by
John B. Rosenman
Chapter One
The Gold Standard
Available on Amazon: https://www.amazon.com/dp/B0CQVQ98C9 . ~
He couldn’t breathe; he was going to die. Screaming inside, he strained in agony, feeling
himself approach the very edge of oblivion. He had no memory, no identity, only a desperate need
to survive, to escape this torment that was about to engulf him.
Finally, as a last resort, he heaved
himself upward, knowing it was his only chance. For an eternity, he hung halfway,
caught between life and death. Then, to his great relief, he shot to his feet
and staggered across the floor.
Trembling, Michael Windsor opened
his eyes, finding himself standing in his bedroom.
The wine, I shouldn’t have drunk
it before I turned in. The same thing happened the first time.
Only this was the third
time it had happened. And bad as it was, it paled before the second time a week
ago when he had played tennis. He remembered sitting down on a bench during a
break in the rotation and falling into a fitful sleep, something he never did
during the day. He had awoken a few moments later with no idea who or where he
was. And he had been screaming even as he came awake, something he later
realized was odd since he couldn’t even breathe. Even odder, no one seemed to
notice his scream, not even the player sitting beside him. How was that possible?
As during the first episode, he had
felt he would die if he couldn’t get some air into his lungs. Fortunately, he
had succeeded, struggled to his feet and managed to walk shakily around. What
was wrong with him? He had shrugged off the first episode but this one was more
serious. Picking up his racket, he found he had a dull headache that felt like
a hangover.
Rather than face the problem, he had
brushed it aside as before and returned to the tennis wars for another hour. Now,
standing in his bedroom after his third attack, he faced the same issue.
What was he going to do this time?
He blinked and once again, shrugged it off. With a sigh, he went back to bed.
*
It wasn’t until his
gastroenterologist called about a procedure that he consulted a doctor. “Something
rather strange happened to me,” he said. “I had some…episodes.”
“Episodes?” Dr. Burns asked. “What
do you mean?”
Why did he even mention it? Didn’t he have enough
problems? He was already seeing Dr. Burns for a precancerous case of Barrett’s esophagus.
What he should do was keep his mouth shut. After all, his episodes weren’t that
serious, were they?
But it seemed his mouth had a mind of its own because
he heard it spilling everything. When he was through, Dr. Burns suggested that
he see a neurologist.
Just what I need, another doctor. “All
right,” he said, feeling his goose was cooked. “If you think I should.”
*
When Michael met Dr. Jason Turner two weeks later, he
was surprised the man was so young. Hell, the good doctor looked like a kid,
easily ten years younger than his own forty-three. Unlike him, there was not a
line in his face, not a gray hair or a bald spot in his full head of rich brown
hair. As Dr. Turner read the summary Michael had written, he found it hard to
believe that such a youngster could advise him on anything, much less prescribe
treatment that would actually help him.
Dr. Turner finished reading and looked up. “So you’ve
had three incidents?”
“Yes,” Michael said. “Uh, I’m a bit relieved I haven’t
had any more since the last one.”
Dr. Turner nodded. “Still, I recommend that you take a
Home Sleep Test to see if you have sleep apnea.”
Sleep apnea. If he had the disease, he couldn’t just
flop into bed anymore but would have to hook himself up to some kind of unholy contraption
to improve his breathing.
“What’s this test like?” he asked.
Dr. Turner shrugged. “It’s easy to
take and you should have no difficulty sleeping. You use it overnight and
return the device at your convenience. If you go to the Equipment Office two
doors down, they’ll issue you one and show you how to use it.”
Michael hesitated. The train was
going too fast, and if he didn’t get off it quick, he never would. He stared at
a multicolored picture of a naked man on the wall across from him, his internal
organs clearly displayed, labeled, and ripe for dissection.
“Do you have any questions?” Dr. Turner asked, his
youthful features expressing concern.
Yes, he did, only he couldn’t think of even one at the
moment. The good doctor opened the door and pointed to his right. “You go that
way and turn left at the next hallway,” he said.
Michael thanked him and followed directions. Still, he
managed to get lost rather quickly. Earlier, he had realized that this place
was the kind that confused and actually frightened him. Narrow halls turned and
branched, and it was so easy to go the wrong way. They made him feel like a
laboratory rat in a maze. Soon, he was completely lost and leaned back against
the wall, waiting until an acid reflux attack subsided.
His world crash down upon him. What a loser he was.
Not only couldn’t he even find his way out of this goddamned place, but just
last week his wife Muriel, threatening divorce, had packed up and left with his
seven-year-old, tousled-haired son Andy. He remembered her disgust over the
years as she’d berated him for his lack of ambition. “Twelve years a clerk in a
shitty hardware store, and you don’t bring home enough money to budge the
needle. Michael, I know your health isn’t good, but we’ve always had to tread
water, getting deeper and deeper in debt, and I have to keep getting part-time
jobs to pay off our bills….”
Blah blah blah, on and on it went. He heard her voice
in his head and moaned, knowing her criticism was valid. He was lazy. He
did lack ambition. But he also had Barrett’s esophagus, third stage
kidney disease, food allergies, and high blood pressure. Sometimes, when he
came home from work, he was so tired, he could barely stand.
Feeling sorry for yourself, Michael? he thought.
Yes, he was, and the realization made him push off the
wall and glare down the hall. Damn it, he was going to find his way out of this
place if it killed him.
*
In the Equipment Office aka the Sleep Lab he was given
a device with attachments and listened to instructions that zoomed right past
him. He nodded, tried to keep up, and after a few minutes headed out with the
Home Sleep Test tucked under his arm in its handy carrying case. It was so
small. How difficult could the test be?
That night he read the directions, studied the
pictures, and found that the device was not that difficult. The belt with the
effort sensor went around the chest, the two prongs went into the nostrils, and
the pulse oximeter went over his index finger. There were a few other details, but
they boiled down to lying down and trying to sleep. As he did, a terrible fear
seized him.
What if he fell asleep only to have his throat clamp
shut so he was unable to breathe? What if this time was the last and he couldn’t
wake up no matter how hard he tried? He imagined himself screaming inside and straining
for air, only to die in unbearable agony.
Michael tossed and turned, trying not to upset the instrument.
Despite Dr. Turner’s reassurances, the device was a little irritating, and
worries kept him awake. When he finally dreamt, he found himself trying to
leave his neurologist’s office again. Halls branched in all directions, and this
time he found he
actually was a laboratory rat. He sniffed frantically at the walls and air for
clues as he scampered this way and that, trying desperately to get out. Only
there was no exit, only endless halls leading nowhere. Finally, though, he saw
an open door and beyond it, fresh air and green trees. His heart pounded with
joy.
But then the walls pressed in, and he began to
suffocate. The trees and air were so close, but the harder he tried to reach
them, the farther they receded in the distance. As he struggled, it became harder
and harder to breathe. He
gagged and choked, feeling everything grow dark.
Then he started and found himself awake, lying in bed.
He was a man again, not a rat. He lay sweating, drawing in deep breaths of air,
enormously relieved he was still alive. The machine—it must have saved him. His
heart filled with gratitude. Was it possible this Home Sleep Test was sentient?
He felt that somehow, on some level, it had sensed his distress and deliberately
awakened him, saving him from death. As he considered the possibility, he nodded
off.
When he awoke again in
the morning, he found he’d had a decent night’s sleep. He turned off the
machine and returned it to the Equipment Office.
*
During the twelve days before his
next appointment, Michael experienced two more incidents while sleeping,
evidence that his condition was not improving as he’d hoped but getting worse. Both
times he had struggled desperately to breathe, feeling as if he were on the
edge of death. On one of the occasions, he had fallen out of bed and hurt his
hand.
He’d read that eighty-five percent of
those with sleep apnea didn’t even know they had it. Such facts reminded him of
his own disorder and his other health problems as well. Being alone certainly didn’t
help matters. He missed his wife, and he missed his little boy more. God, how
he missed him. Loneliness tore at his soul. It was as if they had left him to
die alone.
Feeling sorry for yourself, Michael?
“Yes, I am,” he said aloud, not caring if anyone heard,
even if it was one of the fellow workers at the hardware store. If I don’t catch
some kind of break soon, I don’t know what I’ll do.
He was still thinking that as he drove to his doctor’s
appointment.
When he entered the office and checked in, his hands
were wet and his heart was pounding. There was no reason for his anxiety, of
course. He would learn the news when Dr. Turner gave it to him. His call three
days before had received a pro forma dismissal. “Dr. Turner will discuss the
results with you in his office,” a woman had said.
He sat down in the waiting room and tried to relax. On
the wall, a television program warned about the dangers of hypertension, an
invisible killer. The damn thing could lie in wait for years with no apparent
symptoms. Then bang, without warning, it would strike.
Michael swallowed and looked away.
When a nurse called his name he rose and followed her
through the door. “Do you know the way?” she asked with a smile.
The way to the Minotaur? Of course. I come here often.
He
nodded and headed down the hall.
To his surprise, he found Dr. Turner’s office easily
this time. It might have been nice to have temporarily lost his bearings so he
could have more time to cope, but it was as if a bright beacon had guided him.
Dr. Turner smiled as he entered. Michael smiled back
and sat down. They exchanged pleasantries, then Turner asked him how the home
test had gone.
“I experienced an incident,” Michael said. “It was
awful, as bad as the others. I dreamt I was a rat in a maze and couldn’t
breathe. I felt I was going to die. Fortunately, the machine woke me up.”
Dr. Turner frowned. “The machine woke you up?”
“Well, it felt that way, like it came to my rescue.
Anyway, afterwards, I went back to sleep. It was easier than I expected. I even
slept all right.” He hesitated, feeling a wave of fear. “But I’ve had two more
incidents since. They were bad.”
“I’m sorry to hear that,” Dr. Turner said. He tapped a
form on his desk. “Fortunately, we have your results, which should provide some
guidance. You slept over seven hours and averaged fifteen events per hour. That
places you in the moderate range for sleep apnea.”
Now that he heard the words, Michael was not
surprised. Of course he had it. “Fifteen events. Let’s see. As I
remember, a single event is ten seconds or more without breathing.”
“Correct.”
Michael nodded, waiting for the doctor to go on. But
he remained silent as if expecting him to speak. “Uh, I’ve heard there
is a minimally invasive treatment for apnea. Mouthpieces that keep the airway
open.”
“Yes,” Dr. Turner said, “but they are far less
effective than CABS.” He spread his hands. “CABS is the gold standard.”
CABS. What an odd acronym. Michael knew it stood for
Constant Airway Breathing Support, but it sounded like something you got a ride
in.
“So you recommend I use CABS?”
“I do. It is far and away the best treatment
available.”
“I see.” Michael hesitated. “Is it permanent?” he
finally asked. “I mean, will I have to use it for the rest of my life?”
“Yes.” Dr. Turner said.
Michael waited, hoping for more, but Turner remained
silent. Obviously, the good doctor was leaving the matter in his lap. It was
his mess to decide.
The silence dragged on. On the wall, the anatomically
correct man waited with them, his internal organs labeled and on full display.
“Well,” Michael finally said, “if it’s the gold
standard, I suppose I should use it.”
*
As he waited in the Equipment Office, he gazed at
plastic faces wearing masks of different shapes and sizes. Which one should he
pick? The largest one covered the mouth and nose and looked as if it were
trying to swallow the entire face. The medium one was slightly smaller. The
smallest covered only the nose and left the mouth free, perhaps so it could
scream at the indignity of it all.
Easy, Michael, he thought. Don’t lose it.
But it was easier to say than do. Thanks largely to a
dead-end job, his wife and son had left him, and now he had this new health
problem. He was tempted to get up and walk right out.
He changed his mind when an attractive, darkhaired
woman in a green pantsuit entered from
the back. “Mr. Windsor?” she asked.
“Uh, yes.”
“I’m Sonya Walker, will you come with me?”
Oh hell, yes. He followed her down a
hallway to a room in back. Glancing around, he saw more masks on display and a
sleep apnea machine on a table to his left. She led him to it.
He pointed at the masks on the wall. “Is this what you
wear at Halloween?” he asked.
It was a poor joke, but she actually laughed. The
sound of it warmed him.
“Mr. Windsor, how much do you know about CABS?”
“Not much,” he said.
“Well, suppose we sit down, and I’ll go over it with
you. Okay?”
“Sounds like a plan,” he said and sat down. The
machine was roughly five inches high, five inches wide, and ten inches long. To
Michael, it looked like a device devised by aliens.
“Okay,” she said, “let’s begin with the major
components.” She turned the machine around and pointed at a round hole in back.
“Here’s the Air Outlet where you plug in the larger end of the tubing. The
smaller end you plug into your mask so you can breathe the air.” She
demonstrated the procedure, using a tube and a mask. “Now in front of the
machine…”
Michael listened or tried to. Her demonstration was
clear and effective but there was much to learn, more than with the relatively
simple Sleep Test. Besides that, she was attractive. She stopped now and then
so he could ask questions, but he only half-heard her answers. Soon she was
moving on and talking about Ramp Time, Mask Fit, Humidity Level…
She broke off and laughed. “I know it’s a lot, but
it’s all explained clearly in the booklets we provide, and if you have any
questions, just call.” She produced a business card with her name. He slipped
it into his wallet, his nostrils twitching as he caught a whiff of her perfume.
It reminded him that he hadn’t had sex in months and further weakened what
remained of his concentration.
“Ready to try one on?” she asked.
“Try one on?”
“Yes, a mask.” She waved at the wall behind the desk
where the masks hung. Big, medium, and little. “Do you have any idea which one you
prefer?”
He studied them. “The largest one,” he said. “I want
to make sure it covers my mouth. The smallest one won’t do that, and I’m afraid
I’d breathe through my mouth.”
“Makes sense,” she said. “You’d have more events and
wouldn’t get all the benefits of this technology.”
She rose and removed a large mask from the wall. It
was made of a clear plastic and had a soft rim of cushions. She efficiently
affixed it to his face and adjusted it. Then she had him take it off and put it
back on himself. After the third time, Michael felt he almost knew what he was
doing.
Sonya left and returned with a large paper bag.
“Here’s three of the masks you chose. And I’ve included one each of the other
sized masks in case you want to try them.”
Soon, all too soon, she was escorting him out the
front door as he carried his load. Oddly, the Gold Standard tingled in his
hands even through the nylon and even though it wasn’t turned on. It gave him a
strange, creepy feeling. He waved and left, taking with him her smile and the
elusive scent of her perfume.
He drove up the entrance ramp to the interstate,
sailing smoothly along until he heard a screeching sound under the hood.
Christ, what was it now? He’d taken off two hours from work, and Starret
wouldn’t appreciate him needing to leave again. From the sounds he heard,
though, it was probably a loose or worn serpentine belt, and if it went, this
worn-out old Chevy simply wouldn’t run.
Michael slowed down, hoping the cacophony under his
hood would subside, but if anything, it increased. Cursing, he turned on the
radio. He was just in time to hear an old favorite of his, “Thunder Road”.
When the song was halfway through, he realized he
couldn’t hear any complaints from his engine. He dialed the radio down to make
sure. Yup, the evil genie had crept back into its bottle, though he couldn’t
say for how long. Still, he felt relieved.
Later, after work, he got into his Chevy and turned on
the engine, then pumped the gas a few times. Still not a single disturbing
sound. It was a miracle! The old engine was so soft, he could barely hear it.
Driving home, he kept his ear cocked, expecting the worst, but the serpentine
belt or whatever it was behaved, at least for now.
Entering his apartment, he stopped and leaned back
against the door. Until Muriel left with Andy a week ago, he had never known
how empty a home could be. The furniture was still here as were their beds and
other items, but for him, the silent rooms were a giant void, his personal
tomb. He feared that soon he would forget the sound of his son’s laughter and
the lilt of Muriel’s voice.
He took the machine to the bedroom and placed it on
the table beside the bed, feeling his hands tingle again. Such a strange
sensation. He rubbed his hands, staring down at the device.
It sat there black and deadly, looking like it was
about to spring.
BLURB:
As if that isn’t enough, he experiences three near-death episodes in his sleep, fighting for breath and nearly suffocating. It's called obstructive sleep apnea, and his neurologist advises him to use a device to help regulate his breathing at night. It sounds even more miserable, but Michael agrees.
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