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The Ironman

I drove downtown.

The billboards tallied my descent:


Comerica Bank

The Bottle Shop Fine Wines and Gourmet Foods

I kept driving.

Porsche and Audi

The wealthy that made a fortune selling American cars now drove foreign.

Protestant Cemetery

The Black Leather Shop

Catholic Cemetery


Jewish Cemetery


With six miles to go I noticed the prostitutes shuffling home in the early morning.

On the right an old Donald Ross golf course poorly maintained and unchanged since 1926. The Brown Bomber played there.

Abandoned cemetery

Check cashing

Beauty Salon

Church of Zion

Blood Donation Center

Burned out boarded up store fronts

Salvation Army Woman’s Shelter

The Metropolitan Dialysis Center. No Narcotics Kept on the Premises. I made it, alive.

I entered the dialysis clinic. It smelled of Clorox bleach, indicating a high incidence of HIV.  Patients slept in the warm lobby, waiting their turn on the kidney machine.

An obese African American woman sat behind a glass partition. I talked into a metal speaker: “I’m David Larco, the new medical director.”

“She looked up and announced into the intercom, “Star to the lobby, Star to the lobby.”

An obese nurse came to the front. “Buzz our new director in, Georgia. Bring him in from the swamp.”

The metal lock vibrated, and the door clicked open.

Another alarm went off. I jumped back.

“It’s just the metal detector,” the nurse said. Then she extended her hand and said,

“I’m Star, I’m the head nurse. You packing?”


“You know, carrying a gun?”

“No,” I said. “I don’t know anything about guns.”

“You’ll learn, and I’ll teach you.”

“I’ve never been in a dialysis unit that had a metal detector.”

“Welcome to the Metropolitan Dialysis Center. The dialysis chain put it in after one of the docs was shot.”


“Yeah, a patient knocked him down with buckshot, then shot him with a slug. Didn’t kill him. Just paralyzed from the waist down. The Doc was screwing the patient’s  wife. That’s why the patient shot him. We sided with the patient. The detector’s here for legal reasons. Not because they give a damn about what happens here. Even the Board of Health skips us.”

We walked into the unit. Twelve patients were on dialysis machines. Red coils of blood snaked into the machines for processing. Once cleaned and the excess fluid removed, the blood was returned to the patient.

“What did you do to get assigned down here?”

“I said the wrong thing to the wrong person. This is the only place that would hire me.”

“And you feel sorry for yourself, getting stuck here, correct?”

“Well working in a place like this isn’t what I had in mind.”

“Too bad you had to come on a Monday. Monday is seizure day. The winos are filled with alcohol from the weekend and the machine clears it and several go into DTs, or have seizures, or both. They’ll start popping off in about an hour.”

Star went over to the patient on the second machine. She took the patients blood pressure.

“Jerome’s pressure is low. Give him some fluids.” She lowered the head of the  dialysis chair, turned toward me, and said, “Lets get coffee.”


I looked at the patients. All were asleep except for one. The man stared. His face  twitched.

I pointed to the man, “Star, we better hold on the coffee, that guy’s going to seize.”

“Mr. Ellis. He’s different, he never…. he sure as shit is.” She called to another nurse who was filling syringes, “Lucille, get the valium.”

The man started shaking. Bit his tongue. Blood trickled from his mouth. One of the needles jerked out. Blood sprayed the walls.

“Clamp his lines so he doesn’t suck air.”

“Already done Doc,” Lucille said.

“Get the valium.”

“Already done, Doc. We’re used to seizure day. I hate Mondays. They’re so messy. Georgia, get the mop and the bleach.”

Star came over, shook her head, “That’s Mr. Ellis. He’s not a drinker. He never seizes.”

Lucille injected the valium. His twitching stopped.  His seizure in abeyance.

“That should do it,” Star said. “Doesn’t take much to stop an alcohol seizure. And Doc, always make sure you put on goggles and gloves first. There is HIV all over. This is not like the suburbs.”

“We practiced universal precautions to protect the patient’s privacy,” I said. “You know HIPAA.”

“Universal precaution’s bullshit. HIPAA’s bullshit.  It’s for places that don’t see HIV. We know who has the virus, and we’re more careful. It just makes sense to treat the disease like a disease.”

“Does that patient have the virus?”

“No. That’s why I let you tend to him. Now let’s get the coffee before something else happens. When you quit us make sure your replacement comes on any day but Monday. And make sure he or she brings a gun.”

“You sure I’m going to quit?”


She took me back to the staff lounge. A nurse and an aide had their heads on the table, sleeping.

“Wake up you two, the doctor and I have to talk.”

They rolled up in slow motion, wrapped their blankets around themselves, and walked out.

She poured two mugs of coffee. I wished they used Styrofoam.

“So what did you do? Drugs?”

“No. I said the wrong thing to the wrong person.”

“What did you say?”

“I complained to the hospital about one of the doctors. He was killing people. I had all the statistics. Turns out the guy was the director’s brother in law.”

“Then it was bye to your sorry ass. It must have made them feel good to throw you out. Show they had the power.”

“They probably feel safer.”

Star shook her head, took a bite of a doughnut, and washed it down with coffee. “Were you afraid to come down here?”


“Okay,” Star said. “You need a handgun. It will make you feel safer.”

“I don’t know the first thing about handguns.”

“You go to the gun-shop and tell them what you just told me, they’ll sell you a piece of shit and you’ll spend lots of money and it’ll blow your hand off.  Listen good. Don’t buy a .22 it can’t hurt a fly. A .38 is obsolete. A .45 is too big with too much kick, you aim for the head and you’ll hit the ceiling. You need a .25. You can hide a .25 anywhere, in you shirt pocket, I put it in my cleavage so don’t go putting your hand down there you’ll get more than you bargained for.”



She laughed and slurped coffee. She reached into her ample cleavage and pulled out a gun. Here take mine. It’s loaded. Safety’s on. Just flick this lever and start playing Dirty Harry.”

“This is illegal’” I said. “You can get into trouble, Star.”

“No serial numbers on that gun. I never saw it before in my life.”

“What are you going to use?”

“My Glock.”

I shook my head and took the gun. It seemed like the thing to do, I didn’t want to be rude. Don’t look a gift horse in the mouth.

“Our patients aren’t as bad as they look,” Star said. “I get to know all the patients well. Now Mr. Ellis, he never gives us trouble. He’s not a drinker. For him to seize isn’t right. Something’s up.”

The intercom announced, “Star, Dr. Larco, stat.”


Mr. Ellis was seizing again.

“Give him another dose of valium.”

“We already gave him two doses.”

“This is a bad seizure. Call EMS.”


Star gently placed blankets around Mr. Ellis so if he seized again he would not injure himself.

EMS eventually showed up. They placed him on a stretcher.

“Where are you taking him?”

“He has no insurance. We’ll take him to the County.”

“The General’s closer.”

“They’ll re-route us. The General won’t take the garbage.”

Star threw a chart at the EMS guy and shouted: “Don’t you call that man garbage. Now you take him out of here and he better be at the General.”

“Larco, you get in that fancy car of yours and follow those bastards and make sure they take him to the General.”

“Okay, Star.”

* * *

I put the pistol in the glove box and followed the ambulance. They sped past the General. I honked and flashed my lights. They were told to stop at the General. They kept speeding, lights flashing, and turned into the County Hospital. Damn.

The drivers hurried out and opened the back of the ambulance. Mr. Ellis was seizing. He was admitted and loaded up with medication halting his seizures. I followed him into the emergency room. They parked him in a ward with twenty patients. Screaming, bleeding and vomiting.

A curtain was pulled around us. Ellis was stable and semi-alert.

“Mr. Ellis, I’m Dr. Larco. I came down here from the dialysis unit.”

“Doc, if I don’t make it you tell Star to give me my name back. Tell her it’s safe now. It’s very important. She’ll understand.”


“Do you think Tom Ellis is my real name?”

“Why not.”

“Cause it’s not. I changed it.”

“Why did you change it?”

“Had to.”

“Sounds like trouble. What did you do?”

“Said the wrong thing to the wrong people.”

“I know what you mean.”
“No you don’t.”

“Yes I do, I lost everything. That’s why I’m working at your clinic.”

“No you didn’t. You’re a doctor. You still have your name. I lost everything.”

“What did you have to lose?” I didn’t mean to say it like that. It came out wrong.

“I wasn’t always garbage.”

“Did you hear the EMS guys say that?”


“What did you lose?”

“I was an ironworker.”

“What’s that?”

“We’re the guys that work on the steel beams. We walk the rails and build the skyscrapers.” He motioned to the cup of water. I held it to his lips. He drank then continued his story.

“I was young and good and not afraid of heights, or anything. We were a tough bunch; American Indians and hillbillies.  I was elected the union steward, the youngest ever.”

“Then what happened?”

“I lost both jobs, my family, my name, everything.”

He became agitated, his breathing, rapid.

“Mr. Ellis, slow your breathing down. Take deep breaths.”  If he hyperventilated he would seize.

He stared. I called for the doctor.

Mr. Ellis shouted, “Don’t throw the bomb. Can’t you see the little girl? Can’t you?  She had nothing to do with this.”

The ER doctor looked at him and said, “Shit, he going down again.” He got a syringe and injected medication in the line. Ellis fell back, the seizure aborted. He was in a drug-induced coma. He stopped shouting abut the little girl and the bomb.

They took him to the intensive care unit. I was told I could not follow.

* * *

I returned to the Metropolitan Dialysis Unit the next day. Georgia was behind the glass. She buzzed me in.

“Star’s in her office, you better go see her.”

I walked into her office          `.

Her eyes were red.

“What’s the matter?”

“I told you to take Mr. Ellis to the General.”

“The EMS took him to The County. There was nothing I could do.”

“You should have insisted. If I’d been in that ambulance he would have been at The General. I’d have used my Glock. It doesn’t matter now, he’s dead.”

“Dead? From a seizure? Nobody dies from a seizure.”

“They do at the County. There’s only one doctor there at night. The CAT scan showed he had a brain tumor. That’s why he kept seizing.”

“I’m sorry.”

“We need some money, to bury him.”

“Are you taking a collection?”

“We’ve got about three hundred dollars.”

“How much more do you need?”

“Two thousand.”

“Where are you going to get it?”


“Me? Why?”

“You’re rich compared to the rest of us and you two had a lot in common.”

“Like what?”

“You tried to change things for the better. You both got burned.”

“We were both young and dumb. The old guys tricked us.”

“They always do.”

“I should have kept my mouth shut. Looked the other way like every one else.  I didn’t know the risks.”

“Mr. Ellis did.”

“You knew him as Mr. Ellis. That wasn’t his real name,” I said. “He used to be head of some union forty years ago. Then got into trouble. Did you know that?”

“Yes, I know all about him. He’s been a patient here for over five years. Even the ones who have secrets eventually talk. They trust us.”

“Well he must have done something real bad. He kept talking about a bomb and a little girl.”

Star stood up and pulled a folder from the shelf. She opened it and removed a photograph.

“This is Mr. Ellis forty years ago. His family.”

I scanned the happy family portrait.

“His wife looks like a movie star.”

“Resembled Marylyn Monroe, and the little girl is adorable.” She started to choke up. Tears flowing, she drank coffee and composed herself.

“Mr. Ellis was the head of the local ironworkers union. He tried to reform it. I guess they were more corrupt back then than now. Anyway, he gets elected to clean things up. He meets with the FBI. They fly him to Washington to meet with Bobby Kennedy but at the last minute they call it off. They tell him thank you, but they’re going after Hoffa and the teamsters.”

“I remember what happened to Hoffa. At least Mr. Ellis didn’t end up like him.”

“Worse maybe. He comes home from Washington and he and his wife and daughter are watching television. It’s night and the TV lights the three of them. They usually don’t kill the women and children. That’s what ruined him. Made him not want to fight back. They threw a bomb.”

“They died.”

Star shook her head.

“They survived and entered a federal witness protection program. His wife  couldn’t take it. She left him and took their daughter. He never saw them again. Didn’t want to get them in danger. She had him declared dead.”


“So she could get on with her life. The little girl too.”

“He told me that if he didn’t make it he wanted his real name back. He never told me his real name.”

“Well I got it and I’ll give it back to him,” Star said.

Star put the picture in the shredder. The shredder whined.

“I don’t want to see that picture again.”

“I understand, Star.”

I wrote her a check and left the office.

“Dr. Larco, thank you.”

* * *

Georgia, Lucille, Star and I went to his funeral. I paid for his headstone:

Johnny Hightower

Native American



I walked away with the others.

“It was a proper burial,” Lucile said.

“He got his name back,” Star said.

“That’s good.”

“What’s in a name?” I quoted.

“Everything,” Star said. “For Johnny Hightower everything.”

Published in  The Healing Muse

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