Dr. Evan Gold knew something was wrong but he couldn’t put his finger on it. He didn’t feel right. Something was sending him a signal from deep within; a cell phone ringing with no answer. The feeling was vague and indiscernible. Being a doctor, a cancer doctor, made him feel more helpless.
“Should I wait to see what develops?”
Then the dreams started; recurring nightmares that wakened him, soaked with the perspiration of dread. Evan feared going to sleep. Better to stay awake than to experience that again. He could discern no reason for them. All was well in his life, except his daily dealings with diseases where death hovered imminently above the pending corpses. These transient lives haunted him but nothing had changed. He had a perspective on life and death without infusion of too much emotion. Unfettered feelings would be fatal on this battlefield.
He lifted his stethoscope, placing it on the emaciated chest of one of the victims near the end. The moist rattle hurt his ears with sounds that should not emanate from a human body. Eyes were popping from hollow sockets pleading for help with skin like a diaphanous veil coating weary bones. The heart pumped with vigor, ignoring the signs of futility.
“We will help make you comfortable,” he whispered.
The eyebrows and mouth corners lifted slightly attempting to display gratitude.
On to the next patient, and the next and so on. Not everyone had a dismal prognosis. There were cures and remissions. Evan’s thoughts were clouded by defeats. He tried to expel them unsuccessfully. He could only think of the dead and dying. Had the years of sad experiences taken their toll?
“What’s wrong with you?” asked Cora, his wife.
“I don’t know. I can’t explain it. I feel like something is wrong with me. I just don’t know what.”
“You should get checked out.”
“I keep having this dream. I’m afraid to go to sleep. It’s so real.”
“What’s it about?”
“It’s like a dream within a dream. I dream I’m going to bed, you know, really tired after a long hard day. I drift off to sleep and then I see something in the shadows. I start searching around but can’t find it. I go back to bed and hear moans and see something moving from one spot to another getting closer to the bed. I can’t make out the face but I feel like it’s going to kill me; then I wake up.”
“Tomorrow you’re going to see Joe. I’m calling first thing in the morning.”
At his office visit, he described his vague feelings and his bizarre dream.
“I think I’m afraid I have cancer and I’m going to find out when it’s too late.”
Joe stared pensively and said, “Well, your exam is normal and we both know that doesn’t mean a lot. I’m going to send you for lab work and do some scans. When everything comes back normal you’ll feel better.”
The tourniquet squeezed his arm as the scarlet liquid spurted into the container. He was shuffled from one scanning machine to the next peering into the cavities and inner recesses of his body from head to toe. Evan hoped for some abnormality, something early that could be cured. That would be better than nothing.
“I have great news, Evan, everything’s normal. You should feel relieved,” said Joe.
“That’s great,” his voice whispered.
“You sound unconvinced.”
“I was hoping… well… the way I’ve been feeling.”
“I know this is touchy but, I need to be honest. You are in a really depressing specialty. Did you ever think it can be getting to you? You should consider seeing someone.”
“No, I don’t think so.”
“Really, Evan, you have to consider depression. We all go through times when the pressures of medicine get to us. Physically, you’re fine. You know you’d recommend the same to your patients.”
“It’s different. I’m not…I never considered myself…”
“Anyone who is usually doesn’t recognize it or is in denial. I think you recognize it, Evan, please don’t deny yourself the help you need.”
The psychiatrist was known by Evan primarily through referrals and phone contact. He had a reputation of being practical and employed common sense rather than cluttering his treatments with abstract theories. He sat opposite Evan behind the oak desk strewn with papers. The calming music of Bach’s harpsichord concertos wafted through the air.
“It seems that you have your fears of death and harbor guilt about the fate of many of your patients. Your dreams are an expression of those feelings. You know you have no underlying disease…”
“I know that the technology is limited,” interrupted Evan, “It’s not 100%. I have patients who are attuned to their bodies and those who are not. For example, some patients will feel every extra heartbeat and others have hundreds an hour they are unaware of. What if my body is warning me of something that’s at an undetectable stage? You know, like some genetic mutation about to become cancerous.”
The psychiatrist’s hair was uncombed with white tufts swirling across a wizened brow. His brown eyes darted and scanned Evan’s demeanor and gesticulations, then narrowed in concentration. He needed to act to prevent the poor boy from plunging off the precipice.
“Have you ever had hallucinations or heard voices, outside of your dreams, of course?”
Evan’s muscles tensed, “No, I’m not crazy!”
“Have you ever thought of hurting yourself or others?”
“No, I’m a doctor!”
“You know I have to ask these questions,” he said while scribbling on his prescription pad.
“I want you to start this as soon as you can. You’re headed for a major depressive episode. This will help and I want to see you here next week. Call me with any questions or concerns.”
“I’m sorry but I can’t believe it’s depression; it seems like something else.”
“I’m here as a professional objective observer. I believe you’re very depressed. You must start treatment or things can get much worse.”
Evan resisted the notion. He looked at the paper handed to him, scrunched it and plunged it into his pocket. He planned on waiting to see how things were going before he would acquiesce. Cora rushed to the door.
“What did he say?”
“Nothing much. Thought I might be a little depressed is all. Just recommended some rest.”
“Yeah, you sound disappointed.”
“No, I’m glad it’s nothing serious; I’m just worried about you.”
“I’ll be OK, maybe you and I can get away for a little.”
“Really! That sounds great!”
That night, Evan’s dream began. As he fell asleep his ears were filled with a low hum seeming to emanate from the walls. The intensity rose and fell sequentially, at times causing him to pound his head. Intermittent moans and howls permeated the air from unseen sufferers. Then the demon appeared peeking his head through the shadows and shifting from one part of the room to another. As soon as the face could be discerned, it would vanish into the darkness as it crept closer to his bed. All sorts of indescribable anomalies now began to appear. Former patients cracked through huge eggs only to be devoured into the gaping jaws of serpents. The walls undulated in rhythmic succession as winged creatures with razor talons, spiked teeth and bat wings burst forth. The phantom creeper inched his way closer taking advantage of these horrific distractions.
Like a child, Evan pulled his sheets over his head. The noise and flying creatures whooshing above compelled him to leap onto the icy wooden floor to seek refuge. Faces of patients from the recent and distant past floated, disembodied like puffs of smoke or heads connected to insect bodies with dripping slime. They stared with contempt, visages pulled one way or another by unseen forces, distorting them into unrecognizable streaks absorbed into the blackened room. A creature birthed from the floor, startled him, and he fell on his back. Evan began to rise when the phantom creeper unexpectedly rammed him and perched on his chest like a hawk over its prey. Evan’s breaths were shallow from its weight as it hypnotized his gaze. Pale, hooded eyes with a depth and darkness amassed from centuries of layered evil peered into his eyes, inches from his face. Evan was incapable of looking away. Trying to escape was impossible as the massive weight sunk into his chest.
“I can’t breathe, I’m going to die!”
Evan awoke with rivulets of sweat streaming down his face, pajamas soaked as if emerging from a shower. The pounding in his chest and brain signaled him to do anything to stop this ordeal.
“I’m going to start that medication as soon as I get it tomorrow,” he thought.
Evan began taking the prescription and began to feel better after one dose. His sense of dread diminished and he was able to get a restful sleep. His wife noticed the difference.
“You seem much better. You’re not as tense.”
“I do feel better and I’m not having those dreams.”
Evan had to admit the psychiatrist was right. He was depressed from all the years of dealing with terminally ill patients. Guilt would take root and germinate into a weed that would entrap him in its tendrils. At times he would try to make a macabre joke that all his patients die but such words belied his empathy. He had been suffocating but now he was better. His health was good and now his mind was relieved.
The medicines used for depression act on chemical pathways that determine our mood. With prolonged stress the human brain can become depleted of substances that lead to the symptoms of depression: fatigue, lack of motivation, sleep disturbance, emotional lability, clumsiness, less insight. Along with improvement, Evan noted a certain lack of emotion. Circumstances that may have angered him he now looked at with indifference. One could say he was less sensitive. Evan wasn’t particularly bothered by it but he speculated what its meaning may have for future health issues. Would he be able to sense his body’s signals? He was relieved by the normal blood work and scans but he knew they had limitations. Was there something brewing as yet undetectable?
Evan’s nights were calm and his sleep restorative. At day’s end he could anticipate a night no longer filled with nightmares, seeing the lost patients taunting his clinical failures. He had a new enthusiasm for his work. His wife noticed immediately.
“Evan it’s so good to have you back.”
“It’s good to be back.”
Like a football, air was released just enough to keep its form but now easier to catch, even in the most trying circumstances. He no longer worried about the unknown but focused on the present. The calm of day transitioned to uninhibited sleep.
Deep in the recesses of the human body, cells upon cells dividing and regenerating tissues, so small escaping detection, was there a clump of cancerous cells? The body has its repair mechanisms, recognizing mutations, extirpating genetic code abnormalities, scanning entwined strands of DNA with methods that are sophisticated beyond our comprehension. Then something goes wrong. Is it a failure of the system or forces that our scientific minds refuse to acknowledge; past sins real or imagined with consequences emerging from the depths of the universe of recrimination? A cunning deviant smirks, eluding surveillance, leering with Stygian eyes that swirl with centuries of malevolence. The torturous nightmares he generated were blocked by the chemical pathways interrupted by the victim’s daily medicine. The demon’s smirk spread into a smile; delayed gratification would lead to ultimate victory!
John Ricciardelli is an emerging author who has been a practicing medical doctor for many years. His life experiences have inspired him to compose fictional short stories. Like many, he thought that writing well was the result of an innate talent; words flowing in grand style from pen or keyboard. Whether composing, painting, or getting to Carnegie Hall, he discovered the keys are learning the craft and many hours of practice. He believes that Stephen King gives the best advice; read a lot and write a lot. The joys of his life are his family and friends. Giving back to the community has been fulfilling for him and is intertwined with growing up and being a practicing Catholic. He has a variety of interests including personal fitness, film, music, art history, and sketching. He is also writing his first novel.