An Ordinary Patient

by Lawrence Martin

drlarry437@gmail.com

Silver medal winner in Florida Writers Association’s Royal Palm Literary Awards, 2020, category Published Short Story. “An Ordinary Patient” was first published in What Just Landed in The Villages? and Other Short Fiction. https://www.amazon.com/Landed-Villages-Other-Short-Fiction-ebook/dp/B083MXDNNF/

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Dr. Katz’s Pulmonary Clinic, March 15, 2006

Dr. Jerome Katz’s last outpatient of the afternoon is Frank Reynolds, 80, a spry, alert gentleman, with crew-cut white hair, and a face wizened from years of smoking. He is short, and thin. The nurse weighed him at 130 lbs.

Mr. Reynolds was referred to the lung doctor for “evaluation of dyspnea [shortness of breath] and COPD [chronic obstructive pulmonary disease].” Almost all cases of COPD come from smoking, and Mr. Reynolds is no exception.

He is sitting on the exam table when Dr. Katz walks in. The doctor introduces himself, goes over the chief complaint and a few other items with Mr. Reynolds, then asks, “So, just how much did you smoke?”

“About one pack a day, over sixty years, I guess. Started as a kid.”

“When did you quit?”

“Oh, eight years ago, right after my heart surgery. Doctor said I had no choice.”

Mr. Reynold’s complaint is shortness of breath climbing stairs or walking for more than a few minutes, but he feels comfortable at rest. His cardiologist asked for the pulmonary consultation, stating in his referral note, “I don’t believe his dyspnea is from his heart, more likely from lung disease.”

During the history Mr. Reynolds acknowledges having some “emphysema,” which he matter-of-factly attributes to his occupation — laborer and jack-of-all-trades at the local electric company, 1951–1985.

“How about the cigarettes?” Dr. Katz asks.

“Nah, maybe. But the air at the plant was not good for you. Lots of guys came down with lung disease of one type or other.”

Dr. Katz often hears heavy smokers blame a work environment for their disease, and usually does not try to change this perception — unless, of course, they are still smoking.

“Why did you quit using the bronchodilator?”

“Ran out.”

“Did it help when you were using it?”

“Didn’t really notice much difference, Doc, to tell you the truth.”

Dr. Katz, fifty-four, is chairman of the Pulmonary Division in his hospital. He is well respected by his medical peers and a consultant for many of them. He takes a good medical history and has a genuine interest in his patients, but occasionally comes across as a little brusque. Some say he does not suffer fools gladly, an ambiguous compliment. There is also about him an air of having seen it all in years of practice. He most welcomes challenging, difficult-to-diagnose patients, and confesses to be somewhat weary of run-of-the-mill smokers with their COPD. Still, every patient gets his full attention.

After a brief physical exam, Dr. Katz decides to order pulmonary function tests. He has already viewed the chest x-ray, which shows only some minor scarring from the heart surgery.

Okay, here’s another old guy with smoking-related COPD. I’ll prescribe a long-acting steroid inhaler, get baseline PFTs, and arrange for a three-month followup. Need to finish here, make hospital rounds. Just a little more history and I’m done.

“What did you do before the electric company work?”

“Oh, I did a few odd jobs. Drove a milk truck for a while, then some labor work.”

Standing, Dr. Katz writes quickly on his clipboard, notes scribbled for a letter to the cardiologist he will later dictate. Returning his gaze to the patient, “Over what period of time, after high school?”

“Yeah, well, I went into the army right after graduation, got out at twenty-one, then did different jobs until I began work at the electric company.”

“Did you start smoking in the army?”

“Yeah, they used to give out free cigarettes. Got me hooked, I guess.”

“So if I figure correctly, that was during World War Two. What did you do in the war?”

“I was in the infantry.”

This bit of history interests the doctor. His parents emigrated from Europe after the war. They were survivors. He has studied the period. He once visited the Buchenwald concentration camp, near Weimar, Germany, where they were liberated by American troops. He knows the date: April 11, 1945. How had they survived? Whenever asked they always avoided any detail, saying only, “We were lucky. The Americans came just in time.” His parents married in 1948. He was born four years later.

“The infantry? Where?” “I was in Europe.”

“Where in Europe?”

“France. You’ve heard of D-Day?” Reynolds asks, with a twinkle in his eye.

“Yes, of course. June 6, 1944.”

“Well, I was there.”

“Where?”

“Omaha Beach.”

“You landed on Omaha Beach on D-Day?” There is a childlike incredulity in Dr. Katz’s question, as if he is interviewing someone who once landed on the moon.

“Yep. Part of the second wave. We hit the beach at seven a.m.”

“You were what, back then, eighteen?”

“Just turned nineteen the week before. Landed with the Twenty-Ninth Infantry. Almost killed, too. But we made it past the German gunners. Got out alive. Lots of my buddies didn’t.”

“You killed Germans?” What a dumb question. Sorry I asked.

“Doc, you don’t wanna know. You saw Saving Private Ryan?”

“Yes, I did. Seemed pretty realistic, the opening scenes.”

“Sanitized.” Reynolds lets out a chuckle. “Hollywood. In the movies, you don’t get the smells, the smoke. You don’t get the screaming of men you know, shot and dying.”

“Still, realistic for a movie, don’t you think?”

“Yeah, they showed some bad stuff, but then the camera moves away. Imagine eight-ten-twelve hours of those opening scenes.”

“I can’t. What you guys did was — ”

“Look, I’m no hero. I just wanted to survive. I was damn lucky in the war. I did what I had to do.”

“How long were you on the beach?”

“Two days. After we secured it, they moved us out quick.”

“Well, I’m glad you got through. Where did your outfit go after Omaha?” Dr. Katz looks down at his notes, begins writing again.

“Right through Normandy, past all those hedgerows, straight to Saint-Lô. That was fierce also.”

“Did you get to Paris?”

“Sure, on time off. After our boys and the French liberated it.”

Omaha Beach…Saint-Lô…Paris after our boys liberated it. Dr. Katz halts his note-taking, stares at the page. His mind is no longer on the chart, but on Frank Reynolds as a nineteen-year-old infantryman. On Reynolds landing in Normandy eight years before he was born. On him running through German bullets on the beach, living by chance while many of his buddies were mowed down. On this man as a teenager fighting to save the world, his world. On Frank Reynolds just being there, perhaps the most pivotal moment in world history. Dr. Katz ponders how close his parents came to not making it. I would not be here but for…

These thoughts crowd the doctor’s brain and prevent him from writing any further. He just stares at the page, pen in hand, as if he is about to write something. But he doesn’t. He pleads with himself to finish the evaluation, to break the spell cast by this elderly patient with an ordinary medical problem in an otherwise ordinary afternoon clinic. With every ounce of will, he tries to control an emotion swelling inside, but he cannot. Very soon, tears will come.

Any minute now, I feel it. I must not let him see.

He glances up, and after the briefest look at his patient, pivots so his back is to the exam table. “Excuse me, Mr. Reynolds. I’ll be right back. I have to check something in your records.”

Dr. Katz quickly exits the exam room and from the hallway enters the bathroom, thankful it is unoccupied. He locks the door.

He has avoided other clinic personnel. If co-workers did see him in the hallway, they might think he is anxious to use the toilet. But no, he is just anxious to be alone, to feel this overwhelming emotion — alone. He looks in the bathroom mirror, sees the watery flow. He makes no sound, lest someone hear him and knock on the door, to ask “Are you okay?”

He sits on the closed toilet, paper towels in hand to wipe the tears. Wow, that was unexpected. Did not appreciate I was this vulnerable. But I am, can’t help it. Mom and Dad warned me when I was growing up, “Don’t ever forget. The Americans saved us.” I’ve never forgotten, so why now, why this? I want to say something, to tell him he is a hero, one of the greatest ever in my book. No, not now. Another time, another day. He is not seeking my praise, but help for his lung condition. Have to stay focused.

Finally, the tears stop. He stands by the sink, washes his face and, after thorough drying, cups his hands and drinks some water from the faucet. Comfortable that all signs of his outburst are gone, he returns to the exam room.

Mr. Reynolds is sitting on the table as before, waiting. “Are you okay, Doc?”

He knows. “Yes, yes, I’m fine. Before I left, you were telling me about Normandy. It got me thinking, and my mind strayed a little bit. Have you been back since the war?”

“Once, in nineteen ninety-four, for the fiftieth anniversary.”

“I’ve never been.”

“You should go, Doc.”

“I know. I will … I will go.”

His patient smiles. “Good. I’m glad.”

Me, too. More than I can tell you, Mr. Reynolds. “Now, here’s what we’re going to do about your shortness of breath…”