Keystone Specialists

Philly suburbs, visiting family. Stomach ache, day three.

Try TUMS, but know better—put your shoes on. Remember it’s called the ED now, not ER. Rebranded. A solid distraction, to focus on erectile dysfunction instead of pain, but still, you don’t want to go barefoot. It’s after midnight.

Rush inside, find exactly no one.

Wait five minutes, ten. Guy walks out: “You need to be seen?”

Or: I’ve come for the Friends reruns in the lobby.

Four hours later, five. What it means to be seen. Imaging confirms appendicitis, yes, but your left kidney’s been holding out. Call it a lesion. That sounds like a cut maybe, right? Your kidneys are 40, just like you. Everyone’s got things, you look close enough. See a urologist when you get home, no biggie. And finally, opioids!

Post-op. In the room: the newly de-appendixed, his wife, his father.

The Nephrologist: “What brings you here today?”

(Today: fifteen years to the day that your mom died at 51. A snowstorm threatens, just as then. Her death unexpected, just as now. If this feels over the top to you, it’s because it is. Check your dad’s face when the urologist storms in. For Christ’s sake.)

“I just had my appendix out?” She’s confused, her and the clipboard aggressively not on speaking terms. “And they found a lesion on my kidney?”

“Oh, you need a urologist.”

Like they said.

Cost of 3-minute Nephrologist: $185. You’ll receive several postcards to help you treasure those minutes. In fact, you’ll be terrific pen pals for the next year and a half. They’ll even send you a Happy Appendiversary bill on the exact right date! Guess who plays the inmate with the credit card?

The Hospitalist (9 minutes later): “I’m Dr. John Elway, hospitalist. I’m the quarterback of the team because sports metaphors. I don’t do anything per se, but my smile? Huge. Demeanor? Eager beaver.

“You’ll have painful urination tomorrow, but I’ll neglect to file paperwork for the lab test. It’s true you’ll have whizzed in a cup for nothing, but who needs dignity when there’s breath like mine? Can you guess? Cinnamon. And the mouth feel, mmmp.

“You’ll see some specialists today. It’s nothing, literally. Like that nephrologist. Whatever they say, add 5 cc’s of salt and call me in the morning. Specialists, am I right?

“My serious face. It’s only temporary, but notice the sparkling eye contact. You need anything, just ask for Donovan McNabb, got it? This is me not winking as I turn to leave.”

The Urologist (3 minutes later, curtain whipped aside): “About that cancer on your kidney. I’m a surprisingly effective fire hydrant, only douchier. No need to thank me. My arrogance is blinding, I know (of course), but wait, I have the best science inside my brain, which is huge, like my dick, which probably feels like it’s crammed inside your brain right now. Oop! Here comes the science.

“Odds that lesion means tumor? 100%. Chances you’ll lose your kidney? Positively. Isn’t this great? Statistics for lay people.

“You need a cigarette? I do.

“You’ll remember this about me: I have the facial hair of the recently pubescent. And yet: 80% chance it’s cancer. In other words, totally cancer.

“Have you seen yet? Your lesion-tumor? Trust me. I’ll text it it to you. What’s your number? Annnnnd boom, you got it. Now, look, make your hand like this. That’s your kidney, here’s the golf ball. Believe that.

“K, pull your johnny up, let’s see what you got. Ooof, skin bridge from your circumcision. Unh uh. We can clean that right up.

“Listen, when you get home, go somewhere they do a lot of these. Nephrectomies, not circumcisions. Maybe you’ll keep your kidney after all. Who knows. Look, I’m out. I got a hoagie and a stack of 70’s porn on VHS waiting for me back at my house, which is huge, like living in my balls. You feel me?”

Later, when the post-kidney-surgery infection has arrived, just before they puncture your skin to corkscrew a tube through the thick of your back to drain a fluid they’ll never identify, the nurse who sedates you will be so enthused to learn the two of you share a birthday. You’ll be grateful for her excitement in a way that should be obvious, but that you’ll never understand. You’ll hope it wasn’t just the meds or Sinatra crooning in the corner.