Maria Isidoro Schalalci, a petite mail-order bride from the Orient, is the second wife of Albert Schalaci, a lanky, stubborn fanatic, who has kidney failure, but refuses to accept the standard form of medicine. Explanations, constant urgings and threats, fail to dissuade him from his unorthodox ways and belief. He insists on his own herbal remedies with near-deadly consequences. Despite his curmudgeonly personality, however, she stays with him, perseveres, and tolerates his shenanigans. Only through her vicarious sacrifices, determination, and tenacity, her husband escapes the inevitable. The willow tree by the pond, her retreat for prayers, meditation, and a hiding place from her obnoxious husband, helps maintain her sanity. This story, although a dramatization, is based on the author's professional knowledge and personal experiences with renal failure and its treatment. It portrays patients with chronic kidney disease (CKD): the etiologies, symptomatology, physiology, processes, and benefits of the accepted treatment options. It is an aid to the understanding of the plight of patients and families with CKD: their miseries, frustrations, disappointments, and the successes and failures in the quest for compatible kidney donors. The author aims to give the readers and the public a better understanding of the disease's processes and its ultimate remedy, kidney transplantation, and hopes to erase the clouds of doubt, skepticism, and fear. Life is sweet, help the unfortunates.

The Solace Tree

By Frank Tejada

AuthorHouse

Copyright © 2009 Frank Tejada
All right reserved.
ISBN: 978-1-4490-2274-7

Contents

Chapter I 911...........................................1Chapter II Visitors......................................16Chapter III Treatment Recommendations.....................24Chapter IV The Solace Tree...............................37Chapter V Diet..........................................57Chapter VI Mysterious Letter.............................68Chapter VII Relapse.......................................73Chapter VIII Back to ER....................................82Chapter IX Dialysis......................................93Chapter X The Family....................................129Chapter XI The Pager.....................................143Chapter XII The Donors....................................160Chapter XIII The Other Woman...............................176Chapter XIV Distant Quest.................................209Chapter XV Second Letter.................................224Chapter XVI The Cynics....................................239Chapter XVII Captive Audience..............................245Chapter XVIII Birthday......................................253Chapter XIX Surgery.......................................269Chapter XX "First Pitch".................................278Afterword...................................................289

Chapter One

911

A loud crashing thud and sputtering noise-as if hundreds of marbles rained from the sky-startled Mrs. Maria Schalaci from a sound sleep.

She sprang out of bed, rubbed her eyes, and uttered, "Wha ... what happened? Tornado? A bomb? Oh, my gosh!" She gasped and listened. Had that rotten tree branch, precariously dangling for some time, finally broken and fallen on the roof of her house? She turned on the lights but failed to see anything amiss inside the room-except that her ailing husband was not in bed. Her hurried search found him in a prone position, immobile on the bathroom floor. Plastic medicine containers and toiletries were scattered on the floor, the contents of a wooden cabinet he had toppled on his way down. She checked his pulse with her shaky fingers but was unsure of what she felt.

"Albert! Albert! Albert!" she screamed shrilly. She shook his shoulder vigorously, but he did not respond with even a moan or muscle twitch. She contemplated doing CPR but hesitated because she was not sure how. To do so haphazardly was impossible or disastrous. She had seen the procedure (although decades ago) in the orphanage where she stayed. Her best friend, who had a congenital heart disease, fell unconscious by her side. She was quickly ushered out of the scene while the personnel did a CPR, but unsuccessfully. She also saw the CPR procedure demonstrated once on television.

She cried, sobbed, and screamed his name repeatedly as she tried to flip him over. She strained and grunted, her tears dripping all over her husband while she unsuccessfully tried. For someone as tiny as she was (five feet tall and 110 pounds), to turn her six-foot tall, 210-pound husband from a prone to supine position was like rolling over a big, heavy log within a cramped space.

"Albert! Gising ka! Gising!" she screamed. Wake up! She pressed hard on the pain spots she learned from her school years-on the hand-web between the index finger and thumb, and the bone edge of the brows, but there was not even a slight muscle twitch.

"Oh, my God, he is in coma! Dear Lord, please don't let him die!" she sobbed.

She ran next room and dialed the telephone.

An operator answered. "Hello! May I help you?"

"Dios ko! Saklulo! Saklulo!" Maria screamed and sobbed. "My God! Help! Help!"

"Ma'am, please calm down. Take a deep breath and tell me the problem, slowly and in clear English."

"I'm very sorry. My husband fell unconscious inside the bathroom! Please help! I think he has a heart attack or a stroke! He is unresponsive. What shall I do? Oh, my God! Please help me!"

"Is he breathing? Did you check his pulse?"

"I think, but I'm not sure," she stammered and sobbed. "I'm sorry; I do not know what to do. Somebody, please help me!"

"I'll send an ambulance. What's your address?"

"Please hurry!" Maria screamed and sobbed at the same time.

"Stay with your husband until the paramedics arrive."

Maria knelt beside her husband, took the silver cross pendant of her necklace into her hands, and prayed silently. Periodically, she shook Albert's shoulder and called his name, checked his pulse, and placed her ear at his back and listened, but she was unsure of her findings. Instead, she heard her own heart beating hard and fast like a runaway bass drum.

What if he had a stroke, become a complete invalid in a vegetative state, or had a heart attack and died? She closed her eyes and clasped her hands together on her forehead. "Dear Lord, please help my husband. I beg Your kind heart to get him well and don't let him die. I would be at a loss without him. Please don't take him away from me. Although he is not an ideal husband, I think he has some good potential."

The wailing sound of an approaching ambulance broke the early morning quietness of the old section of St. Louis called Dog Town. Two paramedics in blue uniforms with Red Cross patches on their right shoulders got out of the ambulance. The tall and younger one carried a folded gurney, and the older, plump one, a red metal suitcase. Maria met them at the door and ushered them quickly to the bathroom.

The medics quickly assessed the condition of the patient and administered oxygen and intravenous fluids while Maria stood by the doorway, watching and wringing her hands incessantly. She sniffed frequently and wiped her eyes and nose with tissue.

"What's wrong with my husband? Is ... is he in danger of ...?" Her words trailed into deep sobs. "Is he going ... to make it?"

The tall medic replied, "We don't know yet, ma'am. What is his name? How old is he?" His questions were brisk, his job automatic, and focused.

"Albert Schalaci ... sixty-five." Her voice quivered.

"Is he a diabetic or epileptic?"

"I don't think so, probably neither."

"Has he fainted before?"

"Yes, but not this way." She dropped her shoulders and shook her head.

"What do you mean?" The medic said without removing his attention off his patient.

"When he was younger, he had indulged heavily in alcohol and usually passed out on the sofa, especially during weekends, but not recently, I think ..."

"Is he taking any medication? Is he under the care of a doctor for any illness?"

She blew her nose on the tissue and answered, "Well ... during the last several weeks, he developed gradual swelling of his legs and shortness of breath but refused to see a doctor. He takes care of his own health problems with his own herbal remedies, but I do not know the names. I am sorry."

"It's okay. We'll check later."

Maria clasped her cross pendant. "Mister, what do you think? Did he have a stroke or heart attack?" Her lips trembled as she wiped her tears.

"We don't know yet. He is still unresponsive and his blood pressure is low. We'll take him to Gateway Hospital for the doctors to give him a more thorough examination. Ma'am, don't worry; we'll do our best to help your husband." He gave Maria a placating smile.

The two paramedics loaded the unconscious, heavy man onto the gurney, secured him with leather straps, and covered him with a red blanket. An oxygen mask covered his face, and a plastic fluid container hung from a metal pole. The ambulance sped away with siren wailing. Maria notified her children, quickly changed her clothes, and left.

She entered the gate of Gateway Hospital, a ten-story, redbrick building. She parked, rushed into the crowded ER waiting room, and found a seat near a mother with her restless toddler. She prayed silently while she held her pendant cross and waited.

A tall physician with crew-cut blonde hair, white lab coat, and blue scrub suit underneath entered Albert's cubicle. He was hurried and brisk, which interrupted the postures of a young intern who was listening to the patient's chest with his stethoscope, a plump nurse taking the blood pressure, and an elderly, white-haired priest mumbling his prayer.

"Good morning," the doctor sounded dryly.

The priest interrupted his prayer and said, "Good morning, Dr. Terry Gailes!"

Without more pleasantries, Dr. Gailes fired his question to the short intern. "What happened to your patient, Doctor ahh ...?" He hesitated, bent down, adjusted his tinted-brown eyeglasses, and looked at the red monogrammed name on the right breast pocket of the younger intern's lab coat. "Oh, yeah-Doctor McCoy. You're the new intern."

"Yes, Dr. Gailes. This is my first day of ER duty," Dr. McCoy choked and stammered.

Dr. Gailes pulled his stethoscope from his lab coat pocket and took over the examination of the patient from the intern. He simultaneously talked and did the physical examination of his patient.

He pulled a reflex hammer from his cluttered left breast pocket. While testing the patient's reflexes, he asked, "Dr. McCoy, what do you think is wrong with this case? Do you have an impression?"

"Uh ..." The short intern hesitated while he scratched the back of his curly head. "Not yet. The patient just arrived, and I barely started my physical examination. The info I got from the medics is sketchy, except he fainted at home."

"I hate indecision and excuses!" Dr. Gailes snapped. He pointed his finger at the intern's chest. "I don't have to remind you that this is an emergency and you should act as such. Might as well tell you now as long as you are under my service, that I expect you to do your job more expeditiously, appropriately, and most importantly, without mistake. You must always bear in mind that you are dealing with your patient's life, which depends on your ability to act appropriately, make the right decisions and diagnosis, and apply the correct remedy. So, Dr. McCoy, what are you going to do with your patient?" He frowned at the intern.

Dr. McCoy paused, placed his hand on his right cheek. "Uhh ... the patient is still unresponsive with low blood pressure and weak pulse."

"So ... what do you think? What is your impression? Quick! Quick! Quick!" Dr. Gailes snapped his fingers three times in front of the intern. "Your patient is critical and needs your help! He could die waiting for your decision!" His stern words shot like an arrow into the intern's chest.

"Uhh ... well ..." he faltered, "based on my meager findings of leg swelling, lung congestion, and pallor, he could have congestive heart failure due to chronic heart disease, and anemia probably due to blood loss from gastrointestinal bleeding. Uhh ... his fainting spell was most likely due to orthostatic hypotension, secondary to conditions I have already mentioned." He paused, looked down, and rubbed his chin.

"McCoy, you are guessing! Emergency medicine is not a guessing game! So ... what are you going to do?" His imperious tone struck the intern like a sledgehammer.

"Well ... uhh ..." McCoy stumbled on his words, "my plan is to administer my treatment relevant to my diagnosis and the laboratory findings."

Dr. Gailes asked, "I understand you've served in the military."

"Yes sir, marines! I served two years in Germany!" He bristled.

"So, as a military man, I expect you to be practical, resourceful, and aggressive, Dr. McCoy. Now, going back to our case; I will give you some of the realities in the practice of medicine, which you cannot find in textbooks. Consider this as your lesson for today."

While holding the golden end piece of his stethoscope with his left hand, he flapped his right hand distractively as he spoke. He looked directly at the intern's eyes. "These ancillary tests we routinely do in our job are helpful and necessary in determining the diagnosis and prognosis of our patients, but are also not infallible. We tend to rely too much on these tests, and we become too dependent on them in making our diagnosis. I want you to be aware that errors and misinterpretations of these tests do happen. Also, on some occasions or situations, these diagnostic aids are not always available. Sometimes you have to rely solely on basic physical diagnosis, without the ancillary tests that your instructors taught you in your sophomore year, and most importantly, to make use of your six senses."

"Six?" the plump nurse whispered and quizzically looked at the intern with her arched, thin eyebrows and parted red lips.

"Your common sense," Dr. Gailes mumbled and shook his head. "Dr. McCoy, in the practice of medicine, you must hone your skills in the basics of physical diagnosis with minimal use of the more expensive tests. Although, the current trend is to avail the modern system for various reasons: expeditiousness, maybe laziness, and most importantly, legality. Be aware, however, the concept of defensive medicine that your clinical professors warned you: 'Always protect your vulnerable behinds.'"

"Yes, thank you, Dr. Gailes," he said.

Gailes barked, "Dr. McCoy, what are you waiting for? Execute your plan and write your orders! Make it stat!"

"Yes sir!" Dr. McCoy snapped, straightened his torso, and popped out his chest. He turned to the nurse at his side, wrote his orders on the patient's chart, and handed it back to the nurse, who abruptly left the cubicle and carried out the orders.

The patient started moving his fingers, moaned, and then opened his eyes. He blinked a few times and looked around the room. "Where am I? What's this place?" he mumbled.

"Where do you think you are?" Dr. Gailes asked.

Albert slowly scanned the room and took time to scrutinize the faces of the strangers in the room. "Who are these people?"

Dr. Gailes introduced everybody. "... And this is Father Fitzgerald. Do you have an idea where you are?"

Albert looked at the priest and said, "I don't know. Heaven or ... What's this place?"

"You are in the emergency room of Gateway Hospital. What is your name? Where do you live?"

Albert gawked with a blank stare at the doctor. "I ... I don't remember."

"Can you tell me what day is today?"

After a long frowning pause, Albert answered, "Uhh ... Friday?"

"No, Monday. Who is the president of the United States?"

"Well ..." Albert bit his lower lip and shook his head. "I ... don't remember.

Who are you and these people? Why is the priest here?"

"My name is Dr. Terry Gailes. I am the emergency room physician assigned to take care of you, and these people are my intern and nurse. Father Fitzgerald is here because you are very ill. You fell unconscious at your place. You are better now." Dr. Gailes patted his patient's hand and gave him a broad smile.

"Doctors? Emergency room? Why, what happened to me?" He gawked at the doctor. "I don't like this. Where is my wife?"

"Somebody is getting her. She is coming."

Petite Maria Isidoro Schalaci entered the cubicle accompanied by a blonde clerk. She wore a white dress, blue jacket, and a necklace with a silver cross pendant.

Maria was forty-nine years old, had graying black hair tied into a knot at the back, and wore no makeup. Her features were unmistakably Asian with flat nose, and brownish skin.

Maria wiped her eyes and nose with tissue, and then hugged her husband, who reciprocated with a timid smile. He strained and moaned while he tried to pull his hands out from the leather restraints. Maria held his hand while she related to him the incident at home that landed him in the hospital ER. She assured him he was under the care of the doctors and nurse around him.

The priest shook everybody's hands, said, "God bless you," and left.

Maria asked, "Doctor, could you remove the straps from his arms? He is very uncomfortable and looks like a prisoner. Please, Doc?"

"Only if he behaves and doesn't pull out the tubes."

"I assure you he will behave and cooperate." Maria looked at her husband and nudged his arm. "Will you?"

"Yeah." Albert nodded. After Dr. McCoy and the nurse removed the restraints, he cracked a smile, rubbed his wrists, and said, "That's better. Thank you."

Maria clasped her hands on her chest and stammered, "Doctor, what do you think is wrong with my husband? Why did he fall unconscious? What have you found so far?" She looked at the doctor beseechingly; her eyes wide and her mouth gaped.

The doctor did not answer her questions. Instead, he asked her his own as he held the hearing end of his golden stethoscope. "How long has he been sick? What was his health condition before he fainted at home? Is he under the care of a physician for any illness?"

She sat on a chair and wiped her eyes with a ready tissue. She paused, looked down, and fingered her earlobe. The plump, blonde nurse sat beside her and gently patted Maria's shoulder.

Maria said with intermittent short sobs, "During the past several weeks, he started slowing down. He was easily tired and short of breath, especially going up and down our basement steps. Later, we could not sleep because of his restlessness, noisy breathing, and irritating cough. His intense itching remained despite the use of different kinds of skin lotions and moisturizers. In fact, he always carries a back scratcher, and often times wakes me up in the middle of the night to scratch his back. As far as I know, he is not allergic to anything.

(Continues...)

Excerpted from The Solace Treeby Frank Tejada Copyright © 2009 by Frank Tejada. Excerpted by permission.
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