April 2015

The Medicine

High times

By Karen Hitchcock

After lunch at my mum’s house the other day, my brother and I walked around the corner to visit an old school friend we hadn’t seen for years. Pete had moved back into his childhood home when his parents left for a retirement village. He answered the door pelvis first, the stance he’d had since he was a kid, one that looked slightly obscene now on this old, bald stranger with wild eyes and an open mouth, his lower jaw gyrating rhythmically. He grabbed me in a bear hug and kissed me fat on the lips.

“Kaz! Great to see ya, mate!” My brother and I exchanged a glance as Pete ushered us into the kitchen. He offered us a drink of “activated” water from a row of bottles on his windowsill. As he paced, flicking his fingernails and scratching his shoulders, Pete told us how he bought the house real cheap, what activation does to water, why he had never had kids. We nodded politely, laughed in the appropriate places and said we had to get back for dessert.

I waited till we were halfway down the street. “What the fuck? Speed?

“Ice,” my brother said.

I have a talk I give to the junior doctors about taking a patient’s drug and alcohol history. I knew there was a need for the talk when a registrar asked me what a bong was. I thought she was joking, but when I saw the look on her bright red face I stopped laughing and explained that it was a water pipe used to smoke marijuana. Growing up, I learnt a lot from Pete and boys like him in our neighbourhood. Things like how to make a bong out of a juice bottle and just how many cones it was possible for a human to smoke in an average day. As a result, I can extract a pretty accurate drug history, and it’s always useful to know what you’re dealing with. I start the talk by telling the fresh-faced doctors, “You are not normal.”

Of course, no one’s normal. Everyone is exquisitely weird. Everyone has secrets. And there’s only so long a body can hide its secrets. Some people are better at hiding them than others, or have larger compensatory mechanisms. Pete’s jaw gyrates, and his fingers twitch and pick. A professor of medicine’s belly grows bigger each year, his nose reddens, he develops a wide-based gait. The secrets aren’t always about drugs. A young professional faints at the photocopier, and blood tests reveal electrolyte abnormalities that can only be caused by weeks of dedicated vomiting. A barrister comes in with a deodorant bottle wedged in his colon. Secrets are ritually unmasked in the hospital.

The surgeons once asked me to see a guy on the wards as his blood pressure was high. He was a full-time tradesman in his 40s and had three kids. I glanced at his notes and saw that he drank “socially” and smoked “a bit” of pot. His blood pressure was normal for someone who smoked, drank, ate crap and didn’t exercise, and it was nothing that a handful of pills couldn’t fix. I asked him about his work, his family, his health. His social drinking tallied up to a few bottles of Wild Turkey a week. I asked him if he smoked his bit of pot in joints or bongs.

“Bongs,” he said.

“Would you say you smoked more than 40 cones a day?” I asked casually.

He laughed. “Not 40, doc! Maybe 30? Thirty-five max, on the weekends?”

He’d done so since he was a teenager and told me a fascinating story about how he managed it at work. I told him an equally fascinating story of the barotrauma that years of deep bong inhalation was causing his lungs, and what the near future likely held for the rest of his body.

“Face the facts, mate,” I said. “You’re not 17 any more, and you should stop acting like you are if you want to see your kids grow up from anywhere but the window of a nursing home.”

We stared at each other for a minute. I asked if he wanted an appointment with our drug and alcohol service.

“Nope, not necessary.” He leapt out of bed and grabbed his backpack. “That’s it. I’m gonna quit. I swear to you, doc, I’m gonna quit. I’ll prove it.”

He unzipped a side pocket and pulled out the biggest bag of weed I’d seen in a long time. The registrar’s eyes bugged. The patient held it out for my inspection.

“See, I’ve been here five days and I haven’t touched any of it.”

“Good job,” I said. “See if you can keep it up.”

“Doc,” he said nervously, as I made my way to the door, “can I smoke one joint at night” – he held his fingers 2 centimetres apart – “just to help me sleep?”

I laughed and told him he could smoke as much as he liked – I wasn’t the police – but if he kept smoking 35 bongs a day he was fucked. He nodded solemnly.

“Hopeless case,” I said to my registrar as we climbed the stairs.

About a year later, I heard a wardsman inform a nurse that the lady in bed seven was desperate for a cup of tea. The wardsman turned around: he was my marijuana patient.

“Doc!” he cried out cheerfully. “How’s it going? Remember me?”

“Of course I remember you,” I said as we shook hands. “But what happened?” I gestured at his uniform. “Weren’t you a panel beater?”

“I quit,” he said. “All that dust, no good for the lungs.” He leant forward. “I quit everything, if you know what I mean. And I thought to myself, I’ve gotta change my life and I know exactly what I’m going to do.” He straightened his back like a soldier, looked around proudly. “I’m going to work at the hospital.

Karen Hitchcock

Karen Hitchcock is a doctor and writer. She is the author of a collection of short fiction, Little White Slips, and the Quarterly Essay Dear Life: On Caring for the Elderly.

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