“Thanks.”
“How’s the patient?” Lou says, looking at one of the two screens on my desk. One shows the side view with Sam in the foreground and the doorway behind him. The other shows Sam from the foot of the bed up, so I can focus on his facial reactions.
“No change,” I say.
Lou starts to leave, then stops and says, “It’s good to see you, Donovan.”
“You too, Lou.”
He says, “I’ve got a riddle for you.”
“Go ahead.”
“Two men are on opposite sides of the earth. One is walking a tight rope between two buildings, at the 95th floor. The other’s getting oral sex from a 95-year-old woman. They’re both thinking the same thing. What are they thinking?”
I shrug.
“Don’t look down!”
I smile and say, “It’s good to be back.”
Ten minutes after Lou leaves my office, I see movement on the screen, and notice a doctor has entered Sam’s room. I turn up the volume.
19.
“Mr. Case, I’m Dr. Elton Drake. I’m afraid I have some bad news.”
“Let me guess,” Sam says. “The snake died after biting me?”
Dr. Drake gives a humorless smile. “If only.”
“Let’s hear it, then.”
“I’m afraid we’re going to have to amputate your left leg.”
“What?”
“Not the entire leg. Just to the knee.”
“Oh, just to the knee? Well, how fortunate for me!” Sam says, sarcastically. Then adds, “This is ridiculous. This isn’t the 1800’s.”
A nurse joins them, and starts fiddling with Sam’s IV.
“You were bitten by a water moccasin,” Dr. Drake says.
“Big fucking deal. You’re not cutting my leg off. There’s antivenom available for water moccasin bite. I’ve read about it.”
“You’re referring to CroFab, a serum derived from four species of pit vipers.”
Sam raises his head, closes his eyes a moment, then opens them and recites, “CroFab is a combination of venom components from American pit vipers including three types of rattlesnakes and the water moccasin.”
“Very impressive,” Dr. Drake says.
“There’s more,” Sam says. “‘Untreated, a Water moccasin bite can cause severe pain and tissue damage that can result in the loss of a limb or even death. Treatment with CroFab, within six hours of a snake bite, is virtually always effective.’”
“Are you finished?”
“No. ‘Use of CroFab is contraindicated in patients with a known hypersensitivity to papaya, or certain pineapple proteins.’ I have no issues with those fruits, so I’m within the statistical safe range.”
“Truly astounding.”
Sam waves his arm. “Whatever. My point is, in this day and age, people don’t die from viper bites. Nor do they need their legs cut off.”
Dr. Drake says, “Are you familiar with S.S.S.?”
“Is that your poor imitation of a hissing snake?”
“Snakebite Severity Score. It’s a scale used to assess the severity of envenomation in a patient.”
“So?”
“There are six categories. And yours is off the charts.”
“You’re saying I could die?”
“There’s a treatment algorithm. We’ve followed it carefully. You’re already on the maintenance dosing. You’ll live, but the damage to your left leg is too severe.”
“Why would the poison collect in my lower leg? The bite was on my nuts.”
“It just felt that way,” Doctor Drake said.
“What do you mean?”
“The snake bit your inner thigh. If we were just talking about that bite, you’d probably be fine by now.”
“What do you mean, ‘that bite?’”
“You reported being bit once. But you were also bitten on the calf of your left leg.”
“That’s impossible.”
“The snake must have found you on the floor after you passed out.”
“This is the first I’ve heard about that!”
“Not true. I personally discussed this with you several hours ago.”
Sam stared ahead, blankly.
“I’m sorry, Mr. Case, I know this comes as a terrible blow.”
“A terrible blow? Ya think? I’ll tell you a terrible blow: the one I got from your daughter last night. That’s a terrible blow!”
“There’s no reason to attack me personally—”
“It’s bullshit!” Sam yells. “I’m not allowing it! I won’t sign the consent form!”
“Sam, look at me,” Dr. Drake says.
Sam does.
“We’re trying to save your life here, son.”
Sam raises his head again, and closes his eyes. This is how he accesses information he’s read in the past. Sam’s a genius. He’s one of six people in the world who has Superior Autobiographical Memory, the initials of which are why he calls himself Sam. In addition, he is only one of three people in the world who possess Mega Savant number skills who isn’t mentally disabled. Simply put, he is one of six people in the world who can do one thing, one of three who can do another, and the only one in the world who can do both.
Sam opens his eyes and starts reciting, but his heart isn’t in it. He’s no longer sure of himself, and his words are coming out in a monotone. “Water moccasin bites do not create anaphylactic reactions in their victims. Moreover, their venom does not contain the neurotoxins common to rattlesnake venom. These bites create severe pain and swelling…”
“In most cases, that’s correct,” Dr. Drake says. “And I have to admit, your knowledge of water moccasin bites is far superior to mine, which is why I had to read up on the subject this morning. But there’s one thing you missed.”
“What’s that?”
“Water moccasin venom contains proteolytic substances that can cause severe tissue destruction.”
“I’m not familiar with the term ‘proteolytic.’”
“It refers to agents that aid in the breakdown and assimilation of proteins.”
Sam ponders this explanation a moment, then says, “Something’s happening.” He looks at the nurse. “What did you just do?”
She looks at Dr. Drake.
Drake says, “She gave you something to relax.”
“I don’t want to relax!”
The Doc motions the nurse to leave. When she does, Sam says, “You should be able to counteract the tissue destruction with a course of antibiotics. Try that, before you go around sawing off people’s legs.”
“I’m afraid it’s gone beyond that.”
“Well, I’m not giving my permission. You take my leg off, I’ll sue.”
“You’ve already signed the release form, Mr. Case, and you need this amputation to save your life. As a responsible physician—”
Sam struggles to rise to a sitting position. “I never signed any fucking form that gives you permission to cut off my leg! This is complete and utter bullshit! I want to see the Chief of Staff.”
Dr. Drake says, “The consent form you signed upon admittance authorizes us to perform any surgery we deem necessary to save your life.”
“Yeah, well I’m rescinding it here and now. What are you smiling about?”
“I’m sorry. It’s just that your word choice—rescinding—comes from the Latin words that mean ‘to cut off.’”
“Yeah, that’s really fucking hilarious. Anyone tell you your bedside manner sucks?”
Sam’s words are starting to slur. Whatever the nurse gave him has begun taking effect.
“I apologize,” Drake says. “But it doesn’t change the fact you require this procedure in order to stop tissue destruction at the knee. We’re not just saving your life, we’re also saving the upper part of your leg. And I can tell you, it’s a heck of a lot easier to fit a prosthetic to your knee than it is to fit an entire leg. It’s also less dangerous, and the time it takes to adapt is, by comparison, almost insignificant.”