PRESENT TENSE
Chapter Thirty-Five

Jack walked slowly into the Masline Mental Health Clinic, hoping that no one other than Rose would recognize him. He had tried to disguise his appearance with sunglasses and a baseball cap, but he still worried that someone would recognize him and tell others that he had been there.

He had called his boss that morning and told him that he was still too sick to work. Messner had sighed and suggested, not-so-subtly, that he see a doctor. Jack had decided to do just that, but he was growing tired of people telling him that over and over.

He walked up to the front desk, looking around to see if anyone was watching him. Only a few other people were in the waiting room at the moment, and most ignored him, except for a little girl who stared at him before going back to her coloring book. He wondered if he looked bad enough to scare a child.

Rose was sitting at the front desk, typing something into the computer. She glanced up as he approached and gave him a reassuring look, but spoke as thought she didn’t know him.

"Can I help you?"

"Yes. I...uh...I’m kind of having a...uh...crisis, I think it’s called."

Rose nodded, suppressing a smile. He really wanted to keep a low profile.

"Here. Fill out these forms," she told him, handing him a stack of papers and a pen. "There’s clipboards over there. Oh, and before you do that, I’ll need you to sign in."

Jack looked a little alarmed. He hadn’t expected to have to sign in, where other people might see his name. Rose saw his look and whispered, "Use an alias," before handing him the sign-in sheet.

He thought quickly, then wrote down the first name that occurred to him—Jacob DeWitt. It was close enough to his name that he wouldn’t forget it. He only hoped that Rose wouldn’t be too upset with him for borrowing part of her name.

Rose raised an eyebrow at his alias, but didn’t comment. She just pushed the papers through the window. "All right, Jacob, fill out these forms. Bring them back when you’re done, and I’ll call someone to talk to you."

"Okay." Jack took the forms and a clipboard and sat down to fill them out.

There was an incredible amount of paperwork, especially for someone having a crisis. He wondered what they would do if someone came in openly threatening suicide or homicide. Hopefully they wouldn’t ask them to fill out paperwork first, but one could never tell with government run services. They seemed to have a great fondness for paperwork.

He looked over the forms. One asked about his drug use history, another about his financial situation, a third about his contact information, and the last about his personal and family medical history.

He filled out the contact information sheet first, using his pseudonym, along with his real address and telephone number. He listed Rose as his emergency contact, since she was the only one who knew his alias.

The drug use information paper asked about his use of all substances considered to be drugs, both legal and illegal. It didn’t take him long to fill that out. The only drug he had ever used illegally was tobacco, since he had smoked as a teenager, but he had quit after he was sent to juvenile hall. As to any other habit-forming substances, he had only used alcohol, and that only occasionally. He had also had a couple of doses of morphine in the hospital, but had been taken off of it before he could become addicted. The only other medicines he had used were prescription medications when he was sick, the occasional over-the-counter painkiller or cold medicine, and the herbs Rose had given him.

The financial form asked about his monthly income, how many dependents he had, and how many court-ordered expenses he had, such as alimony or child support. He had what he thought to be a reasonably good income, approximately eighteen hundred dollars a month, at least for someone who had no dependents other than himself. He had no court-ordered expenses, either, as he had never been married, had no children, and had managed to avoid going into debt.

The medical history form was the hardest to fill out. He knew most of his own history—he had rarely been ill prior to his injuries following the earthquake, and the only notable illnesses he had had as a child were a case of measles when he was nine, a new strain that he had not yet been vaccinated against, and a case of hypothermia at age twelve, caused by falling through thin ice on Lake Wissota, near to where he had grown up. The problem was that he didn’t know as much about his parents’ medical history. It had never occurred to him to ask them about such things, and he had no idea how to obtain the information now. He knew that his father had been near-sighted, and that his mother had been unable to bear anymore children after he was born, but he didn’t know anything else. They had both been healthy when they died. It was the fire that had killed them, not any disease.

He thought about that for a moment as he brought the completed forms up to the front desk. It had been just over seven years since they had died. The fire had been started by some illegal fireworks that a neighbor had been setting off just before midnight on the Fourth of July. Some sparks had flown into a pine tree next to the house, and the fire had taken hold and spread before anyone could stop it. Jack had been downstairs, rummaging through the refrigerator, and been able to escape through the kitchen window, but his parents had been upstairs sleeping, and they had been trapped. The dry, brittle wood of the old house had gone up so fast that nothing could be done. He had tried to go back inside to see if he could find them, but the firefighters had restrained him, knowing that there was nothing he could do. By the time the fire had been put out, they were gone.

He handed the papers back through the window to Rose. She glanced over them, them placed them upside down on the desk. "I’ll call Gabriela for you. She’s on duty this morning. Just have a seat."

He nodded and returned to his seat, looking around the room at the few clients, the box of outdated magazines that were expected to distract people kept waiting, and the television in one corner, which was showing some old animated movie. None of it interested him. He shuffled his feet impatiently, wondering what could be taking so long.

Finally, after about twenty minutes, a heavy-set, middle-aged Hispanic woman opened the door and called for him.

"Jacob?"

It took Jack a moment to remember that she was referring to him. He got up and walked over to her, pulling his baseball cap lower over his face.

"I’m Gabriela," she told him, gesturing for him to come through the door. "Why don’t you come back here with me?"

Jack followed her to an office at the end of the hall. They stepped inside, Gabriela closing the door behind her. "Have a seat," she told him, gesturing to a chair beside the desk.

Jack sat down, wondering what was going to happen. He had never been to any kind of psychiatric clinic before, and had little idea of what to expect.

She looked over the forms he had filled out, reading them over. "Jacob DeWitt. You were born June 19, 1981?"

He nodded. "Right."

She read further, looking over his financial information, his medical history, and his contact information, raising an eyebrow at Rose’s name on the form. She looked over the drug use form, and then returned her attention to the medical form.

"You suffered a head injury recently?"

"Yes. My girlfriend thinks it might be why I’ve been acting so strange. She’s the one who suggested I come here."

"Have you seen a regular doctor?"

"I was in the hospital for a month following the injury. I got hit on the head with a piece of concrete from an earthquake-damaged building."

"And did they think you were healing?"

"Yes, but they might have been wrong. Sometimes that happens."

"I would suggest that you see a regular doctor, in addition to coming here."

"I will." He sighed.

"I take it you’ve heard that before?"

"Yeah. Four times, now. I’ll go see a regular doctor. Please don’t tell me again."

"All right." She looked at the form again. "You also got shot, and broke your leg, at around the same time."

"Uh-huh. My girlfriend’s ex-fiancé shot me in the back."

"How did you feel about that?"

Jack looked at her like she’d lost her mind. "I hate that fucking bastard—even more than I did before he shot me. After what he did to her…” He stopped. “Never mind. If she wants you to know, she’ll tell you. As to being shot, it hurt like hell, and I was in a coma for three days after I got the head injury, which wouldn’t have happened if he hadn’t shot me."

Gabriela looked a bit confused. "I’m not sure I see the connection."

"Maybe I should just try to explain everything from the beginning."

She nodded. "Go ahead."

He took a deep breath, then explained about how Rose had broken things off with Cal, and how Cal had subsequently framed him for the theft of the Rose’s engagement ring. He went on to tell her that he had broken out of jail, leaving out Rose’s part in it and saying only that he had met her downtown, then told her how they had confronted Cal on their way back through town, ending with the shooting. He told her about how they had been trapped in the collapsed buildings, how he had been injured, and the problems that had developed after the injury.

"It sounds like you’ve had a lot of stress these past couple of months."

"Yeah, but I don’t think I’m supposed to react to it this way. Getting so upset over things is stupid—"

"It’s not stupid if it means something to you."

He looked at her disbelievingly. “I lost my parents in a fire seven years ago and I didn’t react this way. Of course, I wasn’t hurt in the fire, but still…”

"There’s also a possibility that your head injury may be causing this erratic behavior. There’s a condition called post-concussion syndrome that can cause odd behavior following a head injury. It’s also possible that you may have had some complications that the doctor didn’t catch."

"I have been sick. I had a seizure last night."

"Did you go to the emergency room?"

"No. One of my roommates is a nurse, and she said that I was okay after I came out of it."

“If it happens again, go to the emergency room.”

“It’s too expensive.”

“Which is more important—your money or your life? People have died from seizures. Your roommate may be a nurse, but you need to see a doctor if you have another seizure.”

“I think I’ve had two, actually. I didn’t die from either one…obviously.”

Gabriela sighed. “I can’t force you to seek medical care if you have a seizure, but that is what I recommend. All right? Now, let’s move on. You’ve also had some legal trouble."

"It wasn’t the first time, either. I spent eight months in juvenile hall."

Gabriela nodded, making a note of that. "You seem to be putting a lot of emphasis on the earthquake. Did you lose anyone, or wind up homeless for a time following it?"

"My home came through it okay, but I lost two friends, including my best friend. We’d been through everything together the past couple of years, and...it was kind of hard to deal with him dying all of a sudden."

She nodded sympathetically. "You also said that your parents are deceased. Do you have any other family?"

He shrugged. "Just an uncle and some cousins in Wisconsin. I haven’t seen them in years, and my uncle can’t stand me. Once in a while I get an e-mail from my cousin Emmaline, but that’s it."

She put the papers in a folder. "Jacob, I’m going to set you up for an appointment with one of the psychiatrists. I also want you to meet with me again in about two weeks. Can you do that?"

He hesitated, still not sure this was a good idea. "I can try. I need to work, though."

"There’s another therapist, Ted, who works weekends. There’s also two psychiatrists who work weekends. Would that work out a little better?"

"I think so." He shrugged. "I’ll give it a try."

As they got up to leave, Jack had one more comment for her. "Please don’t repeat anything I’ve said to Rose."

"I won’t say anything, though there’s no guarantee she won’t read your chart."

He sighed, reminding himself to be careful what he said about her. "I guess that’s a risk I’ll have to take. She might not like me repeating some stuff, but if it doesn’t get out, she probably won’t be too upset." He followed her out to the waiting room.

Gabriela went to the front desk and asked the woman working there, Maggie, to schedule two appointments for him, one with Ted for two weeks and one with Dr. Lobb, one of the psychiatrists, for the coming Saturday.

After they had given him his appointment cards, Jack hurried out, wanting to leave as soon as he could. He had just stepped out the door and headed for his car when he saw Rose walking from the fast food restaurant next door, a bag in her hand.

She saw him and gestured to him to follow her around the building, where they could talk in private.

"How did it go?" she asked him, leaning against the wall and opening the bag.

Jack stepped away from her, trying to avoid the smell of food. "Okay, I guess. I talked to the counselor, and she set me up with appointments with a therapist and one of the psychiatrists."

"Which ones?"

He consulted the cards. "The therapist is Ted, who works on Saturdays."

Rose nodded. "Ted is good. He has a lot of compassion. Who’s the psychiatrist?"

"Dr. Lobb."

She grimaced. "I wish you luck. He thinks he’s God."

"Great."

"Just try to ignore his ego. He makes Cal look humble."

"Just what I need."

Rose closed the bag. The smell of food was giving him a distinctly sick look. "Have you made an appointment with a doctor yet?"

"Yeah. Someone at the Southland Medical Center—which is where I’ll go once I’ve worked long enough to earn health insurance—had an opening today, so I have an appointment at three."

"That’s good. I hope you feel better soon."

"You’re not the only one."

*****

Jack walked slowly into the waiting room at the Southland Medical Center, making his way around a man in a wheelchair who was blocking the corridor. There were a few people there, but the waiting room was not overly crowded in mid-afternoon.

It was only about a ten-minute wait before the nurse called him into the office. She took his weight, which had fallen alarming low for someone as tall as him—he was down to one hundred and ten pounds. His blood pressure was also high—one fifty over ninety, which was mildly elevated, possibly as a result of the stress he had been under. In addition, his pulse rate was higher than it should have been—ninety beats a minute.

The doctor came in a few minutes later. "Hello…Jack. What seems to be the problem?" he asked, glancing at his chart.

"I’m sick," he told him. "I have persistent headaches, I can’t keep much food down, I feel nauseous all the time, and I had a seizure last night."

"Well, let’s see if I can find out what the problem is." The doctor performed the usual examination, checking Jack’s heart, lungs, and throat, then gestured to his bandaged wrist. "What happened there?"

"I cut one of my wrists yesterday."

The doctor looked a bit shocked, but proceeded to unwrap the bandage and check on the wound. "There doesn’t appear to be any sign of infection."

"I’ve been trying to keep it clean. I…uh…I’m a cutter sometimes."

The doctor looked at him, noting the lack of scars. Jack saw the look and gritted his teeth, trying to decide whether or not to tell the truth.

“Okay, fine. I admit it. I’m not a cutter. I tried to commit suicide yesterday…but I changed my mind. I went to see a psychiatrist this morning, so you don’t need to lock me up or anything.”

"A 51-50 hold.”

“Right…that’s what my girlfriend called it.”

“As long as you’re not actively suicidal, there’s no need to commit you.”

The doctor pulled out a small flashlight and peered into Jack’s eyes, then began examining the rest of his head. "Where do the headaches start?"

"Right here." Jack pointed to the spot. "Right where I got that skull fracture."

He began examining the spot, his fingers probing. Jack jerked his head away as pain exploded through it, a wave of nausea washing over him.

"Hold still—"

"I think I’m going to be sick," Jack told him, clapping a hand over his mouth. The doctor grabbed an emesis basin and held it out to him.

Afterwards, Jack sat holding his head, trying to stop it from pounding. The doctor gave him a paper cup of water to rinse his mouth out with, then picked up his chart.

"That skull fracture didn’t heal very well," he told him. "I’m going to refer you to the neurologist, Dr. Kordel. I think your illness may be related to your head injury. Wait here a moment, while I call to set up an appointment."

Jack sat quietly, waiting, hoping desperately that they would soon figure out what the problem was and find a treatment. If the problem wasn’t found and treated soon, it would kill him.

*****

The following Monday, Jack went into Dr. Kordel’s office at eight o’clock. He had told his roommates what was going on and had talked to Rose in more detail, but he still didn’t know for sure what was happening. He was still sick, and was only getting worse. He was able to sleep at night now, mainly because he didn’t have the strength to stay awake. He also spent a good portion of the day sleeping if he could. He had had another seizure yesterday, which had scared Rose more than it had scared him, and had slept for hours afterward, refusing to even consider going to the emergency room. His strength was failing fast. He didn’t know how much longer he could keep going. He struggled through each day, and it was only Rose’s care and concern that kept him from giving up entirely.

Dr. Kordel examined the skull fracture, then took X-rays and ran a CAT scan. When the tests were done, he called Jack back into his office to give him the diagnosis.

Showing Jack the test results, he told him, "You have a subdural hematoma brought on by a bone fragment that punctured an artery."

“What?” Jack looked at him in confusion, not understanding the medical terminology.

"It means you have a blood clot pressing against your brain, causing the personality changes, the headaches, and the nausea. The skull fracture never healed completely, contributing to the problem."

"Can it be treated?"

"Yes."

"How?"

"In most cases, certain drugs would be administered that would cause the brain to reabsorb the blood, or a needle would be inserted to remove the clot. However, in your case, the problem was caused by the bone fragment piercing the artery, causing a slow leakage of blood. The fragment itself is blocking most of the puncture, but your blood pressure is high and it appears that blood is still leaking. The fragment needs to be removed and the artery repaired, as well as removing the blood clot."

"So how is it going to be treated?"

"I recommend surgery, as soon as possible."

"Brain surgery!?" Jack stared at him, his eyes wide.

"That’s the only viable treatment."

"Is it really that bad? Couldn’t those medicines help?"

"If I thought that it was only the hematoma causing the problem, I wouldn’t hesitate to go the easier route. However, with that bone fragment embedded in the artery, it’s only a matter of time before it is either dislodged or the damaged artery bursts from the strain. Either way, you’re likely to have a debilitating or fatal stroke."

Jack sat there for a moment, stunned by the news. "How much chance of a stroke? And how soon?"

"I would say about a ninety percent chance within the next month. The sooner you go in for surgery, the better."

"What’s the risk from the surgery?"

"You have about a seventy-five percent chance of surviving, with some risk of further brain damage."

"Am I in good enough health for this?"

"Quite frankly, no. But this is a very dangerous situation. I don’t really see that you have much of a choice if you want to survive."

Jack sat for a moment, weighing the risks. He was in poor health, and he knew it. But if there was any chance he would get better, he was willing to take it. "All right. How soon?"

"I’ll call Memorial Hospital right now and find out how soon you can be fitted in."

Jack sat quietly, half-listening to the doctor. He had to admit that the prospect of brain surgery, of the possibility of further damage, scared him. He’d had so much trouble over the past couple of months that he didn’t know if he could take anymore. But he couldn’t bring himself to give up and let fate take its course. The same strength that had kept him going over the years, the strength that had allowed him to let Rose save his life, wouldn’t let him give up now. In spite of everything, deep down inside he wanted to live.

Dr. Kordel hung up the phone and wrote something down on a card. "I have you scheduled to come into Memorial Hospital on Friday morning at six o’clock."

"This Friday?"

"This Friday. The procedure will probably take six to eight hours."

"How long will I have to stay in the hospital?"

"A minimum of three weeks, depending upon how well you come through it."

Jack was silent a moment, thinking. "All right. I just hope that my boss will understand."

"You’ll probably be eligible for disability while you’re not working, and since it is an earthquake-related injury, the cost of your medical care will probably be covered by the state."

"I hope so. I don’t know if I can afford this, especially if I lose my job."

"If your employer fires you for taking necessary time off for medical purposes, you may be able to sue."

"I’d rather not, if I can avoid it." Jack stood, tucking the card into his pocket.

"Good luck."

"Thanks." Jack left the office, hoping that this time everything would turn out all right.

Chapter Thirty-Six
Stories