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Volume 2, Issue 4
Winter 2006:

The Surge

Richard Jeffrey Mansfield, M.D.

Cell 2 Soul. 2006 Winter; 2(4):a8

Mike Rifkin died today. Well, really he won't be dead for another couple of months, but essentially his life ended today when he met me. He's not the first man to have died by my hands in this way. You'd think something like that would be an important part of a story like this. It isn't. Not to me. What's important is that Joshua will turn seven next week. This is what I thought about as I watched him cry in the back seat of my car.

August 30th, 12:30 pm. Half a day gone; half a day to go. I have changed my bank accounts and am living on new credit cards. My attorney is expecting my call later today about the trust fund. Divorce is purgatory. I don't mean some medieval halfway hell. I mean it is truly a painful purging that has permeated my life. And I was hoping the second half of my day would be lighter so I would catch up on patient charts and lab results, and then hopefully (and grudgingly) turn to the paperwork part of this purgatory. Actually, who am I kidding? Really, I will do very little, being exhausted from anger. I'll just wait for the end of the day to come; then I'll go to the gym and pretend I can lift this weight off my shoulders.

Mr. Rifkin had been scheduled to see me without my knowing. Fine. Whatever. I will put my divorce papers on the stack of overdue pharmacy committee meeting minutes. Then I will put a nice smile on my face and listen to Mr. Rifkin.

A lump on his chest? Is he kidding me? I don't feel anything. There's nothing there. "Those are your ribs, my man. They're just sore for some reason or another." There's maybe some swelling above his collar bone, but no lump. I remind myself that the trust fund is handled through a bank in Texas, a different time zone. I will need to make that call soon. I comment that his left eye looks drooped. He's noticed this for about a month.

My future-ex wants everything, the house, the money, the boys, and a second husband, apparently. I wonder if his pick-up will be in the driveway when I pick up the boys tonight. Dammit! This Rifkin guy could have Horner's syndrome, a "Pancoast" lung tumor that could give this specific combination of vague symptoms. It's one of those things they teach you in medical school, but nobody ever really sees it. I wish I hadn't picked up on this. I could pretend I didn't and just send him home. Really. It's a million to one this guy has it.

Of course it seemed a million to one chance that I would have ended up in the hospital as a patient myself. I had only recently been discharged when my wife asked me to move out and started the divorce. I actually thought that doing what she asked would show her how much I wanted things to work. But what I wanted and what she wanted were two different things. I see now how I reached the end of my patience and nearly went insane. At least those wounds are healing now.

Damn! This is not a normal chest x-ray. Mr. Rifkin won't want to hear this. That abnormal shadow is a tumor. I could call it a tortuous aorta, or old granulomatous disease. But it's a tumor. There's no way anyone could miss this. Though I found out today that I missed David's 'Kindergarten Kick-off' last night. I really will have to be a single father. I did talk with the guidance counselor at school, who was surprised to learn I had not been apprised of this event by my soon-to-be-ex. I'm not surprised anymore. Horrible things like cancer happen a lot.

"Mr. Rifkin, it's a tumor." There are always two questions that come next in some form or other when you drop the big 'C-bomb' on someone: "How long do I have?" and "What's next?" If you ever have to tell someone they're going to die from cancer, make sure you're ready to answer those questions. Me? Well, I've got less than a month before our court date. And, next, I'll go to the house and get the boys for dinner. "You'll need to have a CAT scan and then a biopsy. And it's just too soon to answer the other question without more information," I tell him.

I've got a lot of nice lines that work very well in this situation. They were never 'lines' before today though. They've been worthwhile, heartfelt discussions. Today I'll use the same words. I just won't think about them. "You selfish Son of a Bitch!" It's hard not to think about those words when they're screamed at you by the mother of your children — in front of them. I'm a talker, she's a screamer. The money in the trust fund is just not accessible. It's not a lie. I drove off with the boys to MacDonald's. Mr. Rifkin drove home alone.

Mike Rifkin cried in my office today. I took his life. Joshua cried in the back seat of my car today. He broke my heart.

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