The Leviathan (Part Two)
He licked the blood on his fingertip. It was surprisingly savory.
The doctors used to be more honest.
When he was a kid, they’d kindly usher his parents back into the waiting room. They’d pull up a stool and sit in front of him like a disappointed coach after a bad pass. They’d clasp their hands together and lean in, a paternalistic gesture that, whether he liked it or not, showed him they cared. “This isn’t going to get better on its own,” they’d say. “Breathing issues. High cholesterol. The boils. Even the anxiety. It’s all tied together.” The final verdict—that which could only be said behind closed doors, away from a patient’s loved ones, to spare them any shame that could denigrate their self-esteem: “You need to lose weight.” It was delivered with enough genuine concern that Max, a kid who was confident in a way that made adults giggle, couldn’t even defend himself. He’d look down and nod. He understood. He even agreed. But a pediatrician's room, with its mechanical scale and teddy bears in nightgowns splashed across the walls, is an easy place to submit to clinical wisdom. In the real world, temptations work overtime. They blur your revelations and crush any spirit of self-improvement that may arise from them, until you’re right back where you started.
Nowadays, most doctors were happy to read out the number on the scale, off-handedly suggest weight loss and move on. They didn’t spend any more time on it than they had to. Maybe medical sizeism had finally been defeated. Health at every size was now the law of the land. Your driver’s license came with an Oreo milkshake, and suddenly everyone wanted to fuck only the fat people on dating apps.
Or the doctors had given up. Because having a frank discussion with one patient would mean having one with every patient, and there wasn’t enough time for that. And God only knows what your reaction will be. Besides, a pill can probably put a brief stop to whatever symptom pulled you away from the drive-thru long enough to sign a new patient intake form. With a child, there’s hope that they’ll change. There’s still time for a useful intervention. A lightbulb moment that will usher in a long, healthy life of modest portions. Adults, on the other hand, are fucked. For them, there’s only coping. If health is wealth, its absence is poverty, illness and a ticking clock. A Hobbesian jungle—nasty, brutish and short. But at least no one would be hungry.
On Saturday, Max’s allergies were getting worse. The pollen was triggering his asthma and he was finding it harder to breathe. On top of that, a gout flare-up made him unable to bend his right toe, making walking something of an Olympian feat. There was now eczema on his face—a new development. He went to an urgent care because he had no insurance.
“What are you using to treat your asthma?” the doctor asked.
“Nothing,” Max said. “My old doctor had me on Advair, but he suggested I stop taking it because it’s a steroid.”
“It’s amazing how they don’t treat things the way they should,” the doctor said, scribbling something illegible on his pad. “This is for a rescue inhaler and for Advair. You need both.”
The doctor handed him the sheet, wished him good luck, and left. He peeked his head back into the sterile examination room.
“Oh, and you should try to drop a few pounds,” he added. “It’ll help with a lot of your symptoms.”
A nurse came in and shot him up with steroids to lower the inflammation ravaging his body. Max paid a $150 fee at the desk and bolted for the Whole Foods next door. On his way out, he swerved his body to avoid a little kid walking in at the same time. His left arm pressed against the door’s rusty hinges. He snagged his jacket sleeve and felt a sting halfway between his shoulder and his elbow. He looked back at the kid’s mom, a young woman in her 20s wearing spaghetti straps and flip flops. She stared at Max like he’d just flashed her son in broad daylight.
Driving home from the grocery store, he shoved his hand in and out of a can of fake Pringles, the kind that promises to be healthier but only manages to taste half as good. He thought about his coworkers. A recent Google search taught him they’re not actually anorexic, but orthorexic, a similar illness where people focus on eating “better” instead of less. “They’d never eat this,” he decided, successfully separating another few chips from the pack and guiding them to his lips. The feeling of one chip wasn’t enough. He needed about three at once to feel like anything of substance was entering his body.
He gave the chips a break so he could scratch his arm. It hurt even more now. He pulled his sleeve up and was surprised to see that his epidermis was split open about the length of an inch, revealing his tender, pink innards coated in glistening blood. He didn’t remember it hurting this much. Then again, he was busy being death-stared by a tertiary character from Shameless. He pulled his sleeve down and resolved to take care of it later.
Back at home, he slid his car into the mud pit that comprised his lifeless front yard and stumbled out of the driver’s seat with all the grace of an adult seal attempting an assemblé. His balance isn’t what it used to be. It’d been that way for years now. When he was a kid, he scootered and rollerbladed down broken ramps with nothing but minor scratches to show for it. Now he couldn’t even bend his torso to avoid an incoming kid without impaling himself. Inspecting the wound in the bathroom mirror, he took a detour through the rest of his mangled body. His bulging belly, supple chest and the many gradients of brown on his skin—the products of chafing and early signs of insulin resistance—all made for a repulsive image, he thought. Signs of his lack of self-love. “Look what you’ve done to yourself,” and other sentences flooded past the broken levees responsible for thought stopping. A Category 5 hurricane of self-hatred followed. He used a cotton swab to rub alcohol into the cut. He covered it with an extra large Band-Aid that he stole from his roommate’s side of the bathroom cabinet. He taped more cotton balls on top of it, hoping they would insulate the cut from further injury.
For dinner, he seared a giant New York strip steak and ate it with half a bag of frozen french fries. He scarfed it all down in front of an old episode of Love on the Spectrum, which means he barely noticed he’d eaten so much until it felt uncomfortable to sit upright. For dessert: a pint of ice cream. It was almost 9 o’clock when he realized he never picked up his meds. He jumped back in his car, by now a comfortable temperature courtesy of the sun fucking off. He was careful not to move his left arm too much, lest his makeshift bandage should come undone. The cut stung more and more with each passing minute. One of the cotton balls had absorbed so much excess blood that it had started to slip out from under the Band-Aid . Max pushed it back in with his right index finger. He licked the blood on his fingertip. It was surprisingly savory.
At the Walgreens, he picked up some numbing ointment and medical tape. The woman at the pharmacy counter stared straight at the LED glow of her monitor.
“The Albuterol rescue inhaler is $50. The Advair is $200 without insurance. Do you want both?” she asked.
Max thought about it, bought the cheaper one, and left.