don’t remember,” Mrs. Pearl said.
“That’s okay. We don’t need to remember everything. I’m Dr. Fury. Do you know why you’re here?”
Anna studied her patient’s chart. Edith Pearl had been suffering from chronic kidney failure for two years. Her treatment consisted of dialysis three times a week and a strict diet protocol, by which Mrs. Pearl was clearly not abiding.
“The same reason I’m always here,” Mrs. Pearl said in a whisper.
Anna found herself speaking in hushed tones, as if her voice could shatter another’s. “You had excess fluid buildup and we needed to do dialysis. This was only twenty-four hours after your previous dialysis. Have you been keeping track of your fluid intake?”
“I used to drink four cups of coffee a day. Then water or soda, and then a cocktail before dinner. Now you tell me to chew on ice chips and eat food that has no flavor. I can live without the food, I guess . . . I was playing bridge with my girlfriends, and Lucy made the most delicious lemonade, and I drank a glass and then another glass.”
“Unfortunately,” Anna said, “you can’t do that anymore. If too much fluid builds up in your body, it stresses your heart and makes it hard for you to breathe.”
“I know.”
“I have to remind you.”
“What if I wanted to stop?” Mrs. Pearl asked.
“Stop dialysis?” Anna asked.
“Yes.”
“Have you talked to your family about this?”
“This is my decision, right?”
“It is. But you should talk to your family.”
“What would happen if I stopped treatment?”
“Toxins would build up. That would cause problems with your heart rhythm.”
“And then I would die?”
“Yes.”
“How long would it take?”
“Not very long. A week. Maybe less.”
“Would it hurt?”
“The pain could be managed.”
Mrs. Pearl diverted her attention to her failing manicure. “Would you look at this?” she said, pointing out a chip in the cotton-candy-pink polish. “I just had them done three days ago.”
“They still look nice,” Anna said.
“What would you do?” Mrs. Pearl asked, her voice eggshell thin.
“I don’t know,” Anna said. Lying.
“How do you make a decision like that?”
“It’s a difficult decision.”
“I’m always thirsty.”
“I understand,” Anna said.
TO : Anna Fury
FROM : Kate Smirnoff
RE : Bloodletting
I’ve been reading about this phlebotomy business. What I don’t get is how a procedure that was practiced for three thousand years could have no palliative advantages. So far, I can find none. Sure, I get that the early bloodletting was a crazy religious practice at first and then that it was used to restore the balance of bodily humors. I’m sure you had to be there for that to make sense. But when men of science, capable of some deductive reasoning, got involved, how come they didn’t notice that draining someone’s blood never made him feel any better? The only use for it that makes sense to me is, say, if there was an area that was swollen. I guess if I knew nothing about the human body and was practicing medicine in ancient times, I might find a logical reason to let blood out of a swollen body part. I suppose it’s not that different from lancing a boil.
You know what else is really funny? That barbers were surgeons way back when. Did you know that the red-and-white barbershop signpost was also the sign for a surgeon? I’m sure they teach all that crap in medical school. Even now, a barber must have steady hands and is trusted with a very sharp blade. If I were a man, I’d never let a barber give me a straight-razor shave. I always hate that procedure when I see it in movies. You’d think there’d be more barbershop murders than there are.
How are you doing? And please let me know if you can think of any condition in which bloodletting made sense.
Kate
TO : Kate Smirnoff
FROM : Anna Fury
RE : Bloodletting
Hi. Your new obsession is intriguingly macabre. Most ancient medicinal