My First Stint in the ER

By Charles Halsted

 

A month into my internship, a fortyish man arrived at the ER,
clutching his belly with worsening pain for the past ten days.
His abdomen was tender, his bowel sounds few.

 

His anxious wife said she was certain an old ulcer had flared.
Though she’d plied him with Maalox, at least a spoonful five
times each day, his pain just got worse, more frequent, intense.

 

A respected elder, he’d often flirted after church with the ladies.
His suspicious wife suspected he was up to no good or worse
when he left home after dark.

 

Although his blood tests were normal, an abdominal x-ray
outlined his large bowel in white, as if he’d been prepped
with a barium enema, but this was not so.

 

My year-older resident thought he knew the answer: a different
liquid could appear on the x-ray as white. Confronted, the wife
admitted she’d added arsenic to each Maalox dose, so

 

the more pain he had, the more arsenic he took. This
story ended badly: his kidneys stopped working. Dialysis
not yet perfected, he died. His wife was arrested, indicted.

 

My Village Volunteer

 

My research was to determine whether intestinal malabsorption could result from parasitic infestation, known to be universal in the Nile River delta where villagers had no clean water, most often no shoes. Their houses were made of brick from river mud that had been shaped by stomping bare feet, ideal for the invasion of hookworms that would lodge in the villagers’ small intestines and feast on their blood.

 

A barefoot village girl of fourteen exhibited the pallor of anemic malnutrition, potentially due to intestinal parasitic invasion. Her parents slept outside on the ground while I performed my study in our medical research unit on the outskirts of Cairo, Egypt. From a swallowed capsule biopsy, I learned that that the mouth and jaws of a greedy hookworm were firmly attached to the inside of her small intestine. Further specific testing revealed that she suffered from intestinal malabsorption, together with anemia and severe malnutrition.

 

After a week on our research ward, all tests completed and nutrition improved, she and her parents were driven back home to their village in the Nile River delta. Although I had provided medication to rid her of hookworm infestation, I knew that it would return to become as it was in the other barefoot villagers.

 

Charles Halsted is a retired academic physician in northern California. His poetry has been published in moire than thirty journals, a chapbook Breaking Eighty, and a full book, Extenuating Circumstances, with another full book in press.