The Stone Institute

Excerpt from Pennerian and Lifeblood Novel

Excerpt from Kevin S. Merigian's novel: Pennerian and Lifeblood

Chapter 1: The Beginning of the End

Life did not care about Jude's intentions. Jude did not come to Memphis, Tennessee to be a chairman of an academic emergency medicine department; he came to build a clinical practice in medical toxicology at the Regional Medical Center. Nor did Jude come to Memphis to be divorced; he came to Memphis with a firm commitment to long-term marriage and being a good father to his children. Circumstances made it impossible for Jude to live in his adult, childhood-fantasy world: a big painted brick, two-story house with a white picket fence, two cars in the garage, two children one son and one daughter. He lived a life totally opposite of his childhood, a childhood that left him with demons that haunted each crypt of his neocortical valleys, ghosts that haunted his every thought about the deceit in which people live, their motives, their relationships, and their outcomes.

Currently, Jude takes his marching orders from Dean Henry "Hank" Grummet of the College of Medicine at the University of Tennessee, Memphis. Dean Hank assigned Jude to the Medical Director position of the Division of Fire Services for the City of Memphis. The College of Medicine did not own a University Hospital nor did the educational institution own any clinical office space. Dean Hank and the campus Vice Chancellor executed contracts with private and public hospitals, city and county clinics to provide medical care to the indigent. The contacts also fulfilled the mission of medical education opportunities for the students, interns, residents and clinical fellows. The hospitals' and clinics' incentive was to provide indigent care at a rock bottom cost. Dean Hank's and the Vice Chancellor's incentive was to profit from the fees generated from the medical care that 300 plus primary care, specialty and subspecialty physicians provided to the Delta region. The cunning of running such a large operation weaved in and out of the fabric of the political systems of the City, County, State and Federal governing structures. Hank was Queen Bee, Jude being just another drone in the University hive, a worker bee sacrificing his personal fantasies for a life dictated by back room deals, greed, and mediocrity.

On this cold, crisp morning, uncharacteristic of the southern climate for this time of year, Jude was driving his Ford F150 white pickup truck, he referred to her as his sexy, stick shift, working girlfriend, to the fire department’s training center for a meeting with his staff. Jude's mission was to bring the antiquated Department out of the dark ages of fire based paramedic service into a more postmodern paramedic based fire service. The training center was located in a dilapidated area of north Memphis called Frayser, where house after house, block after block, street after street, was a rat infested maze of houses with collapsed roofs and boarded up windows -- peeling white paint covered their termite infested walls. Wild unkempt grass lawns separated the houses from the trash-filled streets. Old, worn out tires, ripped black plastic bags of garbage, and decayed leaves left a blanket of slimy compost. Rusty dead cars, fenders, wheels, and wrecked car bones scattered the alleyways and sidewalks. This made it difficult for pedestrians to walk a straight path to their chosen destination. Ruins of a once thriving popular blue-collar aristocratic community, Frayser remained as a remnant of classic white urban flight. Jude felt at home here, since the community reminded him of his childhood inner city roots in Detroit. Jude’s childhood was not typical of a doctor, not that he thought there was a typical upbringing of anyone in any family. Jude’s fellow classmates in medical school had come from two parent families with upper middle to upper class incomes; many had their families who pay for their college and medical school education, as well as their gas money, insurance, utilities, well-serviced automobiles, in addition to generous spare change for their vacations, dates, and social activities. Jude on the other hand was reared in an impoverished single-parent family, his grandmother doing most of the rearing, his father doing most of the verbal and emotional abusing. Yet Jude’s meager young life in inner-city Detroit was a far better alternative than the foster homes in which his mother had put him, as well as his brother and possibly his sister. Jude began living in Detroit with his Armenian grandmother and first born Armenian American father at 7-years old, ending a four-year life in foster care abuse. One of Jude’s most vivid memories was living with a family in Lansing, Michigan that had five kids and two parents. Jude remembered his brother living with him but not his sister. The foster parents’ assigned Jude and his brother a furnace room in the basement as their sleeping and living quarters. An ancient mattress, lying directly on the concrete floor, in the corner of this dark gray filthy dirty room served as their bed. Jude and his brother were never allowed to go to the first level of the house, with two exceptions: the first one, to eat leftovers from meals the family enjoyed in the kitchen, the second one, to make their way up the stairs and out the side entrance of the house to go to school. Jude spent most of his time in the furnace room. He fantasized about magic, color, and beauty. He blamed no one for his situation, not even his mother who put him in several of these prisons, for Jude, as most kids do, just assumed that other kids had a similar life to his. These foster families were not compassionate about giving underprivileged children a better home; they were fixated on the money.

Jude’s mother was a beautiful blue-eyed blonde haired woman with a very high IQ. However, she lacked a sense of authentic self. It was as if her personality was broken into hundreds of shards of glass, each piece disassociated from the other shattered pieces. Her emotions were that of a two-year-old, with her being the center of the universe and everyone else a host for her hedonistic tendencies. If treated for psychological illness in the late 20th century, Jude believed that her diagnosis would more likely than not have been severe borderline personality disorder; even current treatment for this disorder is extremely unsuccessful. Jude’s mother had a very hard time trying to keep her duties in accord with her life; housekeeping and child rearing didn’t fit into her work and heavy dating schedule. Therefore, she made the decision to contract out child rearing, since it was the least favorite aspect of her life. Jude remembered always being with his brother, but had a hard time remembering ever being with his mother or sister. He felt that his mother and sister lived together in an apartment, and left Jude and his brother alone to fend for themselves in foster homes, an unintended abandonment. Jude did not spend much time thinking about that separation because he was never close to his sister, even after they moved to Detroit and shared a common home. Eventually, Jude’s mother decided to place him and his brother and sister into the state run orphanage. The administrators for the State orphanage, in an effort to save money, contacted Jude’s father and asked him to consider accepting custody of Jude and his siblings. His father was not a nurturing man, and was not enthusiastic about the state’s offer. Hi father discussed the possibility with Jude’s grandmother and she was adamant that her son take custody, and allow her to rear Jude, his brother, and sister. So his father did just that.

Jude remembered the day of liberation from the furnace room imprisonment. His father arrived driving a brand-new dark blue Starfire Oldsmobile convertible, with the top down. He came to the front door of the home in which Jude and his brother were staying, greeted them both on the porch landing, and told them that they would never have to come back to that house again, as he revealed his plan to take them to their grandmother’s house instead of the orphanage. He remembered sitting in the backseat of the convertible, sun shining down on his face hair blowing in the wind listening to the radio smiling and crying at the same time. He was free. He was free forever. As he arrived at the 60-year old, two story, three bedroom, one and a half bath, 1400 square foot inner-city Detroit home, his heart filled with a sense of belonging. Jude finally had a home.

Some things were different; some things were the same, for Jude’s father was a narcissist. Anyone living with a narcissist would certainly recognize the emotional tolls on all of those who are obligated to them. Narcissists believe that everything and everybody is there to serve their needs, regardless of the effect on the server. When the servant is not able to rise to the occasion, the narcissist will separate from the servant emotionally and physically. Jude’s grandmother was an amazing old school kind and gentle soul; she mothered Jude with a sense of responsibility and independence. Abused as a toddler and young child in many foster families, thankfully Jude’s observant grandmother recognized that his shy and cowardly behavior was cover-ups for the pain he had endured. With healing love in her heart, it was important to her to let Jude know that she was always in his corner; she favored him over his brother and sister whenever she could. It took Jude years to find his voice. But find it he did. Since that day of liberation, Jude has loved convertible cars, rolled down windows and car radios played loudly.

Jude’s truck was no convertible, the chill in the air prevented him from rolling the window down, as he played one of his favorite songs, Credence Clearwater Revival’s, A Favorite Son rather loudly. Swaying in his seat, snapping his fingers, singing as if he were in the band itself, Jude knew he was no favorite son. He always lived a hard life. His desire to leave the inner city and its mountains of despair, it’s rivers of crime flowing through the streets like a flood from a broken reservoir, it’s Darwinian rules, the strongest survive and trust no one - were far from Jude’s ideal place to settle, or start a family. Jude desired to get distance from inner city environments, and their wastelands of poured cement, underground highways, and congested streets, where rude and insolent people fended for themselves in herds of human consumption. Yet he could not rid himself of the attraction of helping the poor, he desperately wanted to bring justice to those who suffered from the high walls of tyranny erected by powerbrokers that did not play by the rules. Jude believed that only inner-city life was inherently unjust, he had yet to learn that all life was unjust not just in the inner city.

Jude wanted more than anything to be a recipient of unconditional love and be a giver of the same; his current divorce situation was ripping at his emotional stability, lengthening his reaction times to stress and change, and numbing his intuitive sensitivities to environmental and social situations that could potentially harm him. Jude’s wife Vanessa, mean spirited and focused on the destruction of Jude, underestimated his will and force of character. His battle to separate himself from Vanessa was in effect the same battle he had waged in childhood in an effort to separate his emotional attachment to his mother. Jude did not lose the social war in his mother’s case, and that gave him the experience necessary to win his current conflict. Jude knew that his greatest talent was that he could out work and out think anyone who desired to take him down. The inner-city street-wise gang members taught Jude how to fight, and fight unfairly he did. Jude knew suburbanite middle and upper middle class men thought that rules, universal directives like an inner city Geneva Convention, applied to fighting. Even in the theater of hand to hand combat, the civilized thought that preventing everlasting harm and collateral damage was some kind of natural moral law. Truth be known, there are no rules in a street fight. Man has removed himself from the jungle, only to find that the jungle still exists in his soul. One of the rules of the jungle was there were no rules. That was rule number one.

Jude drove past some new construction, realizing that there were a number of drivers not paying attention to the road. Rubber-neckers looked around instead of in the direction they were driving, drivers texted, read the morning newspaper, and carried on assertive cell phone conversations while waving their arms and giving other drivers the finger. Multitasking women put on their make-up as they took their life into their hands, or for that matter, took the life of others into their hands. In Jude’s mind, multitasking was over rated and over appreciated. He thought that perhaps attention deficit disorder was a stupid form of multitasking, making extreme forms of uncontrolled multitasking politically correct and medically treatable. Scanning the surrounding areas, Jude looked for sections that would be vulnerable to accidents given the slickness of the roads. Frost covered most of the streets. Jude had set the truck-cab’s internal thermostat to 80°F, since it was so damned cold. One of the reasons Jude came to Memphis was to get away from the cold weather of the North. He hated the chore of shoveling snow, hated the salting of icy surfaces, hated the slush that was left after a snow storm’s thaw, and hated wearing thick coats, as well as, gloves, hats, scarves, and boots just to stay warm. This current cold weather just smacked his head with another cosmic 2 X 4.

Without warning, a massive six-ton dump truck hauling excavated concrete swerved in front of Jude’s truck. “Shit!” In his peripheral vision, Jude noticed that the driver was texting. Thoughts began to swirl in Jude’s head as his unconscious mind took over the steering of his vehicle; somehow, fate was in charge now. Jude’s conscious mind attached to a data file stored deep in his cerebral recesses: forty-two percent of the drivers in Tennessee text while driving, the average nationally is twenty-six percent, texting requires both hand and mind coordination, there must be complete synergy between the human consciousness and thumbs, almost at the same level as playing an instrument. Would anyone drive a car while playing the drums or a guitar? How about a dump truck driver? Would he play a guitar while driving? Why the hell was he texting while driving the equivalent of the rhinoceros of the truck world? Jude was fortunate enough to see the truck’s erratic movement, unconsciously he steered clear of the truck, but unfortunately his reflexes failed to steer the truck off the road safely.

The left side view mirror shattered. His four-wheel drive, white, sexy, stick-shift, working girlfriend with all-terrain tires had an undercarriage modified to handle any off-road terrain, but was never modified to jump over creeks or skip over side road ditches traveling 45 miles per hour. It did not matter how hard Jude turned the wheel, the unsteady Ford monster, countered every move as if following Newton’s laws of physics, each action has an equal and opposite reaction, essentially a bull trying to shake a rider at a rodeo. Seatbelts cannot keep a cowboy on a bucking Brahma bull. Jude hoped to ride the bull until the buzzer went off, but couldn’t get the clown to distract his Ford monster while Jude finished his ride. He heard a loud crash, like giant cymbals clamoring solo in a marching band, as his truck hit the cement embankment and soared into the air like a large steel ball shooting from cannon during an artillery barrage. Jude’s conscious lights went out.

Suspended in mid air, Jude was back on the roller coaster ride, that big old wooden one at Liberty Land, Elvis Presley’s favorite. Jude hated riding roller coasters, he only rode the roller coaster because his kids Ian and Alex were prevented by safety rules from riding the roller coaster by themselves: Children under 4 feet tall must have an adult 18 or older accompany them. Jude thought the rule was silly. Roller coasters made him nauseated, frequently to the point of vomiting. Since this year the Mid-South Fair was held at Liberty Land, on a beautiful late fall night Jude rode the dreaded Elvis roller coaster with his kids, then spent 15 minutes vomiting in a rusty dented trash can near the back of the ticket booth. Patrons laughed as his undigested funnel cake spewed from his mouth, they heckled him, "see the Fair doctor", as if there was such a thing.

“Fuck off,” Jude said in a tone that was unmistakably defensive. Finally the vomiting stopped. Ian asked if they could go again. Jude smiled, “Why the hell not?” And he vomited again.

Jude’s truck rolled out of control until it dropped 22 feet embedding in the north bank of the Wolf River. An explosion signaled the air bags deployment as Jude was pinned to the back of his seat. All movement stopped momentarily, a buzzing noise rang loudly in Jude’s ears. He felt nauseated as he moved his fingers and wiggled his toes checking for spinal cord injury. There was a moment of relief until the pain awakened him to another level of nausea, one that he had never experienced before in his life.

Even though sharp, stabbing, burning pain made Jude’s breathing shallow and difficult, he felt glad he was breathing. He questioned himself as if he was one of his emergency room trauma victims:
Can I take a deep breath? No.
What day is it? I don’t know.
What time is it? It’s morning.
Do I know my name? Jude Pennerian.
What exactly happened? Some motherfucker drove a dump truck into my lane, head on!
Do I hurt anywhere? Hell yes, fucking everywhere.

Jude’s left arm felt backwards at the elbow, a reverse joint like a flamingo, obviously not human. Jude saw blood spatter on the windshield, driver side window, and on the airbag, clinical evidence that he had some sort of head injury. Jude had seen his blood before, many times in fact; football injuries, nose bleeds from fights. And the worst time? He wedged an ax in his leg while chopping wood in his side yard. He pulled the axe out and shouted loudly, "Shit, I'm not going to the emergency room"! Jude crawled up the back yard steps to the driveway, crawled up the garage steps into his house, and took off his pants in the mudroom. He put pressure on the wound, the bleeding stopped. He poured concentrated rubbing alcohol directly into the wound for sterilization, and hopped on one leg to answer a phone call from a mystic in Colorado who asked him if he was injured in his left leg. He reassured her that he was all right, as he reinserted loose bone fragments into his tibia, just below and medial to the knee joint. He kept talking as he sewed up the four inch gash with 5-0 Ethilon suture; then took a handful of cephalexin to help reduce the chance of infection. Jude was not a sissy.

Jude knew the smell of fresh blood, it had a distinctly unpleasant odor, and its taste was similar to that of brackish seawater. He learned the smell from resuscitating countless trauma victims in the emergency department. Blood was essentially salt water. Jude felt more nausea as the pain of the injuries began to filter through his body’s natural pain killers, endorphins and enkephalins, secreted by the brain to help decrease pain in acute injury. Smelling his own fresh blood, Jude fixated on the pain in his chest, knowing much too much to ignore the real probability that he had broken his ribs and punctured his lungs, hopefully only one, but it could be both.

Repeatedly, he thought that if he had a pneumothorax, the trapped air would eventually squeeze his heart, resulting in a reduction of his cardiac output; as a result, his blood pressure would crash, quickly followed by heart failure and cardiogenic shock. Having resuscitated hundreds of patients during his lifetime as an emergency physician, Jude often wondered what happened to people when they died, since he literally watched them die from all sorts of traumas and medical diseases. Reading books on near-death episodes gave him an idea of where people went after they died, but Jude knew something was missing in their descriptions of what happened or where they reportedly went. Some went nowhere, just over their hospital beds; others went to a divine light of some kind, wanting never to return to their fleshly bodies, saying that they felt extreme warmth and enlightenment in the light and that their life on Earth was just so sorrowful. Jude saw something change in their energy before they actually had no blood pressure or pulse, often wondering if it was their soul leaving them before their vital signs bottomed out or was it some sort of an electrical blackout of their nervous system, initiated by the brain before their circulation stopped. Jude frequently wondered about the transitions between birth, life, death and then the afterlife, dismissing the idea of Hell, believing that a loving personal God could never condemn any of his children to the wrath of the devil. Besides Jude did not believe that the devil existed in any form, so it should go without saying that Jude did not believe in Hell. Jude was always aware of evil, however he believed that Hitler and George Washington, the evil and the good, were probably both playing cards together in Heaven with God’s blessing. Realizing that a firsthand knowledge of what death actually is may be on the horizon; Jude knew that if it was his destiny to cross the threshold of death into the Light, he probably was not going to have a choice. But until then, fighting for his life is all Jude knew how to do.

Emerging from the heavens, the music of rescue vehicle sirens signaled the approach of medical help. Momentarily, the sound of liberation filled Jude’s senses. Hearing the bugle sound as the Calvary came to the rescue, old western movies flashed before Jude’s eyes as he remembered watching John Wayne every Sunday morning on cable, or if he Wayne wasn’t in a movie that particular Sunday, Jude would put in one of his John Wayne DVDs. However, this was no movie, terrified Jude knew fire fighter Buck Colby was working A shift. Jude was in the county, so he did not fear that a dispatcher would send Buck to Jude's wreck. Buck was supposed to only cover EMS within the Memphis City limits proper. But he thought that Buck might jump or intercept the call and show up without authorization. Buck had the habit of violating city boundaries and taking command of a scene before anyone else arrived. In the sirens’ crescendo Jude labored harder to breath, the feeling in his arms and legs begin to fade, and Jude entered the realm of the unconscious, conscious thoughts about dying faded, the unconscious took over and his soul began to release Jude’s life biography to the Divine, the most current being released first. Now aware that the story unfolds in segments, one segment connected to another, and another to another. Jude sees what he knows to be true. He sees what is going to happen next. Jude wonders who, if anyone or anything is directing the chaos in his life. He sees a fractal pattern emerge from the seemingly random events. Now calm as he reviews the show; an amateur 8 mm movie projecting what is, as it has to be.

Posted by Kathryn Edmonds at 9:37 AM
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