S.I.C. Memorial

S.I.C. Memorial

A Novel

by

Glenn Vanstrum

Smashwords Edition

A family can survive anything, if it can hang on through a hurricane, the founding of a surf religion, and a fungus among us.

S.I.C. Memorial

Copyright 2011 by Glenn Vanstrum

All rights reserved.

This is a work of fiction. Any resemblance to actual events or persons, living or dead, is entirely coincidental.

Smashwords Edition, License Notes

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S.I.C. Memorial

Table of Contents

Part I--The Blasto Plague

Part II--Surfism

Part III--The Transplant

Part IV--Xavier

Part V--Don't Cry For Me, Anesthesia

About the Author

Works by Glenn Vanstrum

Sample Chapters of Other Fiction

Humboldt

Let Fall Thy Blade

Certain Stars Shot Madly

Northern Liberties

Yellowstone, 1876

Of Lion Paw and Tiger Jaw

Disease Beyond My Practice

S.I.C. Memorial

Full fathom five thy father lies;

Of his bones are coral made;

Those are pearls that were his eyes:

Nothing of him that doth fade,

But doth suffer a sea change

Into something rich and strange.

William Shakespeare

The Tempest

Part I—The Blasto Plague

-1-

I surf, therefore I am.

I live solely for the purpose of inserting my body into the bath of saline that surrounds Planet Earth, paddling around on a board made of fiberglass polymers processed from plants that died in the dinosaur era, and riding solar energy that begets wind that begets waves that beget pleasure.

I support my habit by working in a hospital, where I pass gas. S.I.C. Memorial Hospital, to be exact, Sarah Imogene Cunningham Memorial Hospital. I pass nitrous oxide and dilute fluorinated hydrocarbons--like chili bean methane, they, too, are greenhouse gases--into the respiratory systems of patients, rendering them comatose and compliant for the sharp little knives of my surgical colleagues.

It’s a sweet gig. For a living, I get to help people in their time of need--this satisfies the soul. It beats the hell out of one of those rat-race, gotta-beat-the-other-guy jobs you find in the business world. It’s never boring--each patient is novel and unique. Everybody gets sick in a different way. Taking people to the edge of death, keeping them alive as surgeons slice them with scalpels, saw their bones in half, or otherwise try to kill them, seems far more interesting than pushing papers around all day in an office cubicle.

But the best part of my job: It allows me to take a week’s vacation every month and surf my ass off for nine days straight. That way I don’t make too much money, just enough to pay for my family’s health insurance, groceries, and mortgage, and to cover my wife’s credit card bill. She only buys essentials: high-heeled shoes, Oil of Olay, silk lingerie, summer dresses, gourmet kitchen utensils, French perfume, pearl necklaces, and cute blouses. I also make sure to earn enough to buy myself a new board every two or three years. When I was younger, I worked extra hard so I could travel to exotic places on surfari, but now I’m content to stay at home and surf my local beaches.

One other thing. I am writing a screenplay. Everyone in Southern California writes screenplays. Mine is a musical, entitled, Don’t Cry for Me, Anesthesia.

-2-

In spite of my addiction to surfing and my decades of experience, I am a lousy surfer. My body is too gangly to squeeze into a barrel properly, a large bunion protrudes from my left foot, and I view the world through myopic eyes. Often a wave rears up over my head before I know it is there. I don’t care. It is enough for me to be out in that salty soup with the double-crested cormorants, the orange garibaldis, and the brown, wrinkled trout.

My son, Razor, is not a lousy surfer. He is a pro. He is only thirteen, but he has endorsements, trophies, and contest wins. He gets a free surfboard from his shaper every six months, and a new wetsuit from his wetsuit company every four months. No matter how he spins and twirls over the face of a wave, his feet remain glued to his board. Razor hates being a kid and has acted like a small adult since he was three. He has sun-bleached hair and a dozen girlfriends, although his voice has just begun to deepen. He says the opposite sex does not interest him, much. I don’t believe him, much.

Razor goes to public school, the junior high at Esmerelda here, an hour or two south of Los Angeles (I have a sworn duty to my surfing brethren not to reveal the exact location of my home surf breaks). Each day he surfs for three hours after school, does homework for two hours, and collapses to rise again at six-thirty the next morning to repeat the process. He has been half asleep for the past two years. The only time he’s truly awake is when he’s in the water at Seawind (not its real name), the local hot surf spot. There he becomes a maniac.

My other son, Thor, is nine. You can still hug Thor, unlike Razor. I hug him all I can, for he has chubby cheeks and a winning smile and I love him to pieces. I love Razor, too, only he’s harder to hug. Thor adores being a kid and owns a sweet and playful nature. He’s just learning to surf; his big concern is how he compares with his brother.

Thor caught a four-foot wave two days ago and rode it all the way to the beach, where he kicked out expertly just before hitting the rocks. At least so it seemed to me as I watched from the line-up and squinted my eyes to sharpen my vision. He paddled back out and asked me,

Did Razor ever ride a wave this big at my age?

Nope, I said. Never.

-3-

A nasty addiction, surfing. I have informed both my sons of the seriousness of the disease. To surf on a regular basis, you need to live near the ocean, and that means you must fork over piles of money for exorbitant coastal real estate. That, in turn, or so I teach my boys, means you must do well in school. Delilah and I bought our house twenty years ago, before prices skyrocketed, otherwise we could never afford to live in Esmerelda. I put pressure on Razor and Thor to study hard: I don’t want them living at home when they’re thirty.

Work does not progress on my screenplay. Writer’s block afflicts me. I don’t have much more than a title, really. A title song, I should say. When I’m out surfing, the salt spray flying, the kelp fronds swaying, I search for characters to develop, action to unfold, a setting to reveal itself--but for now, they elude me.

At work, passing gas, I ought to be looking for a plot. But I am too busy studying oscilloscopes, drawing drugs into plastic syringes, and injecting them into veins to discover a proper story line.

-4-

Today we operate on a motorcycle victim. Not knowing how to surf, my patient, a 22-year-old male, got his thrills straddling an overpowered crotch rocket. When he crashed, his body became a bumper. Now he has an ankle fracture, a pelvis fracture, a thumb fracture, and eight fractured ribs. He did not calculate the fun/danger ratio properly. I try to teach this to my boys. Strive for a positive fun/danger ratio! Razor complains there is no mathematical way to calculate such a number. When he raises such objections, I reply, It’s metaphysics. Remember the sound of one hand clapping!

I have trouble with my patient. His oxygen saturation started off at low normal, and even with a tube secured inside his windpipe and the bellows on my machine driving pure oxygen into his lungs (oxygen like you puff on at the bars in Vegas), his sats barely hit ninety when they ought to be one hundred. Lots of disgusting secretions pour forth from his bronchi. The nurses gag as I suction his lungs. Of course I show them every green chunk, every brown strand. This grosses them out even more--one of my job perks, grossing out nurses. I send specimens to the bacti lab and call the pulmonary specialist, Tom Grimeski, to warn him about my patient.

He’s not the first trauma victim to get ARDS--I’ll bronch him post-op, Tom says, in doctor-speak. So. How’s the screenplay coming? Did you put me in there yet?

We have a tight medical staff, everybody knows everyone else’s business. Tom has a gritty voice and packs a kilowatt of soul into any song lyric. He loves to sing: blues, jazz, pop, you name it. He could take lines verbatim from the phone book, put them to melody, and still make the girls swoon. Blue eyes peer out at you from under his shock of curly brown hair. The nurses think he is adorable. His vision of becoming a star depends on my screenwriting.

Grimeski grew up in a mansion near San Francisco, in the wealthy enclave of Hillsborough. Rumor has it he doesn’t really need to work but does so just because it keeps him from getting bored. His father owns some sort of software megafirm, his mother comes from old money back East. He drives a standard doctor turbo-Porsche, black, shiny, radar detector, the works. But being a doctor with family dough and a luxury sports car isn’t enough for Grimeski. He wants fame, too.

Of course, you’re in the script, I reply to his question. You’re the murderer.

-5-

Eight hours later, after I park motorcycle macho man in the intensive care unit, I make rounds and drive home in my battered Subaru to Esmerelda. One boy is surfing, the other is playing mindless computer games at a friend’s house. Only my wife, Delilah, is home. And Darth and Penny, our attack golden retrievers.

Delilah is blond, green-eyed, and so thin you can see her ribs, if she decides to let you. I get hot and bothered just thinking about her--an effect she’s had on me for twenty years. She is calm and cool-headed, the perfect antidote to my hyperactivity, to my pipe dreams of becoming a creative genius. She even surfs--she has ridden a longboard, by my count, on a total of six two-foot da-Momma-kine waves. She will not surf on a cloudy day. She will not surf in murky water. Delilah prefers the ocean to be at least eighty degrees, gin-clear, with angelfish darting over a coral reef beneath her. Rainbow wrasse must hover over their parrot-fish cleaning stations and be visible from the surface. The sun needs to shine directly overhead before she will so much as dream of resting her delectable self on a hard surfboard.

Delilah will only surf in Maui.

Hi, my love, I say.

She says nothing but gives me a hug and kiss. I feel her ribs and everything else I can get my hands on. She smells like gardenias, I think, or maybe frangipani. Oleanders? No, definitely not oleanders. And fruit. I smell mango, oranges, pomegranates. Mmmmmm. What an earth mama.

Delilah, like me, was born and raised in Wisconsin. She hails from Oshkosh, I’m from Muskellunge. We share a cheese-head mentality, a practical Midwestern view of life, although we live, like walleyes out of the lake, in California. I wonder sometimes if we might be related, albeit distantly, although we don’t really look alike. She has high cheekbones, a ski-jump nose, and is gorgeous. I’m lanky and homely.

At last she speaks, batting my hands away from her erogenous zones. Tom Grimeski called. He says it’s important.

-6-

Hubert, Tom says over the phone, we’ve got a fungus among us.

Tom, I say, I can’t thank you enough.

Your trauma patient, the pelvis fracture guy--when you microscope his Gram-stain, he’s got branchy-looking things in his sputum. Blastomycosis of some kind, I’d guess. He’s the fifth patient now at S.I.C. Memorial with pulmonary blasto.

Tom, I say again, I can’t thank you enough.

Huh?

That’s it! The name of another song for the musical.

What? Pulmonary blasto?

No. Fungus Among Us.

Great, Hubert. Glad to help.

You’ll start him on amphoterrible? Amphotericin B--we call it amphoterrible--is a nasty fungicide that has a lot of side effects: fever, pain, itching, renal failure. You’d hesitate giving it to your enemy, let alone a friend. I suspect the Geneva Convention outlaws its use as a chemical weapon.

We’ll see. It’ll take a while to get sensitivities. But if it’s like the other four, it’s resistant to everything else. It’ll be ampho--or a dirt nap.

Thanks for updating me on this, Tom, I say. Now I am going surfing.

-7-

I should be more attentive to this blastomycosis thing, I guess, but a huge storm is churning forty-foot seas somewhere down near New Zealand. Even though the tempest spins seven thousand miles away, pulses of eight-foot waves, smoothed out and perfected by passage across the Pacific, break at this very moment onto the beloved rock reefs of my hometown, Esmerelda.

I should be more attentive to a lot of things, I guess, but I’m not. If I were clairvoyant, I would realize that fate intends, this very autumn, to throw disaster my way. My prescient eyes would note multiple infections about to occur, diseases caused by vectors far more strange and potent than garden-variety viruses or bacteria.

If I were clairvoyant, I’d start inoculating myself with every known vaccine, real or metaphoric. I’d swallow antibiotics by the fistful. I’d retreat to a sterile mountaintop and fast for forty days. I’d wiggle into a total body condom.

But I remain clueless to the signs promising a religious fungus will cause terrorists to invade my hospital. I cannot divine that an ego fungus will spawn the world’s first human brain transplant…but I digress.

I am not clairvoyant, and the surf calls.

It is not easy to leave the house, to pull away from Delilah’s charms, but I do, pausing only to smear sunscreen on my face. The sun begets the winds that beget the surf, but the sun also begets the melanoma. It giveth and it taketh away.

Too lazy to walk, I drive the seven-tenths of a mile to my local break, Boneyard, where fifteen or twenty surfers jam into the takeoff zone, fighting for waves. The surf stars battle for a set wave, a perfect peak with offshore horsetails streaming behind it. The most aggressive--perhaps my son, Razor, I cannot tell for the sunlight shining into my eyes--drops in, makes a deep bottom turn, and slides back to the top for a quick off-the-lip. The surfer races down the line as a section pitches out and covers his head for four seconds. When he emerges from the barrel, he raises both hands over his head in a surfer victory dance, an NFL halfback prance in the end zone. It is Razor. I recognize him now through the top plane of my bifocals.

I am too old to compete with these hellions. Driving southward to check other breaks out, I find high school and college-aged surfers crowding every reef, all riding incredibly tiny surfboards, all ripping the perfect New Zealand swell into shreds of foam and water droplets. Finally my last hope appears, a break we call, fondly, North Turd. A deep water reef, it sits a half-mile from shore, not far from the city’s sewage outfall pipe. The waves here break too distant for a photographer to get a decent shot. They are inconsistent; they shift; they begin as mush-burgers, rear up into enormous peaks, then become mushy again. It is a spot favored by ancient guys with longboards who do not care about attracting sponsors or photographers and who have thirty years surfing experience.

Bingo. Only six guys in the water. Although it is impossible to tell, I assume they are all old farts like me.

-8-

I paddle out on a nine-foot two-inch bright orange Dane Nukunuku Hawaiian Sling longboard. A gleaming beauty, it is every bit as perfect and shiny as my twelve-year old Subaru wagon, with its numerous un-repaired dents and dings, is imperfect and funky. The board has a scooped-out nose, chiseled rails, and subtle rocker. It strikes me as much more gorgeous than the waxed Jags and gleaming Mercedes that lurk in the doctors’ parking lot at S.I.C. Memorial. Between the four of us Humperdincks we have several dozen surfboards stashed around the house, in the garage, mostly, with a few under the deck. We’ve got guns, bonzers, thrusters, single-fin Barry Kanaiaupunis, and Ben Aipa stingers. We’ve got twin fins, quad-fins, Rusties, and fishes. We’ve got longboards, shortboards, fat boards, and skinny ones. All colors. One with an air-brush of Jimi Hendrix on the deck. One with a dolphin.

We love every stick. Sometimes the boys and I go over each one, talk about who made it, remember where we surfed it, note where the dings are, and discuss subtleties of rail, rocker, template, and foil. We never sell old boards, we just add new ones. Sometimes we make our own, shaping blanks down the way we want them and glassing them ourselves.

But there is no board for me right now but the Nukunuku. The two of us have bonded. We have achieved oneness. I press my sternum to it, feel it hum over the water. We’re in love.

As I stroke through the salt spray, a v-formation of brown pelicans swoops overhead. Twenty-two pelicans, to be exact. They look like pterodactyls. Years ago they almost became extinct: DDT made their eggs too soft, and mother pelicans squished their own babies. Now they are back. The last bird lets fly a cluster bomb, just misses my head. A loud splatting sound erupts from the water.

There are reasons we call the spot North Turd.

-9-

In spite of the pelicans and the outfall pipe, the ocean has turned unseasonably clear and warm. I wear only a vest to keep my chest rash-free, and a hood to keep at bay the bony growths that threaten to obstruct my external ear canals. The green sea grass and kelp on the reef sway seductively. A kaleidoscopic flash of fifty sardines explodes beneath me. It is September, and the ocean here often gets warm at the end of summer. The water today, though, measures seventy-eight degrees Fahrenheit: some kind of record for Esmerelda. Last night on TV the weather forecaster said that if the ocean temperature reaches eighty degrees, a hurricane could feed on the heat from the water.

There has never been a hurricane in Southern California. Ever.

Oops. I have just told a lie. There was a hurricane in San Diego, or at least a violent gale. Forgive me for forgetting. It happened 150 years ago, in October of 1858. Barreling up from Mexico, the eye just missed the coast. Because of inexact 19th century measuring devices, meteorologists today cannot decide upon the exact windspeeds, but the storm blew two schooners anchored in the harbor high and dry onto the beach, Plutus and Lovely Flora. It broke George Tolman’s windmill into smithereens and destroyed two houses. The prolonged winds and rain terrified each and every one of the county’s 4,325 residents.

I found a paper discussing this probable Category I hurricane, a paper Chenoweth and Landsea wrote in the November, 2004 Journal of the American Meteorological Society. Unfortunately, the authors could not determine the ocean temperature at the time.

Nor did they discuss the surf generated by the storm.

-10-

Years ago, before I entered the holy halls of matrimony, I worked in an emergency room on the North Shore of Oahu. I worked there so I could surf Sunset Beach and the Banzai Pipeline. With a résumé like that, you might think, once again, I should be a skilled and polished surfer.

Not.

I learned to surf during medical school in southern California at the age of 23. Surfing is such a hard a sport to master, one ought to begin by the second grade, the age I learned to throw a snowball. Kids in Muskellunge, Wisconsin didn’t surf at any age, although we did tip cows.

Anyhow, one November the water temperature off Oahu hit eighty-five degrees, and a hurricane that started near southern Mexico waltzed across the Pacific and smashed into our tranquil island. It fed on the warm ocean water like fire feeds on spilled gasoline. It grew from a Category 1 to a Category 3 to a Category 4. We had plenty of warning there in Kahuku, so I taped the windows of my rental condo. That way, if the glass broke it would not shatter and cut me into a thousand pieces. I also made sure to have plenty of beer in the fridge.

The storm lasted ten or twelve hours. I packed mattresses in a windowless hallway, cracked a cold one, toasted the storm, and tried to sleep. After I drank a few beers, the electricity went out, the fridge died, my electric clock radio stopped, and curiosity got the better of me. I opened the front door and tried to walk down the steel staircase. Rain fell in heavy lateral sheets. By using two hands on the railing, I kept inebriated balance as giant drops battered the right side of my head. Twenty feet in front of me, the crown of a coconut palm flew by. Horizontally. Sideways. It looked to weigh hundreds of pounds. I retreated to my mattress cave and drank one more.

-11-

The aftermath of that hurricane made an impression on me, too. The surf raged, fifty-foot waves hammering the coast for a week. Electricity and tap water disappeared for five days. To flush at home, you had to hike to the nearby hotel, scoop up a bucket of water from the Olympic-sized swimming pool, lug it back, and pour the bucket into your toilet. After two days and many bucket dippings the pool emptied, its level depleted to where the only water that remained lay stagnant in the deep end.

The first morning after the storm I walked the two miles to the emergency room, stepping around downed coconut palms and smashed ironwood trees, jumping over collapsed power lines. I tried not to touch anything that sparked or crackled.

At the hospital, little work awaited me. Amazingly, no one was seriously injured, although a papaya tree did collapse and bruise the head of a tourist sleeping off two pitchers of Mai-tais. We received one interesting patient: A local Hawaiian who worked as a security guard for the Hyatt Nuilima came in and complained that at the height of the wind, rain, and flooding, a bug sought shelter in his left ear.

I looked in the ear with my otoscope. All that could be seen was a mass of wriggling legs and chitinous body parts. I tried the flashlight technique--lure the bug to the light. That failed. I tried the blind-grab technique with a pair of forceps. Not only did this fail to get the bug, but my patient hollered and made a fist the size of a small ham, a fist that hovered menacingly near my own ear. I realized it was time for the foolproof, when-all-else-fails-read-the-instructions technique. I excused myself and slipped into my office to study bugs-in-the-ear in an emergency medicine textbook. Adopting my best professional manner upon my return, I said, This will only hurt for a moment. After pouring thirty cc’s of warm mineral oil into the man’s aural canal, I stood two steps back, ready for aggression. My patient gave me a stoic look, then screamed. Twice. The ham swung through the air. I ducked, and he was OK.

That was the bug dying, I said. Sometimes, after they’re bathed in oil, they try to crawl deeper, past the tympanic membrane. It’s a very sensitive body part. Sorry.

The poor guy nodded. I grabbed my forceps, pulled out a freshly deceased three-inch Hawaiian cockroach, and showed it to the ER nurse.

EWWWWWwwwwwwwwwwh, she screamed. That’s disgusting!

I love grossing out nurses.

-12-

Today in Esmerelda there is no hurricane. But the water is definitely warm. From a surfer’s standpoint, global warming could be a good thing. Heat produces storms. Storms produce waves. More heat produces bigger storms. Bigger storms produce bigger waves.

What’s not to like?

After fifteen minutes of paddling, I reach the six guys in the water. The youngest is in his middle fifties, the oldest in his late sixties. All but one sit astride nine-foot-plus boards.

Hubert! says Barry Buckleton. Barry is an eccentric surfboard designer, a multi-millionaire venture capitalist, and a film producer. My Hollywood connection, he rides a bizarre black carbon fiber and Kevlar board six feet long, two feet wide, and ten inches thick, with a pointy nose and strange radar-antenna-like fins. It looks more like a miniature surfaced submarine than a surfboard, yet Barry can make the thing rip. How’s the screenplay coming, dude? Where’s my copy?

Coming along, pal. Gotta second song ready to go, I say.

A dark blue band appears on the horizon, and like a pod of sea lions, the seven of us churn madly toward it. An enormous wedge of water lifts up into the air, towering over our heads. Barry wheels and strokes his board toward shore, leaps to his knees (he’s getting too old to stand) and fires down the face. The wave smacks me, drags me down, shakes and twists me--the full Maytag. At last, after a minute-long hold-down, I reach the surface, gasping, my leash broken, my board washing far away to shore. I start swimming.

Like I said. Global warming. What’s not to like?

-13-

Tonight I forget that I am on call until the phone rings at midnight. I am not awake, nor do I wish to be awakened. In my dream, I shred and rip the giant wave that beat me up today at North Turd. I swoop and carve over a face the size of a basketball court, only, unlike a basketball court, it wraps over the reef and breaks perfectly, the white water roaring behind me...

Doctor, we have an emergency case for you.

Hmmm. Delilah, sleek and wondrous in her chartreuse nightgown, murmurs in her sleep next to me.

Doctor Painalot has an anterior/posterior neck fusion on a ninety-two year old patient with Alzheimer’s.

A what?

He fell off a chair at the nursing home and broke his neck. Now he’s losing sensation and motor in his hands and feet, so they wanna operate.

I plead, I cajole. This does not sound right, yet it will not go away.