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Clogs under my Bed - Excerpt |
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CHAPTER 11 SOMETHING PREDICTABLE, SOMETHING SURPRISING.
Everyone who has traveled overseas, or even to another part of the country will understand the sense of delight perhaps, or even astonishment, at the sights and practices of the local inhabitants. They do things quite differently in Pofadder and Cape Town. In Holland, too. But few things caught this deracinated South African’s eye more powerfully that first week in Limburg (definitely not part of Holland, the locals would shout as a disclaimer, but more of that later) than seeing children, even quite young teenagers smoking on their way to school. Or the fourteen-year old girl walking down the street with her mother, both with fags in their mouths. Plenty of South Africans smoke of course, but never had I anywhere, not even in the UK, come across such a nation of smokers. The LARGE signs on every pack stating: ROKEN IS DODELIJK has obviously absolutely no effect. A waste of good ink. Another surprise was how seriously Limburgers took my recommendations. Back home in my native South Africa if I tried to get people to lose weight, start exercising or even stop smoking, the vast majority would smile politely and ignore me. But my patients in Limburg I found to my astonishment would, without question, go to bed for three days with their ice packs and exercises if I instructed them to. Quite a large number also took me seriously when I said that smoking would, most likely, end their lives in misery (unless they were lucky enough to have a mammoth heart attack or stroke) mostly ten years before their time. So it was much to my surprise that I found that Mrs Vestjens had in fact given up the weed. One of my first patients she was showing all the signs of emphysema at only fifty-two. She could walk no further than seventy or eighty metres without having to stop, panting and gasping for breath. Her left lower leg looked dreadful, and two toes were quite blue. There was no palpable pulse in her ankle or foot. She had started smoking when she was only twelve and forty years on cigarettes had seriously effected her lungs and blood vessels. She knew it but what she needed most of all was a good hard shove. When I pointed it out to her, and encouraged to consider quitting if she wanted to see her grandchildren grow up, she did just that. What helped was that it was a few days before Christmas and, all across the Netherlands, there was a massive program for January 1: NEDERLAND BEGINT MET STOPPEN. The verbs had helped me in those early days with trying to unravel the intricacies of their grammar: Ik begin, Nederland begint, Wij beginnen. Ik stop, je stopt, ze stoppen. And I haven’t even mentioned the past tense yet! ‘What made you decide to stop smoking, Mrs Vestjens?’ I asked some weeks later. ‘Your prompt of course was important, but it was the memory of my father’s last years that really gave me the big push. His last years were horrible.’ ‘He died of emphysema?’ ‘Yes, and when he was only fifty-five. He was a coal-miner.’ I thought to myself how so many diseases are the result of additive factors. Stress in my own life, for example, had been the cumulative effect of being hopelessly over committed in too many areas, a pressurized and busy work environment and the still lingering effects of not taking proper three-week holidays. Coal dust plus tar from cigarette smoke has a deadly effect. There were still quite a lot of signs of asbestos around in Holland, and I wondered how many of the South African asbestos miners would not have died, had they not also been smokers. Had anybody considered it in the research done on asbestosis? I thought aimlessly that the internet might provide some answers, but moved on knowing that it was a forgotten issue, worried only about by attorneys in London trying to screw large amounts of money out of mining companies, and certainly not relevant in Limburg any longer. The coalmines had closed more than twenty ?? years earlier. ‘And how did you do it? Giving up smoking is one of the most difficult things to do in life?’ ‘I took your advice. I wrote down a list of all the situations in which I heard a Pavlov bell ringing for me to light up. Cup of coffee, the television after supper, the motor car and so on.’ ‘Which bell did you chose to ignore first?’ ‘An easy one. Whenever my son and family came to visit, which was every week, he would offer me a cigarette the moment he walked in the door. I had after all taught him to smoke. I decided to accept your challenge not to smoke when there was a non-smoker in the room. I thought especially of my grand-children.’ ‘Well done, Mrs Vestjens. I’m proud of you. You won’t be sorry.’
What caught me entirely by surprise were the tears that erupted a month later when she came in for her monthly spinal adjustment. I had long learnt that a chronic and degenerate back would never be ‘cured’ but that a monthly grease and spray, along with a set of exercises, made all the difference to the success of chiropractic care. No different to the patient with high blood pressure – as Mrs Vestjens had – who needs continuing care from their doctor and pharmacist. We doctors don’t cure too many conditions. Appendicitis perhaps. ‘Thank you so much, doctor, for encouraging me to stop smoking. It has changed my life!’ ‘Yes, of course, Mrs Vestjens, it is going to add years to your life, and you will regain some of your lost lung function with exercise.’ ‘No, I’m not talking about that,’ she protested. I could see her reflecting for a few moments how to go on and wondered what was coming. ‘I always thought that my grandchildren just didn’t like me. Lots of the people around me too, avoided me. Now that I’ve stopped smoking, my little granddaughter wants to jump on my lap the moment they arrive. It’s only now that I realized that it wasn’t me they didn’t like: it was my cigarettes!’ Over the months, came out the long story of self-doubt, depression and anxiety of thirty years brought on by the fact that Mrs Vestjens felt that so many people disliked her. She had even convinced herself that she just wasn’t a nice person. In fact, there were few of my patients that I grew to love more. A wonderful lady, but thirty years of people avoiding her had taken a heavy toll on her sense of self worth. It wouldn’t be repaired in a week or two.
More predictable, but I was nevertheless nearly caught out by a Mr Herveille’s condition. He was referred to me by his doctor with a year long history of low back pain radiating down the leg. Could chiropractic help this ‘ischias’? Low back pain with an attending sciatica is a daily event in every chiropractor’s life. Two things caught my eye: his birthdate. He was only a few weeks older than me but looked ten years older. And secondly on the initial consultation form: most Limburgers placed their cross in the ‘normal’ line for smoking, but he had gone for ‘heavy’. I was quite sure that it was only in Holland that you fill in ‘normal’ for smoking twenty cigarettes a day. The still unreported x-rays were the first give away: they too were almost normal. Far better than the x-rays of my own back, in fact, but I was a little surprised that he had a chronic sciatica at his age in the absence of any degenerative change. One thing did stand out, and I took it as my cue. I speak to EVERY patient about the devastating effects of smoking, and the heavily atherosclerosed artery, the aorta, lying just in front of the spine gave me my opportunity. ‘Your spine actually looks very good on the x-rays, Mr Herveille. It could of course be a slipped disc that can’t be seen on x-rays. But just look at all the cigarette ash lying in the aorta!’ He looked at me suspiciously. He wasn’t sure whether to take me seriously. Could cigarette ash really get into the arteries from the lungs? ‘What’s the aorta?’ ‘It’s the large artery carrying blood to your abdominal organs and the legs. It is lined quite badly with what we call atherosclerosis.’ ‘Is it serious?’ ‘Smokers get it mainly. Fortunately I can’t see any sign of an aneurysm – that’s a bulging of the aorta, which can be very serious if it’s large. This stuff that’s clogging your arteries is common in smokers, that’s why your blood pressure is raised, and sometimes it may clog a critical artery. For example to your heart. But to be quite honest, we see it on most smokers and usually it’s not that serious when we are considering low back pain. How is your cholesterol?’ ‘It’s raised. I take pills.’ I went back to the form he had filled in. There was a drug that I didn’t recognize and hadn’t taken the trouble to ask. I cussed myself mentally. I was getting sloppy. Not for a moment did I realize just how important it was to his case. I fully expected to find signs of a radiating sciatica on the examination. But there were none. He could bend and twist, and I could raise his leg without pain in the back or leg. I went back over the history again with him: ‘Mr Herveille, tell me again about this pain in the leg. Is it worse when you sit?’ ‘No, it never hurts when I sit? It’s less when I sit.’ ‘And if you work in the garden or dress in the morning. When you bend to shave?’ ‘No, it never hurts then. Sometimes in my back it might be stiff and sore after gardening, but never in my leg.’ ‘Then explain to me again please. What makes it worse and what relieves the pain?’ ‘Like I said, it’s when I walk that this pain comes on in the calf. And when I cycle, I get pain in my thigh.’ Some patients have to spell it out. I still couldn’t see what was staring at me in the face. In my defense, it had stared umpteen medical doctors in the face too. I started thinking in terms of a deep vein thrombosis in the calf, so I examined his calf carefully finding little of interest, and then his hip, thinking of an arthritic hip or myofasciitis of one of the hip muscles, perhaps a Piriformis syndrome but it was all normal. What I did find was a recent signs of a groin operation. ‘What’s this?’ I asked. ‘Oh, I forgot to tell you. I had a lump in the groin and they told me it was a ‘liesbruik’ (inguinal hernia).’ He was becoming rather anxious, fully aware that I was taking an unusually long time examining, and rechecking, his leg. Hernias in the groin are not uncommon so I went back through the basics that every chiropractor does. I checked the orthopaedics (they were all negative for a sciatica) and the neurology again (all his reflexes, skin sensation and muscle power were normal). Something was nagging in the back of my brain. Ah, the pulses, I hadn’t checked the pulses in his leg. I started with his normal leg and found the pulses in the foot, ankle, behind the knee and in the upper leg and groin. They were pumping normally. But when I started on his pain-giving leg I immediately struck not pay-dirt but pure gold nuggets. No matter how carefully I prodded around, I could find absolutely no pulse on the foot (the so-called Dorsalis pedis artery), or behind his ankle or behind the knee. There was a very weak pulse in the inner thigh and I had grave misgivings about the lump in his groin. A hernia? It could have been, I supposed, but I thought I could palpate a pulsating swelling in his lower abdomen just above the groin. Not a place for an inexperienced chiropractor to go prodding about – an aneurysm there could be deadly. XX (the answer to this month's quiz) is a nasty and rather uncommon condition where the blood flow to the leg is restricted due to a narrowing of the artery running down to the leg, somewhere along its course. There was enough blood when he was sitting quietly, but when Mr Herveille started to walk, the artery just couldn’t provide enough oxygen for the calf muscle, which started to ache. A short stop, and the pain would go away as the demand for oxygen diminished. Exactly the same was happening in the thigh, making cycling very difficult. The next question was whether he got any chest pain when he exercised. Angina is also exactly the same: a heart muscle starved of oxygen during exercise. ‘Not good news, Mr Herveille, I’m afraid. You have a minor problem in your back that will respond well to some chiropractic care. Don’t ignore it, because all bad backs start like this. But I’m afraid, it is completely overshadowed by a serious blockage of the artery in your leg. When you exercise your leg isn’t getting enough oxygen. You must go back to your doctor and have what is called a Doppler study done of your leg.’ ‘Where is this block?’ ‘I’m not sure. We won’t know until the ‘echo’ study has been done.’ He nodded. He had never heard of a Doppler but he recognized the term ‘echo’. It is what they call ultrasound scans in Holland. A wonderful diagnostic tool, known by pregnant women but more recently expanded to make wonderful images of many complex soft tissue conditions. For example a torn shoulder tendon. ‘But where do you think it is?’ ‘Probably in the groin or lower abdomen. There’s a spot in the so-called External iliac artery that is favoured for blockages.’ I pointed to the area just above the groin. ‘You mean this lump in my groin had nothing to do with a hernia?’ He was getting angry. ‘I’m not sure, Mr Herveille. The echo scan will tell.’ He shook his head as he stood. ‘I just thought I was getting out of shape, but I couldn’t figure out why it was only one leg that was so unfit.’ I showed him to the door. ‘I will write a report tonight and fax it to your doctor tomorrow. If you want to see your grandchildren grow up, Mr Herveille, then change your diet and give up smoking. This stuff that’s clogging your arteries is affecting every part of your body, not only this artery that we can see.’ I stuck the stiletto in deep. It’s the only way. Shock treatment. ‘And keep exercising. The bicycle is what has saved your life thus far. The demand for blood in the lower leg is what makes other arteries develop. We call it the collateral circulation. It’s probably the only reason you haven’t had a heart attack.’
Mr Herveille came back for treatment for his back after the operation. It was a major operation with a fairly high rate of morbidity but he was one of the lucky ones. It turned out to be a condition called Diffuse atherosclerosis obliterans rather than the large aneurysm that I imagined was lurking in his gut. He did also give up smoking and we had several sessions talking about dietary changes. ‘Why didn’t my doctor talk to me about this? He just suggested I started taking medication. I hate those cholesterol pills, and these changes you are recommending are not so bad!’ ‘You’d better ask him that, Mr Herveille!’ I also decided to have my own cholesterol checked again. It should after all be done every year after fifty. I had become inordinately fond of a very delicious Camembert. Too fond, but fortunately Helen’s wonderfully balanced diet of salads and fruit, grains and olives, fish and even some butter, resulted in a perfectly normal test result.
CHAPTER 12 HEB JE GEEN ZIN IN SEX?
The desire of the man is for the woman, but the desire of the woman is for the desire of the man. Madame de Stael, writer (1766-1817)
"The
majority of husbands remind me Honore de Balzac
Some things from the Dutch language tape-course I remember well, naturally; we repeated them dozens of times, by rote, rather like Kindergarten. Some alas, my aging brain still has not grasped at all; it’s a tough language. But the word zin meaning ‘appetite for, liking, desire’ stuck, perhaps because it is in every day use: “Heb je zin in een kopje koffie?” Do you have the appetite for a cup of coffee? with its simple reply: “Daar heb ik wel zin in.” That appeals to me. Yes, I like the Dutch coffee. But the question in the clinic questionnaire, to be filled out by every new patient, caught me by surprise. “Heb je geen zin in sex?” Have you no desire for sex? I scratched my head when I came across the question that first day in the clinic, not having the language skills or the courage to ask about the question. Why on earth was there a question about sexual appetite in the chiropractic health questionnaire? Holland is, of course, one of the most sexually liberated countries in the world. Amsterdam is notorious for its Red light district where the ‘girls’ literally stand in the doorways, quite naked, or sit at special windows in a provocative stance, inviting strangers in. Gay parades attract hundreds of thousands, even millions of visitors. Even in conservative Limburg, most couples have lived together for some years before marriage and many never marry in a legal sense. I would be surprised if there is one in a hundred virgin brides. Helen and I spent many long winter evenings trying to come to terms with this completely new understanding of relationships, of sex, and what it meant to be married in twenty-first century Holland. Our conservative minds boggled those first few months. Two things continued to surprise: the number of teenagers who openly stated in the questionnaire that they couldn’t get enough sex, and the number of people, even in their thirties and forties who checked the “Heb je geen zin in sex?” box with a tick. Being the perverse person I am, interested in the great contradictions, I started to take more notice of the replies to the question. Why was the question there anyway? Finally I took the plunge. ‘Good morning, mevrouw Barske,’ I said to the tired looking young woman sitting in reception. ‘Will you please come this way,’ I continued, shaking her hand. I noted the drooping shoulders and the slight look of neglect about her as she walked into my consulting room. Her hair was untidy and the inevitable blonde dye revealed several months of mousy brown hair at its roots. ‘Would you give me a few moments to read through your questionnaire, please?’ She gave a brief smile, and nod of the head, obviously amused at my accent and bad grammar but too polite to say anything. ‘Mm, pain in the neck and shoulders, headaches two or three times a week, no referral down the arms, no trauma. When did the pain begin?’ I went through all the usual questions. Was the condition getting worse, what other treatment had she had, were there any red flags? It was some weeks into the treatment before I ventured into the tantalizing new territory. ‘I see you checked the “no interest in sex” box when you first came here. Do you want to talk about it? You’re not obliged to,’ I hastily added. She was lying face down, out of eye contact, while I did some painful cross-friction on her Rhomboid muscles before adjusting her spine. It was some moments before she replied. ‘It’s boring, and I’m too tired anyway at the end of a long day.’ ‘Two small children and a full time job must keep you busy,’ I replied. ‘Too busy, yes’ she replied, ‘and don’t forget the other job too. Keeping the house, doing the ironing, getting meals together. ‘What does your partner think about it?’ I ventured. They weren’t married, which wasn’t uncommon. I wondered briefly whose name the children took, making a mental note to ask one of the secretaries what the custom was. I was careful not to tread on any toes. ‘Oh, fortunately he is also too tired much of the time. He gets angry with me now and again when the need is strong, but it is all over in five minutes.’ ‘How was your sex life early in your relationship?’ ‘Oh, pretty good. Not as good as my last boyfriend before he dumped me, but much better than the first two.’ I absorbed that, Elvis’s words flashing through my mind: You’re so square … Yes, indeed, I am. ‘So, when did your desire for sex come to an end?’ ‘Oh, don’t get me wrong. The desire is still strong in me occasionally, perhaps once in a month or two,’ she said defensively. ‘Probably when I went back to work after the boys were born.’ By that time I had finished pummeling her, had adjusted her spine and given her a new exercise, so we left the discussion to be completed at a later stage. She gave me a dour look on leaving. I had opened a raw wound.
I gave the subject some thought over the next few weeks. It had been something of a wound in my own life that our discussion had opened, paralleling my own sex life over the last twenty years. Finally the penny dropped: amongst other things, one’s sex life gives a fairly accurate indicator of over-busyness, exhaustion and the stress of life. It correlates quite well with the knots and pain in patients’ necks and shoulders. I saw one of the great contradictions of life unfolding in Mrs Barske’s life: Fully alive, less than half way through her life, yet the kernel of life within her was tragically being stifled by the daily grind.
I asked Helen one evening, daring to ask a question that I wouldn’t have broached a year ago. ‘When did our zin in sex end?’ She looked at me with a wry smile. ‘When I went back to teaching after Samantha was born. I would have thought you remembered.’ I nodded. ‘And why do you think it is has been so much better since we came to Holland?’ ‘Oh, you are such a plod!’ she exclaimed. ‘Surely you can work that out.’ Much as I prodded and questioned, Helen wouldn’t give me an answer. No doubt she thought it was time I did some thinking for myself. Holland had done that for us, giving us space and time. Less can be more. It was some weeks before I realized the paradox of how lonely one could be, surrounded by dozens of other overly-busy, yet also miserable people. Had Helen too been miserably lonely with a husband so immersed in hobbies, work and church activities?
Mrs Roomans was just a little older than me, a dumpy little woman with a friendly smile. There being no grey-headed women in Holland, she had quite short stiff blonde hair that stood up in the air, stiff with gel. They call it ‘moderne’. I hated touching the hair of these Limburgers, it was so coarse and sticky with the weirdest of hairstyles. She had one of the commonest chiropractic conditions. ‘When did the pain in the buttock begin, mevrouw Roomans?’ ‘About nine months ago.’ ‘Do you know what caused it?’ ‘I think it started a few weeks after I verhuisd.’ I had learnt that word very quickly on arriving and noticed for the first time that she was a widow. Moving into a new house is difficult for backs. Some of the worst disc injuries I have ever treated came after relocating, and I always recommend a removal company. It’s a lot cheaper than paying the chiropractor and the neurosurgeon. Less pain too. ‘My husband died very suddenly about a year ago, so I decided it was time for something smaller,’ she went on. ‘I can’t sleep lying on that side, it’s so painful.’ It didn’t take long to find that most of the pain wasn’t actually in the buttock but mainly on the side of the hip. There is a small sac of fluid called a bursa that protects the hard part of the hip from the muscles of the thigh. When it becomes inflamed sleeping on the hip is very painful. A quick examination revealed the usual findings: a very active trigger point in a large buttock muscle called the Piriformis and subluxations in her lower back. Mostly it is bread and butter stuff for a chiropractor though very occasionally it can be a sod, especially if it is associated with a nasty spinal condition called stenosis making things more difficult. I spelt out for her what was causing the pain and how I was going to treat it. Home treatment too was essential so I explained how she should ice the bursa and do some exercises and stretches every day. We were two or three weeks into the treatment when I thought it might be a good time to raise the subject of her husband’s early death. It’s not nice being a widow when you are not even sixty and most people need to relive the pain, so often with no one willing to talk about it. It’s too awkward. Mrs Rooman was about 50% better and we had gained confidence talking about this and that; sharing her story again – if she had ever shared it properly with anyone – might be therapeutic. What I didn’t guess was how therapeutic it would be for me too. ‘You said your husband died very suddenly.’ I left the statement open ended. She could talk if she wanted to. ‘Yes, he had a heart attack. Very sudden. It was awful.’ ‘How old was he?’ ‘Sixty-one.’ ‘That’s miserable. Ten years before his time.’ She nodded. ‘It was my fault really. I had allowed him to get quite overweight which caused him to become diabetic.’ “Begrondisch” dining is the delightful word they use. Sumptuous. ‘You can only live forwards,’ I said. ‘Can’t change the past, so there is no point putting a lot of guilt on yourself.’ ‘Yes, but if only I had given him a lot more salads and fruit …’ She was having difficulty going on. ‘Of course all the beer he drank didn’t help either.’ ‘Were you with him when he died?’ It was more than idle curiosity. Telling her story, perhaps for the first time, would be healing. She didn’t answer. Finally she said: ‘I’ll tell you next time.’
I had forgotten all about our conversation and was focused on the decision whether I should be fine-tuning the treatment by changing from adjusting Mrs Roomans’s hip-bone to her sacral-bone. The improvement had plateau’d out at 60% better and I was concerned that I was missing something, when she said unexpectedly: ‘You asked me last week if I was with my husband when he died so suddenly.’ She half turned from where she was lying prone on the table so we could talk face to face. ‘We were making love. It was just as we were both climaxing.’ With that she put head down again on the table, weeping quietly. What does one say? Finally, I gave her shoulder a squeeze and said: ‘Thank you for telling me that,’ and went on with my work. ‘Sounds awful, doesn’t it,’ she said, eventually. ‘I’ve thought a lot about the way he died, and I’ve decided there could be no more fitting way. Quick too. The last ten years of our marriage were the best, after the children had left home, and I quit my job.’ ‘I suppose you had more quality time together.’ ‘Much more time together and I wasn’t so ratty. Our love life really came alive in those ten years. You know something interesting we discovered: Sex takes five minutes, if that sometimes, but to make love took us over an hour, sometimes even two with cups of coffee in between. We learnt for the first time how to climax together. I regret it couldn’t have gone on longer, but in the end we had a wonderful marriage despite the really tough bits in the middle.’ She brightened up and, after dressing, said to me on her way out: ‘You know that nasty old-wives tale about the acorns in the cookie-jar?’ I shook my head. ‘The story goes that if, every time you have sex in the first year of marriage, you put an acorn in a jar, and after the first year, take an acorn out every time you make love, then you will never empty the jar.’ I roared with laughter. With a serious face she said: ‘We emptied and refilled that jar dozens of times! It wasn’t all bad.’ She winked and left.
Mrs Roomans wanted to get properly better so she took me seriously about the three phases of chiropractic care. Fortunately her husband had been well insured, so his premature death left her relatively well off. Chiropractic care is not cheap in Holland. Once the acute pain was over she took to the rehabilitation phase with enthusiasm and then came every two or three months ‘under control’ as the Dutch say. Mostly I found that by the time a few months have passed patients were beginning to stiffen up, or a new condition had started. Pain in the shoulder, or a tennis elbow … all conditions that chiropractors excel in treating, because we treat the underlying cause of many of them: subluxations in the spine. Still I was surprised when our secretary asked me to call Mrs Roomans’s doctor. ‘Good afternoon, doctor, with chiropractor Bernie Preston,’ I said, using the strange Dutch grammar. By then fortunately my Dutch had progressed to the extent that I could converse with most people provided they didn’t speak too fast or in the Limburg dialect. ‘Ah, thank you for calling. I wanted to find out why after five months of treatment you are still insisting that Mrs Roomans come back for treatment. I have instructed her to stop the treatment.’ ‘Mostly, doctor, because she has had that pain in her buttock for nearly a year while under your care. I think a ‘fall back’ is inevitable with such a chronic condition.’ I wasn’t going to give way to his authoritarian approach, but I did appreciate that he had taken the trouble to phone. Not many doctors would have made the effort to confront me like that. It’s healthy. ‘You are making her psychologically dependent on you. I have advised her against continuing the treatment.’ ‘You have a point there. The alternative is an almost certain return of the pain.’ ‘You krakers[1] are just in this for the money. You are just squeezing more money out of her and making her dependent on you.’ A crescendo of anger burst from the phone. I was getting angry too. Fortunately I had taken the trouble to peruse her file before phoning. ‘Are you aware doctor, that she had had that pain for nine months. She was unable to sleep properly and it was disturbing her rest. You weren’t averse to prescribing sleeping tablets for her. Wasn’t that making her dependent on your treatment?’ ‘Hmmf,’ he hesitated for a moment. I took the opportunity to climb in quickly. ‘Do you remember her husband? He was diabetic I believe. Did you not bring him back regularly ‘under control’? We do exactly the same. It’s called prevention.’ ‘That’s different …’ I butted in. ‘I’m sorry doctor but I have a very busy afternoon starting. If you would like to meet over lunch one day to discuss this further … .’ He hung up.
The Limburgers are a spirited people. Mrs Claudia Roomans knew she was benefiting from the occasional but regular treatment and ignored her doctor. Her next consultation was about six weeks later. I was preparing to discuss my conversation with her doctor but she didn’t give me a chance. Once she was lying on her buik[2] (the Dutch laugh if I ask them to lie on their ‘stomachs’ – it would be like asking someone to lie on their liver) she said: ‘I have never told anybody this but there is one more thing I would like to tell you about my husband. I very nearly lost him when we were in our forties.’ ‘Lost him?’ ‘Yes, lost him.’ ‘You mean he nearly died?’ ‘No, that’s not what I mean.’ She hesitated. ‘Like most women I used that very powerful weapon. Quite often for six or eight weeks I would refuse to have sex with him if I wasn’t getting my way. I knew it hurt and it was a way I could get back at him. Then a very good friend of mine came to stay for a week while she was attending a conference.’ (After forty years we still stood with broken swords in our hands.") ‘Mm,’ I grunted, knowing where this was going. ‘The morning she left she told me that she had come very close to having sex with him while I was out at a bridge tournament. She didn’t, so they said anyway, but she had been the one who had to put on the brake, and she admitted that she only did it because I was such a good friend. She found him a very attractive man.’ ‘Whew, and you had such good years after that. How did you reconcile it?’ ‘I was very angry with him. With her too.’ ‘I’ll bet. It’s very sad how often spouses have affairs with their partner’s so-called best friend.’ ‘She asked me a very disturbing question. “When did you last sleep with him, Claudia?” she asked. The telephone gave me a buzz. It meant the waiting room was filling up. The secretary was getting impatient. ‘Thank you for telling me, Mrs Roomans. The last exciting episode will have to wait for our next consultation.’
‘Did you forgive him?’ I asked at her next visit. ‘Not for a while, but it did get me thinking. The last thing my friend said to me was that she had nearly lost her husband the same way, until she realized that a man who hasn’t had sex for weeks is very vulnerable to attack. She wanted to warn me. She said to me, on the phone a few weeks later: “Darling, you use the sex weapon and you will lose him. Do you understand that, don’t you? You will lose him. You see they are such vulnerable creatures when they haven’t had their sex. The first floozie who comes along offering him whoopee, and bingo, right before your eyes, he’s gone. A clever girl like you can find 101 better methods to get your way.”’ ‘A good friend.’ I said. ‘Yes, and an honest one. It must have been hard for her, but it saved my marriage. I thought about it a lot in the next few months. I realized that, in the end, that she was right. We women who use sex as a weapon stand a good chance of losing our husbands.’ ‘And men who use sex as a weapon?’ ‘I don’t think there is such a thing,’ she said with a laugh, ‘but men who selfishly take their orgasms without bringing their wives to a climax run the same risk.’ I thought about that for a few moments. ‘Sex is a form of communication, I suppose. Refusing to sleep with your partner is like to refusing to talk to them. Then if some other friendly person comes along … .’ ‘Exactly.’
Helen and I discuss many of the interesting and titillating stories that came out of my practice. Never before had I heard of a man having a heart attack during sex but it did in fact make sense. Sex is good exercise for the heart and the back – provided all other things were equal, which they weren’t unfortunately in Mr Roomans’s life. ‘They made some great discoveries of life,’ said Helen, ‘but unfortunately it came to an end prematurely.’ ‘It took some patience though,’ I replied. Helen nodded. ‘I nearly left you a couple of times, when you went off gliding or getting bees out of someone’s roof, but now we are discovering for ourselves some of the great things they worked out. No more butter for you! I don’t want to be a lonely old widow! Remember that old rhyme by Caroline Wells? We should live and learn but by the time we've learned, it's too late to live.
Our home was in a tiny apartment ‘op zolder’ on an old farm. Under the eaves where the raindrops drummed on the roof just above the ancient old double bed. Where the hot sun baked on the tiles just above our heads too, for a few short humid weeks in midsummer. ‘I wonder how many children have been conceived in this bed?’ I asked Helen early one morning. A rowdy cockerel, calling for his harem just outside our window, had wakened us with the grey dawn, matching the grey old photos that adorned one corner of the bedroom wall. Generations of the Jacobs family had farmed there for over two hundred years. ‘Plenty, I should think,’ she said snuggling up to me. ‘You’re not allowed a harem, but there is one old hen very interested in your charms!’ ‘You want to stuff another acorn into the cookie-jar?’ We had emptied the jar for the first time in the first frenetic weeks in Holland and it was already half full again.
I had made one other interesting discovery in that old bed. Thirty years of making love in the modern bed had also seriously deprived me. Having a good solid foot-rest to push against at the appropriate moment, increased my pleasure by at least fifty percent.
CHAPTER 25 CHECKMATE
Move 1
‘Greetings from Holland and good luck, Mr VdbTrenton.’ All chessplayers have a nickname in the online tournaments, often quite oddball. My opponent was “VdbTrenton”. It’s a male dominated game, so I was making more that one presumption. ‘And the same to you from New Jersey. I’m a Miz actually, not as in mizerable! (should I spell it miserable?) Chess players aren’t all male you know! Can I presume you are a Mister Preston.’
Move 2 ‘Apologies, Miz Trenton. Anyway good luck. Actually you too have made a presumption. I am really Dr Preston, but Bernie is fine.’
I try to visualize my opponents. Usually I picture an engineer, or a student or an elderly man, determined to keep the ravages of time from besetting his mind, sitting in front of their computers. Sometimes they give you little details, and you find out they have just had a first grandchild, or a player with high rating makes a poor move, and then admits that he is a doctor snatching a moment between patients to make a hurried move. Serves him right, I wish I could snatch a few moments during the day for such indulgences. But Mrs Trenton was only the second woman I had played in over two years. It’s definitely a man’s game.
Move 3. ‘Ah, I see. Bernie, then. And I live in Trenton, but my name is Sigafoos.’
Move 4 ‘Shall we start again? Greetings from Holland, Miz not-mizerable Sigafoos.’
Move 5 ‘Please call me Peg. Greetings Dr Preston, Bernie, from Trenton, New Jersey.’
Move 6 ‘Okay Peg, let’s have some fun. Your move. My father was born in Lawrenceville. Is that nearby?’
Move 7 ‘Yes, just (a?)round the corner. Jersey is full of Prestons. My forebears came from Holland. About 150 years ago. Pretty standard start to our game. You’re not going to try and Fool’s mate me are you?’
Move 8 ‘Always ready to try anything! Are you doing anything special for the Thanksgiving weekend?’
Move 9 ‘Yes, we are going hiking in the Poconos. If the weather holds out, we plan to camp the night out at our favourite spot overlooking the Delaware River.’
Move 10 ‘Enjoy. We are going cycling along the River Maas. Less strenuous than climbing mountains unless the Dutch South-Wester is blowing. Then it’s an Everest.’
Move 11 ‘That’s why Holland has so many windmills.’
Playing internet chess is one of the pleasures of my new life in Holland. Most games are serious stuff, no chit chat, but in others I can relax and the games often become a sort of chat room. However, my conversations with Peg Sigafoos were rather more interesting than most other games. Even the chess was reasonably good. ‘Bernie won’t you check the telephone directory and see if there are any Sigafoos’s. I think they came from Friesland.’
Move 12 ‘Sure Peg, will do. Good move. Did you get to the summit?’
Move 13 ‘Poconos don’t have a real summit, but we did plenty of climbing, not without some difficulty. I’m not as fit as I used to be and it was kinda cold.’
Move 14 ‘What do you do to keep fit?’
Move 15 ‘I jog for about twenty minutes every morning, but I got a bad cold about a month ago, and had to stop. I haven’t yet got back into my old routine. I hope you are not going to swap knights?’
I was having difficulty picturing Peg. Jogging every morning and hiking the Poconos? I guessed a young Dutch-looking blonde woman, with her hair tied in a ponytail, perhaps in her late twenties or early thirties. It’s not PC to ask too many personal questions.
Move 16 ‘Nope, I don’t start swapping pieces unless I am really on top.’
Peg usually took the full ten days allowed, which I found a little irritating, but it meant less pressure, something I didn’t need in my stressful life. The game was threatening to take some months. Thanksgiving soon passed, and we were into the silly season. I emailed Peg, warning her that we were going to Austria for Christmas, and there wouldn’t be any chess for two weeks.
Move 17 ‘Merry Christmas. My hubby and I are going skiing in North Jersey. The snow is early this year.’
Move 18 ‘Enjoy, and don’t break a leg.’
Move 19 I couldn’t afford the risk of a skiing injury, but Helen had thought a bit of culture in Vienna would be a pleasant diversion from our respective salt mines where we were indentured. Even the best of jobs threaten to become drudgery without proper rest and relaxation. I have a theory that America needs so many psychologists because they take so little leave. The Dutch on the other hand are very blessed with five weeks per year for most people, but in between, they work incredibly hard. Perhaps a couple of Strauss concerts or even a Don Giovanni would revive the joy of living to our exhausted spirits.
We Skyped the kids on Christmas day, and I made a phone call to my father in New Hampshire. He answered at the third ring. ‘Merry Christmas, Pops.’ ‘Hello Bernie, and a Merry Christmas to you. I was hoping you might come to New Hampshire this year for Christmas.’ ‘This summer, Pops. I promise. How’s the aneurysm?’ ‘I have it checked three times a year. It seems to be stable. It’s still under six cm.’ ‘That’s a relief.’ My father had a fairly large aneurysm in a large blood vessel in his abdomen and, despite his doctor’s demands, he had decided to follow my advice and not have elective surgery until when and if it reached six centimetres. After that they may progress quite quickly. There was certainly risk not having the surgery, and I was relieved that it hadn’t grown. His surgeon was not pleased with Pops’s quack son. What does he know about aneurysms? ‘Are you all going down to Patrick’s Place for Christmas?’ ‘Yes, Jennie is coming to fetch me. She makes sure that I get those checks, and her professor of Internal Medicine says it is probably okay not to have the operation provided I have the ultrasound echo every few months.’ Jennie’s my niece. She is studying medicine. ‘Say hello to Jen please. And of course, a Merry Christmas to the whole family. Thanks for the calendar you sent. It’s good to see all your faces, and some real New Hampshire scenery.’ ‘Aw, it was easy. We’re just trying to get you a little unsettled. You should have moved back to the States, not to Holland!’ He said it with some passion. ‘Maybe, but we are very happy here, Pops.’ I thrashed about for some way to change the subject. ‘Do you remember teaching me to play chess when I was a kid?’ ‘Of course.’ ‘I’ve started playing internet chess. Right now I am playing a lady from Trenton.’ ‘Trenton, New Jersey?’ ‘No other. Why don’t you sign up, then we can play each other again.’ ‘No, I’m too old for that Bernie. You just come here, and we’ll play together evenings, huh?’ ‘Okay, in the summer, but I like this internet chess. You get to chat to some interesting people.’ ‘So what’s so interesting about a lady in Trenton?’ ‘Well, her family was Dutch, her grandfather emigrated to New York about 150 years ago, and now she wants to find out if she still has any Sigafoos relatives here in Holland.’ ‘Sigafoos! Not Peg, surely! We went to school together.’ ‘Naw, it couldn’t be the same woman. Her name is Peg though.’ It didn’t take me long to pick up my American slang again. ‘Perhaps her granddaughter?’ ‘They told a funny story about old Peg at our fiftieth high school reunion. She always was a spunky girl.’ ‘What happened?’
When Peg Sigafoos left school, not long after the end of the great Depression, getting a job was difficult. But the second world war came at the right moment for many young women, and Peg managed to find work on the railroads, first selling train tickets at the Trenton station, what with all the men at the warfront. It was some two years into the war, just before the end of her morning shift whilst she was tending to a long line, that the phone rang: ‘This is Mrs Roosevelt. I’d like to order a drawing car from Trenton to New York for the two o’clock train this afternoon.’ ‘Oh sure, and this is Mrs Vanderbilt! Don’t you know there’s a war on, lady?’ The Vanderbilts are amongst the wealthiest American families. There was a hesitation on the other end of the line. ‘Yes, all right. I applaud you for your war effort. May I then have four first class tickets please?’ ‘That’s fine, Mrs Roosevelt. I’ll have them waiting for you.’ Peg’s substitute arrived and took over her place at the window, and the pretty young woman found herself walking out wearily to buy a sandwich. It was cold and she pulled her brilliant gold scarf tightly round her neck. It matched her hair. It had been a busy morning and she felt half starved. Scanning the station cafeteria menu, the smell of bacon frying started her mouth watering and she decided on a BLT on whole-wheat bread. Glancing at the newspaper billboard as she passed by, Peg gasped, covering her mouth, instantly grasping its meaning: First Lady ER in Trenton today. Quickly she bought a paper, tearing through the report of the President’s wife on a visit to the capital of New Jersey and, the sandwich forgotten, dashed back into the station, hurriedly searching for her supervisor. It was less than an hour later that America’s First Lady swept onto (on to?) the station platform with her entourage. She cut an imposing figure, the tallest woman on the station, immaculately dressed in a dark-blue business suit complete with pearls, a small matching hat and a clutch handbag. Everywhere well-wishers were gathering around her, officials forcing a way for her towards the train. Mrs Roosevelt made a determined path to the ticket office on her right, searching for an unlikely woman behind the counter. Finding what she was looking for, summing Peg up instantly, she said, icily: ‘Mrs Vanderbilt, I presume!’ a glimmer of a smile tugging at the corners of her mouth. ‘Yes, ma’am. I’m terribly sorry, I never knew (didn’t know?) …,’ Peg’s voice trailed off. Her supervisor, a little mousey man butted in: ‘We have laid on a drawing car of course, Mrs Roosevelt. On behalf of Trenton, may I offer you our apologies for this insult. We will naturally deal appropriately with this impertinent young woman. Actually, if I had my way, there would be no women on a railroad station. It’s a man’s place.’ Mrs Roosevelt stopped abruptly: ‘That will not be necessary. America needs women with spunk and a sense of humour. Just a peccadillo, something to remind me of Trenton.’ Turning to Peg she said: ‘Good day, Mrs Vanderbilt. I do believe we shall meet again in the not-too-distant future. If you change your job, or these imbeciles fire you, be sure to contact me via my secretary.’ One of Lady Roosevelt’s passions was to comfort the distressed and to distress the comfortable. With that she gave the supervisor a scowl and Peg a smile and a brief bow, and made her way towards her private rail car.
‘That’s a fascinating story, Pops. I’ll ask Peg if it was a relative. I think it probably was her grandmother, or even her mother. It’s hard to know how old she is.’ ‘Peg went on to a very successful career in politics,’ my father said. ‘Not top rung, just on the support staff for the President, but she certainly made her mark. I can’t think of anyone else from Trenton who made it to the White House in those war years.’
Move 20 Peg went over her allotted ten days. I could have claimed a victory, but I play for the game not for the points. Eventually she made her next move: ‘Sorry, Bernie, but I slipped on some black ice and fell on my buttocks in the Poconos. It’s been terribly sore, and I can’t sit.’
Move 21 ‘Gosh, I’m sorry, Peg. Take your time. There’s no rush.’
Move 22 ‘Thanks Bernie. I went to a chiropractor but that made it worse. From there it has just been a downward spiral. Anti-inflammatories from my doctor gave me a dreadful rash, the physio put heat on my back and that was a disaster. Then my blood pressure went sky high, which the doctor said was a side effect of the new medicine, and I ended up for some days in hospital with swollen ankles. I could hardly breathe. My friends thought this was the end of Peg Sigafoos.’
Move 23 ‘Backs can be nasty, but surely it’s not likely to kill you. Your friends are just being a little melodramatic.’
Move 24 ‘Maybe so, but I must admit I was pretty miserable. I have been crawling around – literally – for six weeks and I’m miserable. I’m fed up with all the quacks!’
Move 25 ‘Any pain in your legs?’
Move 26 ‘Yes, there is an awful ache going down both legs and the surgeon says I have spinal stenosis. I think it’s going to be an operation in two weeks. You may have to hold on for a long while with this game. What kind of a doctor are you anyway?’
Move 27 ‘I’m a chiropractor actually, Peg. Listen, won’t you send me a copy of your x-ray report?’
Move 28 ‘Okay. I’m sorry, but your colleague here didn’t do me any good. The doctor was mad that he treated me without first taking x-rays.’
Move 29 ‘I have to agree, Peg, even if only to set your mind at rest there is no bogie in waiting. After a bad fall, you could easily have broken something. More usually, though, it is an injury to the sacro-iliac joint or a disc, or even your coccyx.’ Move ‘When a friend comes, ask them to raise each of your legs, one at a time, while you are sitting in a kitchen chair. I want to know what happens.’
The x-ray report duly came by ordinary email:
All bony elements are osteopaenic. A scoliotic curve is demonstrated. The lateral alignment is essentially normal. The disc space L4/L5 is significantly narrow. The space L3/L4 is also narrow. The vertebral body heights are normal. Advanced osteophytic changes are seen throughout the lumbar spine. The transverse processes and posterior elements are normal. The neuro-central joints are normal. Extreme narrowing of the paravertebral joints is present. The sacrum and SI joints are normal. The bony pelvis is normal. The hips are normal. On stress no abnormal movement is shown but the range of movement is limited. The abdominal aortic wall is heavily calcified. Conclusion: Osteopaenia, lumber spondylosis, disc degeneration, probable lumbar stenosis..
I shook my head, non-plussed. ‘These can’t be of you, Peg. These must be your grand-mother’s x-rays!’
Move 30 ‘Nonsense, Bernie. Have you any idea how old I am? Somewhere between 50 and death, nearer to death right now. I’ve managed to make a move in our game by the way. I lie in bed thinking about my next move. At least it takes my mind off the pain.’
Move 31 ‘Good move. But it’s your last for a while. Gosh, Peg, so are you really the same age as my dad? I thought you were about twenty-five! I was about ready to start flirting with you!’
Move 32 ‘Don’t you dare! I’m not in the mood. Do you have any suggestions that are not going to kill me? My friends seriously thought this was the end.’
Move 33 ‘Yes, okay. I have some strict rules for you, please follow them faithfully. Firstly, get an icepack, wrap it in a face-cloth and put in on your back for half an hour, twice a day at least. Secondly, you are not to sit at all for ten days, nor bend or do anything silly like vacuuming. Let your house gather dust. Then, in this attached Word document (link to website), you will find some exercises. Please do them every half an hour. Spend most of the day on your back, with cushions under your knees, but get up every hour after the exercises, and take a little walk around the house. Don’t sit and don’t bath. The shower is fine, but no washing of your toes!’
Move 34 ‘Whew, that’s a heck of a routine. Do you think it might help? I’ll try anything and meantime, I’ll ask my grand-daughter to make my moves!’
A week went by. Then I received a short message from her grand-daughter: ‘Gran is feeling a bit better. We even took a short walk along the river today with her best friend Blythe. It was nice. She’s a pretty gutsy lady and I’m happy to report that the crawling about is over. When she gets up out of a chair now, she can move quite smoothly, not at all the gingerly attempts I make if my back is giving me hell. I hope this is the right move in the chess.’
Move 35 ‘You’re still playing fiendishly good chess, Peg. Nice to have your friend Blythe to help and your grand-daughter to make your moves. Please go on being careful. You can start sitting just a little now but only for meals. This is the dangerous time. You may feel 50% less pain, but you haven’t healed 50% yet. Peg’s grand-daughter replied in a regular email: ‘My gran asks about the surgery. She is due in hospital on Thursday.’ ‘Is she still getting pain in her legs? Please raise her legs, one at a time while she is sitting. What happens?’ ‘She says it pulls a bit in the calf, but no pain. And the tingling in her feet has stopped.’ ‘See if see can convince the surgeon to postpone the op for a few weeks.’
Move ‘Hello, Bernie, it’s me again. Those ice-packs, and the exercises really did the trick. Thank you so much. My good friend Blythe brought me some Salvia seedlings called Red Surprise. Apparently they pup very generously. I have heard them called grateful plants, along with the burgeoning Impatiens. She helped me plant them out and promised that, with just a little attention, I will have lots of colour! Only disappointment is that it won’t be a surprise!
Move 36 ‘Nice move, Peg. Are you still doing those exercises?’
Move ‘Yes, of course, Bernie.’ ‘Now that Spring is coming on, I recommend that you get on and do a lot of hiking again. Build up slowly, you’re not going to the Olympics, you know. I’m afraid that jogging is behind you for the present.’
Move 37 ‘Did you ever read that story called The Last Leaf, Bernie?’
Move ‘The short story by O’Henry? A wonderful writer.’
Move ‘Yes, that’s him. Thank you for painting a leaf on my garden wall, Bernie. I hope you didn’t catch the dreaded Mr Stenosis while you were up the ladder. He’s not what you would call a chivalric old gentleman! I am actually almost completely better.’
Move ‘No, thank goodness all the sitting at my computer hasn’t done me any harm, Peg but you are right. Too much sitting does give that ‘short breathed old duffer’, Mr Stenosis, the opportunity to smite us. I looked up the story again in our local library.’
Move 38 ‘I went down to the beach for the first time in months, Bernie with my friend Blythe. I found I could walk along the uneven sand without difficulty, but I left it to her to collect the driftwood for our fire. We are so spoiled by this lovely place. The backdrop of the sea-scape makes a lovely spot to munch our eggs and tomatoes, and mushrooms, with the Boston-baked beans bubbling merrily in the little billy. By the time we had cleaned our plates my old Pocono kettle was steaming. By the way, why do all this, Bernie. There’s nothing in it for you!’
Move ‘One of your great presidents said: May I never get too busy in my own
affairs that I fail to
Move ‘Well I can assure you that you have not lost yours!’
Move ‘Thank you. How often do you go down to the beach, Peg? My dad used to talk about clamming along that shore.’
Move 39 ‘Oh, until that old duffer started stalking me, at least once a week once winter is over, unless it’s blowing great guns. I managed a little wallow out on the sand flats at low tide yesterday and I’m moving pretty easily. I still have sore legs, sort of 'cramps', not the sort that one gets in the middle of the night so you needn’t be too anxious. I’m very careful.’
Move ‘It comes from the nerve in your back being starved of blood, Peg.’
Move ‘Despite being only the Spring equinox last week, I had two swims. The only fly in the ointment, was in the form of a blue-bottle-- the Portuguese sort-- that met me in the water!! Anointing with Mesembryanthemum proved pretty effective, but the spots Blythe missed on the beach were still fiery by the time the vinegar and Anthisan were applied at home! Yesterday we were back in the same gully, to lay the ghost! Do you swim in Holland?
Move 40 ‘I can’t say we plunge into the mighty deep here very often. It’s probably a bit colder than your side of the Atlantic and the North Sea is hardly a pristine bathe. I am actually a South African practising in Holland. The beauty of our beaches is that you can even venture in on the Winter Solstice, because of the warm Mozambique current.’
Move ‘We shot off to Beach Haven between showers and had a walk and a swim, and our favourite rye-bread and basil sandwiches. I even managed to scramble back to the car without any adverse effects, just as the heavy drops were starting. Thank you again, Bernie.
Move 41 ‘Where do your initials “Vdb” in your nickname come from, Peg?
Move ‘Oh, that’s a long story. I won’t bore you.
Move ‘Nothing to do with another Dutch woman, a Mrs Vandebilt, by any chance?’
Move ‘How on earth did you find out about that, Bernie? You are quite right. A chance encounter with Mrs Vandebilt’s shadow changed the course of my life.’
Move42 ‘My Dad, Dick Preston went to school with you. He was at the school reunion when they told your story. Lovely!’
Move ‘Well, it’s a small world, Bernie. What a coincidence!’ Move ‘Yes, a it is a bit of coincidence, but I did chose an opponent from Trenton, because that’s where my family came from.’
Move 43 ‘Your Dad still alive?’
Move ‘Yes, he’s hanging in. Actually he’s in quite good health despite smoking all his life. You nearly had this game wrapped up, Peg, but now I am going to beat you!’
Move ‘Yes, I know, but remember Shakespeare’s words; there is many a slip twixt cup and lip! I remember your Dad being hooked on smoking while he was still in school! But we all smoked back then. Naughty boy!’
Move 44 As happens sometimes, a player unexpectedly never makes the next move. After the great Christmas Tsunami I never heard again from an opponent who lived on the coast in Sri Lanka. Sometimes they return after a period if you’re patient and don’t claim a win, perhaps having taken a holiday, or their hard-drive crashed but Peg never made another move. It was some three months later that I received a surprise email: Dear Bernie, Perhaps you didn’t know but Gran died suddenly three months ago. While I was tidying up her room, amongst other papers I found a slip of paper next to her bed with this written on: Nc3+. I had no idea what it meant, but last night a friend said it could be a chess move. Gran was a fanatically keen player, but you were the only person she was playing so I found your game easily on her computer. Does it mean anything to you?
Move 45 |
