he no longer even knew what year he was anymore. Correspondence with Martin Roberts slowly had stopped. He had no plans and no prospects. And now he had another problem. His feet. He just could not keep shoes on anymore.

When winter came the next year and he had to move from sandals to shoes, it was not possible. He had the custom made ones, and he could keep those on for an hour or two if he hadn't worn shoes for a week prior to that, but not everyday. Certainly not all day everyday. He limped around in shoes when the cold rains came, but when he got to class or to the library, he immediately kicked them off under the seat. By January he could not keep them on long enough to walk from one building to the next. He began wearing them only while inside, because they threw you out if you didn't. He walked in socks through the winter weather. When he got to the entrance of a building, he put his freezing, soaking feet into his shoes and limped in them until he got to his desk. Then slipped them off under the desk. Other students looked at him funny for it. He felt like a freak.

One evening Cinto went with him to hear an author he wanted to hear who was speaking on campus. Aaron had his shoes off and shoved under his seat. He wanted to take his socks off so they could dry and was thinking he might be able to manage that. Their coats were over the seat next to them. If he positioned their coats correctly, the coats might hide his bare feet. Stocking feet are one thing in an auditorium. Bare feet are another. Bare feet stand out and are unacceptable. It would be dangerous to take off the socks. The author said that in parochial school he had gotten the best education that the twelfth century had to offer. Cinto laughed along with the rest of the audience. She had gone to parochial school but now was an atheist. The author said something about religious holidays and she whispered to Aaron, "What holidays can I have?" Aaron suggested, "No Saints Day?" and she laughed hard, but as quietly as she could. So did a guy behind them who overheard it. Aaron turned to apologize for speaking too loudly, but the guy smiled and nodded, so Aaron didn't say anything.

When the speech was over and they were rising, the guy behind them quipped that he was going to put that holiday on his calendar, and then said, "Ex Catholics?" Aaron said that Cinto was, but that he had never heard of All Saints Day until dating her. It was a holiday he had not noticed on the calendar. Protestants don't celebrate it. The guy said, "Interesting. I didn't know that, but I lived in the insular world of parochial schools and then Jesuit training on the way to the priesthood."
"You're a Priest?"
"No. I saw the light."

They talked about the speech until everyone else had left the hall and they thought they should to. They walked out together laughing and discussing the speech, introduced themselves, his name was Paul, and said goodbye. A few weeks later Aaron was walking on campus when he saw Paul passing on the sidewalk and blurted out, "But Christmas is a saints day, isn't it?" Paul said, "I thought the same thing." Aaron said, "So what do we do about that?" They stopped and discussed celebrating the secular aspects of it. They both agreed that if they lived in China they would celebrate Buddhist holidays with everyone there, so why not this holiday with the people here. Aaron was having a gathering at his apartment in a week and invited Paul. Paul showed up, looked at Aaron's feet and asked, "Should I take my shoes off too?" Aaron explained his foot problems and then introduced him to other people. Part way through the evening though, they got into a discussion that lasted until everyone else had left and ended with an agreement to talk about it more sometime. Paul told him to drop down to Arnold's Bar and Grill on Tuesday. He used to work there and was stopping in to chat with a friend who still worked there. So Aaron did, more than once. Over the next couple of years they became friends who never let a week go by without meeting to challenge and stimulate each other. Their conversations were about peace and art and politics and philosophy. All week long, every week, Aaron would keep an ear open for any new thought or viewpoint or fact to throw at Paul for debate. From time to time people told Aaron that he was too cerebral for his own good. Most people could not relate to it. With Paul he had a friendship based on it. Paul even took his idiosyncrasies in stride, like his odd footwear and his always being barefooted when possible, like during movies with his feet planted on top of his shoes.

Dr. Ober sent him to a podiatrist finally. The podiatrist told him that his feet were a shape that did not fit in the shoes made on the lasts that fit 96% of the people in the country and that spending his life with his feet crammed into shoes that did not fit properly had damaged his toes. "Does this mean that in my entire life I never met a shoe salesman who both knew what he was doing and was honest?" The podiatrist guessed he could put it that way, Yes. The podiatrist sent a note to Dr. Ober telling him to send Aaron to an orthopedic surgeon. Ober sent him back to the same orthopedic surgeon who had told him to stretch hundreds of times per day in a way that injured his back more every time he did it. This time he recommended surgery. Afterwards Aaron would have to wear special shoes all the time, never go barefoot again, for the rest of his life. Aaron said that he was fine as long as he was barefoot and his perspective was not that it was his feet that did not fit the shoes, but that it was the shoes that did not fit his feet. He could not imagine someone operating on his feet to make them fit shoes. Aaron never went to that surgeon again.

He made a bit of a spectacle of himself on campus after that with sandals in the snow. He was despairing about how he ever would have a career if he could not keep shoes on. And then he was offered a job.

The phone rang. It was Cyril Horman with Park One Research. Someone had recommended Aaron, although they could not tell him who. They were told that people trust Aaron and believe what he says. They were told that he was level headed and fair and had a good memory. Park One Research needed someone to investigate securities brokers starting immediately. They had to fulfill a contract in Michigan. The person responsible for it was not going to be able to do it. They needed someone right now. There wasn't time to meet. They would fax documents to a copy shop near him and train him over the phone. But first he had to understand that he must never tell anyone about this work. They did not want there to be awareness of this anywhere. They did not want the general public to be aware of it because that would feedback to the brokers. He must not tell his parents or girlfriend or anyone about this work. He would have to invent some other work to say he was doing and learn enough about it to be able to have conversations about it if he ever met someone else who was doing it.

"Could this lead to more work?"

Horman told Aaron that he was way too young. "I can pass for thirty easily." Thirty was too young. The ideal investigator would be short, bald, fifty and forgettable. But there were other considerations and they were in a jam. He also told Aaron that he probably wouldn't like this work in the long term anyway because of how lonely it was. He'd never have an office. He'd never visit headquarters. He'd never meet any other employees.

What Aaron heard was that he would not have to wear shoes except for during the brief times that he actually was in the office of a broker. He wanted the work.

When he first told Cinto about it she was excited for him, but the next day she came back from work having spoken to her friends at work and asked, "How can you just leave me like that." Huh? "How can you just go away for three weeks and leave me like that?" He did not have a good answer. His earliest memories of his father was suitcases by the front door. His father frequently was gone for a week or two when he was growing up. That's what work was half the time. And this was only three weeks. Well, they had said three to four, but from what he had learned about it, he assumed he could do it in three. And hadn't her father left her mother for a few years soon after they got married? These and more thoughts went through his mind, but he said only, "I've been incapacitated and lying on a floor at my parents for longer than that without seeing you." She said, "But we could have. I could have come there anytime. And we talked on the phone every night." All he could do was promise to come back as soon as he could.

Part of what made separation more severe back then was that long distance calls were expensive and short. He expected to call most days, but the point of this was to make money. Expenses had to be watched. When he called from Michigan, there was no hint in her voice of being upset that he was gone.

Investigating securities brokers turned out to be more rewarding than he had predicted. It was looking out for the little guy. It was making sure that no one was making unreasonable promises to unsophisticated investors or giving them bad advice or failing to follow securities and exchange regulations. But in addition it also protected the brokers he was investigating. Park One Research was hired by firms who wanted to check up on their own brokers. Years from now if some customer sued saying that one of their brokers had guaranteed them that an investment could not lose, the firm would be able to put Aaron on the stand to testify that the broker had not promised him any such thing when he went to that broker.

It also enabled the firm to learn if some broker was making such promises and stop it before someone sued.

Aaron was supposed to change his appearance and demeanor and develop a fictitious identity every time he went into a bank or brokerage firm. He had to drive through the neighborhood, learn street names and the zip code, figure out where his fictitious kids went to school and be able to talk about the locality like a resident. He also had to have a fictitious job about which he could talk. All of these details had to be different for every broker he visited because they talked to each other. If ever once he was discovered, or busted, he would never work in this industry again.

He would make an appointment and sit down with the broker and pretend to have a decent sum of money that needed to be invested, but he also had to pretend to know nothing about finances or investing. There was a list of items he had to listen for. When the appointment was over he was to hurry to his car and fill out forms and write essays about everything from how tidy the broker's desk was to how much confidence the broker inspired to how clearly warnings were made and promises or guarantees were not. As he walked from his van to the door of a bank he would go over the written list of the facts of his life, his name and address and income and amount needing to be invested, where his fictitious parents lived, where his job was, the name of his fictitious daughter's soccer team, etc. One when time he walked into a broker's office the broker put out his hand saying, "Hi. I'm Howard Schlacter." Aaron shook his hand and began to say Hi, but then couldn't remember his name. So he said, "Hi . . Hi . . I'm . . . your noon appointment." Schlacter nodded, turned, looked at his calendar and said, "Russel Franks?" Yes. That's me.

At the end of the day he would talk to his boss on the phone to tell him what he had learned. The clients wanted daily reports. On his third day his boss asked specifically about one broker and Aaron said, "He is great. He is terrific," as though he were reviewing a movie. "By the time I left his office I really believed that I was going back there on Thursday to sign the deal." His boss laughed at how Aaron was getting into this work and said that sometimes their clients send them ringers, send them to investigate their best brokers just to make sure Park One Research is giving accurate reports. This would have been one of them.

There was a Polish community and an Arab community and an Hispanic community. Brokers asked what he was doing there. It was hard not to raise suspicions. Sometimes he said his wife was of the appropriate ethnicity and had moved to be near her family. He had to learn enough about what that was about to be able to speak about that too. After one day of that, after telling his boss about the brokers in a few ethnic neighborhoods, his boss quietly said, "You're reports are so fair. Some people give good marks to everyone of their own group and bad marks to everyone else, or at least to certain ones." He also commended him on his memory for detail. Clients had more faith that each of the brokers actually had been visited and adequately scrutinized when the artwork on the walls as well as the degree to which the brokers' shoes were polished turned out to be accurate when they double checked it later.

It's not as though Aaron was extraordinarily attentive to these things normally, but if he were asked to recall something like this, he could call up pictures of it in his mind and put it back together. Who said what when he always could recall. His whole life he had bee noted for that. What people wore probably normally would not, but now it was part of his job. And, of course, now he was tuned into the language of promises and guarantees and was aware of it everywhere. It was one of the most dangerous problems for banks and brokerage firms. It could cost them millions and hurt their reputations. Aaron wondered why they didn't hire people like him to investigate their loan officers to make sure no one was lending money to bad risks.

Aaron was too young, too tall, too good looking and too memorable for this job, but he was good at it. And he felt good about doing it. His boss (and he liked having one) asked him if he would like more of this kind of work sometime. He would.

In fifteen days he was back in Cincinnati using his key to enter Cinto's apartment. He'd called that morning and said he was on his way. He got in about ten at night and she wasn't there. He climbed in her bed and fell asleep waiting for her. When she came in after midnight, on a work night, and he rolled over to hug her, it could not have been more obvious to him that her heart was not in that hug. He tried to hold her as she fell asleep, but as soon as she assumed he was asleep, she pulled away. He nearly cried.

On the phone then next day she told him that while he was gone she had met someone. No, she had not slept with him yet. She couldn't do that to Aaron. She said that to friends at work and to the new guy. Aaron always had been so honest and trustworthy and straight forward that she could not do something behind his back. So she waited until he returned. But now that he had and she had told him, she wanted to see someone else now.

There was a place on Clifton Avenue where a high school friend of his had wrecked a car. Every time he drove by there he thought of that. He wondered if that ever would change. And there was the fountain next to Clifton School where he had met someone who returned his stolen watch. The first time he was robbed in the locker room, they had stolen a watch that his grandfather had given him. He had puts up signs offering a reward for it and someone responded. Two children had met him at the fountain saying they found it on the street and traded it for the reward. Would he ever pass that fountain without thinking about that?

Now there was a list of places that were his and Cinto's. Parks, shops, movie theaters, parking places. The intersection where they stopped at a red light late at night and the light changed several times while they were locked in a kiss until someone pulled up in the lane behind them. The hardware where he helped her choose paint colors. The corner where he picked her up and carried her so her feet would not get wet in the ankle deep slush that filled his shoes. The restaurant where they got their Greek salads and Spanikopita. The oyster sandwiches at Lenardt's that she never had tried before. The library. How was he ever going to be able to go back to that library.

He was glad she had waited till he returned to tell him. If she had told him while he still was completing that job, how would he have finished it? He was as immobilized by this as he had been by his back. He laid on the floor staring at the ceiling for days. When he went out, people looked at him. Was it that obvious? He went to a movie to sit in the dark and made sure he did not sniffle, but when the movie ended someone asked him if he was all right. He nodded and fled.

Ten days after she had left him, she called. She said it hadn't been "successful." Oh, great, he thought. Did she have to create in my mind a graphic image of some guy in her bed whether or not he was succeeding? She wanted to come back.

The previous winter he and Richard and someone else's girlfriend had gone snow skiing. It had been very interesting spending the day with that woman. Feeling her taking care of the two men with her gave him such an interesting window into what things must be like for her boyfriend. At the end of the day, Aaron was supposed to drop off his rental skis in one building while his shoes were in another. She said, "Do you want me to get them for you?" He said, "You would do that?" She said, "Of course," and jumped up and left to do it. He said, "You'll know they are the right ones if the toes are cut out of them." Yes, she had noticed that.

Cinto never did anything like that. It had been a shock when this woman did. Cinto left him lying on a stairway clinging to a banister in need of help. He cared about her so much that he just did not see it. But now, she left him the minute she felt attracted to someone else. He needed more loyalty than that. He needed more commitment than that. He didn't think you could build a family with someone whose presence depended on whim. The moment she felt differently she left? The moment she felt the same again, she came back? There are mistakes. And there is learning lessons. But he was learning one too. His mother's saying, "Do you think you should get a new girlfriend?" His brother's asking, "Where's Cinto?" when his parents knew better than to. His friends saying they would understand it if he thought he could do better and just moved on. The days and nights he spent lying on the floor of his apartment alone without her there. None of that had added up to anything in his mind until now. This pushed the Total button on the adding machine and did a computation he never had done before.

He told her it was different now. He could not go back.

Inhaling did not come naturally for weeks.        Under Construction

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Medical Novel Table of Contents

Persons, places, events, and situations in this story are purely fictional.
Any resemblance to actual persons, living or dead, is coincidental.

Rough Draft / Under Construction


Home | Table of Contents | It's a Path
Silence versus Patient Safety
Loyalty versus Patient Safety
The White Wall of Silence versus Patient Safety
Blacklisting Patients
Freedom of Speech for Patients
Medical Complaints - How to

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It's a path

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