Gil Porat, M.D, FACP, CPT

Chapter One

You wouldn’t have even noticed his accent much except for the fact that his whole body emitted southern culture. Not the style of the courtly, southern gentleman. Rather, a tough rugged guy who drove a red pick-up truck, and listened to Lynyrd Skynyrd and the Allman Brothers - that sort of thing. He believed the three most important years in American history were 1492, 1776, and 2001 (not because of September 11, but for the loss of Dale Earnhardt on the last lap of the Daytona 500 that year). Be that as it may, to oversimplify Earl would mistakenly veil an astonishingly complex mind.  
            I was glad Earl came ahead of the other guests. We hadn’t seen each other since he passed out at my house two weeks prior to the dinner party. On that occasion, we required a taxi to haul us home from a downtown bar to my place. When we got home, he had made his wobbly way over to my baby grand to ogle one of the carelessly framed photos on top of the seldom played piano.  “Hey, Karen has always been a good looking girl in my eyes,” he said, “but these pictures make her look totally great.” At which point I swore at him and explained he was actually looking at a picture of my mother taken two decades ago. “Well, is she still married?” he asked, not missing a beat.
            “She’s an aging widow on the verge of losing her marbles. If one more difficult life circumstance emerges, she might just transform into one of those crazy ladies who collects every stray cat in the neighborhood. Stay away from her.”
            Earl always arrived at his host’s home carting a twelve-pack of McTarnahans Ale. Actually, he arrived just about anywhere carrying McTarnahans Ale. He was not an alcoholic, but certainly drank to a greater degree than the average person. He claimed that he didn’t drink to relax, but rather to make other people more interesting. Our colleagues at the hospital joked that Earl rarely made a diagnosis of alcoholism because patients could only be diagnosed as alcoholics if they were heavier drinkers than their doctor. He knew the health risks of alcohol, but like most physicians he found ways to justify his hang-ups. It’s true alcohol kills brain cells, but only the wimpy ones, he’d profess.
            Earl’s stellar reputation as a compassionate, brilliant oncologist hadn’t led to a case of high self-regard. Among friends he sometimes despaired that his job was to poison already dying patients. When medical breakthroughs arrive that will eventually make chemotherapy obsolete, it will be a relief to him, even if it means being out of a job. Like most people, he desired respect, but Earl never cared what venue that respect came in. Whether he was a happy hour hero, or oncologist to the elite, it didn’t matter to him.
            As usual, Earl had left all remnants of his professional demeanor at the hospital. He carried the ale into the kitchen and began describing some long-legged girl he saw at the convenience store on the way to my house.
            “Maaa-an, you should have seen her. I felt like dropping protein right on that there spot.”

            Luckily the doorbell rang, sparing me from hearing further details. Our friend Roy stood on the porch, shifting from one foot to the other.
            Roy’s sandy blond hair hung just below his shoulders. He was a nerdy guy, and it never bothered him. Being a software programmer surrounded him with fellow unabashed geeks who repelled cool. Sci-fi books, comics, and classic rock were his passions. He arrived wearing green corduroy pants and a blue t-shirt with a red and yellow Superman symbol on the chest. Roy always wore t-shirts one size too small. That way he could show off the barbed wire tattoo that encircled his right bicep. People with that tattoo usually have well built muscles. But Roy had never worked out a day in his life. Something about him always reminded me of Shaggy from the old Scooby-Doo cartoons.
            Roy sat down on the couch and immediately started fidgeting with his hands and rambling about the craziness of his day.
            “It all started this morning. Well, actually it started last night. I went camping at the coast with my buddy, Potter. We woke up after a night of rain, and discovered we were basically sleeping in a frozen puddle,” said Roy.
            “That’s no way to greet the new day,” I acknowledged.
            “Yeah, well that was just the start of it. We decided to pack up and head for the car. When we got to the car, we both realized we didn’t bring a change of clothes. Man, we were soaked.”
            “Bummer,” I said halfheartedly.
            “Yeah, so we decided to strip and headed back to Portland naked, but dry,” he said, crossing and then uncrossing his legs. Roy’s posture was uncomfortable to observe. His left shoulder was always a few inches lower than the right. No wonder he often complained of back pain.
            “Nothing like feeling dry,” I said, thinking that was the end of the story. Somewhat fruity, but understandable given the circumstances they were in.
            “Yeah, and we drove back pretty fast. We passed this slow Chevrolet on the road. Wouldn’t you know it, a mile later we’re at a stop sign in Tillamook and the damn Chevrolet rear ends us.”
            “Oh gosh,” I mumbled, hoping my intonation sounded like one of concern, rather than one of amusement. In truth, I was internally grinning, just sitting back, amused by Roy’s narration. The ambience in the room reminded me of Thoreau’s Walden Pond. This was the stuff he was writing about, albeit an entire coast away: The simple and ordinary pleasure of good, intimate conversation with friends, neighbors, and loved ones. Roy continued his story, twisting a strand of his long hair between his thumb and index finger as he spoke.
            “Yeah, so Potter and I got out of the car to get our soaked clothes from the trunk. But, wouldn’t you know it, the Chevrolet had smashed in our trunk and it wouldn’t open.”
            Earl and I chuckled. Roy, not amused, paused until we simmered down, then resumed his narrative. “So there we were, on a chilly morning, standing naked in the middle of the road. As fate would have it, there was a church on the same corner as the stop sign. It was called Truth or Consequences Church of Christ. The congregation heard the crash, and everyone poured outside to see if we needed help.  
            “Twenty minutes later we were sitting with towels around our waists in the Tillamook police station. The cop was acting like a real jerk. One of the first things he did when he arrested us was take our watches. He put them in a desk drawer filled with tons of other watches. You know, I never got my watch back.”
            Earl guffawed. Beer came out his nose. “You two gone and got yourselves in quite the predicament,” he said.
            Roy, recognizing he had enthralled his audience with the hilarity of it all, continued. “I was scared shitless. Seriously, I really had to go to the bathroom. The cop eventually let me use the restroom. No kidding man, I ended up clogging the toilet. It was the biggest and smelliest crap-out I’ve ever had. Luckily, Potter had paid the fine on his credit card while I was in the bathroom. When I got out of the bathroom I was just about to tell the cop about the toilet, when he told me I was free to go. Knowing there was only one cop car in town and that it was at the police station, we bolted out of town like bats out of hell – still only wrapped with towels around our waists.”
            I became concerned. Not about Roy, but that Earl was going to get beer on my carpet via his nose. He surprised me when he began to chide Roy. “I never understood why people allow heavy toilet buildup. If you just took a big crap and you know there’s another load on the way, then flush the damn toilet! You know the next droppings could end up clogging the throne. A clogged toilet is the awfullest thing. It doesn’t make sense to ever risk that happening.”

            Roy may not have been done with his story, but by that time Grant and his girlfriend, Tarini, had arrived. Tarini was a lovely half-Hindu, half-American doctor of internal medicine whom Grant had met shortly after divorcing his wife. I was happy to see they made it to our house; earlier that morning, Grant had telephoned to say he might be coming down with the flu. The germ of his disease turned out to be his secretary. She had negligently brewed decaffeinated coffee for his mandatory morning cup, causing his soul to remain in hibernation until his observant nurse discovered the empty decaf bag in the waste basket.
            I had met Grant a few years ago, soon after I arrived in the city to join Portland Premier Health Partners. His medical practice rented space in the same office building as my group. Right off, he invited me to his wife’s (now ex-wife’s) birthday party. They would be celebrating at a “topless” bar, he told me. I was keyed up at the prospect because it seemed I was the only guy on earth who by age thirty-four hadn’t been to a strip-club. In anticipation, I went to the bank to get fifty dollars in singles. What a letdown when I got to the party and realized we were at a “tapas” bar. The tasty array of Spanish “small-plates” was no consolation prize. Not to mention the embarrassment of using forty-three single dollars to pay for my portion of the bill.

             Realizing she was late, Karen had dressed quickly, and raced down the stairs. She was not prone to hysteria and tantrums, but she got stressed when running behind schedule. Karen refused to own a blow-dryer – it would just frizz up her natural waves, she claimed. I could still see where her long, damp hair had left dark wet spots on the shoulders of her jade-colored linen blouse. Quietly by-passing our guests, she went directly to the kitchen to get the hummus and tabouleh she had prepared earlier. She noisily set the bowls on the dining room table, unintentionally creating a clatter that guaranteed her entrance would not go unnoticed.
            I often stared at Karen. She probably took it as endearing while others may have considered it creepy. In truth, I only occasionally stared at her in lust. Usually, I was just wondering why she was still with me, and when she would eventually lose interest. There was no question she could get a better looking man. Like my previous girlfriends, maybe she would make her escape on short notice. There were times that if I’d had the opportunity to escape from myself, I’d have done it.
            “Hey Karen, what’s up?” Tarini asked, as she followed her into the kitchen. I walked in behind both of them to get some more ice.
            “Same old thing. I’m just waking up from a nap. I had the worst migraine today,” Karen replied. She massaged the side of her head and her wavy curls bounced along with the movement of her hand.
            “Isn’t that the worst? I’ve also been getting tons of headaches lately,” said Tarini. As a physician, Tarini couldn’t abstain from giving medical advice. Her sincerity, something I’ve noticed to be common among Hindu women, made her appear so compassionate towards friends and patients. “It’s important you get it checked out to make sure it’s nothing serious. Did you know women get three times as many headaches as men?” Her right eye twitched involuntarily as she spoke, a tic which I had only recently noticed.
            “That doesn’t surprise me. It’s men that cause them,” Karen answered, hoisting herself onto a counter stool. Karen maneuvered like the tomboy she once was, more adept at climbing trees than pirouetting around the room. But this lack of physical gracefulness made her more human in my eyes, since everything else about her seemed perfect. The exceptions included her annoying habit of pressing the snooze alarm six times each morning instead of setting the alarm for an hour later. She also insisted that every location in Portland was only ten minutes away, which resulted in our arriving late to every movie and restaurant reservation.
            Grant had followed us into the kitchen. Usually a reliable defender of the male cause, he stopped listening once he spied the Jelly Bellies on the table.  Instead, he began devouring them, oblivious to all conversation around him. “These jelly beans are awesome. I mean they could seriously replace fruit.”
            “You’ve never had Jelly Bellies before?” Karen inquired, happy for a distracting light topic that would help her forget her headache.
            “I’ve had jelly beans before, but not like these. These are great.”
            “Well, you sound as if you’d never had one before,” Karen went on, “where were you during the Reagan years?” she asked, referring to the famous big jar the president always kept on his desk.  
             Grant replied defensively, “College, that’s where. It’s not like I was in Nam or anything, but I’ve been around. I’ll bet most people haven’t tried Jelly Bellies.” He always said quirky stuff like that. He was a toddler in the Vietnam War years, and nobody would mistake Grant as a war veteran.
            Another peculiarity was Grant’s tendency to correlate, at random, his own insecurities with the topic at hand. “People often ask me if I’m Asian, but I’m not. My mom drank a lot when she was pregnant with me.” That’s a classic problem with doctors. They often think every anatomical variation they encounter is a reflection of some disease process. The inferred connection between his mother drinking and him looking Asian baffled Karen, because Grant did not have the kind of slanted eyes that characterize babies with fetal alcohol syndrome. But I had become skilled in following Grant’s warped logic.
            Back in the living room and over our drinks Earl soon had us in stitches as he related how he had recovered from his typical neurosis of health professionals.  Late one night during his second year of med school, he had noticed a nodular three millimeter lesion on his genitals. After scanning every textbook of venereal disease he could find on his crammed bookshelf, he narrowed his self-diagnosis down to one of two rare diseases -- either Lymphogranuloma Venereum or Chancroid. It didn’t matter to him that these rarely occurred in North America. Earl convinced himself that he had picked it up from the slutty girlfriend he had during his senior year at Auburn University. Plagued by insomnia, Earl decided that a trip to the Emergency Room was in order. His humiliation  deepened when Dr. Jennifer Stover entered the exam room. He hadn’t been expecting this. As he undressed with slow hesitation, his timid apology about what he was going to show her only worsened the awkwardness.
            Dr. Stover recognized him as a medical student. Not the least bit fazed she took one look at the lesion and, without saying a word, grabbed the nodule between her thumb and index finger and gave a firm squeeze. A small amount of white pus came out of the nodule. Clearly, whatever he had must have been quite serious. He felt the blood drain from his face. Dr. Stover, still silent, took off her gloves and threw them in the trash. She proceeded to wash and dry her hands for another twenty seconds, and opened the door to leave the room. Then she turned and congratulated a red-faced Earl for having the biggest pimple on a penis she had ever seen. She advised him to go home and study the manifestations and treatments of acne.
            Inevitably, they still run into each other on hospital shifts. Earl masks his embarrassment by pitching tasteless pick-up lines at her. “You should see me without the pimple.”
            As a hardened ER doctor, Dr. Stover holds her own with piercing wit. “Earl, without the pimple, there would be nothing there.”
            I had invited Dr. Stover to our dinner party, but she declined, stating that her ER shift ended at 10 p.m. If she had the energy after work, she would consider stopping by for a late night drink, she said, but it didn’t happen. Either she lacked the energy, or Earl genuinely repulsed her. Most likely, it was the latter.

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My best buddy, Earl Haynes, was the first to arrive for the dinner party. Earl looked like the college lineman who is just a little out of shape. He was a jovial type who appealed to women who like cuddly, teddy-bear physiques. Having a flattened abdomen was something he desired, but watching workout tapes while eating never produced recognizable results. His slightly crooked nose, a souvenir from his high-school wrestling days, rescued him from the banality of a classic pretty-boy face.

Other than his rustic attire, he had adapted to the big city remarkably well, given that the water tower was the tallest structure in his hometown of Reform, Alabama. Reform was so small, he’d tell us, that people only gave out the last four digits of their phone numbers because the first three digits were the same for everyone. He left the place a decade ago to attend medical school, but retained a slight southern drawl, and much of the town’s character. The thing about Earl was that it didn’t matter where he was. Wherever he was, he felt at home. It’s a quality I envied.

The Other Face of Murder