Witness the wonderful 80s, prosperity, happiness, national
unity, and the benefits of high technology. 
Ronald Reagan was in office.  He
employs supply-side economics and Loeffler’s Economic curve and corporations grow,
and the gross economic product increases.  
He might have gotten shot because he suggested a flat-line tax, but it doesn’t
matter anyway because he was prepared and survived another day.   The eighties rolled by like a grand tsunami,
and then they were over, and the baby boomers started to die and Generation X took
over.  

Where was the Wracks? 
He probably waits in the ready room in surgery, sipping coffee and
eating doughnuts before his next assignment. 
He is not aware of the booming economy or Ronald Reagan’s pretty
daughter who is a denizen of Tranquil Hills too, just one state away. Today he
meets the guy from NYU.  Like all ivory
tower iconoclasts, the guy from NYU is tall, with Sheldon-Kretchmer ectomorphic
habitus, in green surgical garb with a green hat and a large light on his
forehead.  He seems to be made of Norwegian
or Anglo-Saxon stuff, and he moves slowly, turns slowly, and begins to talk to Dr.
Wracks.

The apparatus in question is situated on top of a securely
movable cart with feet that lock to the floor. 
A long spigot, about six inches long and one-quarter inch in diameter blends
into a square body with two stainless steel tubes arising in parallel from the
far end.  The entire fixture is made of
24-carat gold and must be worth at least one hundred thousand dollars in ingot value.  

We had to go to gold says the man.    All other metals get brittle and crack at
the temperature of liquid nitrogen.  
Assisting me at the station with the patient in a stereotactic headset
and temperature-regulated vest, you will instill liquid nitrogen into the
device which inserts into the brain of a patient with a large glioblastoma
multiforme tumor.   The liquid nitrogen
will freeze the tumor, thus destroying it and the expanding gasses will exit
through the other aperture in the device, through a tube into the ambient air
after being filtered.  I will monitor the
entire procedure, in real-time through a fluoroscope and then you will bring
the filter unit to Pathology for analysis. 
Don’t forget to tell Dr. Santos I said hi.

Today is a slow day. 
Dr. Wracks will have to settle for a tendon release rhabdoplasty in a
woman stenographer with carpal tunnel syndrome.    The plastic surgeon is Chinese and he tells
the Wracks he will make five thousand dollars for each radial release and I
should be a cosmetic surgeon just like him. 
All surgeons say the same thing.  
They want you to think that the tons of money they make is worth the constant
stress and subterfuge they encounter daily in the e-coli-infested surgical
rooms that used to be sanitized in the 19^th century with
phenol.  They don’t use phenol anymore,
only cheap emergency rooms in the inner city put up with the smell.  Poor people can’t complain much.   Dr. Lister tosses in his grave and they are
thinking of installing black light panels on the ceilings to bombard the DNA of
microbes when the operating room is not in use. 
Dr. Wracks looks at the board.  He
is up for an Orthro procedure after this where a Saudi in a one hundred-thousand-dollar
Mercedes Benz went off the Brooklyn bridge and ended up in the drink.   He is broken up well.   Dr. Ich is his surgeon.    Dr. Wracks pulls another Marlboro cigarette
from the pack on his fanny belt and lights up.  
It is going to be a long one and nicotine and caffeine will get me
there. 

It is hot and it is summer in the smog-infested central
inner city of LA.  The Wracks wears a
beret and his cheap glasses bear flecks of paint in the shade of beige.   He now is an apartment redeveloper in the
inner city and drinks a lot of Coca-Cola.  
He likes to roll paint because a sprayer gets paint on everything.  His two helpers hide and get some sleep
underneath the kitchen sink and in the hall closet because they are illegal
immigrants and work two jobs to support their families.   On payday, the Wracks brings them to Western
Union and they wire their paychecks directly to their families in Central America.   These people live five to a room and live on
McDonald’s cheeseburgers for sustenance.  
His main man Ramon says that since he doesn’t live on beans and rice
anymore, and he eats quarter pounders all his hair is falling out but the
Wracks don’t dare to tell him otherwise. 
He is happy, his brother offered to sponsor him for citizenship if he
agreed to work as a slave for seven years, and the Wracks light up a filter less
Pall Mall to keep going and then extinguish the smoke and put the but in his
front pocket. Everyone is happy, it is the eighties, and the Wracks is happy to
have a job and make some money.   He couldn’t
cut it as a surgeon and they let him go. 
He was tired of blood squirting in his face and having to shower after
each procedure.  The Wracks wonders what
happened to Ronald Reagan’s daughter. His friend from the upper class whose
father was on the medical faculty of the big U would drive by the Reagan house
and shoot all his nightlights out and then scream like a crow and smoke some
black hash.  She had pretty dark hair and
the eighties are up in flames and soon we will experience Clintons and the white
house a three-ring circus.  President Clinton’s
wife was the sister of an infamous rock singer of the eighties who turned
southern California upside down with his antics.  

I never wanted to be a doctor in the first place thinks the
Wracks as he drinks a coke and takes some Herbalife ephedra.  I am just not nice enough or stable enough in
this great big, wonderful world.  I hear
some old timers say that the quality of life was better in the eighteen
hundreds but they are all dead now and it doesn’t matter. 

GENGHIS KHAN:

The basis of all nations is war, because of this we must examine it closely

MAO TSE TUNG:

All communist regimes eventually become a monarchy

RENDU:

The people will have your soul.

It has been so long, very long ago that it happened.  The Wracks remembers and the image floods into memory and the realization that hindsight is 20-20 but the lessons learned in a brief moment last for a lifetime, even if unused. 

The Wracks is glad to get out of surgery.   The pace and work are demanding, call it every third day and people cry out for sedatives in the middle of the night.  Anesthesiologists ask the surgical residents to not administer neuroactive sedatives to their patients before surgery because they might stop breathing during the procedure.  The patients cry out in the middle of the night, they know they might die and they want to be sedated while it happens.  In Ob-Gyn, women go into labor at inopportune times as dictated by the maker so the staff must always be there and awake to bring new life to the earth

I am glad I am out of surgery says Dr. Wracks.  I cannot take the stress.   All I wanted to do was hand out antibiotics and treat venereal infections in a beach consultation, but I ended up removing organs, doing cancer ablation techniques, and putting people back together who had been broken in car accidents.

You are in internal Medicine now says Dr. Q.   Remember to keep your mouth shut.

The people in the ward in medicine are mostly well-to-do elderly gentlemen who have stressful high-power existences and have high blood pressure and or a stroke.  They lay in beds, propped up, with the TV on and an I.V. bag drips a clear solution of heparin into their arms around the clock.  Heparin is an ideal anticoagulant because overdosage is nearly impossible.  Coumarin causes severe bleeding and none of the patients like it.   Dr. Wracks sits in the nurse’s unit with a warm cup of tea, a teaspoon of sugar, and a smile on his face.  His real education will soon begin

The Italian is a small man about five feet six inches tall who dresses impeccably.  His grey suits must cost at least five hundred dollars apiece and everyone knows he is the best at what he does.   These intangibles make him famous.    His eyes are like laser beams and they burn through your very soul and he decided to keep Dr. Wracks alive.   

Look at the charts he says as Dr. Wracks sits in white, hygienic luxury, in a chair, somewhere, in a nurse’s station.  His right hand pulls a three-by-five flash card from his coat pocket and it says stenciled in black Sharpie marker

Atropine.

This is a busy man, a rich man, and he is gone.  He has better things to do than nurse Dr. Wracks.

Another day in internal medicine and he is there again and he points to Dr. Wracks, and puts a patient chart on the desk and points to it and his left hand pulls a flash card from his wallet pocket in his coat and it says:

Strychnine

A hand flashes up into the air, and he makes one gesture with his index finger, turns, and is gone.   All the patients on heparin smile, and Dr. Wracks has another day in Medicine, taking blood pressures and looking at coagulation parameters.   

About a week elapses and he strides into Medicine in a new expensive pinstripe suit like Don Corleone used to wear in the Movie, “The Godfather.”   A chart in his hand, he sets it in front of Dr. Wracks, taps it and his right hand pulls a three-by-five flashcard from his lapel pocket and in black stenciled sharpie letters it says:

Arsenic

After looking at all his patients he vanishes again like a whirlwind and Dr. Wracks never saw him again.  Dr. Wracks sees an elderly man with white hair looking at him in the distance it is Harvard, and he doesn’t realize what is happening now, then, or in the future.  Most acute hospital admissions are poisonings.    Dr. Clancy finds him.  

We need you back in surgery.   You are on the board.

Surgery is too much for me says Dr. Wracks, I can’t take the pace.

You either come back to surgery or we are sending you back to Mexico.   Do you understand me, says Dr. Clancy.

Yes, I do says Dr. Wracks

I will see you tomorrow at seven AM for rounds on surg floor., He strides away

Internal medicine is a vacation, the ICU is a vacation, taking blood gases and watching the heart monitors around the clock.   If you are in the ICU the attending watches the heart monitor., Heart drugs are toxic and a physician watch for dropped p waves, QRS asynchrony, and inverted T waves. 

Dr. Wracks is not a doctor anymore like he was in New York State.  The brain needs time to process the information and data fed to it and it wasn’t for a while that the Wracks understood.   He finally understood.   The world is a world of people and people do crazy things all for the smell of olfactory money.  The only thing the devil can’t give you is love.   Love is all-powerful and a gift of God and the Wracks hope he gets a second chance.   He goes to church now, sits in the back, and prays for better things.   The Italian had a son and I hear he is good, hopefully as good as his dad.   Summer is in bloom everything is green and the cycle renews, and the tomatoes are growing well.   All in all, in the twenty-first century.   

Welcome to advanced Immunology Elective says Eli.  This quarter we will be studying the possibility of grafting bone marrow between donors and synergistic recipients in a closed system.  The mice we will be using are Balb/c  inbred mice.  A mouse’s immune system is housed in the spleen which is the murine version of the bursa of Fabricius progenitor organ.  In mammalian systems, the anti-body-producing immune system is the gut-associated lymphoid tissue found in the alimentary tract.  We will irradiate some mice to make them aplastic and then transplant different spleen cells and gauge an immune response by the Ouchterlony technique.  I will need some students to take the mice to the Cobalt 60 facility and irradiate them.  Who would like to go?

The students in the class all point to the Wracks

Beauty before age they say.

I don’t have a car says the Wracks.   I am ineligible

I have a car says Mr. Simms I will drive you

Thank you very much, Mr. Simms, says the Wracks.   You are a scholar and Gentleman.

The Wracks have a large three-foot square cage full of screaming and chiding mice. At least twenty of them.

Put them on your lap says Mr. Simms.   I don’t want   waste on my upholstery.  This is a new car

They are not rats says the Wracks, they are mice.  

They look like rats to me says.

The dark war-green Volkswagen bug plods down the side streets to the Veterans Facility

The Veterans facility at the Big U is a bucolic, idyllic retreat where the men and women who serve the United States military go for housing and medical treatment.  The green expanse of beauty with red brick buildings cast about, almost a forest with park benches and walking paths.   The people who agree to fight for our country deserve the best the nation can offer and it is here, and they offered their lives to inherit it.  So shall it be.  In God we trust.   Then there is building 3C.

Building 3C is a government Cobalt bomb facility with marines, cocked and loaded M16, s and bayonets.  They stand at the ready with their fingers on the rifle safety, on the side, slightly out of sight.  A tall man with goggles and freckles asks, May I see your identification, please?  Wracks and Mr. Simms hand him their student I.D.s.   He looks at the pictures and then hands them back.  You both are on the list he says

Go into the room he asserts.   Put your animals on the stand near the center of the room.  The source is in the middle of the room under ten feet of lead armor.  When you hear the sirens go off, head to the door and exit promptly because when the door closes it locks until the source goes back into the earth.  Turning off the sequence takes time and you will be exposed to the bomb if you hesitate.  Irradiate your animals and come see me before you leave

Cobalt 60 is a man-made alloy of the nuclear age.  Emanating intense Gamma radiation for a half-life of 5000 years, the metal is used by industry to preserve anything because the radiation kills everything.

The Wracks and Mr. Simms bring the mice into the room and Mr. Simms is the first one out.  The Wracks scrambles, a loud siren goes off, flashing lights all around spin around in red and blue, the steel and lead door closes with a loud snap, and heaven comes to the earth.    A person can feel intense gamma radiation even through a four-foot-thick lead wall.   Intense gamma feels like a person is being placed into a huge magnetic field and time stands still, and then the alarm stops after about a minute and the atmosphere smells like chlorine bleach.   Radiation and its parameters must be the key to transposition.  You can feel it. 

Mr. Simms says, Atomic

The Wracks says, Heavy

You go in and get the mice says Mr. Simms.   I will wait here.

The Wracks goes into the room and retrieves the cage.   The mice are stunned and barely breathing and the source is back deep in the floor.  Let’s go back to the lab says the Wracks, these mice need some water and food.   Don’t dirty my upholstery says Mr. Simms.  I won’t says the Wracks.  I promise.

Out of the twenty mice, four died immediately from the intense radiation.  The sixteen now have no immune system.   To transplant an immune system in a mouse, a ground-up spleen, forced through a wire screen and loaded into a syringe is injected into the peritoneum of the mouse.  This action renders them immunocompetent.  In ten of the mice revitalized with spleen cells, only eight survived long enough to be assayed for immunocompetence.  A new graft doesn’t always take.   The rest of the mice display an intact immune system as revealed by a plaque-forming assay in gelatin that probably now is paseo.   Half of the surviving mice show self-rejection of the lupus type with running and eventual death.

Out of ten mice transplanted with identical cells only four survived to assay.

Well students, what do you think?  Are bone marrow transplants viable for human beings?   Eli wants to know what you think.  Even in syngeneic highly inbred litters of mice, there exists enough genetic variability to cause graft versus self-reaction.  Eli looks around and listens.  The students are perplexed.  Eli states transplantation of a related strain CJ157 into the rest of the hosts results in an immediate graft versus host reaction with a mortality of 100 percent.

Is what you are saying, that bone marrow transplants don’t work, asks a senior graduate student.    I didn’t say that says Eli.   We are still working on that issue.   For the rest of the semester, we will study how using extracts of cancer antigens can produce viable IgG production in an appropriate host.  We will be working on immunotherapy of cancer for the rest of the quarter.

What is the carrier for the tumor-specific transplantation antigen going to be asks the Wracks?

We are going to begin with polylysine and peptide linkage says Eli.   Dr. Molinero peers in the door.   He has big horn-rimmed glasses and bushy hair like Samy Hagar.   He is Eli’s partner and cohort.

Class is over.   The Quarter is over.  The Wracks will go on to transplant lymphoma between mice and then be expelled from the program.

I knew it was Eli, exclaims the Wracks to himself.   I knew it all the time.

Once a person becomes a pariah, they can’t live it down.  Either can the Wracks.  His father flew back with him to Mexico in case a legal imbroglio existed to get him back in school.  They play rough down here says Father Wracks.   A fellow student pokes his head in the room and says to the Wracks,

Es muy fuerte el, no le preocupes.

Licensario Aces is the superintendent of students and legal officer for the University.  The Wracks has an appointment with him today.  He waits outside the office in the stone room with the stone chairs and small windows and the electric bug zapper that is never turned off.   A pretty, tall woman who is probably part of the landed aristocracy ushers him into the lawyer’s office.   The lawyer beckons the Wracks to sit down.   He is a man of average height with white skin, and thick Indian hair cut short with a slight red tint to it.  His eyes are grey.

Hello, wracks.   I hear you had a problem with the police.  They wonder if I should let you back in the university and not expel you.   You might get into trouble again.   All the students at the university come from professional or upper-class families and they do not tolerate an outsider causing a commotion.   If you get into one more fistfight, you will expelled and escorted to the consulate.  Do you understand Mr. Wracker?  The only reason I let you back is because you have a near straight A average. 

Yes, I do licensure

I will admit you back to the university and you will start clinical respiratory medicine in one week.  Situate yourself appropriately and keep a low profile.   Do you understand Mr. Wracker?

Yes licensario, I will be on my best behavior.

The lawyer for the university and unquestionably one of Mexico’s elites stands up and offers his hand.  The Wracks shakes it.

Good luck and you will need it says the licensario.  Goodbye.

The Wracks are having a hard time finding accommodations.  No one will rent to him.  They run away saying, El es loco, sale.!  Finally, in the daily newspaper, they find an ad asking for a student to rent a room in the neighborhood next to the plaza.   His father says, take it, if no one will rent to you, your career here is over.  Father and son in a rented Volkswagen go to the house on the cobblestone street next to the Patria. The house is made of stone and has an eight-foot-high stone fence, and a steel garage door designed to stop high-power rifle bullets.  Father and son ring the bell and a small elderly lady with whitish hair that used to be blond, and grey eyes opens the door.

I hear you have a room for rent Madam.  Do you speak English?

My name is Ophelia and I am originally from Chicago. Would you like to see the room?

Yes, we would say the Wracks, can we come in? 

Yes, you can she says.

Ophelia has a small white poodle, daintily groomed by the local animal handler.  She sits on a cushion and wags her tail.   It is an adobe hut she says.   It is in the back of the property.  It has a bathroom adjoined to a single room.  It is five hundred pesos a month.  Do you want it?

Yes, I do says the Wracks.   When can I move in?

Anytime says Ophelia

Wracks and his father go back to the motel and get the luggage then go back to the house and move the Wracks in.  The unit has a single glass sliding door.  A small bed sits in a corner next to a small desk and chair.  There is electricity.   The bathroom is small and tiled and the water runs. The Wracks has a small tensor light he brought from the States, sits down and plugs it in and the semester begins.

At first, the Wracks couldn’t figure out why he would wake up in the morning with bite marks all over his body and a swollen face.  He finally realizes he is being bitten by reduviid beetles that are indigenous to southern Mexico.   These kissing beetles are known affectionately to the Mexicans as Cinche.  They hide in cracks and sit suspended upside down underneath the mattress of the bed.  The Wracks try mosquito netting but the maneuver is of no avail.   The black cockroach-like animals with a proboscis are smarter than he is.  He buys spray insecticide from the store and sprays his bed and floor before he goes to school but it is of no avail.   Either the bugs are immune to the poison or they keep coming.  The latch on the window sliding glass has a key but the mechanism is easy to pick and he can not believe his landlady is letting people in his room when he is at the university.  The best solution is to shower as soon as a person arises in the morning to wash the bug feces off your body.  The dreaded American trypanosomiasis or Mal de Chaga as it is called in Latin America transmits when the bug feces are rubbed into the bug bite by itching or scratching.  The infestation continues for a year until the Wracks secured habitation elsewhere with an American expatriate living in Mexico.

Ophelia periodically requests the Wracks to have coffee with her and talk.  She slides a coffee cup from the cupboard and shares a decanter with the Wracks.  She offers pasteurized crème in a ceramic pourer.  The Wracks notices she slides the same cup from the same place level to the table each time they meet.  The Wracks thinks she puts something in the coffee cup before, setting the cup in front of her and pouring coffee into it so the Wracks thinks the cup is clean and empty.  After all, she is the Landlord and the Wracks complies.  He pours some crème into the cup and only drinks half of it.  And so, it goes.   She speaks of all her luxurious Mexican friends, the help they have, and the marvelous life they live.  She says her friends have live-in maids who constantly wash vegetables and prepare food for them all day long.   In Mexico, the farmers use sewage to fertilize and the crops grow huge and fast but they are covered in Salmonella Bacteria.   It is wise never to eat a salad in Mexico unless the cook prepares it himself or herself.  She also talks about Juan Bond who sells chiclets on the street in a stand in front of the barrio.  The children scurry about and play with their toys and Juan Bond sells chiclets and Mexican cigarettes to the Wracks.  Juan Bond is the richest man in the city and he is small, Indian, with greying black hair, wearing thick cotton peasant clothes, and sporting a black mustache like Salvador Dali.  He smiles at the Wracks.   Ophelia also states that the city is getting too expensive to live and because she is a widow, she would like to move to Cuernavaca, would the Wracks like to come with her and share a mansion in this city?  When the Wracks tells her he is moving out, she swings a fist in an overhand right and tries to the Wracks in the head and he is finally gone to an apartment a mile away situated next to a tennis court.  The court is in Mexican clay, the finest surface in the world.

It is just hearsay, and conjecture at this point but the Mexican students tell the Wracks never to go to Cuernavaca because it is the city of the Vampires and the inhabitants bleed livestock and live on their blood.  Of course, the Wracks have never seen a vampire but from experience know they exist and now Ophelia is moving to Cuernavaca so she can be one of them.   The Wracks went to the house of justice in the city and told them about Ophelia but they told him politely to leave.  She has influential friends and the Wracks has left less than a year to go with life so strange, destination unknown. 

The rainy season begins in Mexico.  The vegetation is everywhere, greens and grows.  The Wracks stands in front of the foreign students’ office of the University.   He has acquired a house to rent and needs to find 2 or three roommates.   He waits outside the office on the stone abutment that even in the tropics, is cool to the touch.   In the tropics, they are built from stone because it lasts, doesn’t burn, and insulates well.

The first person he encounters has sandy blond hair, is about five feet nine inches in height, and dresses in wranglers’ cargo pants with a clean linen shirt and Sperry topsider shoes.   He must be of the upper class so the Wracks approach him.  

Are you a student here asks the Wracks.   Would you like to rent a room in a house close to campus?

Yes, I would say the blond.   My name is Mr. Madera and do I get my choice of rooms?  

Yes you do says the Wracks, here is the address.   See you there

Mr. Madera smiles, turns like an automaton, and enters the foreign student’s office.  I have business he says

Next up is a tall man with black hair and a big nose.   He dresses in casual clothes unlike a local in the tropics and wears black socks.   He must be from the east coast of the U.S.    Would you like to rent a room in a new house close to campus, asks the Wracks.

Yes, I would say the tall student with bushy black hair.   My name is Mr. White.  

Here is the address says the Wracks.  See you soon.

They are the roommates for the first year.   And so, it goes.   The year begins

Mr. White is a jet setter.   He likes to go out twice a week to Mexican discothèques.   He dresses up, and in a shirt open to reveal his chest, he takes a taxi and leaves till late at night.   The wracks can not understand how he passes his classes.   Learning science is hard.  Learning science in a foreign language is harder.  His room is meticulously kept clean and ordered and he hires a housemaid to clean his room and the shared bathroom once a week. 

Mr. Madera is an athlete.   He has been chosen for the varsity water polo team at the university and goes to the campus pool three times a week from four to seven o’clock.  He studies until two o’clock at night and even later and lines up his coffee cups on the stairway rail for everyone to see.   They must be a badge of courage.   He has little need of sleep, and his schedule keeps the Wracks in awe.   Girlfriends from the United States fly in to see him and he has a Mexican girlfriend too who obtains the exams for him to study that he does not share.   He seems like an all-American, upper-class, success story in the making and the Wracks envy him until…

The Wracks sleeps a lot and sleeps hard but he dreams in the middle of the night that Mr. Madera is standing over him in a gold priest robe with a chalice and beginning a mass and the Wracks wakes up.  No one is there and it is two o’clock at night the wracks look outside of his room and Mr. Madera’s door is closed but a light shine outward from the space between the door and the floor.  The Wracks makes certain that the door in his room is functional and he checks it, locks it, and goes back to bed.  

The Wracks gets up early and goes to class.  He has a Mr. Coffee coffee maker in his room that is promptly broken so he goes to instant Mexican coffee.   Mr. Madera is up making his ethereal meal of fried egg on bimbo bread three or more times a day.  Mr. White goes out to eat breakfast every day.   The year goes on and time flies and the night becomes dark and finals in the first block occur.  The Wracks are up late making instant coffee with a traveling water boiler and smoking Mexican cigarettes.

Going up the stairs he spies Mr. Madera’s room light on.  A girlfriend from the United States is visiting him.  She is of average height, wears tight jeans, and has a good figure.  Her brown hair is cut short.  She darts out of Mr. Madera’s room in a towel and runs in the bathroom and turns on the shower.   The Wracks retreats to his room.  He is studying Gross Anatomy.  His wristwatch shows past eleven and he locks his door and goes to bed alone in the large bed that comes with the house.  Dreams begin.  In the Wracks’ dream, Mr. Madera’s girlfriend is in bed with him, like any young red-blooded American would and then he wakes up with a start because a woman is sitting on his face.  It is her, and she looks at him, and he looks at her, and Mr. Madera’s head looms over the bed and smiles and then he is asleep again.  He wakes up frightened and no one is in his room, just a vacant bed and a desk, and he peers outside and Mr. Madera’s room shows the light out the crack of the door.   Mr. White is gone for the night.  He double-checks the lock on his door, closes it, and goes to sleep. 

Mr. Madera says nothing about the incident and the Wracks wonders.   He comes home one day and Mr. Madera is buck naked on the floor, spreading his buttocks and saying, sodomy is an oath of fealty.  Mr. White is drinking a glass of baby formula and laughing and the Wracks until he gives up his house in June of next year and barricades his bedroom door every night with his desk and chair.  Sometimes late at night, Mr. Madera heads out the front door and visits the neighbors at two o’clock at night promptly returns in about an hour, and heads to his room.  Occasionally a pack of wild animals concentrate and growl and howl outside his room at night but he is dreaming.  One night before the barricade, the Wracks dream that a vampire is biting his neck and drinking his blood, and Mr. Madera is in his gold robe.  He wakes up in the morning and sees two fang marks on his neck.   The Wracks becomes a religious man and he lives in harmony with the others to survive

Mr. Faulkner was correct when he wrote the Great Gatsby novel.  The Great Gatsby says that the rich are different from you or me.   The Wracks secures his desk against the door, says a prayer and goes to bed.   I hope I transfer he thinks and he doesn’t know why.

A

Wracks, we are having a party this weekend at Eli’s.   Would you like to come

I don’t have a date says the Wracks.

Just show up anyway, it will be mostly graduate students and the staff of the School of Microbiology.  They will be giving oral final examinations and they want you to attend.

Where is it asks the Wracks.   I can use my father’s car.

At the very top of the canyon, there is an access road leading to Eli’s estate.  You can’t miss it; it is the only one up there.  There is a sign, here is his address.

Okay says the Wracks, I will see you there.

It is five o’clock in the afternoon and the Wracks takes the zigzag road up to the summit of Pang-oh.  He brings a bottle of wine and soon reaches the plateau at the top of the mountain where all the shops and restaurants are situated.  An ephemeral river lies below this mountain and meanders to the coast where it forms a surfing point that is good in the winter on a westerly swell.  I don’t see the number he thinks and travels a little farther up and looks at each driveway and can’t find the numbers or the entrance and when he is about ready to give up, he sees a dirt driveway the width of one car with a mailbox and the number posted in small letters on the top of the box.   Putting the car in low gear he moves up the driveway about fifty feet and it culminates in a flat area with ample parking and at least ten cars filling the lot.  The Wracks find a parking place, park, get out, and sight a large one-story Mediterranean ranch-style house that surrounds a small garden. 

Glad you made it says one of the grad students.   We were hungry and didn’t wait for you.  All the pasta with clam crème sauce is gone but we saved you some briquets of French bread.

That is fine says the Wracks.   I live on bread anyway.   Bread is the staff of life

He goes inside and the male grad students are hanging out talking, eating chips, and swilling beer and brown whisky.  Professor Nabut from Israel is there and waves to the Wracks.  Oral exams will soon commence.   Have some whiskey and wash it down with some beer fresh out of a chilled keg.   Take another shot.  All Immunologists must be prepared to work under pressure.  We are all going to swig whiskey and then take the oral exams.

As usual, the Wracks are the last ones to be quizzed, and all the graduate students have moved out to the spacious garden in the middle of the estate.

Have another shot, says Dr. Nabut.  How long does it take for the immune response to mature

IgM begins to appear on day three post-challenge and is established within a week.  Then IgG appears in the serum and the immune response begins at fourteen days.

Good says Dr. Nabut.   Have another shot.  What is the function of T suppressor cells in the afferent wing of the immune response?

T suppressor cells function to stimulate memory factor Ia to limit the immune response.  T suppressor cells work to limit the immune response so auto-immunity does not happen and the immune system does not react against itself.

Wash it down with some beer says Dr. Nabut.  For the final question, how much Ig does it take to activate the complement system which is the effector link of the immune response?

One IgM molecule can activate complement.  It takes two IgG molecules to activate complement.

We are done says Dr. Nabut, you pass.   You must learn to function while obtunded.  All the students are in the garden with Eli.

Two naked women flash out of the bedroom space and smile at the Wracks. Then they are gone

Did you see that asks the Wracks?

They are Eli’s daughters.   Don’t mind them. 

The grad students sit in the garden around a pond.  The Wracks join them.  Mr. Simms is there.  He is part of the group studying bone marrow transplantation in mice.   He shows a foot-long joint of grass to the Wracks and smiles.  He lights the huge cigar, takes a couple of puffs, and hands it off to the graduate students.  All ten of the graduate students take a puff of the huge joint and then hand it to the Wracks.

What is it says the Wracks.  Is it OK? 

Take a huge drag and hold it in says Mr. Simms.  Then tell me what it is.

The Wracks takes a large puff and he is a cigarette smoker like his dad.  Eli sits on a large wicker throne at the head of the pond and is not smoking.   He looks at the Wracks.  Wracks is in heaven and a student plays guitar; the gang swills beer and time moves on.  As night begins the gang moves inside and the wracks sit on the sofa completely anesthetized and fall asleep.

The big greyish-blue eyes of the chief of Microbiology are peering at the Wracks.  The Wracks wakes up.

What hit me says the Wracks.  Where are the girls

It is past their bedtime and they have gone to bed.   The party is over and you can go. 

Thanks for the party, Eli.  I had a good time.  Eli waves from the front door and the Wracks finds his white Pinto runabout with the green coupe roof.  He slowly backs down the earthen entrance road.  Jan is down the way with a hunting rifle and a 3–9-inch scope that he carries recon style.   The Wracks waves and he waves back.   I guess he is guarding his field thinks the Wracks.

Down the mountain, he cruises slowly with high beams on.  There are no street lamps up here and the guard rails on the road are only three feet high and the river runs down below the serpentine highway.

He makes it down to Highway One and the moon is full, with a slight offshore wind blowing out of the canyon and small three-foot waves break down the point.  He pulls into the lot, gets out, and looks at the point, the moon, and the stars, and he gasps.   This beautiful.   I must check it out tomorrow morning.  Night is here in Tranquil Hills and unlike everyone else, the Wracks use the darkness to sleep.

Dr. Gull appears as a man of medium height and build with thick wavy black hair.  He dresses in a white physician’s smock, a white shirt and tie, black loafer shoes, and a Rolex watch.  He smokes Marlboro cigarettes incessantly.  His bright eyes search the surroundings through a thick grey wisp of tobacco smoke that slowly floats upwards and seems to linger everywhere; Dr. Gull holds the title of Chief of Oncology Services at the big U.  He likes to teach anyone who will listen, the Science of Tumor Immunology.  He will instruct a student if he or she has the IQ and prerequisites to enter the halls of the Health Sciences. In a small classroom in the School of Microbiology, Dr. Gull instructs medical residents, Graduate Students, visiting professors from other countries, and even Wracks.  

Good afternoon, Dr. Gull, says Wracks, I am enrolled in your course in Tumor Immunology.  I look forward to an exciting and enlightening quarter here while I work on an independent research project down the hall.   May I smoke also during the lecture?   I like Marlboro Red cigarettes also.

Sure, says Dr. Gull.   Most of my staff here and at Woodland Bethlehem Hospital are also smokers.  We need the lift to get us through the day.  Go right ahead and light up but bring your ashtray.  Get seated, I have to start the lecture.

Mr. Simms also completed upper-division Immunology with Wracks and now sits next to Wracks in the lecture hall.  Dr. Gull starts writing on the chalkboard the first topic of the course.  Sir Burnet’s theory of Immune surveillance.  All the medical residents pull a cigarette out of their coat pockets and light up.  The room slowly fills up with smoke and Dr. Gull lectures through a thick haze of photochemical smog.

Does everyone have to smoke, says Mr. Simms.  Mr. Simms stands as a tall-boned Nordic-derived student at the Big U.  All the smoke makes me sick.  Will everyone put out their cigarettes? Wracks extinguishes his cigarette immediately.    Two of the medical Residents blow heavy smoke clouds at Mr. Simms.  

Mr. Simms exclaims, if you do not stop smoking, I will drop the course and file a complaint against everyone.  

The residents continue to blow smoke toward Mr. Simms until he closes his notebook with a bang and storms out of the hall.   Dr. Gull tries to ignore the situation.  After time assures that Mr. Simms has left for good, everyone puts out their cigarettes as if inspired by unseen forces.   Dr. Gull turns to his audience and smiles.

Does everyone understand Sir Howard Burnett’s theory now that it is on the board?  

Everyone nods their heads in agreement and the instructor smoking cigarette in hand continues.

Forty-five minutes later the instructor concludes and assigns case studies and term papers to the students of his class.  Everyone leaves in a hurry because they all have work to do, families to go to, or a sweetheart somewhere.   Wracks has his dinner at the student union waiting for him and then a long bus ride home ending in a walk up a hill at night.   A wrack has no experiment scheduled now because his tissue-transplanted mice have to grow up.  Then their spleens and blood will be harvested and the statistical construct begin.  A wrack takes the elevator down to the first floor and emerges at the entrance to the school of medicine.  A huge black onyx building is in construction and the cranes hoist enormous steel girders into place as the sun sets in a reddish flame framed by grey petrochemical smog. Today wracks will enter the student cafeteria by an alternate route.  Walking underneath the suspended hallway connecting the health sciences with the biological sciences, Wracks takes the connecting road down to the front of campus past the big buildings that house the professional schools and clinics of the Big U.  Up the main promenade to the student store, in the front door and then take the elevator to the second floor.  Wracks exits the elevator, then walks left to the queue lines in front of the cafeteria.  The budget student menu does not draw the crowd expected for such a bargain and charity offering.  No other place on the west side delivers a full meal with all-you-can-drink coffee for one dollar and a quarter. Most of the student body eats instead at the fabulous exotic bars and discotheques located ten miles away.  For the more affluent students, the best restaurants in the state are less than five miles away on the miracle mile.    At five o’clock on a weekday, only twenty people utilize the vast resources of the student cafeteria.  Adjoining the student cafeteria situates the varsity athletes’ dining room.  The privileged few awesome athletes that join the fabulous and famous football and basketball teams, eat steak and hamburgers to infinity, cooked in front of them on a huge gas-fired charcoal grill.  Wracks sit in front of Kirk’s Hall and smell the delicious odors emanating from the athletes’ dining room every day while enjoying a cigarette and a cup of coffee.   Then an occasional nap in the huge leather armchairs decorating the picture windows in the student hall happens.  Curled up in bliss, in uteri in a friendly place, with warm feet and toes, Wracks knaps in the world of opulence.    The moment occurs now and tonight at five, Wracks chooses the chicken pot pie on the student menu with all-you-can-eat crackers.   Wracks grabs one of the large porcelain cups provided for the coffee-drinking student body.   In his usual spot, facing the entrance line, with his back to the wall sits Dahlman.  Both of Dahlmans’ Parents have accolades as tenured faculty members in the health sciences at the Big U.   Tonight, Dahlman dines on a sumptuous roast beef sandwich with de jour dressing, a bag of potato chips, and a tall glass of brown tea.  Wracks slams his stew out of a large beige bowl into his mouth and sends the food to his stomach with shooters of hot coffee with excesses of half and half creamer.   When the bowl licks clean, Wracks eats the first of his three packages of Nabisco saltine crackers.  

How did the war go on the southern flank, asks Dahlman.

More of the same says Wracks.   I go to class, then study for an hour in between, then go to the lab, check on my animals, go back to afternoon class, and then show up here.  We go to the Research library after dinner, put in two to three hours of exam preparation, and then take the bus home.  What happens on the North campus?

The same, says Dahlman, I research law books and take notes then transcribe the data to three by five cards.   Only three by five cards can be admitted to a courtroom if he or she is not the defending or prosecuting attorney.  Then I come here.   In the morning, I sit for exams until lunch. 

Why are we doing this asks Wracks.

There is no other way, says Dahlman.  Academic achievement occurs as the only game in town.   Everything else gets old.   Let’s get going.   See you at the end. 

Spring starts to break at the big U.  The large trees bear buds and the winter ebbs and the entire leaves have blown away three months ago.  The quad sits deserted in the dark twilight and the Romanesque forums stand adamant in utter solitude.  Up the steps to the marbled halls of myriad classrooms, and through the café connecting the old building with the new to the lighted entrance promenade signaling the Buckminster fuller rendition of glass that houses the research library.  Up the central elevator to the fifth-floor rocket the two students. On the fifth floor, they separate because the line of sight of movement distracts attention while reading.  A huge physics graduate student sits at a little desk next to the elevator and looks up to see if Wracks smokes.   Satisfied, he continues reading.  Sitting at his window to the opulent world Wracks surveys the beauty, organization, and technological majesty that money creates.   In this world of non-olfactory money, where source seems unimportant and effect paramount Wracks digs in at the end of the short winter and promises himself, that he will not fall asleep tonight. 

Let’s hit it!  Yells Dahlman at Wracks, we have only 12 minutes to catch the 8:55 bus. 

 Wracks throws his huge heavy books into his briefcase and jumps off to the run.  Trotting down the staircase, they bound through the glass frontal portal and lope across the North Campus Avenue.  Trotting down the hill they cross the entrance road and stand at the pole on the island where the RTD stops on Hill Street.  Just as they arrive a huge yellow bus without any passengers careens into view and stops suddenly without screeching its tires.  The door opens and both Wracks and Dahlman flash their monthly student passes at the bus driver.  The door closes and the huge yellow rectangle accelerates at magnum speed down the hill. 

One minute later we would have missed the bus, smiles Dahlman. At a jog, it takes eleven minutes to get to Hill Street and the bus was one minute early.    Ten seconds later we would have missed it.  It seems prudent to allocate at least fifteen minutes to transit to the Hill stop.  

I am tired says Wracks. I am glad today ends and tomorrow becomes Friday. 

On the undulating bus, Wracks falls asleep as usual clasping his heavy briefcase to his chest.  

Dahlman shouts this is my stop, see you tomorrow morning on the steps.

Wracks waves goodbye and Dahlman exits.   Two miles later on the hill of Moonrise Avenue, Wracks becomes the last passenger to leave the bus.   From here the bus travels to the ocean, turns around, and then goes back up moonrise to nightclub land.  He crosses the street in the darkness and walks across the gas station turf.   Up past the drug store, liquor store, and convenience market, Wracks heads up the long Quiz way and then up the hill to Bacon Way.   The nights are still chill and the wind blows offshore so the waves cannot be heard echoing up the canyon and the stars twinkle because the smog blows out to sea on nights like this.  The beautiful night lives and wracks cannot be enjoyed because the day as it lives tires the disciplined who must sleep to replenish the mind that drives them mercilessly.  Punkin wags his tail while sleeping on his cushion in the family room. He is the only one welcoming Wracks and wracks strips off his shoe’s pants and shirt, dives into bed, and falls asleep immediately after pounding the alarm clock that rests next to his bed.  Tomorrow is a new day. The Fonz is long gone.

Mental illness is not an inherited genetic proposition.  Inborn errors of metabolism may predispose but are not causal factors of the condition. Rather, mental illness results from intoxications and aversive lifestyles.  Acquired conditions like brain tumors, infectious disease, and generalized metabolic disorders can cause mental illness indirectly and the underlying condition is treated rather than the overt phenotypic reaction.  The main causes of schizophrenia are major intoxications that disturb cognitive thinking or elucidate aversive memories that disturb behavior. 

The intoxications that cause schizophrenia are atropine intoxication, psychedelic intoxication, and sympathomimetic analog intoxication.  These causal elements contain about 90 percent of all acute and chronic cases seen in the clinic and they can be treated. 

Atropine and its congeners are non-competitive analogs of acetylcholine.  The agent binds to neural receptors and won’t let go.  The brain is unable to break down or detoxify these agents.  The site of action is primarily the frontal and parietal lobes of the neocortex.   This is why the subject exhibits disordered thinking or abhorrent memories.  To treat an atropine overdose, the chemical that exerts the most effective competitive effect on neurons is nicotine.  Most mental patients must become cigarette smokers as nicotine pushes atropine off the neural receptors and the free base present in cigarette smoke is the most effective way to deliver nicotine.  Phenothiazine antipsychotics help by blocking the dopamine receptors in the Archi cerebrum and limbic structures so clinical behavior is not so violent or overt.  Newer novel atypical antipsychotics like risperidone that look like atropine molecularly may help displace atropine from neurons but at the cost of impaired mentation and a decrease in intelligence quotient.  Probably the best treatment for schizophrenia is non-polar volatile solvents liberally poured on a subject daily.  Hexane and ethylene diamine solubilize atropine, carry it to the bloodstream, and then excrete it by the kidneys., The use of non-polar solvent results in brown-colored urine, evidencing the presence of high levels of atropine.  People of low socioeconomic status use ethanol, present in alcoholic beverages to excrete atropine as ethanol is slightly polar and acidic which dissolves alkaloids for excretion.

Psychedelic drugs cause schizophrenia.  LSD, Mescaline, and psilocybin are indole alkaloids with a structure similar to serotonin and its primary metabolite, Hydroxy indoleacetic acid.   Psychedelic drugs pass to the Archi cerebrum or primitive animal brain, cause indole active neurons to fire, and are not broken down by cellular enzymes hence the long duration of action and persistent loitering effect.  They eventually diffuse out of the brain by physical osmotic laws of diffusion.  Hallucinations are the result of persistent firing in the occipital area of the neocortex area 18 as directed by the globus pallidus and limbic system.  Since all parts of the brain are intricately connected,  damage to the primitive brain can be evidenced by changes in cognition, disturbances of memory, and sensory abnormalities.   The visual disturbance of chronic alcoholism is probably due to Wernicke’s malnutrition rather than ethanol itself.

In our capitalistic society probably the agents of major abuse are sympathomimetic amines, notably methedrine also known as speed.  In a sad society where all good jobs are saved for the children of the wealthy,  citizens self-medicate with speed to avert the sordid feeling of poverty present in our society.  Methedrine abuse leads to high blood pressure and kidney failure, paranoid schizophrenia, and premature heart attack.   Because sympathomimetic congeners are competitive agents and broken down by Monoamine oxidase present in the dendritic end of neurons,  effects are short-lived, tolerance develops rapidly and habituation ensues with an ultimate nervous breakdown or heart attack.  On the street, speed is cheap and the most readily available of the aversive illegal substances of abuse.  Because sympathomimetic agents act in the nigrostriatal system of neurons in the archicerebrum, they can be blockaded with dopamine-blocking agents that penetrate the blood-brain barrier like the tricyclic phenothiazines first recognized in Germany in World War 2.  The use of phenothiazines is safe and economical and the often heralded side effect of Parkinsonianism is rarely seen except in unusually high doses or disease of chronic duration greater than 20 years.  The abandonment of phenothiazines in the treatment of mental illness resulted from the loss of patent rights of the drug companies and the synthesis of the newer atypical antipsychotics that have a patent duration of 30 years with one ten-year extension upon arbitration.  Nowadays, like everything, economic factors rule the day. 

Depression or more exactly endogenous depression not due to causal agents is a hot topic.  People whose life is horrible due to economic factors or poor intimate relationships become depressed.  It used to be that depressed people ate a lot of chocolate or drank hot cocoa because chocolate contains phenylethylamine, a nor-epinephrine congener.   That is no more.  Now Monoamine oxidase inhibitors are the mainstay with the side effects of psychosis and high blood pressure.   Additionally, some agents like bupropion are said causally to induce abdominal aneurysms.  Depression in reality can be due to an intoxication of a chronic nature with heavy metals most notably those of the uranium or lanthanide series.

The soldiers returning from Iraq with Chronic persistent depressive anomaly merely are soldiers that have been fed by the nationals,  the depleted uranium shells that tanks unceasingly hurl at them.  Uranium, and most notably thorium cause endogenous depression, and the treatment is chronic chelation therapy in the hands of a trained professional intravenously.  All the psychology in the world will not avert a gross systemic intoxication. 

Gone are the days of Sheldon’s somatotypes where tall lanky people are schizophrenics, short bald people are manic-depressives, and normal people or euthymics are people with mental illness which is not heritable but causal and elucidated by intoxication.  Medicine is now a big business and costs one-third of the national budget.  What happened to the days when doctors were welcomed everywhere and health science was a service, not a sale?   Vance Packard in all his genius had no direction or advice as to where the nation should head, regarding health care.  Will anyone care to ask him, again? 

Good morning Dr. Lector says Dr. Wracks.  I just had an egg, a strip of bacon two toast, and two cups of coffee and I feel great.   I have something I want you to see says Dr. Lector.    We don’t know what happened to this man or if there are any antecedents but his family brought him here to eventually be committed.   We have to evaluate him and the board will agree to a final disposition.   I feel he is a catatonic schizophrenic but he could be something else.   A fine line exists between genius and schizophrenia.   I would appreciate your opinion.   The patient is an older man with white hair, tall with an ectodermic somatotype.   He sits in a chair and doesn’t move a muscle for hours at a time and the staff cannot even see him breathe.  However sometimes upon observation, he will move rapidly to a position of superiority to his keepers, like a caged tiger.   Everyone is afraid of him and says it is spooky.  One of the staff reports that one day he was hanging from the ceiling like a bat and they don’t know how he did it.  The prognosis with the direst eventuality is catatonic schizophrenia and dual personality types. There exists no cure for catatonia or dual personality and clinicians like to keep them sedated for their lifespans.  I am going to show him to you, do not speak or make any noises until the conclusion of our observation.  Are you ready?

Yes Dr., Lector let’s go.

The padded cells stand on one side of the unit and are sequestered by a huge oak blast door.  If all else fails, a staff member must make it to this door and it closes automatically with an audible click.  The two clinicians come to the huge door and Dr. Wracks opens it with the key slung around his neck.  Dr, Lector precedes and they come to the final padded cell, the one closest to the end of the unit, the one it is easiest to run from.   Dr. Lector looks at Dr. Wracks and opens a portal in the solid wooden door.  The portal hangs at eye level, has a lock on it and swings open fully so a staff member can look inside.  The dimensions are 12 inches by 12 inches.  It is unlocked, the door swings open on two sturdy hinges and Dr. Wracks looks inside.  Sitting in a chair next to the table is the patient.   He has stark white hair and wraps bedsheets around his body so he looks like a Messiah.  He is tall and lanky with a long angular head.  He doesn’t move, not an inch, not a muscle almost like a plastic mannequin.  Dr. Wracks knows he only moves when no one is watching.  Dr. Lector Closes the door.   What do you think says Dr. Lector?

Catatonic says Dr. Wracks.  Overtly catatonic.  He washes himself and uses the toilet without help says Dr. Lector.   Could he be pretending to query Dr. Lector?   What is his medication asks Dr. Wracks.  We have him on Haloperidol ten mg each day IM with no effect.  There is no betterment or worsening of symptoms and the extrapyramidal effects of the butylphenones do not manifest.  If you must go inside bring an attendant with you and have him stand on one side.  For some reason, mental patients can move quickly when induced.  Please be on your guard with him.   You will check him twice a day through the portal and make a report if there are manifest changes of any kind.  Please keep me informed, asserts Dr. Lector.   I have things to do and he walks off. 

Having free rein in a psychiatric lockup may be exhilarating to some, and prestigious to others but Dr. Wracks views the situation as an ominous burden, not to be shared by a single individual.  Seven more weeks must pass before rotation back to surgery, thinks Wracks. He hopes the nose of the director heals quickly.  Would I like to do this for the rest of my life?

In and out of the subsections with the key and the doors close automatically with a large click.  Dr. Wracks makes the rounds.  He asks the medication nurse in the plexiglass enclosure if all is well and whether there have been any side effects or adverse reactions to the psychiatric medications.  Acute mania and violence quickly resolve with a 100 injection of Benadryl intramuscularly.  He asks the muscular attendants who circulate through the unit if there are any current episodes of violence or acting out.  They say no and the Wracks circulate and move to the canteen where the stabilized patients of long duration go to pass the time.  There is a big color television on the wall, and they sit around in sofas and chairs and smoke cigarettes, and look up at the large ticking wall clock to see how soon the five o’clock dinner will ensue.  Dr. Wracks makes rounds one more time and looks in to view the catatonic.  There is no one in the room and Dr. Wracks cannot see anything but a chair a table and a draped white sheet.   He knows the patient is crouching low in front of the door or to the side to preclude viewing, Dr. Wracks slowly closes the viewport, locks it, and precedes the blast door as fast as he can move.  The big door closes with a loud click.  Dr. Wracks asks the nurse in charge behind the screened barricade if the catatonic patient is in the medical unit to have some tests.  She says he is in his room and this happens often, usually furtive activity precedes a meltdown, says the Wracks.  Be certain that the attendants are present should you have to enter or give him his food tray.  She says she will and makes a note in her log. 

The Wracks exits the section and goes to dinner.   He has a piece of chicken, a vegetable, and a small shortbread biscuit.  For dessert, a small bowl of apple cobbler appears waiting for him.  He goes back to his room in the resident’s quarters and the gang for the most part exits to the local bar.   A Cuban student is there in her cell studying for the licensure examination.  He goes back to his cell, takes off his clothes, barricades the door with the reading table, pulls the covers over his body, says a prayer and goes to sleep. Seven weeks to go.