It was eight am when Cason found himself sitting in the waiting room of his clinic. In his work clothes and concrete work boots he felt out of place from the other much more polished patients waiting that morning. His refills were denied, a doctor’s visit was required. When he’d arrived for his appointment he’d been advised that his doctor had been pulled away on a family emergency and they were scheduling patients with other doctors. He’d be fitted in at some point, but they didn’t know when.
He’d asked if the nurse practitioner could just OK the refill. A resounding ‘no’ was given, there had been specific instructions that he be seen before the next refill.
Cason tried memorizing all the magazines on the wall first. Then counted the number of corners in the room before pacing to ease the sharpened stabbing in his hip that was now making his thigh go numb. It was nearly noon before he was called in. It was another half hour in the exam room, in the exposed exam gown, before the doctor came in.
“Hello Cason, I’m Doctor George Mathers. So sorry for the wait.” He said and reached forward shaking Cason’s hand.
Cason was agitated from the wait and the gnawing pain in his joint, “Sounds like it’s a big cluster fuck out there.”
Dr. Mathers chuckled as he closed the door. He was tall and thin like a marathon runner, brown hair and brown eyes, and a genuine smile. He pulled a pen from his lab coat and gestured for Cason to sit, “Feel free to sit, from your charts though, it seems you might prefer standing?”
“Alright, let’s dive in shall we? It looks like you need a refill on your meds?”
“Just the pain pills.”
“Alright, let’s have a look at you.” Dr. Mathers made small talk as he checked Cason’s vitals, and overall health. “Looks good. Despite the hip.”
“Great, three month’s supply is what Dr. Steven’s suggested last time.” Cason said getting his jeans up off the bed.
Dr. Mather’s nodded, “We’re not quite done - just yet. Tell me about your hip. Your chart says it’s shrapnel wound from your time in Afghanistan?”
“Correct.” He said letting his jeans stay.
Doctor Mathers stood and sliding an old fashioned x-ray from the packet that was his medical file put it up on the light box flipped the switch. “I see.” He said as Cason’s pelvic bone and upper right femur illuminated. “This little guy is causing the problem,” he said pointing his pen at a white spot parallel to the joint. He turned back to Cason, “Has Dr. Steven’s talked with you about your options?”
Cason thought of his ex-military doctor, “Sir, he just supplies the remedy to my problem we don’t discuss much.”
“Huh. Well, I’m a surgeon by trade, I run the cosmetic surgery clinic next door. I spent my residency and several years post residency in the trauma unit at New York General. Since then I switched careers - for my blood pressure’s sake,” He said smiling, “And moved down here. In my experience Cason, it looks like your initial surgery went well. But you’ve needed a second, and you’ve needed it for some time.”
“I’m alive, it’s all that matters.”
Doctor Mathers nodded, “Yes, that is a very good thing. But, your second surgery was necessary. Did you have one scheduled?”
Cason was quiet for a moment before answering, “It was, but I had a family obligation that required me to leave the hospital.” One that required him to sit with the Sparlings when they were told the news. Cason still remembered the pulling of the stitches and bandages along his side that day.
“I see, why don’t we get that scheduled today then? The reason I say this Cason, is that you can take pain meds for the rest of your life, but at some point that shrapnel will dig deep enough that it will finish cutting through your cartilage and will begin etching on your bone. These x-rays are from over a year ago, so that piece of metal could already be at your bone.”
Cason didn’t say that it felt like it. “That’s fine. Sir, understand that men in my crew lost their lives, a hip replacement will be nothing compared to their losses.”
Doctor Martin un-clicked his pen and slipped it back into his pocket and sighed. He turned his gaze on Cason, “I see.” He said then added after a pause, “I see that I could tell you that the procedure will be easy. An in and out the same day laproscopic procedure. I could tell you that we have payment plans if your insurance doesn’t cover it, but it sounds like you really need to hear about Joy. Joy was a girl I met one night in the trauma ward of New York General. She was from the Bronx, she’d been shot twice by stray bullets from a drive-by. They were bullets from a 45 caliber, and were specially made to shatter upon entry into a body. Lethal. When she came to us she’d lost her ability to breathe, her organs were shutting down and at one point we had to paddle her every sixty seconds to keep her heart active. I spent four hours in surgery with her and another two days later when she’d stabilized. We pumped bag after bag of blood into her and she’d just pour it out onto the table. What she didn't know, was in the next room were her baby brother, mother and father. They’d been out visiting their family and were all hit as they came down the steps of their cousin’s brownstone. I picked every last piece of metal out of her body over those two days. She eventually lived, but her family died.” Dr. Mathers paused, letting her family’s death have weight and respect in the room. After a moment he continued, “Joy, took the death of her family hard, she and I have kept in touch over the years. Patients like that leave an indelible mark on a person. She could have easily been enraged, or let guilt on her survival weigh her down, but she didn’t. She was twelve at the time when she’d been shot, by the time she was sixteen she had organized a dozen rallies against neighborhood gangs. She’s twenty-five now and this past year she’s been recruited to the lead gang task force in her ATF region. That was how she found her peace. She had her scars and carried them with her but she sought for peace. What will bring you peace Cason?”
Cason nodded, he knew what the doc was saying. Everyone had their chunk of hell, it was what you did with it that mattered. “I hear ya doc. I do. But it’s not guilt that keeps this shrapnel in my hip, I can live with it. This isn’t my hell, I don’t need peace with this.”
Doctor Mathers nodded, “OK. But think about it, because I’ll only authorize another week’s worth of refills with the recommendation to Dr. Stevens that you get surgery. Your shrapnel is a simple and easy fix to remove and you can be back on your feet in just a few days. If it hasn’t done too much damage, you should be pain free once the incision heals.”
“I’ll think about it. I doubt my insurance will cover anything from a plastic surgeon though.” He said feeling the visit was over and picked up his pants, shoving his legs in.
“Alright. Having seen your hip and this x-ray I can say positively that this will be a one day surgery. We’ll just need a prelim exam - a thorough one at my offices then schedule surgery the next day. And we have financing if you need it. I’ll send you a budgetary estimate of what it all will cost, today.”
Cason thought about his hip for the rest of the day. On his way to get the prescription filled. At work pouring and skimming concrete. He’d not taken another pill despite the visit. He wanted to feel every gouge of that piece of shrapnel.
Surgery, he thought. There was just one penance to pay, just one promise he’d made, but there was more he could do. He hated that the doc had been right. He was feeling guilty for being alive. But it was harder now that there was a honoring ceremony ahead. He didn’t feel like he should be honored. The men in his crew were to be honored - they’d given the ultimate sacrifice.
He had lied about more than the guilt to Doc Mathers, he did need peace. The pain was his medication, it distracted him from wanting that peace.
Cason worked late that night and after catching a bite and a beer with the crew headed back to Helen’s. She was still up finishing the last of the crossword… with someone.
“Hi.” Cason said announcing himself as he closed the door.
Helen turned and looked over her shoulder at him, “Oh hi Cason! How was your day? Do you need some dinner?”
“I’m good.” He said looking at the man on the couch, an older gray haired man about Helen’s age. He turned and was smiling at Cason in a fatherly way. His wire rimmed glasses made Cason think of a turn of the century doctor.
“Oh!” Helen said, “Where are my manners? Cason McPherson this is Doctor Martin Lowe. Martin this is Cason,” she gestured.
Martin came around the couch to shake Cason’s outstretched hand, “Nice to meet you,” Cason said thinking that Helen had some how heard he’d been to see Doc Mathers.
“Like wise! I’ve heard so much about you from both Helen and Sophie.”
Cason felt his eyebrows arch, maybe it wasn’t what he’d thought. “I see. Well I’ll just grab a few things and let you two get back to… your date?”
At the mention of date both Helen and Martin said, “Oh! No.”
“No. It’s not that—”
“We were just two friends catching up!”
“Yes,” Helen interjected, “I worked with Doctor Lowe for thirty years, he’s Sophie’s pediatrician, we’re just catching up.” She said smiling.
Cason felt relief that he was indeed Helen’s date but then it was followed by awkwardness. He watched their two faces go red, “Ah…”
“Helen,” Martin said to her, “It’s getting late, I’ll let you get your rest. He said going for his coat, “Cason,” He said slipping it on, “Very nice to meet you. I’m sure I’ll see you again soon.”
He waved goodbye to Helen and promised to see her the next day then headed out the door.
Cason turned back to Helen, she opened her mouth to explain and Cason just laughed, “It’s OK Mrs. Sparling no need to explain. See you in the morning.”
Cason lay awake that night, his mind a rat on it’s wheel of