The Count of Monte Cristo
The Count of Monte Cristo, a tall black male in aged clothes, walks up using his eyes to inspect me from stem to stern. The Count repeats his scrutiny from stern to stem, locks his eyes deeply into mine, searches deeply down, then inquires, “For real?” Unflinching I respond, “For real.”
The Count’s body relaxes as he says, “OK Doc, I need help. My blood pressure is all outta control.” I gesture to more private ground where we convene. “Ok, let’s talk”, I say as we arrive. We start with basic information as I lead the Count through a medical history. He recounts his troubles both recent and longstanding including hypertension, smoking, heroin, and methadone use.
I calmly clarify, “Are you using both heroin and methadone together?” The Count answers, “Yeah, on-and-off. Heroin is on-and-off, but I stays on methadone. What worries me is my high pressure.” The Count’s perspective is most worrisome. Death from hypertension requires decades of time. But, death from heroin can happen in the one-inch push of a plunger.
Next, the physical exam. The Count has a long, thin neck with a visible, healthy jugular vein. It stands as a lone fruit tree rife with red apples in the desert of peripheral veins coursing throughout his body that are as sclerotic as the Sahara sands. His heart, feeding the lone apple tree, beats a regular rhythm but resounds an S4 echo at the end of each beat decrying that it pumps against abnormally high pressure to feed the body. A dearth of blood from sclerotic veins arriving to the heart, and the blood trying to leave the heart fighting against the high pressure, damages both the heart and the arteries. A blood pressure cuff confirms moderate hypertension. My faithful stethoscope also reveals moderate wheezing.
I inquire, “Do you have blood pressure medicines?” The Count replies, “No.” I ask further, “Have you ever been treated for high blood pressure?” Again, he responds, “No.” I delve into my black bag for a blood pressure remedy. “I’ll be back here tomorrow to check it again.” The Count smiles, gives me a firm handshake, and looks me again in the eye.
His eye with yellowish, blood-shot conjunctiva still has a glint of remnant hope despite the loneliness, the cold, and the hunger of the street. His eyes belie his thoughts as if saying: “The loneliness is the worst. Cold. Unloving. Alone…. Except… there is a Catholic shelter that provides a warm meal every day. Everyday. Except… there is a physician who wanders the street healing the sick. How is it possible? It don’t make no sense. The shelter says that it is Jesus at work. Jesus? Jesus.”
The loneliness remains but loses its bite. A comforting blanket of compassion covers the cold, uncaring darkness. The cold loneliness still shivers the sinews at night but no longer permeates into the soul.
more to come…
We encourage you to take to the streets and get to know the people, the struggles, and the stories for yourself. Bring food, socks, and an open heart.