The One who swallowed clocks.

Visceral Surgery, 4th year.

"- So ?"
"- Easy one : clock !"
"- Right !"
"- What was his excuse ?"
"- Oh, this one doesn't really theorize things. It's not the first time, actually. He is coming from Saint
Gargoyle* (* Psychiatric Hospital of the area).
"- Oh, I see."
"- Yes. We're waiting for the clock to pass through the pylorus and then the cecal defile and he'll
be free to go on swallowing whatever he likes."

That awkward moment when you understand that it is the item more than the human being or the
reason he swallow strange things which matters to you.

That terrible moment when the simple sentence "He is coming from Saint Gargoyle" suits to undoubtedly justify nearly everything.

The one who drank caustic soda in order to forget.

Visceral Surgery rotation, 4th year.
Digestive surgery patient hosted in the high located E.N.T. service.

I quietly stare at her, waiting for any kind of answer.
It won't come.
Her blurred look insists on ignoring me, heading towards the window. We can't see anything else than the summer sky through this one. From her eighty-five years and her erratic medical follow-up, i am not convinced that she actually sees that sky.

I hold on to her file.
According to the nurses, the first thing she said to the psychiatrist was "I failed, but i'll do it again.".

I inform her that i am going to check up her scar.
She starts holding her lips and blouse tightly. With that strenght that can only be shown by the elderly while defending themselves against the White Coat Confraternity.
I instantly start reciting an endless flow of words in order to establish some kind of non-agression pact. Doing that, i brought back her record in my mind.

Eighty-five years old, social isolation, domestic violence lasting for more than half a century, eighth suicidal attempt recovered at the hospital.
Phlebotomy and defenestration didn't work out, neither the absorption of caustics. Unlike some others doing it again and again, it is not due to a lack of will.
This time, she drank two bowls of Destop(R).
As our Psychiatry professors say "When an elderly does a suicidal attempt, he or she usually succeeds."
She, indeed, stood close to self-dissolution.

She reluctantly accepts to show me her abdomen, rightfully hoping that it would make me leave quicker.
The scar is smaller than what I had expected. There is a  nearly clean draining pocket and a gastric tube for enteral nutrition. I follow the tube with my finger.
Indeed, compared to the other clinical cases I studied before entering her room, she "was lucky". I mean that the soda didn't have the time to nibble her stomach as it did for her now removed oesophagus.
The firemen, called by the family, came up pretty fast, which is of prime importance in the cases of chemical burning by strong bases.
She won't be able to swallow her saliva anymore. A little pocket on her neck is here to collect the limpid liquid.

I can't help thinking that she might be planning another suicidal scenario right now.

I step aside and let her button herself, ending the contact which was obviously painful for her.
I reach the door of the room and try a last glance. She is still huddled on her armchair, staring at the window.
"- The one who is always there to call the firemen, don't you think that he could prevent her from being beaten ?" would eventually spat my senior surgeon.

The occasional impotence of our caring system and the morbid grotesque of her situation still freeze me to the bones.

The one who celebrated his cupper wedding with the kidney of someone else.

Daycare Hospital, Nephrology, Sixth year.
I grab the following file of the "Annual checks" pile and open it.

I like to picture the transplant physicians as a form of National Matrimonial Agency.
"Nothing will ever prevent us from finding you the perfect HLA-match, so let's sign up now !'

We have to acknowledge it, organ transplantation is a complex process requiring a huge amount of concessions.

The recipient, in need by definition, is accepting the graft by doing some sacrifices.
He has to rethink the notion of "self" and the idea of autonomy. Which, i bet, does not come that easily. He also have to make a clean sweep of his past, muting his immune system oftenly using heavy treatments.
And yet, even if they are sometimes grumpy, the recipients rarely refuse the idea of this planned matrimony. Their destinies rely on it. They eventually are the ones soliciting the services of the Transplanting Agency.
So, our recipient is in waiting (sometimes for quite a long time). And suddendly, one day, the Agency calls because it has a match and has set up a meeting.

On the other side, the story of the sweet graft is quite different.
Rarely spontaneously offered, it is oftenly torn from its homeland while things are seriously going crazy. It is seperated from its birth-organism, arteries cut, and bend to another body. Maried by force to a great machinery more or less functional requiring its urgent and constant services.
So, expectations towards the newcomer are somewhat huge. 

Since Romeo and Juliet have finally met, the transplant physicians pamper them.
They do all they can in order to put on soft mood music (peaceful immune environment), make sure that everyone feels comfortable (clinically and paraclinically) and then hide in a corner (behind some computer) and do what every matrimonial agent would do : wait.

Sometimes, none of the main characters can suffer the other one. The first one is attacking the second evoking some old love story (aka transplantation) that had gone mad. The weapons are an immune battery able to recognise every graft that more or less looks like the previous one. And on the other side, the second is panicking because it has suddenly understood that he wasn't home and is so terrified that it tries to burn everything down.

Sometimes, it goes softly. The protagonists can understand each other. They cohabitate by doing some concessions and go every year to the Agency for their "Annual Check up". Then, they do the  together. This kind of relationship usually lasts for a decade. Ten or fifteen years of good services, then the two of them get tired and the story ends.

And sometimes, rarely but sufficiently anough for a chatty student to meet them, it is love at first sight. The recipient end up living with the graft longer than his own previous organs and the graft feels so comfortable that we can't tell it apart from the host.

The smiling man and the zen kidney i met this day were of these misfortune lovers. When i opened up the file that day, i saw the pre-filled column saying : "Annual Check up of the thirty-two years".

I looked up to the transplant physician still hiding behind his desktop, his finger on the mood music prescription, and raised a thumb. Well done.