Travels with Lizbeth Read online

  In fact she did not get fleas while we were on the streets. I found this hard to believe, for it seemed we were subject to every other kind of insect attack. I formed the theory that Lizbeth did not support a flea colony because she did not have a fixed nest. At any rate, although Lizbeth did not have a problem with fleas, I received a number of gratuitous lectures from strangers on the subject of flea control.

  Small children, however, were oblivious to any defect in Lizbeth and surprisingly few of them showed any fear of her. Having seen her reaction to the little monster we had ridden with, I felt certain Lizbeth would never intentionally harm a child. But I thought she might deck a child if she jumped up to greet it. Fortunately that never happened. I formed the opinion that the dog brain reserves some substance, equivalent to twenty milligrams of Valium, which is rushed into the dog bloodstream at the sight of a human child. Were that I so equipped.

  Lizbeth was good with children, but she was far from fond of them. When she was mobbed by toddlers, as sometimes happened in the park, she would often look sidelong at me, as if she wanted reassurance that I would rescue her if need be. Curiously, boys seemed to be more likely to be afraid of Lizbeth. Although they would come to see her, they tended to hold back at a range of three or four feet. Girls walked right up to Lizbeth and would even try to ride her without so much as a by-your-leave. Girls always asked the questions. “Is he a boy or a girl?”

  “She’s a girl.”

  “How do you know?”

  This was a stumper and it took me awhile to perfect the answer: “I read her birth certificate.”

  “Where do you live?”

  “We don’t have a home.”

  “Are you married?” As I have said, the girls asked the questions.

  One evening when Lizbeth and I had stayed rather late at Shipe Playground, a little girl out with her father ran across the playground to pet Lizbeth. Things went well at first and the father stayed back. But as the girl petted Lizbeth and spoke to me, I saw that the father was drawing nearer slowly and he seemed more and more displeased with the situation. At last he dashed forward and snatched the child away. His movement was so sudden that I instantly commanded Lizbeth, “Stay, Beth!” for fear that she would react. That brought the father up short.

  “Is the dog’s name Beth?” he asked.

  The child’s name was Elizabeth and she was called Beth just as I often called Lizbeth Beth or Bessie. I offered to show the father Lizbeth’s tags.

  He had heard me saying “Be a good girl, Beth,” “Stay calm, Beth,” and “That’s a good girl, Beth,” all in the particular tone one uses to calm animals and children. He was alarmed to think I had known the child’s name from the start and that I addressed her in such a familiar fashion. The child evidently also thought I was speaking to her, for otherwise she surely would have said, “Beth’s my name, too.” Fortunately the father had the intelligence to reevaluate the situation when he heard me command Lizbeth. The father and I looked each other in the eye. We were horrified.

  I read in the father’s face that he was ticking off the what-ifs, just as I was. What if he had thought the encounter should be investigated? What if the child had been subjected to a social worker who needed one more case to justify her budget? How many leading questions would it take before the child understood that it was supposed to implicate me or her father or both of us?

  I suppose the crones of old Salem exchanged many such expressions of shared horror as they wondered which of their number would be the next to be condemned by the mouth of a child.

  The father did not need to examine Lizbeth’s tags and the situation was so plain to both of us that there was nothing more to say.

  * * *

  UNTIL I BEGAN to receive my mail at Sleazy Sue’s, I used the gay bookstore in town as my mailing address. On Thursdays we went to check my mail. The bookstore was some distance to the west and south of our usual haunts, and we broke the journey by stopping at Pease Park to picnic on whatever had turned up in the Dumpsters along the way.

  The rest room near the picnic tables was a traditional place that men met to have sex, usually on the spot. I found that a pair of very attractive young men had undertaken there to give guerilla workshops on safe sex, and they turned up almost every time I visited this rest room. They had plenty of condoms and leaflets describing the proper use of condoms, and they distributed these to the patrons of the rest room. Not only that, but the young men participated in the activities. They disrobed and modeled and gently redirected the others away from unsafe activities.

  This struck me as a singularly effective form of education, for of course people who give formal safe-sex workshops usually find themselves preaching to the choir. Moreover, to see these young men with their first-rate physiques practicing safe sex dispelled the notion that safe sex was in some way second rate. No lecture or tract could ever be so effective. The young men seemed entirely selfless in this work, and gave as much attention and concern to the old and unattractive participants as to the young and handsome ones.

  They succeeded in establishing manual sex as the preferred form in the rest room. Because my hygiene on the street was less than adequate, I was really rather happy that my partners in the rest room had been encouraged to satisfy me in that way.

  Days that we did not go to Shipe Playground or to the gay bookstore, we went only a few blocks west of Adams Park. I made the rounds of the Dumpsters at the student condos as early as possible, for I hoped to find our sustenance before the day grew too warm. Usually we stopped for lunch, if I had found it, under the awning of the abandoned taco stand at Sleazy Sue’s. The management at Sue’s cast a benign eye on us and later I was allowed to receive my mail there. More important I could use the rest room at Sue’s. Truly public rest rooms were few in Austin and far between.

  I often thought, as I began to discover the numbers of other homeless people on the street, that a distribution of public rest rooms would be a useful investment in public health. I thought also that such rest rooms might, at little additional expense, contain a simple, cold-water shower, and I do not suppose that anything else could provide a better return per dollar in terms of morale.

  Across the street from Sue’s was a very small strip shopping center. The shop nearest Sue’s was Ramblin’ Red’s. Head shops are illegal in Texas and it would be libelous to write that Red’s was a head shop. Red’s was a tobacco accessories and gift shop. When Red’s had first opened some twenty years ago, it had been located in an old house that had a large front porch. I had not been into Red’s since those days. I suppose I was not the only old customer who felt Red’s was a little out of place in the steel and glass of the little strip center. Perhaps to mitigate this jarring effect, the proprietor had installed an old church pew outside the store and green canvas awnings.

  Lizbeth and I began to spend much of our time on the pew. From it I could see when the letter carrier arrived at Sue’s. Except for a couple of hours in the afternoon, the bench was in the shade, and the overhang of the roof and the awnings offered some protection from rain. The proprietor at Ramblin’ Red’s suggested that I might water Lizbeth from the tap at the side of the building, and he and the staff were always gracious about allowing me to use their rest room. The pew was near enough a streetlight that I could read or write there at night.

  From the first there were many reasons the pew seemed a convenient place to spend time. After a while there was another reason. After we had spent so many hours at the pew, it began to seem a little bit like home.

  NINE

  Phlebitis: At the Public Hospital

  I pressed my thumb into my left ankle.

  I easily produced a half-inch dent in the watery swelling, and the dent remained in my ankle after I lifted my thumb.

  I had forgotten the system for classifying degrees of edema, but it seemed to me that the relatively sudden onset of this sign would require medical attention.

  As I examined my ankle by the light of a con
venience store sign, two men on a drinking spree passed on their way to buy more beer at the store. They insisted on buying a bag of dry dog food for Lizbeth. I could not refuse. My leg had been so painful that for more than a week I had been unable to walk more than a few hundred yards at a time. Lizbeth was hungry.

  I must have looked pretty ragged. I had not been able to walk to Shipe Playground to bathe. And I had not shaved, conserving the water I could carry for us to drink.

  Since I was not bleeding and was breathing regularly I thought it would be useless to go to the emergency room on a Saturday night. Besides, I had to make some arrangement for Lizbeth. As late in the month as it was I guessed Billy would have spent most of his state salary and probably would be at home and relatively sober. Billy had paid a pet deposit at his apartment because he had a cat, and since I now had a bag of food for Lizbeth, he would probably agree to keep her. I had his new telephone credit card number, so I called him.

  Billy’s plan that I visit him on the first of every month had been forgotten after May. Perhaps he felt guilty about that. He agreed to pick us up in the morning. He would take me to the emergency room and keep Lizbeth while I was in the hospital. I thought my condition was serious enough that I would be admitted to the hospital. I would not have thought of applying to the emergency room otherwise. Lizbeth and I returned across the street to the pew. I tried always to keep a supply of ibuprofen tablets and I had found some Vicodin, a synthetic codeine, in a Dumpster. Although I was in pain I decided not to take either drug. I did not want to cloud the clinical picture. Besides it had been some time since a safe amount of either drug had helped the pain much and I wanted to save the ibuprofen because it is the only thing I have found that is any good for my migraines.

  If there had been ibuprofen when I was younger, when my migraines were more frequent and had disrupted my school and work, perhaps this story would be different.

  At the pew I had light enough from a streetlight to write. I began to write out my medical history.

  One of the winos came by and wanted me to drink with him, although I had told him many times that I do not drink on the streets. I showed the wino my leg and ankle. He gave me what turned out to be an accurate diagnosis, given the limitations of his language. At the time, however, I took it for drunken gibberish. The pain had exhausted my patience. I stood up, and Lizbeth and I returned slowly to our bedroll in Adams Park.

  * * *

  I ARRIVED AT the emergency room a little before eight on Sunday morning. A few joggers had reported with running injuries. From the years I had worked at the admissions desk of the state lunatic asylum I recognized a malingerer. He had discovered that he could get some attention by complaining of chest pain. I could see that the staff knew it was a sham, but they had to go through the motions of ruling out a physical cause of his pain.

  Someone drew the drapes around my gurney and that was all I saw of my fellow patients for quite some time. My vital signs were taken and my blood was drawn. I told my complaint many times over and offered my written medical history to whoever looked important enough to have a use for it.

  I heard one of the staff shout, “Dr. Leo.” That is a hospital code for cardiac arrest. I was alarmed. Perhaps the malingerer had been telling the truth this time. There were several other calls of “Dr. Leo” during the next couple of hours. I was astonished that there were so many arrests on an otherwise quiet Sunday morning.

  Finally a gentleman who looked a great deal like Pagliacci in a white coat came into my cubical. His name tag read: DR. LEO VELASQUEZ, RESIDENT. It was just a little ER inside joke to call him by his given name. I should have smelled a rat because the cries of “Dr. Leo” had not been followed by the usual crash-cart uproar. But what, I wondered, would they call out if they happened to have a cardiac arrest?

  Dr. Velasquez finally accepted my written medical history and disappeared through the drapes again. When he returned he had developed a Chicano accent and spoke in what he must have thought was street language. In conspiratorial tones he inquired about my IV drug use.

  I have never used IV drugs.

  I explained that the hepatitis B I reported on my medical history had been contracted sexually. I assumed the questions about IV drug use were inspired by the history of hepatitis B. Dr. Velasquez clearly did not believe my denials. He warned me that he would send someone around to collect a specimen for a urine toxicology. That was fine with me. I had been lying on the gurney for many hours and was more than prepared, was in fact anxious to provide an ample specimen.

  Eventually my gurney was wheeled out of the ER to the ultrasound lab. The ultrasound sensor was run over my affected leg several times. The ultrasound operator consulted the ultrasound physician. Then the operator ran the sensor over my leg again while the physician watched the monitor. Again they conferred out of my hearing. All was not as expected; so much was clear to me. But after a third pass of the sensor I was sent back to the ER.

  I had lost my cubicle, and my gurney was left adrift in the ER so that it had to be moved whenever someone wanted in or out of the nurses’ station.

  Dr. Velasquez found me again. The Chicano accent was gone. He diagnosed me with thrombophlebitis—that is, a blood clot that is irritating to a vein. The danger is that it will break loose, and if it is large enough it will cause a pulmonary embolism, which in turn is a medical term for the end of the road.

  Dr. Velasquez wanted to run an HIV screen on me. That I survived exposed to the elements and eating garbage seemed to me to be good evidence my immune system was functioning adequately. I asked Dr. Velasquez how my HIV status was related to the treatment of phlebitis.

  He strung some words together, which did not in fact amount to an explanation. But I was no longer thinking clearly and I consented to the test. He sent a tech to draw my blood and promised that someone would be along to collect that urine specimen. He said he would admit me to the hospital.

  Another couple of hours passed. No one came to collect a urine specimen. But eventually the drift of my gurney brought me in range of a men’s room.

  Finally someone came to wheel my gurney to the elevator. I got a chance to go through my ER chart. My vital signs were recorded for a couple of times they were not taken. I could not tell if someone else’s vital signs had been recorded on my chart or if a busy tech had just made up some numbers. Dr. Velasquez had ordered a psychiatric consult. And all the bastard had ordered for pain was two Tylenol. I did not want an opiate, but I did want ibuprofen or Naprosyn. My gurney was wheeled out on one floor. But for some reason I could not be accommodated there and I was returned to the elevator and taken to another floor. I was given a private room.

  A nurse gave me a shot of Lasix—a powerful diuretic. He hung a small plastic urinal on the bed and left a cup for the urine toxicology specimen. I made a nervous remark about whether they suspected Richard Nixon of IV drug use.

  The Lasix came on like gangbusters. Fortunately, I hobbled to the bathroom with the toxicology cup; fortunately because I was passing enough water to have filled ten urinals the size of the one that had been hung on my bed.

  The nurse returned after an hour or so. I had made a half-dozen trips to the bathroom by then. The nurse was very upset because he was supposed to monitor the amount of water I passed. Besides, I was supposed—he told me—to be on strict bedrest. That meant I was not supposed to use the bathroom for any reason.

  I made another nervous remark about Richard Nixon. The nurse said I seemed to be fixated on Richard Nixon and disappeared before I could reply.

  Uh-oh. I was already down for a psych consult. I could easily imagine the kind of note the nurse was writing in my chart. He was too young to have remembered Richard Nixon’s bout with phlebitis. I was not fixated on Richard Nixon; he was simply the only person I had ever heard of who had ever had phlebitis.

  * * *

  BUT I HAD more to worry about.

  A person has to draw the line somewhere. Some people draw the line at
brain death, some at ventilators. I draw the line at bedpans. I believe it is physically impossible for me to use a bedpan, and I have no intention of finding out if that is so. I planned at first simply to use the bathroom when I was unattended. I knew I was to have an intravenous infusion, but I did not think it would impair my mobility because I saw other patients moving about the halls, rolling their IV standards with them.

  Unfortunately when my infusion was started I saw that it was controlled by an electric pump. The pump’s cord would not reach the bathroom, and devices of this sort are commonly equipped with an alarm that sounds when the power supply is interrupted. I expected to find a way around this difficulty. In the meanwhile my plan was to eat as little as possible, thereby putting off the trip to the bathroom as long as possible.

  Eventually Dr. Stalin came by. She struck me as the black-garter-belt, stiletto-heels, and riding-crop type—perhaps it was only that she resembled Cloris Leachman in Mel Brooks’s High Anxiety. She explained the risk factors for phlebitis. One was sedentary life-style. That had not applied to me for a long time, since I customarily walked five miles a day scavenging for food. Another was trauma. I could not remember any recent injury. The third, and evidently last, risk factor was IV drug use. The textbooks simply would not allow me to deny using IV drugs.

  I complained that Tylenol was not touching my pain. Dr. Stalin nodded knowingly.

  After she left a new nurse brought me some Vicodin. Another uh-oh. I could not remember how long it had been since I had taken any of the Vicodin I had found in a Dumpster. If it had been within the last few days my urine toxicology would come back positive for opiates and it would be a medically proven fact that I was a heroin addict. I don’t know what heroin is like, but I hate Vicodin and codeine. In early attempts to control my migraines, doctors had given me rather large doses—two and more grains at a time—of codeine, to no avail. Codeine and Vicodin make me nauseated and keep me awake and never do any more for my pain than ibuprofen. I should have told Dr. Stalin that I wanted ibuprofen. She just assumed I was having opiate withdrawal and ordered Vicodin.