Final Diagnosis - Book 1: No Second Chances ebook i audiobook

FINAL DIAGNOSIS

Second edition—2020 by The QUPI Legacy Foundation (softcover and ebook)

First limited edition 2019

Copyright © 2019 in text: J. T. Madicus

J. T. Madicus asserts the moral right to be identified as the author of this work.

All rights reserved. Except for short extracts for the purpose of review, no part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means, whether electronic, mechanical, photocopying, recording or otherwise, without prior written permission from the publisher.

ISBN: 978-1-7351289-0-0 (softcover)

ISBN: 978-1-7351289-1-7 (ebook)

Front cover art and internal images by Gabriel Rodak

Book design by Jill Ronsley, suneditwrite.com

Printed and bound in the USA

CONTENTS

Check Your Diagnosis

From Prague with Love

Doctor Danger

Doctor Damage

Doctor Deliverance

Czech Mates

Coming Out

Heart

Fight or Flight

Fragrance from the Past

Port of No Return

Breathless

Feelings

Game Over

CHAPTER I

CHECK YOUR DIAGNOSIS

ALL GOOD THRILLERS START WITH a bang. A gunshot. An explosion. A beautiful woman. But on the day this saga begins, I wake to the sound of a knock on the front door. Three loud thumps that rip me from an uneasy sleep. I have no friends … as far as I remember. People dislike me, but few hate me enough to come knocking in person at such an ungodly hour of noon. A shot of whiskey sits on my nightstand. Life is short, so why not start the day with a proper breakfast? I down the whiskey in one swig. There can only be one person knocking at this hour.

I hear the front door unlock and I smell coffee. Instinctively, my mouth waters. Breakfast is here. Well, lunch. Lunch with a side of guilt. Phil is his name. Phil the pill man. Or did I just make that up? Whatever his name, he complains about being forced to make deliveries to me—especially deliveries of a certain controlled substance. A simple pharmacist, but, unfortunately for him, a foolish man. At least I didn’t cheat on my wife with a prostitute. Not that I have a wife. What I do have is a never-ending supply of orange bottles containing small, white pills. They look like over-the-counter painkillers. But you can’t get these over the counter.

Friends come and go, and we all know where we fit in; I am no one’s friend, but everyone has their value and I always get what I want. Usually, it is the satisfaction of being right. This time, it’s small rounds of beautifully crafted, pharmaceutical-grade opium. Bon appetit.

Tiffany disapproves. She’s … well, she’s the employee, with an ample supply of skills. I pay her to keep me alive—better yet, to make me feel alive, at which she succeeds—and to keep me sane, at which she fails. She is the whisperer of sweet nothings in my ears, the provider of tender touch that melts away all the pain. She provides a good service—the girlfriend experience with the voice in my head that most people are born with. The one that tells you to brush your teeth before bed. To call your mother on her birthday. To pay your bills before the IRS knocks on your door. To take your medicine before bed. Apparently, most people think of these things by themselves. I don’t. Hence Tiffany. But she doesn’t seem to be here today.

No sooner has Phil scuttled away when my door once again clicks open. Another person strolls in off the street like he’s family. He brandishes a soggy sandwich and healthy stack of mail. Oh, will someone just punch away that look on his face! Pity … some contempt? No. Fear. Fear and sadness. Ughh! Disgusting combination. The hour goes by with Jeff. Fortunately he only visits once a month. Since there’s no TV to stare at or WiFi to dive into, we are forced to interact. It’s brief and awkward. He sorts through the mail and tosses the New England Journal of Medicine at me. I’m sitting up in bed, surrounded by stacks of JAMA (Journal of the American Medical Association), BMJ (British Medical Journal) and of course my favorite, the NEJM. I take the proffered sandwich and eat in silence, contemplating suicide. Oh don’t be so dramatic! You would be suicidal too if you ended up in Mississippi, one of the cheapest states to live in. The South with its “Southern charm.” Jeff seems to have left. Now I’m alone. Just one of these pills to help me deal with Jeff, another to take the edge off the day and another … well, why not? It’s so hard to count when you’re sober, isn’t it? Good night, dear reader. Tomorrow will probably be the same. I wonder what Phil will bring for lunch.

The room is cold. The air tastes strange. Something has changed. My head throbs, but not in the usual way. Something is different. My eyes still shut, I notice that I’m sitting up. The chair is soft, and moves gently below me as I shift in the seat. Did I fall asleep at my desk? No, it’s a hospital wheelchair. If you’d lived the kind of life I have, you’d recognize it too.

I feel a sharp, metallic coldness on each of my wrists. Handcuffs. Kinky, in other circumstances, but right now downright inconvenient. I open my eyes. The room is dark. I squint. Lifting my cuffed hands to my face like a goddamned rabbit, I rub my eyes. Images swim before me.

A light clinks on, for a moment blinding me, before revealing a cold room. No natural light. A single bulb hanging down from the ceiling. The light is not bright, but my eyes still sting from the change. Before me is a metal desk. On it sit four iPads, a glass pitcher of water, and four empty glasses.

The pills I took the night before—or whenever that was—are beginning to wear off. I find myself sober, handcuffed, sitting in a wheelchair in a dimly lit room. The walls are concrete, the humidity is high, the temperature is cold. I am underground. Things could be better. Maybe I am dead and this is hell. Well, at least it’s quiet. At least I’m alone. Four iPads though … that is not a good sign.

“Diagnose the patient, Doctor Tseng, and earn your freedom.” The voice echoes in the small room. Distorted, artificial. And bloody annoying. I should be scared, but when you are this hungover, it doesn’t matter. Behind me a door opens. A guard—hulking, pale, expression-less—walks in, wheeling before him a slumped figure in a wheelchair. The unfortunate prisoner is parked beside me, facing the table. I say “facing,” but it’s hard to tell when somebody has a sack over their head.

The guard leaves, and another follows, pushing another captive, head covered like the last one. This guard exits, and yet another walks in! Is it my birthday? No. The liquid in the pitcher is most certainly not vodka. This isn’t a party.

The final guard removes the sacks from each prisoner in turn. A blonde woman. Quite fetching. Cuffed like me, squinting into the light. A bulky, square-jawed man, who glares at the guard. And finally, a dark-skinned man with a gentle face who looks around curiously, taking in the whole scene. Both men have bruises and cuts on their faces, as though they have been roughed up a bit. The blonde is the first to speak:

“What time is it? Where are we?” Of course the woman speaks first.

“Interesting that you want to know the time of day before finding out where you are,” I say, but I do add helpfully, “In either case, I don’t know.”

The distorted voice speaks again. Can I hear evidence of a slight smile, buried below the layers of electronic distortion?

“Welcome, doctors. I’d like you to meet Doctor Tseng. This will be his home for a while. It doesn’t have to be yours. I hear he’s not a good roommate. Before you is a conundrum. Solve it for me, and you will earn your freedom.”

The iPads light up. I look around. The blonde has somehow removed a hairpin, and is fidgeting with her handcuffs, trying to pick the lock. Her hair is falling across her face.

“Are you going to keep staring at me, or are you going to help us get out of here?” As the woman speaks again, I try to place the accent. American, with a rough, aggressive tone. Possibly New England. Most likely New York.

Her cuffs click open. They fall off and dangle on the arm of her wheelchair. She passes her hairpin to the bulky man sitting next to her. Surely these guys can’t be much use here! What about the third bloke. Dark, thin, looks a bit ill. Bet he’s quick with the hairpin though. Hmmm, maybe that’s why I don’t have any friends? People often say I’m offensive. I wonder why … Anyway, my head is starting to throb more. Focus, I tell myself. Let’s get out of here. The less time with this circus, the better.

My hands are bound tight together, but I can still reach forward. Assuming my amnesia is due to a heavier-than-usual dose of drugs, I reach forward and clumsily grasp at the water on the table. Better start flushing the system.

The muscular man picks up an iPad and begins to read. “Patient is a 35-year-old male with undulant fever, fatigue, and an enlarged spleen. Current diagnosis is chronic fatigue syndrome.” Time to take control. I never was a patient man.

“What do you think, Muscles?” I ask the man holding the iPad. “Well, yeah. Undulant fever. Fatigue. Enlarged spleen. It fits.” Apparently he is an idiot. Maybe the blonde has brains? “Blondie?” I say. She sits up and takes charge.

“The patient is male. Most chronic fatigue syndrome patients are women. Why are we playing this sick game anyway?”

She has some knowledge, but ultimately fails to deliver. “Nice pun,” I say.

It’s always a painful thing, to watch a beautiful woman roll her eyes. Anyway, speaking of pain, I am always in pain. I am always tired. I want out and to be home in my flat. And of course, I want my pills. I reach into my pocket, praying the pills are there. I’m even starting to miss Jeff. Let’s get this riddle solved. Lucky for the patient, one pill is there. I take it out and pop it into my mouth. Time to shine my light on this mystery.

“Syndromes are used by incompetent doctors who are unable to find a real diagnosis,” I say. “Let’s actually think here. What causes chronic fatigue syndrome?”

“Lyme disease,” says the thin man. His voice is soft, almost feminine.

“No maculopapular rash,” I say, trying to keep the disappointment out of my voice, but not trying too hard. “Look at his history. He’d been on a ton of antibiotics recently, yet he’s still ill.” The woman leans forward. “What about brucellosis? The patient has an undulant fever, the infection affects both men and women, and could also lead to enlargement of the spleen.”

Now it is my turn to roll my eyes at her, which annoys her. The muscular man interjects, reading from the iPad.

“The patient has lactose intolerance, so exposure to milk or dairy products containing Brucella is pretty unlikely.”

“What if he was exposed to them unwittingly?” she says. I pick up an iPad, and read through the text.

“You missed something,” I say, looking first at the muscular man to my left, between me and the woman, and next at the thin, dark-skinned man to my right. “The patient was admitted to a hospital two weeks ago. If it were a simple brucellosis infection, it would have resolved by now, and we wouldn’t have the pleasure of this meeting.”

“What about the enlarged spleen? Only a handful of diseases cause this,” says the blonde woman, tapping her iPad with a carefully trimmed nail.

“Only a handful? How medically precise. You sure you’re a doctor?”

“Top of my class at Harvard,” she retorts, scrolling through the text on the iPad. “The patient lived in Prague for three years. He has slightly elevated cholesterol levels, slightly elevated alanine transaminase and aspartate transaminase levels. Oh … naughty boy. He contracted chlamydia three years ago and was treated with azithromycin.”

“He’s clearly an alcoholic and a slut—brilliant diagnosis,” I snap. That was harsh; I must be hungry.

“It could be Lyme disease,” the woman says as she looks at the man across from her, trying to figure out who this skinny black man is. She is probably desperately reaching for any diagnosis that will get her out of this situation. I can see the frustration on her face.

“What about lupus?” the muscular man pipes in.

“It’s NEVER lupus!” the dark-skinned man exclaims. “I think it is thalassemia.”

Finally! He has something correct to say, and says it with power and passion. Maybe he is not as useless as I thought.

“A little too focused on the spleen, aren’t we?” I say, glancing at Mr. Muscles. “What did I tell you about syndromes? Lupus is a diagnosis of exclusion. All that muscle and no brain!” That’ll show ’em. Oops, Muscles isn’t happy. In fact, he is red with anger. I probably shouldn’t be pissing off a guy who outweighs me and has biceps bigger than my thigh!

“Look, Mr. Tseng. Or Dr. Tseng. Or whatever your name is,” snaps the blonde. “It’s DEFINITELY Lyme disease. Okay. So we have our diagnosis. Can we go now, please?” She stares at the ceiling where the distorted voice was coming from.

Oh if only patience was a virtue—then again, I am not a virtuous man. I can be rude. I can stereotype. I can cause offense. But those who put up with this know that more often than not … well, let me show you. Hopefully, my new “friends” will learn too. “You have no life!” I shout. The blonde recoils in her chair, looking shocked. “It is not Lyme disease! You said it yourself: the patient lived in Prague. When have you seen wildlife in Prague?” I look around the room at the stunned faces and continue: “What happened when you all woke up here? None of you wept. None of you screamed. Not one of you begged for your freedom. You didn’t even look surprised! What does this mean? It’s clear that there’s nothing waiting for any of you back at home.”

Silence. Why does this always happen after I speak? Ah well, in for a penny, in for a pound …

“None of you have any life. Sure, you have some medical knowledge, but it’s clear that none of you have practiced in the last five years. Let’s see, what do we have here?

“Girl doctor with trimmed nails, straight permed hair. Five-inch stiletto heels. Looking good without makeup, even in captivity. Beautiful, confident, and aggressive. You are definitely from Harvard as you claim. You may have even been at the top of your class. But not in medicine. Computer science?”

A defiant stare. Not a trace of hurt. I know I’m right. Muscles should be an easier one to solve. I turn to him.

“Meathead. Well groomed but still stuck in the golden years of your lost prime. The suit is from the 90s and your hair, well … Sure, you were a jock and the ladies couldn’t resist your biceps and your charm. You did study medicine. Maybe you even practiced, for a time. But that’s not who you are now. No doctor would wear that suit. Your whole look is designed not only to impress, but also to ingratiate. You need people to like you, but not for long. You’re a salesman. Used cars? After this we should talk. You can prescribe me a new ride.”

“How about I just punch you in the face?” Muscles says. “I worked the streets of Chicago. I’ve watched men die many times. Who do you think you are to dictate the value of a life?”

“Now now, Muscles. We’re all in this together. Speaking of … YOU!”

I turn to the final person in the room. The slim man looks at me calmly, without fear. The muscular man fumes silently to my left but still listens, curious to learn about his fellow prisoner. I knew that would be easy. But what are we in for now?

“You. Slim … very slim. Even sickly. Quiet, reserved, only giving input when needed, not concerned about being the loudest voice in the room. You’re an introvert, and you’re clever. Your appearance is polished with everything in its proper place. Not a single strand of hair is out of place, despite the rough treatment you had getting here. Your suit is perfect. Your boots polished. But there’s a speck of dirt on your left heel. You know this. You’ve been glancing at it constantly, desperate to take it off and give it a polish. You have OCD. You have no job and are currently living in the basement of your mother’s home …”

The thin man flashes me a look. Some small detail out of place? He would hate that. But my diagnosis is accurate.

“Okay, until recently you were living in the basement of your mother’s home. Things changed for you recently. Your mother loved you. But your father walked out when you came of age. Since then, you’ve been trying to make everything perfect. You blame yourself for his leaving. You know rationally that it’s not your fault. But you feel guilt. Guilt about something. You think some aspect of yourself caused your father to walk out … your sexuality. Oh, you poor thing! And now you have committed yourself to doing good. Good grief.”

That’s the three of them. Solved. Humans are like illnesses. Everyone has cause for how they are now. The difference is there’s usually no cure.

“Well done, well done,” says the blonde woman drolly. “You’ve figured out all of us. But have you figured out this patient? Regardless of what you say, I do want to go. I do have places to be. If you’re so brilliant, solve this problem and let’s go.”

The other two doctors nod in agreement. Sycophants. There’s a moment of silence, and then the familiar, distorted voice blares down from the ceiling.

“Oh, they were right about you, Dr. Tseng! I am definitely keeping you. As for the rest of you … no. No, I’m afraid you’re staying here too. You see, our Tseng needs an audience. He needs people to impress. And you, unfortunately, are the audience he needs.”

“We need to eat!” snaps the blonde. “And I need to make a phone call. I don’t know who you are. I don’t know where we are. I don’t know who HE is”—she points at me—“but we have rights. You can’t just keep us here.”

“Very well. I have no use for dead doctors. The water on the table is pure. And you shall have what you asked for. And when you have your final diagnosis, you will go free. You have my word.” The blonde snorts and runs her fingers through her hair. The muscular man stands and kicks the wall. He sits down with a sigh, burying his face in his hands. The thin doctor just sits there silently, staring into space. I read through the iPad, searching for clues.

With a creak, the heavy door slides open, and a guard appears. He passes around four pizza boxes, still hot, and hands a mobile phone to the blonde who snatches it out of his hand. He turns to leave but pauses, and pats his inside pocket. He takes out a small, orange pill bottle, and hands it to me, his face expressionless. “She says you might need these.”

She?

Glancing sadly at the soggy pizza, I hear a dial tone and the beep of numbers being entered into a phone. There’s no ring. An automated voice comes out of the phone, audible to all of us. It’s in an unfamiliar language. Not German. Not Russian, but Slavic. It could be Polish, or Slovak. I glance at the pizza box. On top in big orange letters is written “PizzaPraha.”

“So,” I say, unscrewing the lid on the pill bottle. “I guess we’re in the Czech Republic! Vítejte.”

A few pills, a few slices of pizza, and some water. It’s not a party. But it could be worse. This wheelchair ain’t so bad, once you get used to it. The room is getting dark again.

CHAPTER II

FROM PRAGUE WITH LOVE

THE OLD TOWN OF PRAGUE. Nighttime. Those winding streets, the dominating castle, streetlamps illuminating the footsteps of revellers: old-time locals staggering out of the pivovarnia (beer halls), their faces coated in sweat, insides bloated and greasy. Backpackers, tourists and foreign students mingling with the young locals in the bars and clubs. Faint tang of weed smoke in the air, and the moon hangs low above Karlův Most, otherwise known as the Charles Bridge. The buskers have gone home, and Joe is walking purposefully toward the town center, clutching his cell phone, guided by his Tinder account across the medieval city. Irina looks even more stunning in person. That red dress, necklace that draws the eye, just teasing the line of her bust. Blonde hair, blue eyes, and a smile that is simultaneously an invitation and a challenge. Joe cannot believe his luck. She likes his confidence, that American charm. Economics student, too. Though isn’t he a bit old to be studying? Still, he has moves. Drinks. Shots. Maybe some pills? Nothing they haven’t done before. A kiss in the bar. Your place or mine? Counting down the minutes until the Uber arrives. Dawn illuminates the ancient city. Tomorrow. A kiss goodbye. Another date. A couple of selfies. Chemistry fades. They both move on.

The light flicks on. The floor is hard beneath me. I find myself in a bright cafe and not a dark basement. I remember the basement, but whatever pills they gave me, they are good. So where was I? Ah yes, the Czech Republic. Lunatic disembodied voice and circus party of non-doctor doctors diagnosing a mystery man on an iPad. How long have I been asleep for? Again, must have been those pills. Pretty good hospitality, considering. Anyway, where is my coffee?

“Good morning, Tseng!” The blonde. A bit smiley, a bit too cheerful—but I am not complaining. Sitting with the others, businesslike around a table in a cafe, each holding an iPad, scrolling through details on our dear patient sipping on their morning joe. Is that a croissant? Okay, enough, don’t overplay the delusions. And who says “good morning” these days, anyway?

“Any new ideas?” I say, asserting control.

“It could be thalassemia,” repeats the thin man with conviction. “Patient has an enlarged spleen, so it’s possibly a genetic disorder that’s causing his chronic fatigue.” I like him; he might just be my star pupil, and he is so convincing in his conviction, but he missed something and I unfortunately will have to ruin his dream. Apparently, they didn’t get any smarter during my nap, I see, but they are coming up with better suggestions. Still, the thin man doesn’t waste his words.

I politely reply. I am never polite—but this is my hallucination, not theirs. “It’s not thalassemia,” I say, “but not a bad diagnosis. Look at his blood work.”

“Blood is normal with no elevated ferritin levels,” Muscles replies, but this time without a smirk. Maybe I was wrong with my preconceptions about him.

“Is there a tox-screen on the patient?” I ask. I am thinking the drugs might have fried his system. Believe me, I know how that feels.

The muscular doctor answers … now in a British accent. Did he always talk like this?