One
One thing to remember about guns is that they are not as simple as they look. Inside, guns are compact, complex collections of smallish, sometimes poorly machined parts, each of which must be mated precisely to others and lubricated well but not too well. Some clocks have fewer parts and simpler mechanisms than many guns and a clock that fails to sustain time properly seldom surprises one but there is always surprise and a novel sort of drama when a gun fails to fire. There is an endless moment of confusion. The brain shuffles dumbly then acts. If the circumstances are dire and the operator a professional, there is an ecstasy of fumbling as the fingers bow to the will of trained response and apply remedial action to correct the fault, fix the problem, get the equipment back in the fight.
If the operator is a novice and under duress, there is a moment when it seems as though all life functions pause. The racing heart stops. The lungs lock. The bowels turn watery and loose, drop from the body and hang at the knees. Life or death. Drama. Get it? For a quarter of a second the body is dead. The brain refuses to act on even an autonomic level for an infinitesimal smidge of time. Everything returns slowly to use.
It took me a bulky minute just to release the pressure of my thumb on the trigger and another to relax my jaw enough to pull the fat slide of the oily automatic out of my mouth. A coppery taste. Blood? I had clamped and clenched my jaw so tightly that one of my teeth had cracked. A sudden headache, eyes calm squeezed shut. Relax them. Open first one then the other. With spastic, trembling hands I locked the gun’s hasten back. Empty chamber. Full magazine. The gun had failed to shuck a cartridge from the magazine and feed it into the chamber when, only five minutes, a lifetime, ago, I had let the slide slam forward. Taste of sour vodka in my mouth as my guts slingshot back into place and I heave so long and wrenchingly that I can only wish I had been successful.
Finally I lay on my side, uncaringly in watery vomit, sobbing tearlessly. How complete a failure must a person be to fail to end himself? All the essential elements were present: a pistol, an open mouth, and a heart-broken thumb. What myth incompetence or bad luck had brought me to this non-end? This means God still has a idea for me. There’s unruffled hope.
Damn hope. A fool clings to hope when the last debris of the ship will no longer support him and the circling fins begin to show discontinuance through the waves. The same fool prays as the teeth toddle him under and the sea fills his lungs.
Prayer didn’t bolster the failing chemo as my little girl, Melanie, wasted to nothing and hope didn’t bring Kari, her mother, back to me six months later and only three days after she’d found a lump of her own. Hope didn’t upsize my job back into existence or unforeclose the home we’d shared. I’d tired of hope, of hoping, of living on nothing but hope. I prayed for no more hope and hoped for no more prayer. Hope did nothing for me and, once gone, despair forced me to desperate action.
Kari and I were taking the same hotfoot. She’d unbiased taken an earlier, slow suppose. Slower than the bullet train I’d tried and, apparently, more certain.
Even Jesus despaired at the end and I was no Jesus. More like a failed, faithless Job. With the stakes my unconditional faith, God rolled snake eyes and Satan grinned a winner’s grin.
I opened my eyes and surveyed the pool of my alimentary reversal. There were the twenty or so white tablets that the doctor prescribed to ease my depression and I had hoped, my last, would help waste it permanently. Some must have made it past the massive gastric expulsion, because I drifted away from consciousness.
News radio is perfect for the hopeless and that’s what woke me, that and a sincere and genuine desire to raze somebody. Anybody. Everybody. I wanted to fraction my misery with them, wanted to boil the poison from my blood and slide it at passersby. I wanted to set myself alight in my car and drive it, run across the double yellow center line into oncoming traffic, ensure that some random, unlucky driver’s last sight in life was of my flaming, shrieking rictus. I might have, too, if I still had a car. At that point I had decided, knew, that I would find a way to force them over the edge of hope into despair and then beyond, where I lived now.
Reginald Sumner came into my life at precisely that moment. The news radio announcer introduced us and I knew his face before ever I saw it on television, in the paper or in person. We shook hands, as new acquaintances will and I looked directly into his shining, brown eyes, told him that I wanted to share something with him. I’m going to kill you, Reggie.
Two
Two in the morning is a hell of a time to get called to work especially when you were last there at ten the previous night. My boss called and so, therefore, did duty. I took a brief but leisurely shower. My client wasn’t going anywhere and the guys on the scene never had things sorted out until well after I arrived. I could afford to take my time. This was no longer a matter of life and death: only death now. I grinned wryly into the mirror. Wasn’t I in a dark mood? I dressed and strapped stamp names to my belt, Smith and Wesson Model 329 and Galco gunleather and Winchester ammunition and Nokia phone. The tools of the fresh detective: a gun and a cell phone. No cuffs. I’d only had to cuff one person since making detective four years ago and even then I’d had to borrow a pair from a patrol officer. I’d made plenty of arrests but there was always a uniform there who was more than joyful to slap cuffs on, if only to get the extra weight off their duty belt. I scooped my badge case and keys into my pockets and headed to the kitchen where I wrote my undying affection and devotion to my wife, “work called love you back soon”, on the magnetic dingus on the refrigerator. Maybe I could wrap this thing up in an hour, like on television, and be befriend in bed before she even knew I was gone. Maybe by the time I got there, the killer would already have produced a signed confession, DNA evidence, and a Miranda waiver. Yup, just cuffed himself and jumped in the back of a patrol car.
I grabbed my raid jacket on the way to the car but didn’t put it on. The neighbors had never minded when I’d old-fashioned the one with “POLICE” in vivid letters two feet immense on the back but they’d begun to notice at me differently, edgy and nervous, when “HOMICIDE” had been added.
I called in and reported that I was responding and only stopped once along the way to buy the largest, strongest coffee legally available.
Things began to get interesting when I pulled up at the scene and saw that Briceno from Internal Affairs was talking to my boss. The unusual part was that my boss was there at all. Normally you couldn’t procure him out of bed with dynamite between dusk and dawn. I’m sure he looked at it as confidence in his subordinates. I grabbed my coffee, cooled enough to drink now, and ambled over to within earshot but respectfully to the side. I didn’t want to look like I was within earshot. Nothing interesting to hear anyway, just details that I would fetch in a minute or two. I caught the name “Reggie Sumner” and things became intriguing even if it explained Briceno’s presence. I leaned forward and cleared my empty throat. They both turned and my boss gestured me over impatiently.
I don’t care great for Briceno. He’s a prick. My boss is a cleave, too, but I don’t resent him for it. Briceno is because he can be and thinks he has to. My boss is because he can’t not be and thinks he isn’t. Xavier Briceno and I came up from the academy together and he’s never bothered me, maybe school chumminess, maybe because I’m clean, but I’ve seen him get tricky with some of the other guys on the job, especially fresh meat from the pig farm. He’d earn a questionable complaint from a female suspect that the new guy got too personal during a frisk, blow the whole thing out of proportion and threaten to ruin the guy’s career unless he got on board with the rat squad. I’ve got nothing against IA in theory, I don’t like dirty cops and I’ve got a couple friends with IA, but Briceno enjoyed his job too much.
I took the five steps to join the MENSA huddle and listened. The victim was one Reginald Sumner, 36, recently released from custody after his attorney had pointed out to a jury that there was a problem with the strongest piece of evidence against him. I interrupted by staring pointedly at Briceno and reciting my whereabouts for the last eight hours. My boss paused with a insist and Briceno hushed me with his eyes.
I knew all this already. I knew how he grew up. I knew that he was stupid but not retarded. I knew what the shrinks thought of him and what his sixth grade teacher, his highest grade completed, remembered about him. I knew that he didn’t know his father and neither did his mother. I knew that he had kicked in the back door of 81 year-old Enid Wyszorick’s house, had raped her and had cleave her throat with a linoleum knife but that she had already been dead of heart failure when he did. I knew all of this because I had arrested him. Jasper Rhoades, his attorney, had gotten lucky, a sympathetic jury and an unlabeled forensic baggie containing a single pubic hair found at the scene. Jasper argued that with no label there was no chain of evidence and that the sample could have been mixed with the sample taken from Sumner after his arrest. The jury bought it. Reggie walked. Walked to here. He’d been out less than 72 hours.
I knew all of this. I didn’t know how or who. I had a graceful good guess as to why.
I turned away from the brain trust and rapidly walked over the yellow tape to the sheet-covered Reggie. I asked the forensic geek nearby if I could take a little peek. If there was a sheet, it meant they had already collected samples and photographs. Quincy looked at me and shrugged assent. I looked around for curious onlookers then, seeing none not wearing blue, I pulled the sheet down to expose his face. Something depraved with his left eye. It was obvious even though it was puffed closed; there was a runnel of dried blood down his cheek and onto his neck. I exposed his body to the waist. Wow, a huge gashed opening in his belly, slashed guts hanging out, lots of blood. Lots. “I DID IT” was written in blood on his chest. I lifted his hands, one at a time, and peered at them. There were no defensive cuts but there was an angry, red ligature mark on the left wrist and the thumb appeared deformed. I asked the nearest evidence tech if they knew yet what he’d been tied to or with and he shrugged. I looked to Reggie for answers, his face had gone late and seemed to hold a sad wisdom it never had in life.
I felt a presence at either shoulder, the boss droning the details.
The good news: There were two witnesses. Christ, somebody witnessed this mess.
The unpleasant news: One of the witnesses’ descriptions matched Mrs. Wyszorick’s grandson.
The really bad news: The other description didn’t come anywhere near the first.
Briceno said, “Have you looked below the waist, yet? “
THREE
Three days have passed since Reggie and nothing. I’ve waited, not sleeping, cracked tooth throbbing, for figures in SWAT gloomy or angelic white to appear and take me to prison or hell. Nothing. Maybe that’s what I deserve. Maybe I am what Reggie deserved, part of God’s plan but I prefer to consider that God didn’t perceive the empty gun in his plan and I’m working outside the plan, invisible outside the plan, stealthy. A karma commando.
I saw the cop on television, the one that is investigating Reggie’s death. Murder. Homicide. Foul play. Slaying. Killing.
Sloane has a Humpty-Dumpty head, spacious and egg shaped and the hair is receding unprejudiced a little and it looks like his skull grew but the scalp stayed the same size. His head looks even bigger because his mouth is so small but I’ll bet there are no cracked teeth in that head, just pearly whites in perfect rows like white cabbages on a farm.
“Several leads,” he says. Not just leads but “strong leads” and “credible witnesses”, though I suspect they’ve got nothing. “We have no clues,” wouldn’t bolster public confidence. They showed a composite drawing that looked nothing like me, maybe a little but the hair was all wrong and the composite was grinning crazily, almost grimacing. There used to be a guy, a blind guy, that worked a corner at the public market downtown, did charcoal sketches by feeling your face. He could have put together a better likeness.
They arrested the old lady’s grandson the day after the incident but called it voluntary questioning and that angered me. Angered me enough to call from a payphone come Superburger and ask for Sloane. He wasn’t there but the other detective wanted to know how I knew it wasn’t the grandson.
“I did it,” I said. He says, bored sounding, they get calls like this all the time and I can net in a lot of trouble. “No, I wrote, ‘I did it’ on Reggie’s chest in Reggie’s blood. Have they gotten the lock off yet? The combination is 23, 15, 37.” I said it calmly but I was shaking furiously. Even with the traffic noise behind me, I actually heard him sit up in his chair, heard the change in his announce as he realized that I was me, so to speak. He stalls, asks why I’m calling, asks why I did it, and tells me they can get me help if I want it. Do I want to talk about it?
“Leave the grandson alone,” again calmly. Click. I hang up. I use my Superburger hat to wipe any fingerprints off the phone and traipse, peaceful as anything, back to work, back to the fryolator and the walk-in fridge and the punks I have to work with, act like twenty years has fair worn them down, life owes them better, that they had nothing to do with the choices that brought them to servitude at Superburger. They all claim they’ve spit, or worse, on somebody’s burger but they’d never have the guts. Whiners are bad but there are worse out there. Emergency room doctors who think Tylenol will touch a cracked tooth and dentists who take two-week vacations and hire bitchy, uncaring, inhuman receptionists to keep their schedule light after they return and step-fathers that beat their kids and wives.
Back to Reggie.
He was easy to find, easy to hurt and deserved everything that came to him but, lord, life had shit on Reggie. I saw in his eyes, one lazy, big and moist and brown like a cow’s, how simple and boring and just pathetic he was. Here was no arch-villain, just a guy whose eyes begged life to stop hammering on him, give respite, just for a moment. Reggie was born to die the way he did.
I’d come up behind him while he was looking through the dumpster unhurried the grocery near his apartment. I got the address from his arrest record on the Internet at the public library. I stood a distance away and coughed to get his attention. His head bobbed up, caught, and he started to explain his presence at the dumpster, “Sorry, sorry, but you throw out lettuce and bread and stuff that’s still good. I wasn’t stealing.”
The words trailed off as he saw the gun in my hand and he knew, he knew this was it. It was in his good glance. The lazy eye just couldn’t seem to settle on one thing to look at. The helpful eye glanced sharply to his right and he lifted his right foot to start running. I took two long, quick steps and hit him across that homely, lazy eye with the barrel of the automatic. Instantly, blood began to run down his face and Reggie howled and bent over, both hands going to his injured examine. I stuck the gun in my waistband, slow my hip, and grabbed a zip-tie from my relieve pocket. I pried Reggie’s left hand away from his face and zip-tied it to the steel bar that formed a hinge on the dumpster. Reggie brought his head to his hand and it looked like he was weeping or praying and maybe he was.
“Reggie, look at me or I’m going to shoot you.” He continued to hide his face in his hands. I gave him a little thump across the back of his head with my begin hand and his face sunk deeper into his hands. I could hear that he was very quietly sobbing the word “Lord” over and over.
“God’s not in this alley, Reggie, but I am and if you want to live you’ll do whatever I say.” I thumped him again for emphasis, his sobbing beginning to annoy me. He peeked out from between his fingers and gave a little shivering nod.
“Good, you do just what I say and I won’t pain you any more.” I reached into my back pocket and Reggie’s head dipped back into his hands. “Not the gun, Reggie. It’s okay. I’m just getting a little knife to cut you loose so we can talk.” I fished the little box knife out of my pocket and held it out so he could see it. He shrank again. I guess if you cut an extinct woman with a knife, you have an understanding of what they can do. I reached the knife towards Reggie’s lope wrist then backslashed the knife across his gut, cutting him deeply. Surprise in his good eye, blood in the lazy one.
The rest is really just a blur, a collection of sensations and memories that I have to struggle to put in order and, even then, who knows how it actually went down. Me telling Reggie that he needed to hold his gut together with his free hand, hold the stinking, bleeding loops of bowel that even now were trying to slither past the guardian hand. If he held them where they belonged, the paramedics and doctors could put him back right. Reggie sobbing and “lording”. Me cutting his clothes off with the dinky knife, reassuring him that he’d be okay, digging the cheap Maestro-Lock out of my front pocket, attaching it to Reggie in the worst way. All that he suffered and he cried out when the shackle clicked home and pinched that sensitive skin. Me writing Reggie’s unnecessary dinky confession on his chest for him while his manhood turned an unhealthy and unnatural shade of purple-black.
Then, the choice, guts or nuts, did he want to spend the rest of his life shitting into a bag or sitting to piss? I told him the combination, said it accurate into his wild eye, and made him repeat it. He understood, I could tell he understood the choice. If he used the combination his guts would spill out like wet noodles into the colander. If he saved his insides, he’d lose something that, to a simpleton like Reggie, might be far more valuable. By this time, blood and parts of his most recent meal had splashed down to his knees but I could peaceful tell that he had swollen grotesquely below.
I was going to slay Reggie regardless of his choice and perhaps he knew that.
“Tick-tock, Reggie.” Did I say that or only contemplate it loudly?
Reggie decided. He went with an unanticipated third option. He chose the coyote’s way out and went mad with pain and fear and shock. It may have been the smartest bit of problem solving he’d ever done or just a short step down a rickety stairway to his animal survival instinct.
Reggie, still holding his gut, made a strange growling and hurled himself away from the dumpster, away from his own bound hand, away from the zip-tie, not unlike the flex-cuffs that cops use to restrain bodybuilders on PCP. Something had to give to the vast, manic energy that Reggie had put behind his attempt at flight. For a moment, I thought that his skin would just strip away, leaving a skeletal hand and a fleshy glove. Then there was a tiny snick as a bone in his thumb gave way and he was free.
He made a staggering, lurching run for the twenty yards towards the street and the two figures who had appeared and were silhouetted there, surveying this hellish scene. How long had they been there? He was shrieking the combination to the Maestro-Lock. Part of his gut had dropped and, halfway there, halfway to safety and help, he tripped on the tangled, sausage-like jump rope of his intestine and pitched forward. He staggered back to his feet and that long ten yards to life
Calmly, as calmly as I had ever done anything in my life, as though rehearsed a million times, I retracted the blade on the box knife and returned it to my pocket, drew the pistol from my waistband and shot Reggie in the spine, between his naked shoulders. He pitched forward and fell on his face three feet short of the two newcomers.
I stared at them over the barrel for a moment, turned and left the alley at a fast walk.
Reggie, at least two people will never forget you, always lift with shudders how brave and smart and decisive you were at the kill. We knew each other so briefly, we’re both better for the relationship and it’s good that it ended this way because I’ve met somebody new.
Four
There are two dead now and the press, keen for a sensation, has dubbed this killer, the “zip-tie vigilante”. One writer with a darker sense of humor than most referred to him as “Zippy” in his column this morning. My boss’s head nearly burst when he read that in The Post, screaming about progress on the case before the national media became interested. The only reason I was assigned to the case was to prevent speculation that the police had killed Reggie, that I, insane with rage because he had gone free, had offed him. There was a two-day shit storm when the media whipped John Q. Public into frenzy over the fact that I was the investigator.
Public Relations set up a press conference after Reggie, pet reporters who knew they’d never get another word from Media Relations if they even hinted that there was anything unscrupulous about me investigating Reggie’s murder. They all toed the line and refrained from asking anything other than the prepared questions. They got a nice sound byte of the Chief of Detectives saying that I was one of the finest detectives he’d ever worked with. This is the same chief who, as some junior journalist at The Post dug out, was brought up three times on charges of police brutality in his first two years as a patrol officer. None of the charges ever stuck but thank you any way PR Department. None of this is going to look good on a resume’ that I may need very soon.
Then Fred Mason did nineteen flights at 22 feet per second per second and though he may have been dead during most of the trip, still suffered significant damage when he stopped. The forensic geeks call it sudden deceleration trauma and the detectives who retired while I was still a rookie called it pavement poisoning. Ordinarily, these sorts of injuries are due to suicides doing the forever leap but they generally don’t pull a zip-tie tight around their necks from slow, or stab themselves in the shoulder with a screwdriver, or write “GUILTY” on their foreheads at any point during the jump. Though people have found out about the zip-ties, how we aloof don’t know, they are detached unaware of the bloody notes Zippy has left.
Compared to the dramatic nature of these crimes, catching Zippy will be mundane. He leaves evidence and, despite the fact that we haven’t gotten anywhere arrive a complete print at either scene, doesn’t seem to be making any attempt to hide his identity. The psychologists say that deep in his crazy cramped heart, he wants to be caught and that the longer it takes us, the bolder and sloppier he will bag. He’ll probably get caught in the act, subconsciously on purpose, and might even engage in a little suicide-by-cop once he is caught.
I’m a believer in evidence, well collected, well-documented evidence. I didn’t collect the evidence in Reggie’s case, by the way. I inherited the case from a guy who retired, been working the case four months. I found Reggie two days later. It’s like a relief pitcher who takes over in the third inning and pitches perfectly after the first guy let’s twelve runs go, getting blamed for the loss. I’m a believer in the simple answer: a Colombian found stabbed through the heart with his testicles in his mouth and his tongue in his rectum; well, it isn’t a mercy killing because of gross birth defects. It’s drug-related, right? Some people call this profiling but I call it common freaking sense and it seems to work well. My conviction-to-arrest ratio, excepting Reggie, is perfect.
My boss has a slightly different conception system. He believes that sometimes you get lucky and get a confession if you haul in the murdered, raped old lady’s grandson. He also believes that if I don’t come up with something soon on this high profile case, that chief of detectives, who had such nice things to say about me and who was so clumsy as to open a door into a suspect’s face, four or five times, when he was a patrol officer, is going to hand both of us our respective asses. I believe he may be right.
The evidence narrows things down to just one or two suspects. Then, if you can’t narrow it down any further, you gut one and throw the other down a stairwell, problem solved. Bad joke but being thrown into the middle of police politics has not do me in the best of moods. Even my wife says I’m acting a little bitter and we agreed not to bring our work home with us. She’s a biologist who specializes in fungal diseases so I’m pretty happy with our arrangement.
This is how evidence works.
Zip-ties are made of tough, flexible plastic that has some tantalizing edges, left over from the manufacturing process. These edges pick up fibers. The fibers in this case are a stain resistant, fire retardant polyamide in alternating brown and green. The FBI narrows this down to one manufacturer who matches the colors to a defective batch of nylon fabric. Defective because the colors were so ugly the fabric had to be sold at a steep discount. They send me to a manufacturer of bus seats who sold the seats, at a minor discount, to the Red Bird bus company who sends me to the local Metro who bought five buses with hideous greenish-brown seats at a slight discount. Two of these are out of service because hooligans state the seats on fire. I say “eureka”. The zip-tie and, so, probably the suspect, has been on a metro bus and I catch the route information on each from the dispatcher. Each bus has between 35 and 50 stops on a route that it makes several times each day. I’ve narrowed it down a bit. At this point I wish the grandson had a Metro pass.
Maestro locks have a serial number stamped on the assist in case you ever forget the combination and care enough to call the company. They also use this serial number for inventory control. This lock was sold to a discount chain which has one warehouse store in the area and it happens to be on a bus route, not one of the routes I’m looking at but it’s a enlighten transfer to route 16 which is, and sells the type of zip-ties conventional, in packs of 100, and the inventory computer shows only one purchase of these two items together within the last 30 days along with a razor knife that might be the one used on Reggie and a green plastic handled Prince and Reed screwdriver exactly like the one found sticking out of Fred Mason and which uses dummy security cameras to discourage shoplifting and only hires blind zombies with memory problems to work their registers.
The phone booth, from which Zippy spoke to Rogers, my semi-competent colleague, as I was busy with the PR rep, was almost clean. Almost. There were three paper fibers on the handset and a light covering of canola oil. The canola oil alone told us nothing. There are more than 5,600 manufacturers of canola oil in the world and no special ingredients or chemical tags in any of the formulas. The paper fibers AND the canola oil told us a lot. The fibers were a particular color of orange, that, when I saw it, looked familiar, very familiar and when the forensic fiber guy told me about the color, told me that it was called Superburger Orange, I again said “eureka”. Now we’ve got Zippy riding a certain bus, buying his home improvement supplies at a specific store and eating a certain speedy food. Unless he just picked up the napkin from the ground or out of the nearby trash basket. I contacted the paper company to confirm and they told me about the wide variety of paper products that they manufactured. I mentioned that the fibers were Superburger Orange and was told that it couldn’t be a Superburger napkin. Their napkins are white. Fizzle. Then the guy tells me that they only expend Superburger Orange to make the paper hats that the employees wear. Eureka. Now we’ve got Zippy probably working at a Superburger.
There are 19 Superburgers within walking distance of the suspect bus routes. I checked. Damned corporate propagation.
The medical examiner says that Zippy is between five-eight and six-feet and right-handed based on the way the zip-tie was pulled tight and the entry angle of the screwdriver. No prints on the screwdriver.
What was Mason guilty of, at least in Zippy’s eyes? Well, there’ve been multiple domestic calls to his residence in the past four years. Wife and kid both have shown signs of injury but the wife would never press charges. According to the school, the son has missed an inordinate number of days due to frigid and flu and seems prone to injurious acts of clumsiness.
I learned all of this without leaving my desk.
During my home visit with the widow Mason, she confirms that Fred had a temper. She also confirms, by wearing thick pancake cover on her face and down her neck that Fred was a puncher and a choker. The son’s arm cast tells its hold story and the hospital confirms it, spiral fracture of the Radius and Ulna, usually associated with a severe twist, and a dislocated shoulder. Kid fell off a ladder while painting the garage but who has a nine-year-old painting the garage? Hospital security was called, social workers talked to Mrs. Mason but she refused to give Fred up. Left the domestic violence pamphlets in the restroom. I leave her with my card, home number on the back in ink, tell her if she needs anything, if anybody like Fred ever tries to hurt her or the son again, call me. She denies, I tell her he’s not going to wound her any more. She denies again.
I called social services on my way back to the office. Jennie down there is pretty squared away; she’ll do a home visit and do it moral.
Mrs. Mason had never seen anybody that looked like the Zippy composite and didn’t know the grandson. My boss still making me chase that Doberman tail.
I’m getting ready to do my fifth Superburger stakeout in two days, “just coffee, thank you”, when PR sends down this Normal Norman in a beat-poet turtleneck to talk to me about what it’s like to do what I do. Well, PR hasn’t let me down so far. I talk to this guy, kind of old for a student, for about half an hour. He’s an aspiring writer, returning student out at Brendan College, wants to impress his professor with insight from a real-life, gee-whiz, homicide cop.
The guy, Joe Morrison, actually turned out to be alright, apologetic about taking up my time, savvy, quick on the uptake. This bad guy keeps making this strange face at me and I realize he’s sucking on one of his front teeth, looks cracked in half. He notices me looking and apologizes, launches into a still rant about how his dentist can’t scrutinize him until next Thursday at two because he’s scuba diving in Belize for two weeks. Geez, the pain must be awful, go peek a different dentist, I tell him. His insurance only covers a few preferred dentists but on the bright side, hey, at least he has dental insurance.
We talk for a bit then I tell him I’ve got to go but he can call me if he has any questions. He seemed genuinely thankful when he took my card and when he came close I noticed the guy kind of smelled a bit, like old fried food. Can’t blame him, I’m not sure I ever washed any clothes when I was in college.
I’ve got to go get more Superburger coffee. I’m not sure whether Fred Mason deserved to die but I know that Zippy had made up his mind and now I worry at what he’ll do next.
Five
His head isn’t so Humpty-Dumpty in person but he does, indeed, have some high quality choppers. Maybe the camera honest added its’ twenty pounds to his head.
I’ve reconsidered my position on God’s involvement. I have been doing God’s will. I am the unwilling arm and unwitting sword of the lord. God has duped me, into becoming his killer. I’m God’s ninja. I’ve only killed people who deserved to die under God’s law, God’s plan. Even if I chose to end now or turn myself in or continue full bore, it will be part of the conception. There are those who would argue free will and maybe I bear that, maybe only the rules are set and only the way we play within those rules determines how we slip into the ample beyond. Maybe events are set and there is no changing them. Perhaps, every decision that we consider we make has been made for us. I don’t know. What I do know is that if God’s love for us includes suffering, whether it’s children starving in some far-flung country or a cracked incisor that throbs and aches and leaks thick pus, maybe there’s a loophole. Maybe free-parking pays. Maybe.
Fred is dull. Unlike Reggie, who needed dying, Fred needed killing.
If you find yourself in the emergency room and if you listen carefully, past the moans of the elderly sundowners and the low conversations and beeps of myriad medical machines, listen in a defocused plan, you can hear the background noise of what’s really happening. I listened, through the curtain; to the drama unfold next to me. I heard and, in hearing, could almost stare. I knew Fred was a grand man before ever I laid eyes on him, bigger than me anyway. His deep, rumbling voice was bigger than me. Bigger than the doctor who applied the cast to the boy’s arm, bigger than the wife who spoke only once to say that she was going to the restroom. Bigger than the social worker that appeared with the pamphlets and coffee and the security guard with the holstered Taser.
Sure as hell, he was bigger than that boy.
I closed my eyes, listened and watched the whole farce. They tried to collect the wife apart from Fred. Tried to get the boy to slouch up and tell the truth. I watched this soap opera of shadows through the curtain and shuffling feet. I listened and, despite myself, hoped, watched and prayed. I wanted the boy to lash out, the wife to have, finally, had enough. I wanted Fred to become enraged and wished that the security guard had a real gun and imagined him having to shoot Fred, emptying the gun into Fred and all the bigness running out of him through the bullet holes like a deflating balloon.
As I realized that none of this was going to happen, mom was mum and the boy felt more fear than anger or pain, I realized I was crying. Not much, not sad or angry tears, just the moisture of frustration. Here was a sanctuary full of ologists who had oaths to make a difference, the difference, and were so constrained and chained by the same oaths that certain sufferings were off limits, closed to their ministration.
I sat up on the gurney where I had lain, not even a pleasurable bed, rose and left the emergency room, left that stark beige hell. I don’t think anybody even saw me leave, maybe nobody had ever even noticed that I was there at all. Perhaps I really had become invisible.
I saw Fred for the first time as I waited for the bus, watched, unseen, as he crumpled up the discharge instructions and threw them, not in the nearby trashcan, but on the ground. Watched and heard as the wife defended herself against a sudden verbal assault, accusations of treachery, until his hand on her throat stopped the flow of defense. Fred may never have seen the look that I saw on the boy’s face, a powerless exasperate, a silent cry for help. I saw on his face the same frustration that I had felt earlier: the inability to do anything and the knowledge that nobody else would.
Fred wasn’t just big, he was a massive, great man but somehow hollow. An X-ray of Fred would have shown only a huge outline of a man, like the chalk drawing around the much smaller Reggie. Evil doesn’t show up on X-rays and Fred was full of evil. I imagined that with a few holes in him, the harmful leaking out of each, Fred Mason would shrink to the size of a garden gnome.
The wind whipped up briefly after they left and the crumpled discharge paper rolled across the parking lot, coming to rest against my foot.
No, that’s a lie. I walked over and picked it up.
The form had a carbon imprint of Fred’s insurance card, showing his employer’s address. See you at work, Fred.
This was Friday so I had all weekend to check out the building housing Dreedle Enterprises. I site myself up as a maintenance man, tool belt and all, and meandered invisibly through the Twenty-Four-story building. I was checking out the elevators when fate and luck conspired against Fred.
Who knows why he had to be there on a Saturday. The elevator doors opened and there he was, filling the open doors. Elevator going up and up and up. The doors opened on nineteen and he exited, the elevator actually rose slightly as his weight was removed. Faulty must be heavy.
The elevator doors slid shut and I breathed deeply for a moment. I was getting better at being unnoticed. I had objective made myself small and stared at the control panel as though there was some secret, maintenance related information relayed there. I pushed the door open button and stepped out surveying the hallway. A sudden plan: not perfect but spontaneous enough to work.
I walked to the stairwell door across the hall and prepped one of the long zip-ties then pulled the fire alarm, stepped into the stairwell, slipped late the door and waited. I terrified that Fred might not know enough to take the stairs in a high-rise fire but as it turned out the elevators all returned to the ground floor when the alarm went off.
I wanted to make Mason feel the frustration of powerlessness, impotent to help himself, helpless as a scrawny nine-year-old boy or a frail, beaten woman. When the door opened, I stepped behind him and looped the zip-tie over his head, stepping back and pulling the zip-tie tight. I wanted to watch this huge, hollow man collapse to his knees and beg me with his eyes to attach him, his hands clawing at the thin plastic band that was killing him. I understanding that, before he lost consciousness, I might stomp on the bones of his arm, maybe both arms.
He didn’t claw or drop to his knees or beg. He spun around, stepped towards me and grabbed my throat, squeezing and crushing as the tunnel vision began to close in on him. Oh, but he was strong, filled with loathing for everything. I guess evil dies hard.
He was forcing me to my knees when my hand brushed against the handle of the screwdriver in my tool belt and I seized it and swung it awkwardly. It was almost effortless, the arrangement it slid into the point where his massive shoulder and bull neck met. His meaty hands released my throat and I exploded upwards and forwards, towards Mason and the painted steel railing gradual him.
It didn’t seem that he resisted at all. He just went backward and over the railing. I didn’t see him descend but I heard him hit the opposite and lower railings with a pong, followed the progress of his tumbling fall, bing, pang, pong, smack. When I stood and leaned over to look, my hands on the railing it was still vibrating and it transferred that gong-like sound through the bones of my arms to my ears and I wished I detached had the screwdriver to puncture my eardrums, drive the noise out of my head. It sickened me and I still don’t know why.
I leaped and flew down the stairs, somebody would respond to the fire awe soon. I reached the bottom, the basement level and heard radios crackling with fireman talk on the level above as I wrote Fred’s confession. He really seemed to have deflated or at least flattened slightly on impact. Then I simply walked up the stairs, through the lobby and out. Still invisible, I guess.
My neck was so bruised by his crushing strength that I had to wear an old turtleneck, despite the warm weather, when I went to bask in Sloane’s arrogance. Actually, he seemed like a decent guy, a little tightly damage but not so self-important that he seemed bothered to take a few minutes to talk to a college student. He had a dim light of intelligence behind his eyes.
I suspect that Fred did feel powerless before he died. Everybody is powerless to gravity’s pull.
Six
When the answer comes, it comes hard and fast but in little bits. It’s a bit like throwing the last three or so pieces of a jigsaw puzzle at it from across the room until they fall in region. That’s what it was like this time.
I’d had a blooming chat with my boss and the chief of detectives this morning after CNN reported the killing of Father Theodore Dodd by crucifixion and exsanguination. The national media was on the case and the bosses were on mine. It felt like I’d had a proctologic exam from Captain Hook.
It may even have been a copycat killing, no little note this time, but it felt like Zippy’s work. It had his flair but not his signature. Once the boys from forensics found that ugly greenish brown fiber in the pool of blood beneath Father Dodd there was no seek information from for me.
Saint Cecilia’s altar was awash in blood, no surprise since the victim hung from a chunky size crucifix directly above it, bound to it hand and foot with, you guessed it, zip ties. All of the blood, it still surprises me how powerful eight pints really is when it’s splashed everywhere, came from four cuts, what the medical examiners called surgically precise incisions of the brachial and femoral arteries. In all likelihood, he was dead long before the crucifix had been raised by crank and pulley abet to its’ position over the altar.
From all appearances, Dodd was a good man and a sterling priest with no vices. Of twenty people interviewed, there were only three negative comments about Dodd, each the same, that he was a bit too literal, too fire and brimstone, even in a parish known for that sort of thing.
Just my luck that the Chief of detectives lived in that parish and Dodd had been his priest for fifteen years. The Chief also seemed a little fire and brimstone and I could only wonder at what he’d confessed over the years
The retort came at Superburger, The Superburger.
Sean the fry guy gave me the reply. He brought coffee to me in my car, wanted to rap with the man, enlighten me he’d seen me on TV. With him, he also brought the smell of food fried in canola oil and his orange paper hat. Everything fell into place. This Superburger was only six blocks from the pay phone and I don’t know why I hadn’t realized it before. Canola fried food and the smell of Joe Morrison. The bastard had talked to me, had sat right at my desk, crossed his legs and laughed inside while he listened to me go on about what a great cop I was.
“Joe Morrison work here? ” I asked Sean.
“Not today, man.”
“Why, has he got classes today? “
“Classes? “
“Yeah, at Brendan.”
“Joe doesn’t go to Brendan. He told you he was in college? Naw, he’s at Winter Center getting that tooth of his fixed.” I barely noticed the quizzical look on Sean’s face as I threw the car in gear and squealed off. I knew the plot to the Winter Center. It was only three blocks from my home.
Thanks Sean.
Seven
Maybe the priest didn’t deserve to die but I’d gone to him for help, maybe to confess, and all he’d wanted to do was harangue me for contemplating the ultimate sin.
I started to tell him everything but where to begin? I couldn’t start with Reggie, got to build up to something like that, and I didn’t want to start by talking about Kari and turn this into a grief counseling session. So, I started by telling him about the miracle of the empty gun and, stammering, tried to explain my theory of God’s notion and hope and prayer and despair but he interrupted me to tell me that I was going to Hell. Not exactly but that was the gist of his message. There is no forgiveness for suicide. He wouldn’t cessation hammering that point and didn’t realize that maybe that’s where I belonged for my sins, in Hell with my dead, unforgiven wife and our unbaptized dinky girl. Hell has strange rules. Everything I’d done and I could still miss the reunion by confessing and making a sincere act of contrition but my little girl, innocent of all but dying without a little water sprinkled on her, was doomed for eternity.
I’d commence over. He’d hammer again. I gritted my teeth and the pain jolted through me, a white flash and when the flash was gone, Dodd was on his back and my fist hurt. I’d just wanted him to shut up and support me with the real problem: had I done enough for damnation? Would I see my loves again? Even in Hell, better than heaven without them. Better than life without them. Had I earned my residence in Hell?
I have now. I’m sure of it.
Eight
Following Sloane every day was about the most boring thing I’d ever been assigned to do but the Chief wanted somebody from IA to do it and, while doing it might not help my career any, not doing it obvious would hurt it. The whole thing was political; everybody knew that Sloane had nothing to do with Sumner’s death but…honest in case.
Sloane just did his job, had a better marriage than my first two and his wife made enough money that corruption wasn’t even a temptation for the golden boy. Every time I saw him with that revolver of his, I felt a little cheated. At the academy, without studying or midnight cram sessions, he’d edged me out for honor graduate by a full three percentage points. Then, again with no effort, when he’d gotten the only perfect score in departmental history on the detective boards, they’d presented him with that engraved super-lightweight, super expensive .44 Magnum. Made of some space-age alloy called Scandium and weighing half what a steel gun weighed, it was meant to be a presentation piece, something you hung cased in your den but he wore it every day. The thing was, if you knew him, you knew that he didn’t carry it to be arrogant but because it was more comfortable to wear all day than the issue autoloader.
Sloane was such a straight arrow, hard working cop and all around swell guy that you couldn’t help but hate his guts.
But what was he up to now? Running home for a limited afternoon delight? Not Sloane. He’d left his assigned stakeout at about half past one in enough of a hurry that it was difficult to withhold up without him realizing that I was tailing him. He raced across town, of course not violating departmental speed regulations or misusing his siren and pulled to the fall off circle in front of the Winter medical complex, right near the bus stop. Then he just sat there, engine running.
I went to the parking lot and exercised police privilege by taking a disabled parking area so that I could keep Sloane in view. What the hell was he doing here? He unprejudiced sat, watching the front door then the bus stop, like a bloodhound casting for a scent. He was on to something, wasn’t he? The bastard was going to gather Zippy and maintain golden status, probably with a nice fat commendation and press coverage. He’d probably turn down a book deal because he felt he was only doing his job.
An hour passed and his head still bobbed back and forth, then it stopped, locked on the front entrance. Sloane opened the door and stepped out, leaned over the top of the car and gestured at somebody hidden by a pillar near the entrance.
The hidden man appeared, an unremarkable sort but for the turtleneck. He turned away from the line he’d taken towards the bus stop and walked toward Sloane’s car. He leaned across the other side of the car’s roof then opened the door and they both got in. There was a moment where their heads were turned towards each other in conversation then Sloane pulled away. I was a little slow to follow and when I did catch up only two blocks away it looked like all hell had broken loose. Sloane’s car was slewed sideways across both lanes of traffic and still running. I jumped out of my car but didn’t arrive, not wanting to interfere with Sloane’s bust then I noticed that there was a struggle going on in the car. I drew my weapon and raced the thirty or so yards towards the car. Halfway there, there was a single gunshot, muffled inside the car but still fairly loud as a .44 Magnum makes a decent boom.
I circled towards the passenger door, gun held in the Weaver stance as I moved in. I’ll never erase what I saw when I got close enough to look into the car.
Nine
So, what happened? I’ve regained some mobility in two fingers of my suitable hand, which allows me to operate the wheelchair, and I can twitch some facial muscles. I also found recently that I can let my right arm fall to the side of my wheelchair and then, with vast peril and concentration, raise it again to the level of what used to be my face but I want to surprise the doctor with that another time. The rest of me is useless. The speech centers of my brain were unaffected but that hardly matters as my lower jaw, my tongue, half of my soft palate and maxilla and my left eye were blown all over the inside of the car by the massive muzzle blast generated by a .44 Magnum. The 240 grain bullet, launched at 1400 feet per second, did relatively little damage, just passed through the back of my head at the neck, destroying half of one cervical vertebra on its’ contrivance. I mean, it apprehensive me but the damage was nothing compared to what the muzzle blast did. The bullet still had sufficient velocity to rip through Sloane’s skull, honest below his receding hairline, making a hash of his brain and continuing on through the roof of the car. They couldn’t put Humpty-Dumpty together again.
Ironically, the tooth I’d had fixed is one of a handful that survived the explosion in my mouth and now hangs from the demolish of my face like a lonely, solitary headstone. I guess that dentist was worth the wait.
I’d gotten it fixed that Thursday, had handed my co-pay to the bitchy receptionist, thinking I might see her later, and left. Sloane was waiting for me out front and called me by name as though he’d just recognized me. He waved me over and asked how my assignment had gone. I told him I hadn’t finished it yet. Great, he says, he’s got a little time now to talk; do I need a lift somewhere?
Sloane may have been a great detective but he was a terrible liar. I was caught and knew it and he could tell that I knew it. I think he was surprised when I accepted instead of making an excuse or running.
We got in his car and he turned and asked where I’m headed. Possible answers rushed through my head; “Hell, hopefully” or “That’s really up to you, isn’t it? ” but I just gave directions instead. We turned onto the main road. Anger flashed through me. Why was I being so docile and meek? Who was Sloane to bring me in? After everything, what did I have to lose by resisting?
Sloane looked over his shoulder to make a lane change and I reached out and yanked his gun from the leather holster at his side. Too late, he made a go to stop me by pulling at his holster but his seat belt was in the way and I snaked the gun from beneath the elbow he tried to block me with. Events sort of tumbled as things happened simultaneously. I rocked forward and was thrown to the side as Sloane slammed the brakes and reached for me as the car spun sideways and stopped suddenly against the curb. I more or less bounced off the passenger door and into a acquire hug as Sloane tried to wrestle his gun from my grasp, his entire upper body wrapped around mine, pulling my arms tight to my chest.
I was already pulling the trigger and opening my mouth as the gain hug awkwardly forced the barrel deep into my throat. The world exploded in afflict and light and I was rocketed into a dreaming unconsciousness.
I dreamed through the medical treatment and the legal proceedings, unable to reply to the doctors or my attorney. For several months, Sloane and I were the center ring of a media circus, entertainment for slack-jawed viewers: the dead hero and the undead monster. Speculation ran rampant: whether I would live to face the death penalty, whether I would even stand trial. Once I was able to communicate by blinking my eye and requested that I be removed from life-support, the circus began again. Activists from all sides advocated and rallied and held vigils. Groups against the death penalty fought for my right to die with dignity and proponents of tough justice sought injunctions against removing my breathing equipment so that I could live to face lethal injection. One group even filed a lawsuit against the police for brutality.
I never even went to trial. A believe ruled that I was too guilty to go free and too crazy to be guilty, I represented the worst sort of imperfect but was no possible wretchedness to society. I could do no harm but must be incarcerated to protect me from harm, despite my wish to die, so that, were I someday deemed sane, I could face the death penalty, though he doubted that, because of the massive media coverage and my inability to adequately express the facts of the case, there could ever be anything other than a mistrial. He cited an obscure state law, never removed from the books, that allowed private citizens to be removed from society against their will to protect them from danger. This law, the Issei, Nisei and Sansei Protection Act, was originally written to justify internment of Japanese-Americans in this state during World War Two. The media dubbed its’ new use Sloane’s Law. Droll.
Funnier still is that I couldn’t agree more with those who wish for me to die for my crimes. Heaven waits for me in Hell. The fiery pit could not compare to being trapped in this useless body, unable to communicate, a breathing tube, feeding tube, IV tube for high octane hurt meds, urinary catheter and colostomy bag. Everything dripped into me and then trickled back out. Those who sought to protect me have doomed me to a fate worse than death. I was thinking rationally throughout, I never was crazy, but to get what I need and desire more than life, I’ll have to show psychological recovery so that I can face a mistrial and freedom. That would be truly crazy and I’m remorseless not crazy. I fulfilled Reggie’s destiny, spared Mrs. Mason and Fred Jr. a lifetime of pain and it’s not like Dodd left a weeping wife or kids behind. I gave him a firsthand look at God’s kingdom. Sloane? Well, Sloane wasn’t my fault. Sloane was an accident. They say you’re most likely to have an accident within a mile of your home.
The judge’s ruling left everybody equally unhappy, except the members of the Fourth Estate who rooted and reveled like hippos in mud.
I am protected from society, and vice-versa, by the walls of Saint Vitus’ Hospital and I’m not the only one. I have a roommate. Rodger Dodger, the nurses call him. Roger Darling was in a situation similar to mine but was in no diagram similar to me. Roger deserved Hell. I had had to earn it. Nobody held vigils for Roger Dodger after he hacked his pregnant wife to death. Nobody rallied for his civil rights after he drowned his six children, one by one, in the bathtub. Roger even cooked their Yorkshire terrier in the microwave before he slipped into a permanent catatonic state. Even the ASPCA wanted the Dodger dead. Only his swallow reflex kept him alive. The nurses spoon-fed him a mix of baby food and milk four times every day and the monster swallowed it. That’s all he could do or all he would do: swallow. Because he wouldn’t blink, the nurses kept his eyes lubricated with saline solution and white petrolatum ointment that leaked from his eyes and made him appear to be crying all of the time. They sponge-bathed and changed his diaper and exercised his muscles for him and turned him to avoid bedsores. All they had to do for me was change my tubes and change the bib where my sinuses and the remains of my salivary glands drained all day. They didn’t talk to me; they didn’t protest eye-blink, and avoided looking at me. Hell, I avoided my own reflection. The thing I had become was only recognizable as human by thinking about all the parts that were missing or didn’t work. I was a brain, an eye, and two fingers bound together with plastic tubes, scar tissue and weeping sores. Oh, and an arm that worked a little but they didn’t know about that or that I’ve been exercising it after lights out every night. I would watch the physical therapists work with the Dodger; they’d massage one muscle group at a time to increase circulation then contort him into unlikely, unnatural positions. Whatever position and whichever muscle, he’d stay that way, completely locked into location by his diseased mind, until they’d force him back to a position that looked restful.
Tonight’s the night. I’m stepping out and Roger Dodger’s going to help. If I let my arm dangle near him and lock his hand around my breathing tube then drive away, it ought to yank the tube true out of my open throat hole giving me only a few minutes of life. Before I drive away though, I’m going to disconnect the tube that drips the noteworthy pain meds into me and let them run into his mouth, let him gulp and swallow a week’s supply of Fentanyl in two minutes or so.
See you in Hell, Roger Dodger.
Daddy’s coming, Melanie.
I love you, Kari.
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Filed under Gastric Banding by on Feb 19th, 2011. 
A lot of people that are morbidly obese elect to have a gastric bypass surgery. But this surgery does not reach without at least a few risks that you should be aware of. I’d like to point some of these out.
One of the dangers is Dumping Syndrome which is where the food doesn’t digest anymore, but just apt on through you, and can cause cramps, diarrhea, and the person to feel very unwell. This is one of the things you should be aware of before having gastric bypass surgery.
There is another danger known as Anastamotic leakage. This can be very unsafe since what happens is if the stomach and bowel are not sealed tightly enough so that there is no leakage, then a leakage will occur. What happens is that the fluid off from the intestines will leak out into the stomach. The person can then develop some serious infections and will probably need hospitalization to earn rid of it. Abcesses can also come up from this problem.
There is also a type of stricture that can manufacture known as anastamotic. This is due to the scar tissue growing back too much, and causing a hole so tiny, that the body will no longer have proper nourishment and starve. If this complication happens between the stomach and the bowel, then a procedure known as gastroendoscopy will need doing where the surgeon will region a balloon where the connecting link is between stomach and bowel to open it so food and nourishment can go through.
Since your stomach is obviously made much smaller, and can now only hold diminutive portions of foods, you may find that you are lacking nutrients. people that have had gastric bypass surgery in the past, have found that they are lacking in vitamin B12, iron, protein, and also the very important calcium needed for bone health. The absorption of these nutrients fails after this surgery many times, and as a result, you become undernourished and other medical conditions can result from lack of these vitamins. And the other drawback is, the essential vitamin D that is so needed by the body may fail to absorb too.
If your lines of staples break after this surgery, you run the risk of stomach ulcers which can bleed if not treated promptly, and gallstones too, which often cause pains.
This is the reason whywhen considering having gastric bypass surgery, you should think carefully and whether the benefits will outweigh the risks. Sometimes it is better to lose weight by trying to reduce food intake, and do it slowly. In gastric bypass surgery, if you don’t follow all of the guidlines for eating properly after having this done, this is most commonly when the complications I mentioned can set in. Weight can also come back a few years if you are not careful enough with your dietary regime.
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Filed under Gastric Banding by on Oct 2nd, 2010.
If you are considering having gastric bypass surgery, I’m definite you want to know how mighty weight you can inquire of to lose and impartial how quickly you will lose it. It’s necessary to understand that each individual is different and will experience different results from the surgery. Some people will lose more than others, and some will lose more quickly than others.
There are a number of factors that influence how much weight we will lose, including our starting weight, our metabolism, how carefully we follow our doctor’s dietary guidelines after surgery, our activity level, whether or not we have any health conditions that can affect weight or metabolism (like diabetes or thyroid problems), certain medications we may be taking, the size of the stomach pouch our surgeon creates, and the amount of small intestine our surgeon bypasses. As you can see, some of these things are things we have some control over, like whether or not we follow our doctor’s dietary guidelines and how active we are. Other things, like whether or not we have thyroids problems and our metabolism, we can’t really control.
Studies have found that the average person loses about 60% of their excess body weight after a gastric bypass. That means if you are 100 pounds overweight, you could seek information from to lose about 60 pounds.
To calculate your excess body weight, first choose your ideal weight. You can obtain charts online that will give you the ideal weight for your height, or you can ask your doctor. Subtract that number from your current weight. That is the amount of weight you have to lose.
To calculate how considerable you might lose with gastric bypass surgery, get a calculator and multiply your excess weight by .6.
However, there are several things you should keep in mind while making your calculations. This is just an average, so that means some people lose significantly more than 60% while other lose significantly less. And there are plenty of things you can do to maximize your weight loss. Remember the factors I listed earlier? You have control over some of those things. You can settle to follow your doctor’s dietary guidelines. You can choose to exercise. If you take medications that affect your weight, ask your doctor if there are any alternative drugs you could try instead (there may or may not be).
Also talk to your surgeon about how big he or she will make your pouch and how that will affect your weight loss. One study found that a smaller pouch size was associated with greater weight loss. Ask your surgeon if he or she will be using a sizing balloon to size your pouch. Some surgeons use them and some don’t, but one study found that using a balloon helps get the pouch the right size and maximizes weight loss.
The same things that affect how much weight you will lose also affect how quickly you will lose. Most people lose most of their weight during the first 12 – 18 months after surgery. Those with the most to lose tend to lose the most quickly. Dr. Dirk Rodriguez of Cincinnati, Ohio, says that patients should expect to lose three to five pounds per week at first, and that weight loss will start to slow down after the first few months. However, some patients lose even more quickly than that at the beginning. You should also be aware that it is common to have a week or two (or longer) here and there when you don’t lose anything. It doesn’t mean you are done losing. Weight loss will start up again. Your body is just adjusting to the loss.
Sources:
Matthew Hoffman, MD. http://www.webmd.com/diet/weight-loss-surgery/what-is-gastric-bypass-surgery. What Is Gastric Bypass Surgery? Science Daily. http://www.sciencedaily.com/releases/2008/09/080915165816.htm. Factors Associated With Poor Weight Loss After Gastric Bypass Surgery Identified.
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Filed under Gastric Banding by on Aug 9th, 2010.
Chronic patients who suffer with different health problems which affect their GI tract and who cannot eat or procure pain when they eat or do not tolerate lots of foods can be malnourished. For those patients the doctors by placing different kinds of feeding tubes save their lives. If it’s not taken care of the malnutrition can make lot of other health problems. Sometimes the patient can die when the body does not get any kind of nutrition it weakens the immune system and they are prone to get all kinds of infections and becomes hard to fight them.
The Science and Medical Technology made so much progress to keep people alive for years without eating too. The doctors either suggest that the nutritional supplements that are available in the super markets like, Breakfast Carnation in different flavor, Pediasure, Boost, etc. If the patient can tolerate that they continue that so that they won’t get any problems with the malnutrition. They check them every week to see whether they are gaining weight or not. But there are some chronic patients, Cancer patients who cannot tolerate any kind of food and they accept pain whenever they eat that’s when the doctor’s decide the placement of J-Tube and the way called Jejunostomy. The J-tube is placed in the upper portion of the small intestines called the Jejunum which is just below the stomach. The tube will be located lower and closer to the center of abdomen.
The main reason of J-tube is to bypass the stomach and directly feed into the small intestines so that it won’t bother the stomach. The patients regain a special Enteral pump through which they are supposed to be fed. Enteral treatment means a formula is given to the patient through the tube feedings. Different brands of formulas like some are not that high in fat, some are high in protein and has little bit fat too and the doctor taking all the facts of the patient into consideration writes the prescription for the right mark. The tube feedings can be short term or long term. When the patient has to go through a major surgery and lost too remarkable weight then the doctors plot the feeding tube and give the patient Enteral tube feedings until the patient gains enough weight and has all the nutritional levels are normally required. The tube feedings take a while to adjust to the bowels and the doctors choose that the patient should derive the nutrition at a certain rate which helps them to tolerate and also helps them to gain weight. The tube site should be taken care of everyday cleaning the area and changing the dressing so that the infections can be avoided. When they do the Jejunostomy they check whether it’s in the right place or not. Whenever I go to Radiology Department of Penn Hospital to get the new J-tube after the procedure they check it to seek whether it is in the right place or not.
As I am a chronic Pancreatitis patient and none of the surgeries could pick away my pain I ended up with J-tube forever. I can eat snacks but I will never be able to eat full meals like everyone. When I got the J-tube it was such a hard thing to gain used to. The body does not like the foreign bodies and it always tried to push it out and whenever the tube moved it hurt so much. No matter how much I took care of the site I ended up with so many infections and had to be treated with anti-biotic. At one time I think I was on antibiotic almost every month or alternate month for a year. They had to give good bacteria to replace it which was lost because of taking too much antibiotic. After having so many infections the pain around the tube became very severe. It wound when I toddle, when I try to sleep on to the side, sit for continuously an hour in a chair working on something the injure became unbelievable. So the radiologists told me that it has become chronic. I was very mad for a while. My life was full of pain and they keep adding new kinds to the already exists. When tube was placed it has a small balloon to block the tube from coming out from the small hole but after few months or rarely a year after the balloon gets ruptured and the tube comes out. We make appointment to replace the tube and the Radiologists at the Interventional Radiology replace it. Sometimes this balloon ruptures and the tube starts to come out that means it’s time to get a new tube. I go to Penn Hospital Radiology Department to get it changed.
I ended up in the hospitals with the infections to secure I.V antibiotic treatments by a injure specialist. Then they figured it out and said because I have Meta Port I can retract the I.V treatment at home when the nurses from Infusion Company will come and show me how to do it. I have suffered like that almost two years. My friend from Nevada said one of her neighbor’s daughter have some chronic problems so she has this J-tube too but she uses an ointment which blocks the infections. So she sent me the name of the ointment and we showed that to the wound specialist which he has not seen before so he called the pharmacist in the hospital and gave the name of the ointment. I have started using the ointment and the infections stopped all of a sudden and now the tube site is very clean and I take marvelous care of it. Of course the afflict around the tube also came down. It is still there but it gets worse when I work for hours sitting or bend too much if I get in the mood of cleaning and carried away without paying attention to the time.
Having J-tube helps me to get the enough nutrition for my body. Last year I had very tough year and lost too much weight even though it bypasses the stomach whenever I get the wound I can’t use the tube feedings at the normal rate. Sometimes I have to stop it until the Pancreatitis attack goes away and then start with the low rate and increase it slowly to my normal rate. As I lost too much weight my G.I doctor suggested that I should get TPN for 12 hours at night time. TPN (Total Parenteral Nutrition) can be given through a central line or Meta Port because it is very thick solution which cannot be tolerated by the usual veins used for the I.V. So the TPN treatment is given through intravenously bypassing eating and digestion. This is temporary treatment for me. The TPN formula has all the nutrition required for the daily supplement of the body. It has lipids, amino acids, salts, glucose and all the important nutrition. We have to add vitamins when preparing the formula to hook up. For the first few days I had to check my sugar levels and if they are normal then I don’t have to do it regularly. If the sugar levels go up they give insulin to the patient. Every week the nurse from the Infusion Company visits and she draws blood from the Meta Port to send it for the labs. They check everything to see the TPN is working or not and if they have to make any changes. If something is low or high the doctor who gets the blood work recount asks the nutrition nurse at the Infusion Company to make some changes. The nurse then takes out the needle; well-organized the area, accesses it with the original one, then puts the dressing and flushes the port. The Port which was accessed needs to be flushed with Seline flush before hooking up TPN formula then when the formula is done it needs to be flushed with both Seline and a Heparin. This keeps the port clean and avoids the infection. There is always a great risk of infection with the ports. The first Meta Port I had for almost more than 5 years without any problems. But when they started TPN in fall four weeks later I had very dreadful infection and luckily caught on time. Sometimes the patient can go into Sepsis shock as the infection spreads very posthaste and can be dangerous. That’s why the patients need to be very careful in taking care of the port.
Every week the nutritionist calls and finds about the weight, and whether am I having any problems with the TPN or is it working without any problems? Usually every week I gather one or two pounds. Some times when I have lot of pain I don’t gain any weight but I don’t lose whatever I gained too. So, that’s a good note and means I am on right track. When TPN starts working I feel more energetic, when I do things I do not fetch tired quickly, the paleness goes away and the skin, face look healthy and I start looking healthy and people start noticing too. I have gained fair few pounds and I have a long way to go.
TPN is mostly musty temporarily unlike the J-tube can be used for long term. TPN is venerable for the Cancer patients, GI tract malfunctioning, diseases that need total Bowel rest, Crohn’s disease, Ulcerative colitis, Bowel destruction, Pediatric GI disorders, short bowel syndrome due to surgery.
There is another kind of tube feeding which is almost like J-tube except that it is G-tube and is placed in the stomach and they are archaic for the long term Enteral nutrition. It’s placed in the abdominal wall surgically. Just like the J-tube the station around the tube should be kept clean and use gauze for the dressing. G-tube is also called a Peg tube.
NGtube is called Naso gastric tube another kind of tube feedings which is inserted through nose and passed down the pharynx through the esophagus and into the stomach. NG tube is worn for the short term. They check it whether it’s in the right place or not before each feeding. Before my second major surgery Whipple when I was in the hospital and the doctors were horrified that I was losing the weight so badly and before they send me to the surgeon again they wanted to try NG tube so that I can get some nutrition daily, slowly gain weight and get some strength before they decide what can be done. I was reluctant about it and after the doctor pursued and explained for a long time then I agreed. My Gastroenterologist tried to insert it through my nostrils but he couldn’t get it where he wanted. I was gay it didn’t work out because if they send me home with that my kids could have been so frightened. Then they decided about the J-tube and sent me to another hospital where the surgeon agreed to do Jejunostomy.
These are the different kinds of tube feedings that are used for the people who cannot eat like the normal people because of some GI problems or some other chronic conditions. When they first talked to me about the J-tube I totally gave up at that time but they did not want to give up on me. As the doctor was explaining I said, ‘why don’t you just kill me? ‘ The doctor could not talk to me and got up and left the room. I know they were trying to save me from dying due to malnutrition. Then next day my Gastroenterologist came and slowly explained everything step by step then I agreed to get it done.
I am very glad now that the doctors did not give up on me and also I’m thankful for all these wonderful medical advances which help people like me to live and see the kids graduate, going to college and enjoy watching them becoming successful and happy in whatever they are doing. I have to thank all the doctors and surgeons who gave this life to me.
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