Hospital Diaries VII: The Sweet-Smelling Ward

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Version française

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This is part of a series. You can begin at Part I and follow the link at the end of each installment to read the next. 

Paralysis is a terrible impediment to autonomy. Not only are you not able to move but also you cannot get dressed, wash or go to the bathroom by yourself.

In the Gurney Hall I had to let go of my shirt and pants and I felt humiliated wearing nothing but briefs under the ridiculous patient smock with the wide opening in the back.

You see, clothes not only serve to keep you warm and decent, they also symbolize your social status. In a hospital this hierarchy is quite obvious: doctors wear white smocks and a tie, nurses and orderlies wear pastel-coloured scrubs, and patients lie half-naked at the bottom of the social ladder.

The social ladder is nowhere ever more present than in a fire brigade. Here a firefighter is climbing the social ladder in an attempt to become lead firefighter, a dangerous position with more responsibilities. Exactly why is a mystery to me.

I was sharing my embarrassment with my friend Lucide as she was pushing me in my wheelchair back to my room at the Emergency Overflow.

“You know, when you’re in a hospital, you have to give up your pride,” she said.

Unfortunately, my vanity prevented me from appreciating her wisdom.

The next day, I squirmed for an hour in my stretcher, finally managing to put on a pair of jeans. I could not button them because of my swollen and numb hands but I did zip them up.

As I was basking in this accomplishment, I looked up and saw a tall blonde woman who had been observing me for awhile, standing at the foot of my gurney.

Although she was smartly dressed and not wearing a white smock, I knew she was a doctor simply because she appeared out of nowhere like all the other doctors who came to see me in the hospital.

“Good morning sir. I am Doctor Sveta Tiplova,” she said with a strong Russian accent. “How are you feeling today?”

“Quite well thank you. Are you a neurologist?”

“No, I’m a physiatrist and I’m here to assess your condition.”

I thought I heard “psychiatrist” and for a moment I had a vision of the Soviet Gulag and the snowy Siberian steppes. I feared this new doctor was sent by the “Seagull,” the doctor who thought I was faking my illness, as a first step to having me committed.

Seeing my distress, Doctor Tiplova explained that she was a specialist of the musculoskeletal system. She then proceeded to thoroughly examine my hands, my arms, my shoulders, my neck and my knees.

Physiatry, a medical discipline that became popular during WWII, is about restoring the bones and muscles connexion after an injury otherwise than through a silly Bible camp song.

She seemed puzzled but I could see that she was carefully considering my ailment. She finally said:

“Listen, for what it’s worth I am going to submit your case to the Internal Medicine Department. They might be able to recommend some tests to establish a proper diagnosis.”

After she left I realized that medical science was as much in the dark about the nature of my illness as I was, although it did not have to cope with the pain and paralysis.

For the time being however, Doctor Tiplova’s visit had an instant benefit for me. For her examination, an orderly had moved me to my wheelchair and I was no longer lying down on my stretcher.

I had not been to the bathroom since I arrived at the hospital several days before. My friend Lucide had brought me prunes when she came to visit and I was beginning to feel their effect on my bowels.

Plums (prunus domestica) were introduced to the western world during the Crusades and offered as a perk to crusaders (whence the expression “plum reward”) who left their family and possessions behind to massacre Moors in the Holy Land. Once dried, they are called prunes and can be preserved for a long time. Their laxative properties are legend.

I rolled my wheelchair to the toilet, put the brakes on and painstakingly lifted myself up by leaning on the chair’s armrests. With great effort I advanced the three steps to the bowl and collapsed on its seat.

At once my intestines began to void. Oh! The joy I felt when I realized that at least this part of my body was fully functional! My hands, my arms, my legs and my neck may have given up on me but at this time I swear I was in Paradise!

However, after I was done and had wiped away the traces of my deed I was faced with another challenge. How was I to get up from the toilet? There were holding bars on the wall but my arms did not have the strength to lift me up.

I realized I would have to ask an orderly to help me get up from this awkward position.

There was a chain on the wall with a sign that said “EMERGENCY” in red letters. Humbly I pulled on it and after ten minutes an orderly showed up.

“Oh! Poor sir! You shouldn’t have tried to go to the bathroom by yourself! We could have brought you a commode chair!”

Commode chairs, such as this padded specimen, were popular in the 18 and 19 centuries before the advent of sewers. To each his own, using a commode chair is not a pleasant experience yet it is better than relieving yourself in a diaper.

He tried to pull me up but the bathroom was too narrow. He left to get another orderly and together they managed to make me stand up. The second orderly pulled up my trousers, buttoned them and zipped them up.

Nothing can wound your pride as much as having several people witnessing the embarrassing situation you are in.

As a consolation, I thought of Dante’s Divine Comedy where the author, while travelling through Hell, met an acquaintance who had been condemned to swim for eternity in a sea of excrements because of his pride.

Dante Alighieri is the Italian poet who established the Tuscan dialect as the standard Italian language. The Divine Comedy recalls his climbing the social ladder through the nine circles of Hell, the nine rings of Purgatory and the nine celestial bodies of Paradise. The journey is the reward indeed. Illustration by Gustave Doré, Public Domain

Once I was sitting in my wheelchair, I asked if I could go outside to have a smoke.

“That will not be possible sir,” said the orderly. “We have to put you back on your gurney. We found a permanent room for you in another ward and somebody will take you there shortly.”

As the gurney attendant was rolling my stretcher towards the elevator I was rejoicing because I believed that being transferred to a permanent room meant I was now a legitimate patient. Doctors would soon find the nature of my ailment, prescribe the appropriate treatment and I could go back home.

Alas! When the attendant pushed open the doors of the general medicine ward where I was to stay for the next several weeks a poignant stench of excrements assailed my nostrils.

I thought I was being taken to Dante’s first circle of Hell to be punished for my pride.

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To be continued in Hospital Diaries VIII: Lying in the bed I made

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Hospital Diaries VI: The Overflow

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This is part of a series. You can begin at Part I and follow the link at the end of each installment to read the next. 

I had been in the gurney hall for two days. Every move I made was painful and I still did not know what I was suffering from. It had all started with a gout attack but then I was told I had twisted my knee and had torn some ligaments. After being admitted to the hospital, doctors talked about arthrosis, spinal stenosis and a neurologist I nicknamed “the Seagull” insisted I needed back surgery.

Lying on my gurney I was pondering about how difficult it is to establish an accurate diagnosis. In all fairness I could not blame doctors for failing so far to identify the cause of my handicap. In a way, I felt it was like an evil genius, some kind of Keyzer Söze from the movie The Usual Suspects, was living inside my body, wreaking havoc at the expense of doctors/detectives who were completely baffled.

Only in literature and movies the issue is finding the “true” culprits. In real life, detectives and doctors are content to find a convenient suspect – all the best if it’s the real guilty party – to lay charges on, close the case and move on.

Those were my thoughts as I watched the hospital chaplain offer his sympathies to the family of a dying patient to whom he had just administered the last rites in one of the private rooms of the gurney hall.

At that moment an attendant showed up and began to place my personal belongings under my gurney. I was terrified she was going to take me against my will to the operating room for spinal surgery. I nervously asked her where we were going.

“I am taking you to your room sir.”

I could not believe my ears! Finally I was leaving the noisy gurney hall with its blaring bells and alarms! As I was profusely babbling my thanks to the attendant, she curtly said:

“I’m just doing my job sir.”

After I was wheeled into my new room, an orderly slid my body to a wider gurney with a thicker mattress. From the conversation the orderly and the gurney attendant were having, I understood that I was now in a place called the Emergency Overflow, a somewhat “underground” department set up for patients who had been residing in the emergency ward for at least 48 hours. This was the way the hospital had found to avoid the heavy fines that were imposed if the ministry of health’s performance goals were not met.

Mankind is obsessed with order, yet lusts for chaos. Maybe that’s why bureaucracy was invented. Bureaucracy is a form of labour organization purposedly designed to effectively achieve a cost-efficient use of resources in a rational way. However tremendous effort and considerable ingenuity are needed to get around bureaucracy’s cumbersome rules.

I owed my escape from the gurney hall to this paradox.

I was now in a no man’s land of a sort, some temporary quarters run by a minimal staff. From time to time a nurse would come by to take my vital signs and ask me to rate my pain on a scale from zero to ten and an orderly brought me my meals.

In Canada, hospital menus are designed by dieticians. Low-salt, low-fat and low-sugar meals usually taste like cardboard. If the food is not particularly tasty, it is however very healthy.

Everyday I had a visit from “the seagull,” the neurologist who was convinced I was faking my illness since I would not agree to have back surgery.

“Come on! Show me what you can do! Get up on your feet and walk!” the seagull would mock me.

I was nearing rock bottom. Having been confined to a stretcher for almost a week, I still did not know what I was sick from, my doctor was treating me as if I was imagining my ailment and I was taking painkillers that had no effect on my pain.

When my friend Lucide came to see me, she brought a bottle of Ibuprofen. I quickly took two tablets and hid the bottle in my bedside table hoping no overly conscious nurse would steal it away from me again.

While I was waiting for the medication to take effect, I told Lucide about my frustration and despair.

“Hmm… I saw three empty wheelchairs in the hall as I was coming to your room” said Lucide. “Maybe if we could borrow one and go to the cafeteria it would lift your spirits a bit.”

US president Franklin Delano Roosevelt (1882-1945) was confined to a wheelchair for the rest of his life after being struck with paralysis during a vacation at Campobello Island in New Brunswick. Still today doctors disagree about whether FDR suffered from poliomyelitis or Guillain–Barré syndrome.

My friend is a genius. I rang the nurse right away. After about 15 minutes of waiting, an orderly arrived and I asked her if I could have a wheelchair to go for a stroll with my friend.

“I’ll ask your nurse,” she replied.

Lucide and I continued our conversation for about 20 minutes and having no news from my nurse, I rang again. When the orderly returned, I asked her if the wheelchair I requested was coming.

“I’m sorry sir, your nurse is taking a break and I haven’t been authorized to give you a wheelchair yet.”

That was too much. The frustration that had been building up in me for the last week overflowed.

“Listen miss: are you telling me there is only one person in this ward who can allow me to go down to the cafeteria in a wheelchair to have coffee with my friend? This is a simple request! I’m not asking for a liver transplant! All I want is a wheelchair! This is not the third world, is it?”

My outburst took the orderly by surprise. She began to cry. Her sobs alerted her supervisor who rushed into my room.

“What have you done to my employee?” he enquired uneasily.

Ashamed, I told him what happened while a nurse was taking the orderly to the hallway to comfort her. Five minutes later, the supervisor came back with a wheelchair in which he helped me sit. Lucide wheeled me to the elevator to go to the cafeteria.

Still astounded by the drama that just happened I was nevertheless ecstatic to be sitting, moving away from the confines of my room.

Lucide and I got some coffee and I asked her to take me outside to smoke. It was a cold January night and at minus 20 degrees I was shivering. It was the first cigarette I had had in six days. It felt like I finally had found relief for my pain.

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To be continued in Hospital Diaries VII: The Sweet-Smelling Ward

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Hospital Diaries III: Incubation

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Version française

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This is part of a series. You can begin at Part I and follow the link at the end of each installment to read the next.

Parked in a wheelchair at the hospital’s emergency ward, I soon understood why sick people are called “patients.” Patience is the ability to wait in silence while surrendering to calamity.

Unfortunately, the young lady sitting in front of me did not grasp that concept. With her cell phone glued to her ear, she was ranting over the senselessness of the health care system.

“I’ve been waiting for five hours! I’ve had a splitting headache ever since I got vaccinated last week and I’m leaving for Thailand in two days! Why is nobody taking care of me? Don’t they realize this is an emergency?”

Many people think that all emergencies require immediate action. This is not so. There are different levels. Some emergencies need to be addressed without delay, others can wait a little while. Few are a priority.

While driving me to the hospital, my friend Lucide tried to reassure me about my stay at the hospital by telling me the difference between private and public healthcare systems.

“A private healthcare system sees patients as a source of revenues whereas a public system – such as the one we have in Canada – views them as expenditures. A public system aims at getting you well enough to send you home as quickly as possible in order to minimize costs. You’ll see: in a snap you‘ll be back in your apartment, happily cleaning it up.”

I was not as optimistic as my friend. I believed that the waiting time at the emergency ward could be long. That’s why I asked Lucide to prepare some supplies for me before leaving my place.

In a shoulder bag I had a sandwich, some apples, an orange, a few biscuits, a water bottle, two packs of cigarettes and a small jar of Ibuprofen, the muscle relaxant I was using as a pain reliever.

Ibuprofen is an anti-inflammatory drug used to alleviate fever, pain and swelling. One can say it is basically a “super Aspirin.” Ibuprofen is included in the core model list of essential medicines published by the World Health Organization and should be part of everyone’s medicine cabinet.

The enraged Thailand traveller was furiously pacing when I was called on the intercom.

Clumsily I wheeled my chair to an office where a nurse was waiting for me to check my “vital signs.” It took me a minute to understand she wanted to take my blood pressure and my temperature.

The nurse tightened an armband on my upper arm and stuck a thermometer in my mouth under my tongue.

Fever is measured by inserting a thermometer into the mouth, the rectum, the ear or under the armpit of a patient. It was only in the 19th century that doctors realized that fever was a symptom, not an ailment. Besides their taste, there is no difference between an oral and rectal thermometer.

While she was writing down the results I asked the nurse if she knew how soon I would see a doctor.

“Not right away. We’re very busy now. We will call you to let you know which cube you should go to.”

“A cube? What do you mean?” I asked, puzzled.

“That’s what we call our consultation rooms. Now if you could please return to the waiting room, I have other patients to see.”

I was not thrilled by the idea of being “incubated” at the hospital. I was also less than elated to wait for ten long hours until I was called to Cube 67. During this waiting time, several patients – including the traveller to Thailand – grew tired of waiting and left the ward without seeing a doctor.

I had been looking at the walls of Cube 67 for twenty minutes or so when a young doctor showed up. I told her why I had come to the hospital. I explained my gout attack, the torn ligaments in my twisted knee, the weeks spent in bed at home and my paralysis.

She wanted to examine me. To do so she had to call two orderlies to lift me up from the wheelchair and sit me down on a bed. I painfully took off my jacket and my shirt and put on an open-back smock that one of the orderlies tied at my neck with a lace.

After the doctor checked my knees, my hands, my wrists and my arms, she left the cube without a word.

I could hear her talking with a man on the other side of the door:

— “He’s well over 50, he can’t walk and he has trouble moving. I wonder if...” she said.

— “He’s got all the symptoms, said the man, it could very well be spinal stenosis.”

— “That’s exactly what I thought,” she concluded.

Those were the last word I heard from her and I was never to see her again.

After 30 minutes, a nurse came into the cube carrying a plastic basket filled with small glass bottles and stickers.

“I need to take some blood samples, she said. Please roll up your sleeve, sir.”

I obliged half-heartedly. The nurse filled 31 vials with my blood then left.

There I was, alone in my cube, sitting on a slippery leatherette and foam mattress. I was cold. My arms, my shoulders and my legs were sore. What would become of me? I did not know what “spinal stenosis” meant and I was afraid.

One of the most widespread myths of modern times is that medical officers specializing in nerves and the spinal cord are called “spin doctors.” Because of that belief, people think that spinal stenosis means these doctors write down their observations using shorthand. However, spinal stenosis is really about an abnormal narrowing of the spinal canal running through the backbone.

Shivering, I managed to stretch and pick up my jacket that the orderly had left on the wheelchair. Despite the pain, I put my coat on, lay down on the bed and dozed off.

When I woke up, a man dressed in tan scrubs was putting my clothes, my shoulder bag and my shoes under a gurney. He then proceeded to skillfully slide my body over to the stretcher.

The attendant opened the cube’s door and wheeled me out to the corridor. I asked him where he was taking me and he replied:

“Where am I taking you? Why, to the gurney hall, of course!”

A gurney is a wheeled stretcher used to take patients on a journey. It is often equipped with a hydraulic system for raising and lowering patients so the attendant does not injure his or her back and develop spinal stenosis.

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To be continued in Hospital Diaries IV: The Gurney Hall

Hospital Diaries II: The Firefly

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Version française

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This is part of a series. You can begin at Part I and follow the link at the end of each installment to read the next.

Every time I see a doctor, it seems he ends up making recommendations that are totally unrelated to the purpose of my visit.

I have gotten used to the persistent advice to stop smoking but I just can’t stand it when I’m told to lose weight.

That’s exactly what the good doctor who diagnosed a sprain on my knee said to me. I left his office annoyed but resolved to follow his advice if only to stop receiving unwanted suggestions.

The road to slenderness is simple: follow a balanced diet. Forget about gyms and fitness centres. Sure they will tone your body and build muscles but you will really need to exercise a lot to lose weight. And the more you exercise, the more you risk getting injured.

According to a Canadian study, 40.2% of people aged 20 to 64 who were injured in Canada in 2009-2010 did so practising sports, exercising or walking. Only 16.5% suffered from work-related injuries. This may mean that Canadians are either smart workers or simply lazy.

In Canada, the key to balanced eating is found in Canada’s Food Guide published by Health Canada. This system is based on four essential food groups: fruits and vegetables, grain products, dairy products and alternatives, and meat and other sources of proteins.

The Food Guide explains what constitutes a typical serving for each food group and how many servings males and females need according to their age. If you keep a record of how much you eat, you will lose weight quickly without risking your health.

That’s what I did as my knee was failing me. I lost 40 pounds in three months. Now I only needed to lose another 15 pounds to reach a healthy weight and turn my doctor speechless.

However, I was not worrying about dieting the morning I woke up paralysed in bed.

I was in a bad predicament but I found out I had an unexpected advantage: I had a full bladder.

Despite the pain and because of the urge, after about 30 minutes I managed to move my head, then my fingers, my wrists, my elbows and my legs until I laboriously sat on the edge of the bed.

I relieved myself in my homemade bedpan and then assessed my situation. My twisted knee was not the issue anymore. I could no longer move easily because I was sore all over. It would take a miracle for me to get out of my apartment by myself. My fridge was getting emptier by the day but worse, I was almost out of cigarettes.

I found myself in the middle of the proverbial tunnel looking for a light.

As I was moping about my condition, the phone rang. It was my friend Lucide who, worried, was calling to enquire about me.

I told her about my disablement and that I was running out of supplies. Right away she offered to run some errands for me and said she would stop by that night after work.

In the darkness, a firefly was shining her light to help me find the way out.

The firefly or lightning bug is an insect of the lampyridæ family. There are more than 2,000 species of fireflies. Some females lightning bugs do not fly and look like their larvæ. They are called “glow worms.”

When Lucide arrived at my place carrying several bags of groceries she was struck with consternation, not because she was seeing her friend bedridden and disabled but because of the sorry condition of my apartment.

I had been confined to my bed for several weeks and household cleaning was no longer a priority. Dirty dishes were piling up on the kitchen counter. The floor was covered with objects that I could not pick up because I was unable to bend over. A heap of dirty laundry gathered in a corner of my bedroom and dust was taking over my lodgings.

“What a pigsty! exclaimed Lucide while dropping her bags on my bed. How can you live in such a mess?”

« Erm... Did you bring me cigarettes?”

“They're in the bag,” she answered distractedly while inspecting the jumble in my apartment. “Do you have any garbage bags?”

“In the cupboard, underneath the sink,” I answered while looking for cigarettes in one of the grocery bags.

Lucide disappeared in the kitchen while I tried to unwrap a cigarette pack with my numb fingers. It seemed I had lost all the manual skills I once had.

Lucide came back to the room with a garbage bag and as she saw my shaky hands fighting with the cigarette pack, she cried out:

“What’s with your hands? Look at your knuckles! They’re all red and swollen! This is much worse than a twisted knee, you must see a doctor! Come on, I’ll take you to the hospital!”

With great difficulty I began to dress. I had lost a lot of weight and my clothes did not fit me anymore. I was in a bad shape and I felt weak and distressed.

It took me almost half an hour to manage to get up with Lucide’s help. When I took a first step leaning on my walking cane, it felt as though I had no kneecaps, like my thigh bones were resting directly on my shin bones. I almost passed out from the excruciating pain.

I live on the second floor of an apartment building. As I began to climb down the 14-step stairwell, AC/DC’s Highway to Hell was playing in my head and I had to sit down on the second step to gather my wits.

Highway to Hell is a song about the gruelling conditions of constant touring. Six months after its release, Bon Scott, who sang on the original recording, was found dead at 33 in the back of a Renault 5 after a night of heavy drinking. Show business is a mother who enjoys eating its young.

Finally, I was outside. I had been locked in my apartment for a month and winter had settled in. It was cold and the snow was cracking under my steps. In a last effort, I sat down in Lucide’s car as she started the engine.

I was on my way to the hospital, a harbour for the unfortunates of the world.

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To be continued in Hospital Diaries III: Incubation

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Hospital Diaries I : A Gout-Ridden Wretch

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Ouch! I was awoken by a shooting pain in the middle of the night.

For the fourth time in 30 years I was having a gout attack. By now I knew the story: the sharp pain in the joint at the base of my big toe would fade away after I applied ice packs and took muscle relaxants. This meant I would be lounging in bed for a few days while rereading the works of Guy de Maupassant.

After three days, the swelling had subsided but the pain in my foot remained and I was unable to walk without limping. It was not unbearable so I went back to work where a lengthy report on crystallizing the Canadian public health system through the infusion of additional government funds was waiting to be edited.

“Gout? What’s this? You think you’re Charles Dickens?” joked my friend Aaron when he saw me at the office.

I tried to explain that gout was not some outdated distemper and that its occurrence was on the rise in North America but my colleague was no longer listening: instead he was focusing on the coffee machine sputtering a reluctant espresso into his cup.

The espresso machine is believed to have been invented in 1884 by Angelo Moriondo, in Torino, Italy. The drink gained in popularity worldwide in the 1980’s so much that automatic dispensing machines such as this one are now common in North American public institutions.

Weeks went by, I was still hobbling and to make matters worse, one of my knees failed. I now had an even clumsier gait. I went to a doctor who told me upon quickly examining my swollen knee that it was sprained. He recommended two weeks of rest and to avoid putting weight on my leg.

So I took the last two weeks of annual leave I had left and went back to read Guy de Maupassant’s tales.

As this forced vacation was coming to an end and the time to return to work was approaching, my knee was still hurting. With the help of a walking cane, I went back to the clinic where the doctor summarily felt my puffy knee to immediately declare:

“This is a splendid case of a sprained knee with torn ligaments! You must get to bed my friend! Didn’t I tell you before to get some rest?”

“But I’ve been at home for the last two weeks!”

“In bed? No, no, my friend, stay in bed with your leg raised and apply ice packs four times a day. I am prescribing you some muscle relaxants to ease the pain.”

With the prescription in my hand, I called a cab to take me to the drugstore while realizing to my displeasure that, having used up all my annual vacations, I had to take unpaid leave to attend to my health.

The cab driver was talkative and seeing my cane asked me what happened to me.

“Oh, it’s nothing, I just twisted my knee” I said.

“You should stop smoking!” he replied.

Not impressed by the man’s popular wisdom I was stunned by the effectiveness of the advertising campaign put together by the Government, the health system and the pharmaceutical industry to blame all worldly problems on smoking.

So I went back to bed, determined to heal my costly lame knee. I would get up once a day to use the bathroom and prepare some food. My meals were simple: sandwiches, fresh fruits and vegetables, cereal, cheese, social tea biscuits and water.­­­ I ate lying down. With a razor blade, I cut up a two-litre soda bottle to use as a bedpan to avoid standing up.

The polyethylene terephthalate bottle was invented in 1973 by Nathaniel Wyeth, an American engineer, for pressurized liquids such as soda pop. Carbonation is weak in human urine. However it is surprising how many people use such bottles to relieve themselves when nature calls.

After a week this idleness was taking its toll. My back was aching so much that it was becoming a challenge to sit up in bed or to get up.

I could pull myself out of bed with a strap I tied to my bedroom door while I pushed myself up with my elbow resting on a stool. Every day walking from my bedroom to the bathroom and the kitchen became more difficult.

One morning I woke up laying on my back with my arms extended, completely paralysed.

I was sure this was the first time in the history of modern medical science that a gout attack turned into a sprained knee spreading to the upper body and limbs of an individual.

This is when I realized I needed some serious help.

To be continued in Hospital Diaries II : The Firefly.

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Mexican Rabbits

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My wife and I had been separated for about two months and I was living in an unremarkable and noisy bachelor apartment in a depressing neighbourhood.

There were about 40 apartments in the building where I was. My neighbours directly above me – a young Mexican couple, the Conejos – were polite and spoke in a nasal Spanish gibberish which I could not understand at all.

One night around 11:00, I was sleeping on the couch when their relentless lovemaking woke me up.

“Ain’t love great when it’s well made,” I thought, annoyed by their indecent sighs.

I tried in vain to get back to sleep. After awhile I decided to go out to read in a café until my neighbours’ Mexican hormones calmed down.

There was a coffee shop a short 20 minutes walk away. It was one of those franchised chains lit by crude fluorescent lights where young people in ill-fitting uniforms served the dark beverage in paper cups. It was open all night and smokers were relegated to a packed glass-enclosed room while the rest of the restaurant was empty.

One would think that following the smoking ban in public places coffee shops would have lost all their clientele as coffee without cigarettes is just not the same thing. I guess people are quick to give up life’s simple pleasures. Many thanks to Zebra Jay for the photo.

I entered the cramped smoking room with a coffee and a copy of Herman Hesse’s Steppenwolf, hoping that the Swiss-German author’s eastern wisdom would help me forget the emptiness I felt.

Sitting at a table for four, two girls were talking.

— A funny thing happened to me at work, one of the girls said. After my shift, while I was changing in the backroom, Jason snuck in and took me from behind!

— Ah! Ah! That’s typical! scoffed the other one, Jason always does that!

I could not believe my ears. Here I was in a crowded public place and people were actually having this kind of conversation oblivious to their surroundings! I tried to focus on my book, lit another cigarette and took a sip of coffee. I was there to clear my mind after all.

I managed to follow Harry, Steppenwolf’s main character, as he was caught in his personal ontological maze. I had almost forgotten the girls’ obscene conversation when two guys joined them. I did not pay much attention until the girl who was groped by Jason got up to use the ladies’ room.

The two young men and the other girl looked lustily at her leaving.

When she came back, she said:

— So, what were you talking about?

— We were saying your ass looks great in those jeans, said one of the guys.

She immediately responded:

— You know why? It’s because I’m not wearing panties!

Flustered, I went back to my book, lit another cigarette, gulped some lukewarm coffee and really tried hard to think about anything else. Oddly, Tales of Ordinary Madness, Charles Bukowski’s famous short stories collection, came to my mind.

Maybe I needed to meet my Hermine, the Steppenwolf character who helped Harry to come to grip with his situation and learn to enjoy life again.

My predicament was not the same however. I was not depressed nor suicidal, I was only bitterly disappointed that my marriage had failed. And now, because of the Mexican rabbits who lived upstairs and those kids sitting at the coffee shop, I was entertaining lewd thoughts that were rubbing raw my feelings of loneliness.

Rabbits (conejo in Spanish) are not rodents. Rodents have incisors that are continually growing and needing to be ceaselessly worn down. Rabbits have two sets of incisors one behind the other. The female rabbit ovulates by reflex and can give birth to up to 12 kits three times a year.

I did not feel like myself anymore.

Finally the youths got up and left. Relieved, I tried to focus on my book again.

That’s when four ladies in their fifties coming back from bingo sat next to me and passionately discussed the most efficient manner to pleasure themselves with a hand-held shower head.

That was it, I had had enough. I closed my book, put out my cigarette, finished drinking my coffee and left, glad I had not brought a Henry Miller novel instead of Steppenwolf.

:Henry Valentine Miller (1891-1980) was a prolific American author whose books were banned in the United States on the grounds of obscenity until 1961. A couple of years later, western high courts rendered that kind of obscenity obsolete. The times, as the song says, they were a-changing.

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Pneumonia

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Several years ago, around the time smoking in Canadian workplaces was banned, I was working under a contract in a gigantic office complex. Smokers had to go outside under a large, damp, concrete portico with a two story-high roof sarcastically called the “Batcave.” It was there, in the middle of winter, surrounded by the haggard faces of scores of other smokers, that I developed a nasty cough.

The Batcave is where Batman retires to light up a Batsmoke when he needs a Batfix. The stairs, of course, lead to Wayne Manor.

After a few days, I started having trouble breathing and my chest hurt. When a fever set in, I knew something was wrong. I took a day off hoping rest would improve my condition. It did not and I became convinced that I had pneumonia.

I went to a walk-in clinic early the next morning. After about 45 minutes of waiting coughing my lungs out, a young doctor finally saw me in his office. He asked me the reason for my visit while distractedly looking at his computer monitor.

– Doctor, I have this bad cough and a fever. I think it might be pneumonia.

– Really? Let me have a look, he said, taking out his stethoscope.

He auscultated me, looked at my eyes, my tongue, inside my ears, took my temperature, checked my pulse and my blood pressure then said the only way to be sure would be for me to go to the emergency ward at the hospital and have some x-rays taken.

– But this is a medical clinic, don’t you have an x-ray machine?

– We would need specially-trained personnel and right now we only have doctors, a nurse and some administrative staff.

– Well, I have a friend who’s a dental hygienist. She operates the x-ray machine all the time at work. If I may, let me call her and ask her to come and take the picture.

– Sir, we don’t have an x-ray machine, you have to go to the hospital.

– You don’t have an x-ray machine? Even the vet where I take my dog has an x-ray machine!

– I’m sorry sir, go to the emergency ward at the hospital, they will help you there.

I had the feeling I was annoying him and that he was politely trying to get rid of me.

Pneumonia is an inflammation of the alveoli, where oxygen passes from the lungs into the bloodstream. According to William Osler (1849-1919), the Canadian-born physician known as the “Father of modern medicine,” pneumonia will kill you quickly and relatively painlessly. This affliction is celebrated on World Pneumonia Day, November 12 every year.

So I left for the hospital, knowing that my case was not an emergency yet and that I probably would have to wait hours before seeing a doctor.

Emergency waiting rooms are grim, sullen places. At this one, the medical staff was limited to a receptionist and a nurse locked up in a glass-enclosed office.

I pitied this caregiver: outnumbered in a roomful of dangerously sick people, she could provide no relief until the intervention of a medical doctor.

I arrived around 10:00 AM. There were already 25 people waiting. Some were old and silent, others were restless children accompanied by their parents. The rest, like myself, were in their 40s or 50s and did not look overly sick except for some hacking coughs, ugly skin rashes and obvious lack of energy.

I gave my requisition to the receptionist and took a seat. I picked up a two year-old issue of People magazine on a nearby table and set myself for a wait that I expected to be long. I hoped I could sleep between coughing fits.

A young couple entered the room in a frenzy. The man had his hand wrapped in a bloody towel. He had taken off two of his fingers with a circular saw as he was building kitchen cupboards. The nurse put on a temporary dressing on his wound and told him to take a seat. Soon he was being attended to by a physician.

Sick people came in, others left, tired of waiting. I wished I could smoke a cigarette but I was in no condition to indulge in my favourite pastime. Finally, I dozed off and dreamt of drowning: I woke up painfully choking on my phlegm. I was feeling dizzy from the fever.

Around 3:00 PM, I was called into an examination room. A nurse gave me a hospital gown to put on and asked me to wait. When the doctor came in 15 minutes later, I explained that I thought I had pneumonia and she proceeded to examine me in the same way the walk-in clinic doctor had several hours before. Then she asked me to lie on my side and left the room.

As I was facing the wall in a daze, I heard the door of the observation room open and close followed by the characteristic snapping sound of latex gloves being put on. Then I felt somebody trying to pull down my underpants. Startled and confused, I quickly rolled onto my back to find a surprised young nurse dressed in scrubs with her hand caught between my bottom and the gurney I was lying on.

– Excuse me, but what exactly are you trying to do? I said.

– I need to take a stool sample, she replied, flustered. Please let go of my arm.

– I’m afraid you have the wrong room, I said, lifting my behind to free her hand. My bowels are just fine, It’s my lungs that are causing me grief. I will gladly give you a mucus sample instead if you want, I replied snarkily

– No, I need a stool sample, she said, missing the irony. It’s a standard procedure. We have to take one from all patients to have it checked for harmful bacteria. Now, please, turn on your side and let me do my work.

I cringed as she uncomfortably probed me with a plastic tool. Having bacteria potentially lodged deep in my rectum threatening the outside world did not make me feel any more dignified.

John G. Bourke (1843-1896) in Scatalogical Rites of All Nations, explains that ancient Romans worshipped Cloacina, goddess of the sewers. In the above illustration, Roman priests and their acolytes prepare to take a stool sample from a woman as an offering to their deity.

Finally, the doctor came back and told me x-rays would have to be taken. I was to get dressed and go back to the waiting room.

Two hours later I was called to the radiology room, three floors up and hidden in a maze of cluttered hallways.

I put on another hospital gown and a technician asked me to stand still against an upright table. He then rolled the x-ray machine close to my chest. The machine whirred, clanged and banged while it was taking pictures of my innards. After a few minutes of this, one of the attendants said I could get dressed and go back to the emergency ward’s waiting room. Despite feeling disoriented from the fever, I managed to find my way back to the anteroom of the hospital.

Dozing on and off, I waited for another 90 minutes before I was called back to the observation room. The doctor told me the x-rays were positive: I had pneumonia. She wrote a prescription for antibiotics and sent me away telling me to take a 10-day leave from work.

After having my prescription filled at the drugstore, I laid in bed at home considering the 12 hours I just spent among the sick, the injured and those commissioned to care for them. It seemed a long time to have somebody qualified telling me what I knew all along.

Ultimately I fell into a nightmare-filled sleep. I was standing half naked in front of a fingerless man who was holding an insect repellent vaporizer and asking me to spread my buttocks while a group of doctors and nurses observed the procedure smilingly nodding their approval.

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Cannabis in Canada

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Version française

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People often come to me and ask me all kinds of questions, assuming I know the answers. I must confess that when I don’t have one (which is often) I make one up, just to please my enquirers.

Strangely, the question that I’m asked most often is: “Why is cannabis illegal in Canada?” This one is tough, I had to go back 50 years or so in history to come up with an answer.

In the 60’s, when the United States of America was at war against the ferocious enemy that was Vietnam, many young men dodged the draft because they were not allowed to smoke cannabis while enlisted. Some of these people fled to Canada for protection and to quietly engage in their psychoactive hobby.

Unfortunately, at that time cannabis was not yet growing in Canada. Its closest cousin was some low-grade hemp, good enough to make ropes to hang people with – pretty useless in a country that had just abolished death penalty. American people are smart and known internationally for their entrepreneurship, so it is not surprising that these young American deserters imported seeds to grow their favourite crop.

A healthy cannabis crop in the great Canadian outdoors. The cannabis plant came to America from Eastern and Central Asia. The seeds were probably carried over by sea currents or the wind.

The summer of 67 was sunny, warm and humid: ideal conditions for pollination. Cannabis started to spread quickly in the great Canadian outdoors, so much that it became an invasive species.

Canadians are simple, hard-working people but they are not idiots. They soon realized the benefits of this new plant and began growing and using it.

Alas! Cannabis was growing so well in the rich and fertile Canadian country soil that it rapidly exceeded the needs of Canadian consumers. Regrettably, cannabis growers – who, like all farmers, hate any form of waste – started looking for external markets to get rid of their surplus.

This is how cannabis cultivation became what it is today, a flourishing export industry that would significantly contribute to Canada’s gross domestic product (GDP) if only it was not a more or less underground activity.

Every year on April 20, thousands of demonstrators gather on Parliament Hill in Ottawa to openly indulge in cannabis smoking. The smoke and smell from this activity can linger for days. This in a city where it is illegal to smoke cigarettes in a public park. I never thought I would live to see that.

Of course, Federal departments dream of legalizing this economic activity to increase tax and royalties revenues. However, few people know that since taxes were introduced in Canada, the Prime Minister goes to bed each night weeping for Canadian taxpayers who work so hard only to remit more than half of their income in municipal, provincial, federal and sales taxes. You understand that Canadian statesmen cringe at the mere idea of collecting or introducing new taxes.

As well, the machinery of Government is awkward and costly. To regulate cannabis trade, more civil servants would need to be hired to manage the new program, implement complex administrative structures and develop strict monitoring and enforcement. A real nightmare.

By keeping the status quo, the Canadian Government avoids all kinds of hassle and the income from this product is able to circulate freely within the Canadian economy. Also, all durable and semi-durable commodities and real estate purchased thanks to the gains of this industry are already taxable. Of course this economic activity is impossible to monitor through the System of National Accounts, but maybe it is a lesser evil.

So this is why even though weed grows like weeds in Canada, it is still illegal to farm and use.

The true story probably has nothing to do with the one I just told but mine could make sense and it is entertaining, don’t you think?

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Electronic Smoking

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Version française

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Back in 1980, a friend of mine went to France for three weeks to pick grapes. She returned a year and a half later after having travelled throughout Europe and the Mediterranean.

On Friday nights she would come over to visit me and we would play Scrabble and cribbage for hours on end while drinking wine and coffee.

Those are good memories.

One night as we were opening a third bottle of wine, my friend, whom I had never seen smoking, took out of her purse a pack of Egyptian cigarettes which she had brought back from her travels, and lit up a cigarette. I was not a smoker, however for fun I asked her to give me one. I was 25 years old and this was my first smoking experience. I enjoyed it so much that a month later I was smoking a pack a day.

I like the smell and the taste of tobacco. It reminds me of my grandfather who smoked Canadian tobacco that he purchased from farmers. It reminds me of my father, who before my parents’ divorce, when I was a child, would send me to the store to buy Sportsman cigarettes for him.

I like the gestures that come with smoking: opening a pack, taking a cigarette out, lighting it up while protecting the flame of the lighter or the match from the wind, holding a cigarette between my fingers, feeling the cigarette dangling from my lips, deeply breathing in the smoke and enjoying the taste of tobacco.

These feelings are irreplaceable.

At university, I had a non-smoking girlfriend who, when she woke up before me in the morning, would light one of my cigarettes and place it between my lips to awaken me. This is one of the most sensual memories of my youth.

Everybody smoked back then; it was the quintessential social activity. We shared cigarettes to get acquainted, to make a conversation last, to prolong an evening, to muster up courage at work. And drinking coffee or alcohol without smoking is just not the same thing.

In Jim Jarmusch’s excellent movie, Coffee and Cigarettes, Tom Waits manages to convince Iggy Pop that the beauty of quitting is that then you can have a cigarette, because you quit...

Everything is different now. First, governments implemented regulations to make cigarette packages less attractive. Then, they raised the price of tobacco products by applying whopping regressive taxes that sparked contraband and created a new underground cigarette manufacturing industry.

At work, employees were first relegated to smoking in badly ventilated rooms, then forced to smoke outside 30 feet away from the doors. The most basic principles of hospitality and health were ignored. Patrons of bars and restaurants would be subjected to the same predicament a few years later.

Which is the biggest threat? Catching cancer after decades of smoking or catching pneumonia after a few days or weeks of smoking outside in -30 temperatures?

To spare myself from having to smoke outside during the harsh Canadian winter, I decided to try switching to electronic cigarettes.

Electronic cigarettes, or e-cigs, were patented in the United States in the early 1960’s. At that time, the negative effects of smoking were not generally recognized so the product was a marketing failure.

An e-cig is about the same size and the same weight as a pen. Its components are an LED light to indicate when it is activated, a battery with the relevant electronic circuitry, a vaporizer and a cartridge containing a liquid that produces the taste and mist.

E-cigs are activated by inhaling from a hole at the end of the cartridge containing a liquid after it is screwed to the rest of the contraption.

This liquid contains propylene glycol or glycerin. These chemicals are often found in atomizers used to produce relief from asthma. It also contains food additives or nicotine although the importing of nicotine-based e-cigs is not authorized in Canada. Otherwise, it is fairly easy to find non-nicotine e-cigs.

I spent 10 dollars for a food additive-based e-cig that was supposed to provide me with the same enjoyment I would get from smoking two packs of regular cigarettes.

Unfortunately it was not to be.

While this e-cig gave me the impression that I was smoking “for real”, I was disappointed by the taste and smell of the cigarette. The device produces a sweet, herbal odour and taste that reminded me somewhat of the mixture hookah pipe smokers use: you know, the herbal stuff that tastes like apples or jasmine. I was never fond of flavoured tobacco; I prefer a strong bitter taste.

I also found the weight and size of the e-cig uncomfortable. It is impossible to let the cigarette hang from your lips because it is too heavy. Its length makes it awkward to handle.

Finally, the electronic cigarette produces a “smoke” that is really only a mist. It results from the evaporation of the liquid from the heated cartridge. In public, that mist is conspicuous and it might annoy oversensitive non-smokers or former smokers.

Since we are constantly bombarded with anti-smoking messages, it is hard not to be aware of the negative effects of this habit on the heart and the lungs. However, I am of those who believe that there are two sides to every coin. To every Romulus there is a Remus; to each Cain there is an Abel. If smoking is still popular despite the huge deployment of efforts to eradicate it, tobacco must have some benefits, benefits strong enough to resist advertising campaigns heavily subsidized by governments, the medical profession and the pharmaceutical industry.

Maybe we could learn some useful insight into the virtues of smoking from the Natives in America if we cared to listen...

In Canada, an often disgusting photo and a threatening warning about the danger of smoking must be displayed on half the surface of a pack of cigarettes. On the side of a package is a list of toxic products it contains. This kind of warning is likely to appear someday on restaurant menus, entrances to public buildings, cars, etc. Because, let’s face it, about everything we ingest, every location we visit, all consumer products we use and all of our activities constitute a health hazard of some kind.

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The Tax Collector

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Version française

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That morning when Matthew got up to go to work, there was a gutted pig on his porch.

Disgusted at the sight of the carcass, Matthew called his servant and asked him to remove it and to clean the porch. Then he went to the stable to get his donkey.

In the alley leading to the livery, someone on the upper floor of a neighbouring house threw the contents of a chamber pot out the window. Matthew stepped away just in time to avoid being covered with excrement. When he looked up to see who did that there was, of course, nobody there.

He could hear his donkey braying in its stall: somebody had painted the donkey green during the night.

Passersby laughed at him as he headed to work on his green donkey.

The donkey is known for his laziness and stubbornness. However, it is a more economical way to travel than by camel or by horse.

How he hated his job as a tax collector! Even though the pay was good, it was a permanent position and there were benefits, the contempt and disapproval from his fellow citizens were hard to take.

Since the beginning of time taxation has never been popular. Nobody enjoys paying taxes and everybody believes, whether it is true or not, that state finances are badly managed and that taxes profit the government and the rulers of the country.

The Taxation Office had assigned Matthew to Capernaum, on the shore of Lake Tiberias. The Jews kept calling the lake “Sea of Galillee” not wanting to recognize the authority of Tiberius, the Emperor of the Roman invaders. However Matthew did not work for the Romans: he was a public servant for the Governor, Herod Antipas, a Jew who was raised and educated in Rome.

Herod was praised by some for the great infrastructure works he oversaw and paid for with tax money. Others hated him because they saw him as the Romans’ puppet and as a man of loose morals.

Matthew arrived at work and tied up the donkey behind the building in the shade, and checked that there was enough water in the trough so the animal could drink when the sun was high.

He then entered his office, mentally preparing himself to meet merchants and traders who would shamelessly lie about their income and sales, and then, as soon as he threatened them with a tax audit, would end up begging without dignity.

At lunch time, Matthew left to get his donkey and have lunch under a palm tree before taking a nap.

The animal was lying on its side, still tied up, dead. Somebody had poisoned the water.

Appalled, Matthew stared at the animal’s corpse. He could not believe how cruel people were. He was not looking forward to walking, from now on, once a week, the six miles between Capernaum and Tiberias, the region’s capital, where he had to submit his report to the head office.

In Hebrew, Capernaum means “town of comfort”. However Matthew saw no comfort when he looked around at the customs office, the market with its tables crumbling under the weight of goods and produce, the warehouses bursting at the seams with merchandise waiting to be delivered by caravan or by boat to other towns, other countries.

He looked at the barracks where lodged the Roman soldiers responsible for keeping the peace in town. He knew that they would laugh at him if he reported the death of his donkey and that he would never be compensated.

He saw the inn and decided to have a pitcher of wine.

Smoke from hookah pipes filled the room. The patrons gave Matthew dirty looks as he came in. There was a free spot in a corner near a table where Simon, Andrew, James and John, local fishermen, were talking with a stranger.

The hookah pipe is a water pipe that was invented in India. It is very popular in the Middle East. It is mainly used to smoke flavoured tobacco but also other substances.

The innkeeper slammed the wine pitcher on the table where Matthew was sitting, his face in his hands, crying silently. Matthew poured a glass and, as he was about to drink, he noticed the stranger sitting with the fishermen looking kindly at him.

The way the man was looking at him troubled him and when the stranger asked “Tough day at work?” he could not hold back and started to cry again. The stranger rose and came and sat at Matthew’s table.

The stranger said his name was Yeshua. For whatever reason, Matthew felt safe and told him about the string of bad luck that had befallen him that day.

Yeshua quietly listened to him then said:

– We all have our cross to bear, myself maybe a little more than others. Follow me. Together we will wander on the dusty roads of Galillee. We will eat whatever food people give us and we will sleep in the fields to wake up in the morning drenched with dew. Some day after I am dead, you will write about all that you saw and heard. Then, you will go to Ethiopia where you will be stoned to death by the King’s soldiers for exposing his debauchery. I am sorry; there is nothing more I can do to help. Are you interested?

The Gospel of Saint Matthew recalls the years Matthew, patron saint of tax collectors, accountants and tax lawyers, spent with Jesus. However the account does not say much about how he became an apostle, that’s why Straight from the Bowels is gladly filling the blanks.

Was it the wine? Was it despair? Whatever it was, Matthew thought that the idea of becoming a vagrant and living a life of adventure was better than remaining a taxman.

In a second, his mind was made up.

When Matthew and Yeshua left the inn, Simon whispered to Andrew:

– I told you it would work! We still have some green paint left over. Let’s try again with someone else’s donkey tonight!

Andrew replied:

– All right! Let’s try with Judas, the moron working at the currency exchange who always complains that he is 30 silver coins short!

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