Chasing a Light Beam – Chapter 10: “The Light Beam”
THE LIGHT BEAM
The fact that a believer is happier than a skeptic is no more to the point than the fact that a drunken man is happier than a sober one. - George Bernard Shaw
Ben came to discover “the light beam” in a way rather simple, if unpredictable and unwanted. He thought he already had a problem, but the light beam was something on another level.
Maggie had been gone now for two years, taking their daughter and their dog. Ben was alone in the big house on the river. For a while, he had lived in an apartment, but when the divorce became final, Maggie had wanted to move away. Ben had purchased her equity in the home, and moved back in. He lost half of his retirement fund and almost all of his liquid assets in the property settlement; society’s pendulum of fairness had swung from women as victims to housewives as conquerors.
The Hebert malpractice action had dragged on for two years, and after it was dropped, Ben’s liability insurance was cancelled. His big house had a new mortgage, both to cover the self-insurance bond and to finance Maggie’s buy-out. But he still had his knowledge, skills, and license, and he figured to be well off again as time went by.
He met women from time to time, and most seemed to enjoy his company. There was sex; pills had harnessed his recalcitrant member. But Ben was empty. He could generate no feeling. The women frequently said on parting that he talked about Maggie too much.
He bought ten rose plants; they were a hybrid called “Knockout”, developed for the south Louisiana climate, resistant to both heat and disease. He intended for them to become new tenants on his back deck, overlooking the river. But first, he had to remove a bad idea from one of the enormous built-in planters: it was a dead palm tree that had not survived the winter. No wonder he never saw any native palms in Lafayette.
Ben climbed up on the edge of the planter and gave the dead palm a pull. He hadn’t imagined that it would put up so much resistance. He moved around for a better angle and began pulling again. The lot on sloped down toward the river, and the top of the planter was about twelve feet above the ground. As he pulled more forcefully, the roots suddenly yielded; it immediately occurred to Ben that that this plan was not well thought out. He felt himself leaning backward toward the yard, and there was nothing left to grab. It must have happened quickly, but it seemed like he had time to consider his limited options, even as he began falling. A controlled fall was definitely the preferred decision, and he turned to face the yard, and jumped. Even as he glided through the air, far longer than he had imagined, he planned to land as he had been taught in the Army: bent knees, hit, and roll. He did so. His flip-flops touched the ground, left before right, as the yard was uneven. He rolled. An indescribable pain shot from his left foot to his brain, and he writhed. The pain was unrelenting; it clouded his mind. Eventually, he tried to stand, but he had no control of his left foot. He lay in the yard and pulled his cell phone from his shorts. He was due at the office in an hour.
He called Martha and asked her to get crutches, come to his house, and take him to an orthopedic surgeon’s office. Later, Ben Bob could not remember the intervening events, but apparently he dragged himself up the three levels of deck steps, into the house, and he was sitting with an ice bag on his elevated foot when Martha arrived. He performed with the crutches like the novice that he was, but he made it to Martha’s car without falling. In just the time it took to make the thirty-foot journey to the car, the dependent position of his foot had heightened his pain ten-fold. He sat in the back seat sideways, with his left leg across the seat, the ice bag on his foot.
Ben’s genes did not carry the code for the Boyle curse of heart attack, hypertension, and high cholesterol. He was more like PawPaw’s side of the family, where everyone lived too long. For a doctor who has never been ill, the role reversal in the doctor-patient relationship is a bitter pill to swallow. It conveys a feeling of helplessness that is magnified by its contrast to a lifelong experience of control. The first inklings of the frustration of patients locked in a system designed from the viewpoint of the healthcare provider began to fall on Ben. His pain was intense, still he was stuck in a waiting room, filling out forms and signing away rights, with no place in sight to prop his injured extremity. Yet the doctor’s specialty was injured extremities. How much worse the situation must be for the patients when fear is added to the equation, a fear of the unknown, generated by ignorance of all the things Ben had had spent so many years storing in his brain. Fear heightens pain: it’s a fact.
There followed some painful, if not impossible, maneuvers in the radiology suite, an attempt to accommodate the fact that x-rays travel in straight lines, and bones do not. Eventually, with Ben’s films in hand, Dr. Tom Fruge entered the exam room and greeted his friend.
“Let me guess: you operated on a patient, and now his peter’s too short?” He turned and stuck the films on the wall viewer.
Ben didn’t smile; he couldn’t. “Yeah, and he attacked my foot, because he knows he’s goin’ to need my hands to fix things.” Ben was looking at the viewbox, the bones of his foot and ankle glowing white against the darker background of the surrounding soft tissues. “Presence of bones” was about the only diagnosis he could make; contrary to popular belief, the object of his special knowledge was bone-free.
Ben shifted his left leg a little, trying to get the foot a little higher. It was purple, and pounding. “So, whaddya see? A broken ankle?”
Fruge turned and faced him, not smiling. “No, the ankle’s fine. You’ve got a displaced fracture of the calcaneus.”
It had been a long time since Ben’s ortho rotation, but he remembered the doctor-word for “heel”. He figured it couldn’t be too bad; the technician hadn’t even noticed it. He was thinking, “cast” or “splint” for a few weeks, then back to normal. “What kind of little thing do we do about that?” he asked.
Fruge frowned. “Ben, this is a really serious injury. No matter what we do, you’re going to be disabled.” He paused.
The ignorant patient’s fear flooded over Ben. He didn’t have the first byte of knowledge about the calcaneus. He was healthy. He was the club tennis champion. He was Dr. Benjamin Robert Boyle. Things like this were not supposed to happen to him.
“Some people would recommend surgery,” Fruge resumed, “but I think the best thing for you is a air-cast boot and elevation for the next two weeks, and then we’ll check to see how it has settled in.”
As if he had not understood the import of his friend’s words, Ben finally stammered, “Should I stay home from work?”
“Absolutely.” Fruge was pulling the x-ray films from the viewer, ready to see his next patient. “No moving around that you can avoid. Foot elevated all the time. As much Lortab as you need.”
Ben didn’t mention that he lived alone; that wasn’t Tom’s problem. Martha filled the narcotics prescription for him, and helped him to get settled in his bed. Ben had her to place his laptop–with wireless Internet connections–and the TV remote on his bedside table. She left for a while, and returned with a wheelchair and two plastic urinals from the office. “We’ll get someone to check the post-op patients, and reschedule the rest,” she said, with an expression that told him she was far more concerned about his welfare than about the appointments. Ben had to chase her out.
The next two weeks required two months to pass. The plastic urinals at his bedside became Ben’s favorite possessions. He quickly learned why public restrooms require a special design for the handicapped: it was a Herculean challenge to get himself to and from the toilet. Once there, the wheelchair had to be positioned directly in front to hold his foot, for whenever it dropped below his waist, an intolerable throbbing and burning seared straight to his brain.
He was determined not to allow his new roses to die. It was if they were locked together with him in a time that was perhaps his last healthy moment. He found that he could drive the wheelchair over the back-door threshold, onto the upper deck. From there, he could use the garden hose’s jet nozzle to bathe all his children. It became a daily ritual.
The day arrived. He put a little extra pressure in the air-cast and wheeled himself out to the rear of the SUV. Balancing on his right foot and leaning against the truck, he folded the chair and slung it into the back compartment. He crutched his way around to the driver’s door, and jumped in, using his right foot. The crutches followed. Elevating his left foot as high as possible on the firewall, he drove to Fruge’s office for his two-week follow-up. Ben would have strongly admonished any of his own patients, had they taken Lortab before getting behind the wheel; it was a case of do as I say, not as I do, and he popped the narcotic as his foot screamed.
Fruge came in with the films, and examined Ben’s bare, discolored foot. The purplish-red coloring was no longer that of a bruise. It was a variable phenomenon that increased dramatically when the foot was lowered, and improved with elevation. The pain and burning sensation followed the same pattern.
“The swelling’s down, but the bones don’t look like they’ve improved in position at all,” Fruge said, looking at the x-rays. “I’d like to get a CT scan to see more detail.” Such a test usually takes a while to schedule, but Ben Bob called his radiologist friends, and went right over. He was back at Fruge’s office in two hours. One of the perks of having a union card.
Ben passed the films to the receptionist, and took a seat in the waiting room. He made a bridge between his chair and the adjacent one with a crutch, to hold his foot at a tolerable level. He made it through a Car and Driver article that was four years old, comparing Camaros to Mustangs, before he was called in. He saw the nurse and the physician assistant oohing and aahing at his pictures. They smiled at him as he passed. Ben just had a feeling that Tom Fruge was about to eat his words from two weeks earlier. He could imagine him saying, “I can’t believe it! You must have amazing healing powers. Your heel looks great!”
Fruge came in. “Ben,” he said, “this is a much worse fracture than I thought. On the plain films, I saw only two main pieces with some displacement, but the CT shows severe comminution, at least twenty pieces. Your heel exploded.”
It wasn’t cancer, but Ben had no reference in his life for such a negative message. He was stunned. “So what does that mean?” he asked, with the same dependent attitude that he had seen in so many of his own patients.
Fruge gave him a sympathetic stare. “I still think conservative therapy will get as good a result as anything, but I want to show these films to our new partner, Jim Perrin. He did a fellowship in foot surgery over at Parkland Hospital in Dallas. I’ll get him to call you later today.”
Ben Bob’s cell phone rang at four-thirty that afternoon, during a re-run of “Law and Order”. The voice identified himself as Dr. Jim Perrin. After some niceties, he said, “I looked at your scan, and I think you need surgery right away. Actually, I would have done it two weeks ago, if I had known about it. If we don’t do it now, there’s no sense in doing it all. You’re older than I normally accept for reconstruction, but Tom says you’re healthy and active, and I think I can cut down on the amount of disability you’ll get.” Blunt and to the point. Ben Bob didn’t mind that at all.
“OK. What do you want me to do?” Ben asked.
“Nothing by mouth after midnight, and show up at the Orthopedic Surgery Center tomorrow at seven. I’ll put you on for my second case. You can go home in the evening.”
Ben Bob’s elevated foot on the ottoman reminded him of that conversation with Dr. Perrin. It was early evening now, not dark, but grey, outside the sun-room’s glass. He reached out from his chair and clicked a switch that shot light beams up through the foliage of the plants scattered around the periphery of the room. The beams reached their destination faster than any other phenomenon in the universe, or so he had been told. He took the fluid level of his glass down by half; there was no doubt that it was more than half-empty. The vodka had brought on a little buzz, a mild change in personality, as he continued.
Being on the opposite side of the scalpel was bizarre. You hear things from people about hospitals and their doctors, but I really never gave them much credence, until I was the patient. An internist friend called my cell phone after the procedure was completed. I’d been sedated with an amnesiac drug during the operation, but the actual anesthesia was a regional block, an anesthetic injected into the nerve plexus behind my left knee. My left foot and lower leg were still completely numb. He asked how I was feeling; I told him I wasn’t “feeling” anything. He was surprised when I told him I’d be going home in a couple of hours. He hadn’t known the procedure was scheduled as outpatient surgery; he thought he was calling me at the hospital.
“Perrin told you that you could go home tonight? Does he know you live alone?” he asked. If I could have seen him, his brows would have been raised.
“Yeah, he said I’d be fine, and he gave me another ‘scrip for Lortab, just in case I needed it.”
“Sport, that’s not gonna work,” he said. “I’m gonna come by in my big-cab truck and take you to be admitted to the hospital under my name. This isn’t my first rodeo; you’re gonna need some help.”
It seemed like overkill to me, but it was Friday afternoon. It wouldn’t hurt to spend the weekend in the hospital and let them do the cooking. He got me there without going through all the admission fanfare, and I settled into my mechanized bed with my numb left foot elevated higher than my heart. My friend checked back by before leaving, and just about then, the anesthetic wore off. Over a period of about ten minutes, it went from tingling, to uncomfortable, to a three-alarm fire. If I’m wrong, and there is a Hell, this might have been the preview.
He got me hooked up to an on-demand morphine drip STAT; just push a button and get your drugs. I punched the button for the narc every time the light came on, like it was a slot machine, only this one had a better payoff. When I had thoughts, they were of being at home alone with a Lortab pill, as the young Dr. Perrin had planned.
After I had been in the hospital for four days, my insurance company called to see how I was doin’, and to say, “Oh, by the way, we’re not paying for anymore hospital time.” Another little aspect of medical care that I had never personally experienced. My internist friend left his office and took me home in his truck.
I’m not going into all the rigmarole that was involved with the year of my rehab, or how I got fed, or cleaned myself, or gradually learned to walk in a swimming pool, or eventually went from wheelchair to crutches to cane to orthotic shoes. They told me ahead of time I would be disabled, and I was. But I am going to mention a couple of changes that were important: money and attitude.
Ben killed the last of the martini in one gulp. He was no longer drinking artistically, but he wasn’t out of control, either. He was right on schedule.
When I was lying on my back in bed a month after the operation, the foot still up in the air and the room still smelling of half-full urinals, I realized I was in some serious shit. Not like guys coming back from Iraq, or quads from motorcycle wrecks, but serious for me. The accounts receivable was down to nothing, I hadn’t worked in six weeks, and I had no clue whether I’d be able to do surgery again. I had disability insurance, but there was a six-month waiting period, and the company had been featured on “Sixty Minutes” because of their penchant for turning down legitimate claims. I had a huge new house mortgage, thanks to the buy-out with Maggie; if I sold the house, I’d have nothing to pledge for the malpractice bond. I wasn’t sure I could meet the office overhead by seeing only non-surgical patients. I had about fifty thousand in cash in my IRA, but I was only 58, and I would waste a bunch of it in penalties if I took it before the age of 59 and a half. The last time I had been that scared was when I knew I wasn’t going to get into medical school in time to beat the draft.
I took the IRA money out to use for living expenses, losing about forty percent in taxes and penalties. I took the wheelchair to work and treated those patients I could with pills and shots. I listed the house for sale, and I filed a formal application for professional disability. My insurance policy, if honored, was gold: if there was any aspect of my profession that I could not perform, my disability was total, even if I continued to do part of the job. And, I hoped–atheists don’t pray. Now that I think about it, hoping and praying might really be the same thing.
For the next three months, my office work paid for Martha and the girls, and the other overhead, but nothing more. The IRA money paid my personal bills. Then Hurricane Katrina destroyed New Orleans, and I was able to sell my house to some wealthy evacuees from the Garden District. I was treating office patients without any insurance at all, and I was off the staff of all hospitals. I got the patio home with the sun-room that I’m in right now, and waited for the disability decision.
I’ll be the first to admit the irony that my situation was enhanced because of a law passed with the strong lobby of the plaintiff attorneys. In Louisiana, if a disability insurer refuses to pay claims, and the claimant subsequently wins in court, the insurer has to pay TRIPLE, plus legal fees. Rather than risk that outcome, the company started my checks right on time, even as they continued to have a gum-shoe on my tail. Barring a setback, I would be able to get by until age 65, and I still had my brain.
And then that brain turned on me.
Ben had a lot of spare time, because there were enough office appointments to fill only three half-days a week. He started educating himself. Back before Bonnie-in-a-bathing-suit had steered him toward being a missionary, he was interested in physics. It’s just as well he got sidetracked, because he didn’t realize the complexity of the math. Physics is math, and math is the language of the universe, a language foreign to Ben. The human brain is constructed to visualize the world in three dimensions. Physics visualizes the universe in “N” dimensions, where “N” approaches infinity. Humans can experience this only through the use of math. So Ben began to read about physics interpretations, the kind written in words rather than numbers. In “New Scientist” magazine, he came cross a review of The Fabric of Reality, by David Deutsch; he bought it and consumed it.
The grail for physicists is the “theory of everything”, or as physicist Leon Lederman puts it: The real goal of physics is to come up with an equation that explains the universe but is still small enough to fit on a T-shirt. Deutsch’s first sentence captured Ben: I remember being told, when I was a small child, that in ancient times it was still possible for a very learned person to know everything that was known. By “knowing”, he means “understanding”. Understanding, he posits, does not depend on knowing a lot of facts as such, but on having the right concepts, explanations, and theories. He uses seven words that became the crux of the “problem” for Ben: we do not experience underlying reality directly.
All Ben’s early years were governed by an imaginary underlying force that he could not experience directly, but not the one of which Deutsh wrote: it was God. Some form of this invisible force was, and is, accepted by the vast majority of all humans who ever have lived; many believe they have experienced it, yet none has ever found any evidence of its existence. Paradoxically, Deutsch was speaking to Ben of an underlying reality that CANNOT be experienced directly, yet for which there is a rich body of evidence, known to a relative few. Searching for evidence of this reality leads to the discovery of unsuspected aspects of existence, substantiated by subsequent experimentation and observation. The concept of “time” being a fourth dimension of “space” is counter-intuitive, but that’s a problem with intuition, not a problem with relativity. The deeper language of mathematics led Einstein there, counter to his intuitions, and all subsequent experiments and observations have confirmed it. And that light beam: Einstein’s math shows that no matter how fast a man may travel, he will never be able, even in theory, to catch up with a simple light beam. By the definitions of the universe, man can’t go there. Even though that’s not the way it seems.
That’s the beginning of the “problem”. The Founding Fathers said, “We hold these truths to be self-evident.” They were wrong. The nature of reality tells us that none of the basic truth is evident at all: NOTHING IS WHAT IT SEEMS. Yet reality is perfectly normal. Since the “beginning”, not one unusual thing has ever happened, only unusual interpretations. This theme ate into Ben’s brain, and he began to see it on multiple levels: not just the objective level of science and the universe, but all the perceived levels of human existence and interaction. Ben began to see life through the eyes of science, rather than the rose-colored glasses of emotion and faith.
