Ascites Proprieties

My patient had an enormous belly- the kind one might endow compulsive congratulations... if he were not male. There are some patients one can immediately identify as "sick", and Mr. Ascites was one of them. Liver cancer had turned the well-muscled mechanic into a jaundiced, gaunt specter with an exaggerated paunch.

He didn't say much, but every inhalation was an agonized groan. His belly was taut with mysterious pregnancy. When the doctor pierced his peritoneum with a needle connected to long tubing, putridity birthed violently into vacuum-sealed bottles. Mrs. Ascites was nonplussed and put on samba music from her phone. "Sometimes he fills up 7 whole bottles of that stuff." Since his diagnosis almost a year ago, he undergoes paracentesis once a week. She showed me the needle marks dotting the underside of his belly, puckered like an orange.

Our efforts yielded over six liters of brown liquid.

"And that," Mrs. Ascites remarked, "is why I never drink beer."

As I carried the bottles away, I could feel the heat through my thin gloves and I shuddered involuntarily. It was irrational, but the heat felt like radiating poison. There are so many faces that evil wears in this world, but one of the most powerful, not to mention ugliest, is cancer. It is merciless. No one is indefinitely spared, no one has an out-of-jail-free card- not the bravest, the smartest, the most accomplished, the most seemingly healthy among us.

I looked back once more to see that my patient was shivering, so I took a heated blanket from the warmer and draped it over his bony shoulders. He moaned, for happiness this time. Warm blankets are my favorite way to make patients happy. "Do I look like the lady of Guadalupe, now?" he asked his wife and they shared a laugh. She took his hand and drummed the samba beat on his arm with her fingers.  Cancer was an unwelcome intruder to the warmth of their lives and they treated it as such, with complete irreverence.

S