“An admirable work ethic indeed,” Dr. Lee said. “Be that as it may, however, long term use of any stimulant has been irrefutably linked to early onset heart damage and susceptibility to life-threatening arrythmias such as SVT. Just because this doesn’t happen every time you use cocaine does not mean that the cocaine is not what caused it or triggered it.”
“It doesn’t mean that it did either though, right?” Matt countered.
“It is impossible to prove a negative,” Dr. Lee said. “That is one of the principals of logic. But...”
“Hey, that’s some deep shit there, doc,” Matt said brightly. “Impossible to prove a negative. Nerdly used to say shit like that all the time—at least he did before he turned traitor and helped kill Darren. Were you a nerd back in school? I’m guessing a lot of you docs were.”
“Yes, I was a nerd and I still am, in fact. My teenaged angst aside, however, there is another principal of logic which says that if it walks like a duck and talks like a duck and looks like a duck, it’s probably a duck. Your SVT episodes walk like they are induced by long term cocaine use, they talk like they are induced by long term cocaine use, and they look like they are induced by long term cocaine use. Therefore...” She held her hands out invitingly, trying to get him to draw the conclusion she was trying to illustrate on his own.
Matt thought this over for a moment and then nodded. “I’m picking up what you’re laying down, doc, but I still don’t think so. There had to have been something else that caused this.”
Dr. Lee sighed. “All right then,” she said, giving up. “In any case, I’m going to admit you to the telemetry floor for a complete cardiac workup in the morning. Before we do that, however, I want to get some ... why are you shaking your head at me?”
“I can’t stay in the hospital, doc,” he told her. “We’re heading to Chicago in the morning. I got three shows to do there. After that, we’re going to Minneapolis.”
“Matt, you’ve had a significant cardiac event,” Dr. Lee said. “And this is the second time it has happened to you. You need a cardiac workup to see what kind of shape your heart is in. I must insist that you stay here and let us check you out.”
“No can do,” Matt told her. “I’ll sign your little against medical advice paper for you, but I gotta hit the fuckin’ road. The show must go on.”
“You could die if this happens again, Matt,” she told him.
“We all gotta go sometime,” he said.
“Will you at least let me run some labs and do some tests here in the ED before you go?” she asked.
“Sure, why not?” he said. “I’m sure the groupies are all gone from the hotel by now anyway.”
“Uh ... right,” Dr. Lee said. She turned to the two nurses, who had been watching the entire episode quietly, their faces without expression. “Go ahead and get a repeat EKG and then draw standard cardiac labs on him. I’m also going to order an ETOH, a urinalysis, a drugs of abuse panel, and an STD panel.”
“You don’t need that STD panel, doc,” Matt told her. “I always use a rubber ... unless I’m boning Kim, that is. We go bareback when it’s just the two of us.”
“Kim?” Dr. Lee asked.
“You probably know her as Mary Ann Cummings,” Matt clarified. “She used to be a porn star.”
“And ... you have a sexual relationship with her?”
“Yeah, she hangs out at my house and we fuck each other when I’m home. I help her run her business too. She’s all right.”
“I see,” Dr. Lee said. “If it’s all the same to you, Matt, we’ll go ahead and run that STD panel, just to be sure.”
“Whatever juices your clam,” Matt said with a shrug. “And speaking of that...” He looked at the nurses, who were pulling things out of a cart in preparation of carrying out Dr. Lee’s orders. “Do you mind if they step out for a minute? There’s something personal I want to talk about with you real quick.”
“More personal than what we’ve already been discussing?” Dr. Lee asked.
“Yeah,” Matt said. “It’ll only take a minute.”
“Sure,” Dr. Lee said, looking at the two nurses and giving them a nod. They left the room, closing the door behind them. “All right. What did you want to talk about?”
“Well ... it’s kind of embarrassing really. The shit I tell you stays between us, right?”
“Right,” she said. “Doctor-patient confidentiality is a thing.”
“Cool,” Matt said. “It has to do with ... you know ... my equipment.”
“Your equipment?”
“My schlong,” Matt said with a whisper.
“You mean your penis?”
“Right, my schlong,” Matt said. “You see ... right before all this shit happened tonight, I had a couple of groupies with me. One was this bleach blond bitch, the other a goth bitch with a tongue stud. Hot skank, you know? The kind of sluts I fuck all the time after shows.”
“I see,” Dr. Lee said slowly. “Is there a point to this story?”
“Yeah,” Matt said. “You see, when it came time for the action to start, I ... I wasn’t ready.”
“You mean you failed to obtain an erection?”
“Right. My shit wouldn’t get hard. Goth went down and started slurping on it, tongue ring and all, and Bleach Blond was sucking on her tits while she was doing it, but I couldn’t get it up. That shit ain’t never happened to me before, doc. It was distressing.”
“This happened right before you noticed you were in SVT?” Dr. Lee asked.
“That’s right,” he confirmed. “Does this SVT shit keep you from getting a boner?”
“Well ... in all honesty, I’m amazed that with all the substances you abuse simultaneously that you’re able to achieve an erection at all, under any circumstance, but to answer your question, yes, if you are in SVT it is unlikely that you’ll be able to ‘get a boner’ as you say. The blood flow in your body during SVT is compromised to some degree and this causes what we call a sympathetic response, meaning that your sympathetic nervous system is putting you in fight or flight mode. Sexual arousal is primarily controlled by the parasympathetic nervous system, which is suppressed during a fight or flight response. Does this make sense to you?”
“Are you saying that there’s nothing wrong with my shit? That it was the SVT that kept me from getting it up?”
“In all likelihood,” she said.
This made Matt happier than he’d been all night. “All right,” he said. “Thanks, doc.”
“Anytime,” she told him.
She left the room so the nurses could start their work. Even though she had only touched Matt Tisdale a few times to listen to his heart and lungs, she had an almost irresistible urge to go take a shower.
Jake had lived in California all of his life, in southern California for the last twelve years of his life, but he had never heard of the town of Oceano before. Now, at 1:30 PM on April 21st, he was flying into the small San Luis Obispo County town to check out a piece of property that was for sale just a few miles north of it.
Laura sat beside him in the copilot’s seat. She had a notebook open and was transcribing notes on the trip for Jake. Jill the accountant, who had scoped out this particular piece of property for him (very much against her better judgment and advice), was sitting in the passenger seat behind Laura.
“Airport in sight,” Jake said, looking out the right-side window at the single runway facility located only a hundred or so yards from the beach. “What’s our flight time from takeoff?”
Laura checked her watch, wrote down the time, compared it with the time they went wheels-up from Santa Monica, did some quick mental arithmetic, and then reported her answer. “Thirty-eight minutes.”
“Not bad,” Jake said. “And we’ve only burned a hundred and fifty pounds of fuel. Definitely commuter distance as far as I’m concerned.”
“How many gallons is a hundred and fifty pounds of fuel?” asked Jill, who had her own notebook open before her and was jotting down her own notes.