Удушье (Choke)

Alcohol.

Street Drugs.

Tobacco.

Social History.

The only way to get through medical school is mnemonics.

The girl before this one, another blonde but with the kind of hard old-fashioned boob job you could chin yourself on, this last patient smoked a cigarette as part of her act, so I asked if she had any persistent back or abdominal pain. Had she experienced any loss of appetite, any general malaise? If this was how she made her living, I said, she'd better make sure and get regular smears.

'If you smoke more than a pack a day,' I said. 'This way, I mean.'

A conization wouldn't be a bad idea, I told her, or at the very least a D and C.

She gets down on her hands and knees, rotating her open butt, her puckered pink trapdoor in slow motion, and looks back over her shoulder at us and says, 'What's this 'conization' scene?'

She says, 'Is that something new you're into?' and exhales smoke in my face.

Sort of exhales.

It's when you razor out a cone-shaped sample of the cervix, I tell her.

And she goes pale, pale even under her makeup, even under the wash of red and black light, and pulls her legs back together. She puts out her cigarette in my beer and says, 'You have one sick issue with women,' and goes off to the next guy down along the stage.

After her I yell, 'Every woman is just a different kind of prob­lem.'

Still holding his cork, Denny picks up my beer and says, 'Dude, waste not...' then pours everything except the drowned butt into his own glass. He says, 'Your mom talks a lot about some Dr. Marshall. She says he's promised to make her young again,' Denny says, 'but only if you cooperate.'

And I say, 'She. It's Dr. Paige Marshall. She's a woman.'

Another patient presents herself, a curly-haired brunette, about twenty-five years old, exhibiting a possible folic acid defi­ciency, her tongue red and glazed-looking, her abdomen slightly distended, her eyes glassy. I ask, can I listen to her heart. For pal­pitations. For rapid heartbeat. Has she had any nausea or diarrhea?

'Dude?' Denny says.

The questions to ask about pain are COLDERRA: Characteris­tics, Onset, Location, Duration, Exacerbation, Relief, Radiation, and Associated Symptoms.

Denny says, 'Dude?'

The bacteria called Staphylo coccus aureus will give you STAPHEO: Skin Infections, Toxic Shock Syndrome, Abscesses, Pneumonia, Hemolysis, Endocarditis, and Osteomyelitis.

'Dude?' Denny says.

The diseases a mother can pass to her baby are TORCH: Toxo-plasmosis, Other (meaning syphilis and HIV), Rubella, Cy­tomegalovirus, and Herpes. It helps if you can picture a mother passing the torch to her baby.

Like mother, like son.

Denny snaps his fingers in my face. 'What's up with you? How come you're being like this?'

Because it's the truth. This is the world we live in. I've been there, taken the MCAT. The Medical College Admission Test. I went to the USC School of Medicine long enough to know that a mole is never just a mole. That a simple headache means brain tumors, means double vision, numbness, vomiting followed by seizures, drowsiness, death.