The Divine Elbow
Houston, Texas, USA
were a sickly off-white color and the worn tile floor waxed and shiny yet still
appeared dirty, the fresh wax not able to hide its scars, but it was the
oppressive smell that oppressed him the most. A mixture of sickness, medicine,
body odor and over-used cleaning products had created a pungency in the
hospital's stagnant air. Made him impatient. Didn't matter though. If it was
one thing he was good at it was ignoring unpleasantness. He had been doing that
for nearly 50 years.
"Mr. Noble?" The doctor was one of
the few he had found who had any idea of what my symptoms meant. It was the
sixth doctor he'd seen.
Just wanted his medication so he could leave. In this day and age there was a
cure for everything.
the last round of tests we've been able to pinpoint the problem." It was the
doctor's eyes that made him put down the surf magazine and listen. "The
inflammation and discoloration, and the stiffness and pain are the symptoms of
a rare disease called Scleroderma." Like a master Buddhist he showed no
Derma. Something to do with the skin? But what about the hardening of my
fingers and the swelling?" The doctor, whose name he had already forgotten,
is a systemic anti-immune disease that characteristically affects the hands,
arms and face."
matter what tricks of the mind or skill of ignoring employed, he knew at that
moment that this was exactly what he had. Ran his finger over an
elongated spot below the skin on his cheek that was hardened, like a long
island of semi-hard rock.
are two types and I'm rather sure, due to your shortness of breath and the
increased heart rate you have described, as well as your description of the
difference in the color of your urine and whatnot, that you have what is called
Diffuse Systemic Scleroderma. Unfortunately there are no known cures."
silence that followed was a flurry of random thoughts: Damn it there has to be
a cure! No cure? Fuck it. Carpal Tunnel yeah sure. Major elbow by God.
It means no more work. Don't have to do that bloody report. What about my
retirement fund? Can finally do what I want. I gotta live before I die.
then what's the treatment?"
then how do things play out with this? I eat more fruit and take more vitamins
and some pills and it stops?"
afraid not Mr. Noble. It will progressively worsen, affecting your major
organs. You kidneys, your lungs and your heart. The hardening of tissue will
continue." For some reason he laughed.
this isn't a case of Carpal Tunnel Syndrome?" The joke fell flat. Butterflies
attacked his stomach and could feel sweat on his forehead.
then how serious is this Derma piece?"
is fatal." He looked at my swollen hands and wrists, the bruising and little
dark bubbles that had begun to cover both hands. Straightening his hands the
knuckles and joints changed to a dull green color.
how fatal is fatal? I mean talk to me here. What the fuck do I have?" Voice
raised, jittery, an aggression emerging.
what we know, five-year survival rate is 70 percent. The ten-year survival is
mean I'm going to fucking die from this?" Noble walked to the far side of the
room, turned and glared at the doctor.
is likely you will. Whether in five or ten years, or fifteen or twenty. It is a
progressive fatal disease Mr. Noble, so it will kill you eventually. Or if
you're lucky, old age will. But the affects can be horribly debilitating and
painful." That's nice. That's really fucking nice.
I know you're a good doctor but are you sure about this?"
We're sure. I had my suspicions but from the results of the last round of
tests, this is our confirmed diagnosis. Only when we're sure would we give this
kind of news to a patient. You understand."
a clean and safe life I've lived! No. Posture straight. Strength returning.
There was no way this could be right.
what causes this Derma?"
has no known causes. It affects men and women between the ages of 30 and 50. We
don't know what triggers it."
cure. Fatal. And no treatment. Anything else?" Grabbed his bag from the chair.
would like to see you in two weeks for some pulmonary tests. When it hits the
lungs it is the most dangerous. See, your cells in these organs die off, along
with smooth muscle cells, and are replaced by collagen. Without getting too
technical, healthy cells die, harden and eventually cause organ failure."
Impassive. Indifferent. Knapsack over his shoulder. "Well then I'll see you in
two weeks." He walked out the door but turned around and went back to the
doctor to shake his hand. "Thank you doctor. Thank you for being honest and
direct." Looking deeply into his eyes, somewhere in his mind Noble knew it
would be the last time he would ever see him.