Thirty

I was waiting for an ultrasound scan in Gastroenterology. I had an appointment booked two days earlier with a certain Dr Horowitz. I pictured him as a tall, bony man with hollow cheeks, greying hair and horn-rimmed glasses. I hoped he was a superb diagnostician. The slip of paper they'd given me at reception said: “Room 3, 2nd floor, Dr Horowitz, 09.10.2018, 8:30.”

By 7:30 I was already sitting outside the room. At 4 minutes to 8 an old boy shuffled up holding a similar slip. Then a woman too – at 8:12. I'm not the passive type, so I was curious what their slips said – above all, what time. My suspicions were confirmed:

Theirs said 8:30 too! Well, would you believe it!

At 8:27 two women unlocked the room and went in – perhaps Dr Horowitz's nurses, I mean his medical nurses. All the better that there were two! At 21 minutes to 9 a man went into the room without knocking, whom I at first took to be Dr Horowitz. From inside came the sound of conversation, not businesslike at all, but all ha-ha and hee-hee.

When you're outside a doctor's room, you think not so much about the examination as about making sure nobody sneaks in ahead of you. By 10 to 9 my intuition was telling me that the man who'd gone in was probably a patient with connections. With all that giggling inside, it was better that he wasn't the doctor. After 9 I was convinced he was someone they knew. Now and then one of the nurses would come out of the room. She'd look straight ahead, as if, like a dog, she had no peripheral vision and didn't notice what a stir she was causing on the bench.

The two of them walked quite differently. The dark-haired one walked very fast. She'd go into some rooms and come back almost immediately. The blonde one took tiny steps in little shoes, size 33 at most. Every 9 minutes she visited only the toilet. In my opinion, her place was in Urology. Let me open a bracket here: the toilet door said “Staff” and it locked.

These excursions of the Blonde's stirred up our own needs too. But everyone held it in – nobody was mad enough to miss their turn over a mere pee. Evidently, knowing this, medical establishments provide no toilet other than “Staff”. At 9:11 the adrenaline of us multiplying patients was maxed out: who would go in, when, and if it was somebody else – what gave them the right.

At regular intervals I looked at my watch and let out a sigh meaning: “Lord, if I don't get in within 5 minutes, the irreparable may happen!” Others went for a tormented look and barely suppressed pain. It reminded me of the entrance exam at the National Academy for Theatre and Film Arts. As performances went, we were all at a high level and giving it 100%.

Just then that fellow, the one they knew, came out, but closed the door. Those of us waiting stirred and stood up. We tried to take up good positions in front of it. The situation resembled an imminent corner kick in football. The only difference was that the cross would come from the door itself. One man stayed on the bench. We suspected him of having connections. And so it turned out. A little later, it was him they called. The dark-haired nurse sternly ordered us to wait patiently for our turn. I was about to point out that it had long been the turn of all of us, but I held back.

When she went back in, the pain drained from our faces at once. I reacted first and sat down in the seat nearest the door. I hoped the referee of the invisible match wouldn't blow his whistle for offside. The others almost came to blows over who would sit next to me. We went back to our previous activities – surveying the corridor, eavesdropping and little artistic miniatures. The nurses made a few more runs each. We'd jump to our feet, ready to salute them military-style. Our faces were a mixture of pain, servility and hope.

I counted the tiles on the floor and on the walls. Also the benches, the rooms, the patients and the lamps. I set about predicting how much time and how many steps the Blonde nurse would need to get to the toilet and back. It wasn't a complicated task – a step under 30 cm, a distance of about 22 metres. The first time my prediction was out by less than 7%, but the second time I was spot on.

This connected fellow came out after only 22 minutes, but closed the door. I stood up in front of it and bent my index finger into knock-knock position, but couldn't bring myself to do it. My inner struggle led to several more bendings and straightenings of my finger, on which everyone's eyes were focused. That's exactly what a sniper does just before he pulls the trigger. After 112 endlessly long seconds, the Dark-haired nurse opened the door. My head had already popped up in front of her like a lump of cheese and she was slightly startled. I had put her in zugzwang and she said resignedly: “Well, you go in then!”

A warm wave washed over me. Oh, we Bulgarians, we're something else! What are we so unhappy about with our health system? I went into the room and shut the door firmly. The plebs stayed outside to stew. On the left there was an ultrasound machine with a screen. Next to it, a couch. The Blonde nurse was sitting behind a desk, writing. On the right there was a screen. Could Dr Horowitz be lurking behind it? I broke the silence:

• “Good morning! I'm here for an examination with Doctor Horowitz.” I stressed the name.
• “Yes, yes,” she said, without looking up. “Just a moment!”

The little dark-haired nurse asked her, looking her in the eye:

• “Dr Horowitz, shall I call the trainee too?”
• “Yes, call him! And tell him not to dawdle! And you – lie down and take off your top!”

At this point the orchestra should have struck up a fanfare. Well, how about that – it turned out the Blonde was Dr Horowitz! For two whole days I had pictured the doctor in vain as a man who fully understood other men's gastro problems.

• “Shall I take my shoes off?” I said, stalling for time while I digested the new situation.
• “No! Lie down flat on your back!”

Now that's an expression I didn't like at all. When they say it to you on the beach, they probably want you to tan your back. Do I lie flat on my back or just on my back? In my view, lying flat on your back is vague. That sort of phrasing has always got on my nerves and never flat on them. I worked out that if my back was underneath, I'd be able to look up, rather than having my nose stuck in the sheet, guessing what they were doing to me at that moment.

My next dilemma had to do with a strip of plastic, about two hand-spans wide, laid across the couch. It was obviously protective, but what was it protecting – the patient's head from getting dirty on the sheet, or the sheet from the shoes? At the other long end of the couch there was a paper towel, also of unclear purpose.

The dark-haired one seemed to sense my hesitation and said politely:

“Lie with your head to the North!”

I'd have easily worked out which way North was if there had been some moss and lichen somewhere on the couch – I was a scout. Or if I'd had a compass on me. I lay down the way I liked. My back was on the couch, my head was on the strip, and that way I could see the ultrasound screen if I spread my shoes apart.

At that moment the trainee came in and told me to lie the other way round.

That was unclear too – should I swap my stomach and my back, or my feet and my head? I took a little while to decide.

• “The other way round, grandad! – Ah, you've got shoe marks all over the paper towel! – Nurse, change grandad's towel!”

He said it as if – change my nappy! A moment ago I wasn't supposed to take my shoes off, which I had offered to do, after all. So who was in charge here, may I ask? And I was no grandad to this drip!!

I was now lying on my back, but I couldn't see the screen. Never mind, I told myself: “I've forgotten my glasses anyway. And since I'm hard of hearing, I'll be their ideal patient – a sort of teaching aid. I'm putting myself in their hands. Better they practise on me than on a young person! And let's hope that in an hour or so they don't call my wife in to identify me!” I crossed myself.

The trainee sat down next to me and smeared gel over my abdominal area rather sloppily. Some areas were left completely dry. I didn't say anything to him, even though people my age love making remarks along the lines of:

• “Not like that, grandad – a bit more here! – No-no, higher /lower/! – That's it, there's grandad's boy!”

The trainee reported that he was ready. Ready, my foot – here and there I had no gel, and in places there was too much. I could see that even without glasses.

During the ultrasound the doctor showed him where to place the probe on me. Then she explained something to him, but far too quietly, pointing at the screen, which was to the right of my head. Every now and then they seemed to want me to turn on my side. I waited for something clearer – left or right, East or West. They caught on and started turning me clumsily with their hands – like a kebapche on the grill. I worried that sometimes they put me back in the old position. Evidently something on the screen made them not believe their eyes. Now and then they'd tell me, more loudly, not to breathe as well. That was unnecessary – I was holding my breath so hard I was already giving up the ghost.

My original expectation had been:

A quick swish-swish with the probe – after which the doctor announces solemnly, so that even the trainee hears it clearly:

• “N.A.D. – Nothing Abnormal Detected.”

But they kept going, unevenly, for over 6 minutes now. Sometimes they interrupted the ironing of my stomach with the “iron” /the probe/. Exactly the way my grandchildren did with the joystick when they played on the PlayStation. They'd stop jabbing when they were waiting to “go to the next level”. At least they'd shout “Yes!” and “Give me five!”! Whereas the doctor and the trainee kept whispering, more and more conspiratorially, in my opinion. After a while even that stopped. Total silence. Even worse.

I got seriously worried. The diagnosis /the verdict/ was evidently complicated. This was exactly when Hugh Laurie /from “House”/ should have come limping in from somewhere.

I calmed down when I guessed what – God willing – was going through their heads right now: “There's nothing wrong with the patient, but we need to dig up some suitably expensive treatment pathways according to the health insurance fund's rules.” There really was something very rotten in our health system!

“Tissues, thirty,” I heard the commanding voice of Dr Horowitz.

That startled me. Her gaze was pointing to the left of my head. I wasn't sure whether I'd heard right, or whether it was meant for me. I waited – I'm a grandad, after all.

She repeated:

• “Tissues, thirty!”

I looked to the left of my head again. Yes, there – on the cabinet – there really was a big pile of tissues. There were at least 80. Pass her some, fine, but a whole 30? Or maybe it was about “size 30”? But the tissues were 20x20, even 15x15. Where was the logic? The saving thought came to me to pass her 3 or 4. They really were far away from her, but I didn't dare – I was sure she'd tell me off. Until recently I'd been dreaming of getting into her blasted room, and now – of getting out of it.

The doctor, after a few more scribbles on the form, looked up, eyed me like an artefact and said it a third time:

• “Tissues, thirty!” After which she whispered something in the dark-haired nurse's ear. The nurse went out, visibly worried. The trainee also headed out, presumably to dawdle about, the drip, with the rest of the drips.

I buried myself in the tissues again. I counted tensely. I had just got to twenty, still holding them in my left hand, when the doctor looked up at me:

• “Thirty, I said!”

It seemed her experienced eye had quickly judged that there were only twenty tissues, so just in case, with trembling hands, I added another 10 or so onto my stomach, just like that – by eye. She carried on writing something on the rebus of a form.

You may snigger at me, but at the time I was reasoning anxiously:

The dark-haired nurse had been sent off urgently somewhere by the doctor, perhaps for a scalpel. The next examination or operation possibly required the doctor to open up my abdominal cavity. Blood would gush. Evidently the doctor was a real old hand. Who knows how long she'd been opening abdominal cavities, and she knew the exact number of tissues needed to stop the bleeding. I had no room for error and set about counting more precisely whether the tissues on my stomach were exactly thirty, rather than just by eye. I arranged them on myself in parallel, after putting the two spare ones back in their place. She kept on writing. Now on a left-hand and a right-hand form. In my opinion – one for intensive care /if I survived the intervention/ and one for the morgue. I said the prayer in my head – all of it, exactly three times. I prepared myself mentally for the anaesthetic and possibly a requiem, a tunnel with a light, and so on.

The doctor finally looked up at me again and met my meek, sheepish gaze. She got up, angrily took the tissues off my stomach, which at that moment truly was an abdominal cavity, and put them on top of the others on the cabinet without counting them. From there she took one and made as if to rub my stomach, rather squeamishly, but changed her mind and put it down. She shot me with a look and commanded in an unnecessarily loud voice:

• “Dirty, I said! What are you waiting for – wipe that gel off your stomach with the tissues and get up!”
• “But doctor?”
• “There's nothing wrong with you!”