Health Services

by Luke Perrotta

Illustration by Ella Rosenblatt

published September 28, 2018

“Oh, honey.”

The paper crinkles when I hop up on the shiny patient bed and face the nurse, whose nametag screams ALICIA.

“Honey, what did they do?” She’s got my eyelids. Somewhere in her education she’s been taught to pick at the eyelids.

“Who— nothing. Nobody did anything to me. I just don’t feel right.”

“Oh thank God, you have insurance.” She tosses the clipboard aside; it clatters off the doctor’s desk to the floor. “Everything’s going to be fine. Jesus is watching over us today.”

I tell her that I think she has the wrong patient.

“Oh, no, sweetie, something’s definitely wrong with you.”

“How do you know?”

“Honey, take a good, hard look at yourself. Not even. A passing glance. Here.” Pocket mirrors like hers are cheap. I almost break the thing squeezing the clasp, and barely locate my middle part before Alicia snatches it back. “Easy, girl. You’re here to get better, not worse.”

“Can I see Doctor Rathburn now?”

Because I am done with the Alicia part of the day, I do not know if she replied. That information is simply unavailable to me. But after an indeterminate ride on this blue-skinned bed and the Arrow of Time, I see that Alicia and a Doctor Rathburn have traded places in the room. I appear to have remained constant.

“Afternoon.” The swivel chair complains when he flops into it.


Colors ripple from Rathburn’s phone screen and soak into his flesh, bright blotches of chemical disease. These are lovely coats they have now. Stitched evenly over the breast pocket, RATHBURN. This must be where they put my co-pay.

He asks, “Have you played this iPhone ‘2048’ game?”

“Years ago.”

“I don’t know what on earth is going on with the numbers in the little boxes. After 64 I always get myself trapped in a corner.” His bald spot, an ozone hole, wiggles beneath the headshook skull. In fact, it appears to contract and expand in the manner of a camera lens, or a giant’s foreskin. “Fun as anything, though.”


“Anyway, what can I do you for?”

“I need some drugs.”

“Anything in particular?”

“Doesn’t really matter.”

“Not at all?”

“Surprise me.”

“Sure can,” Rathburn asserts brightly, scribbling something in pen.

I blink. “Really?”

“Oh my God, are you kidding? There are tens of thousands of drugs out there. You could check the capsules, obviously, except I’d take them apart first and pour them in different dummy capsules, only not the clear ones you get with like niacin but solid color dummy capsules, so you wouldn’t have the right information. And then I’d throw a few dozen different chemicals into the capsules, and then put all those in one bottle, so you’d really have no possible way to determine what’s going to happen to you every single time.”

I ask, “Can we do that?”

“Sure. Do you drive?”


“Are your coughs dry, or productive?”

“I don’t have a cough.”

“I know, but isn’t that a hilarious question?” Rathburn writes furiously.

“Are you writing the prescription right now?”

“No, sorry.” He takes a break from writing, bends his left leg over his right, and absent-mindedly scratches the portion of left inner ankle beneath his sock ferociously. Stuff comes off. “I’m in this epic Words With Friends battle with my kid’s elementary school superintendent, and I’m trying permutations of letters out on this page. I could go with an easy fix, but I’m behind and I wanna really whoop ’em, you know?”

“What are your letters?”

“a. a. p. a. t. c. n.”

“Oof,” I wince.

“Hand like a foot.”

I ask, “Can I see the board?”

Together we observe the board.

“Oh my God, he’s trouncing you.”

“She,” Rathburn corrects, “and I know.”

“Oh, no. Ichthys? On the triple word?”

“It’s not even worth all that much. Just wounds the pride, you know?” Rathburn’s head goes left, right, left, right, like a well-oiled pendulum. He shifts in his seat and looks me up and down. “What’s wrong with you again?”

“Ask Alicia, why don’t you.”

Rathburn consults the clipboard. “All she wrote is ‘LORD HELP US’.”

“That’s not far off, I guess. It’s hard to explain, but I’ve slowly come to have the idea that I’m just a complicated mechanism, only I still work when submerged in water. I don’t enjoy feeling this way, but at the same time I don’t dislike it, I’m not like suffering. And when I think about that word, suffering, the entry’s blank. Just a name for something that’s gone, Failure to Refer. Like that word’s made of gears like me, nothing behind the tiniest innards. And I don’t mind that. It’s comforting. Consequences are nowhere to be found, and I could walk outside into the beautiful crisp day with the fat chipmunks and dig myself into the ground and just decompose until this train of thought no longer occurs to me. Speaking more clinically, doctor, if I peeled my skin off with some implement I wouldn’t find anything underneath. I’d just have to pierce the surface once, create a microscopic gap of a place, and I would pop. The air would gush right out, and folds of the membrane that is me would pile up on each other into a heap, lifeless and cold, and my parents wouldn’t have to pay as much for their insurance anymore.”

Rathburn nods. “Like a balloon.”

“A balloon fits.”

Rathburn takes note of that. “Let me check your pulse.” His knees creak. The right hand plops on underneath the curve of my jaw.

“Oh, fuck.


“Your skin is like, putty.” He kneads it between his fingers in amazement. “That’s wild. You should really get that checked out.”


“Great neck, by the way.”

“Thanks,” I murmur.

“Mine used to be like that. Years ago. Looked just like this one.”


“It’s amazing I can remember this. I have to say, after the age you are right now, life sucks itself straight down a hole. Blink and you’ll miss it.”

“I’ll remember that.”

He hums for a while, then stops. His brow crinkles.



“No pulse, either.”


“It’s the strangest thing. Just nothing at all. How are you feeling? You seem fine, though I must say you don’t move a whole lot. Like the final result of entropy. Total heat death, full stop. And then there’s the skin thing. Damn, that’s really something. Decades of the practice and you get used to all these things, settle into a routine. The blood and guts and incontinence of it.

And then suddenly out of the blue it’s like Whoa! Spinal compound fracture. Anal prolapse. And now this. Some people.” Rathburn throws his head so quickly over his shoulder that I hope it will snap. “Dawn! Dawn, get in here!”

Outside, the steps of deeply arched feet inform me of the approach of Dawn.

“What?” Dawn has arrived. It is Dawn.

“Feel this. Here.”

“Whoah.” Wavy-haired Dawn pinches my cheek. “Are these the new practice dummies?”

“Patient, actually. Right?”

I respond in the affirmative.

“Definitely confusing, though,” Rathburn concedes.

“Man,” Dawn wiggles my flesh, “I could do this for hours.” She looks into my eyes and asks, “What’s she here for?”

Rathburn shrugs. “Haven’t decided yet.”

Dawn exits but the Doc’s thumb remains. “You’re supposed to take the pulse with your fingers,” I wonder aloud, “not your thumb?”

Wordlessly Rathburn trades his thumb out for his middle and ring fingers, pressed to the same place. “Nah, still nothing.” Hand withdrawn, Rathburn slings off the unused stethoscope, sending it clean through the office drywall. “That’s amazing. Something’s wrong with you, all right.”

As he returns to his chair I lift my fingers to my neck to find a Bump, bump, concussive proof that my pulse is in attendance. “No ideas?”

Staring at his phone screen, Rathburn massages his foreskin head. Forehead skin. “Pot is available. Should we try pot?”

“Wait, really?!”

He shakes his head. “Cant. Cant.”

“Then why’d you mention it?”

“I hadn’t realized I can also do cant, in this instance, which it turns out is much better. How ’bout a blood transfusion?”

“That’s way more than seven letters,” I tell him, “and there’s no b on that whole board.”

“I meant for you.”

“What will that do?”

“I dunno. Mix things up, probably.”

“Okay. Yes. Yes,” I say again, this time with feeling.

“Will do.”

“What blood type?”

“Human, barring some special request.”

“Well, I don’t know what I’ve got. A, B, O–”

“Sure, I mean, I’ll have to take your blood first. Before the transfusion.”

Evidently expecting this turn of events, Alicia returns, wheeling in with cart, gloves, needle, and a healthy dose of the utmost concern.

“Don’t you worry, honey, we’re going to figure it out,” she croons to the ghoulish footlong stabbing implement in her hand. “We’re gonna fix you.” I can’t help but notice that her eyes glimmer like moonlit pools, brimming with tears either of empathy or ecstasy. I’m not sure which of those is worse.

“You’re– you’re going to stab me with that?” My pulse quickens, which I realize is circumstantially convenient.


“Oh, Christ, really?” Rathburn watches, rapt. “Cause that is one huge needle. I had no idea they came in that size. Is that safe? Wow. Do we have more of those?”

Alicia grips my forearm, makes me a fist, and draws first blood at an acute angle. I look. I stare. Alicia is good at this, fast and efficient and professional, nailing me right smack in middle of the inside-elbow vein. Maybe there will be some excitement, a climax. But no. Though the needle is sharp, the process of the wound is blunt, expected, all the edges shaved off. No bite. I don’t even need to wash it down.

“Here.” Job done, Alicia sticks the needle out point-first in Rathburn’s direction without looking while she swabs the point of entry with alcohol and cotton in the other. Greedily Rathburn accepts. “Sweetie, you’ll receive a call from us in two weeks, once the results from the bloodwork come back.”

“Thanks,” I say, watching Rathburn replace the vial holding my blood with an empty one before trying the needle on himself. He observes the outflow of his blood for a while, then gets bored and goes back to his phone without removing the needle, which dangles. There’s a lot of space between us once Alicia leaves, and I ask if that’s all.

“How should I know? It’s your appointment.”

“Right, but, we’re just going with blood transfusion? That might fix me?”

Rathburn’s arm makes a sucking sound when he extracts the needle. “That is what we’re going with. Oftentimes in cases like these, the patient’s suggested remedy is the best one.”

“Cases like these being ones where you don’t know what’s going on?”

“That’s a way of putting it, yes.” He extends the blood-filled syringe. “Want some?”

“No, thanks. What about the prescription?”

“Oh, of course.” His palms slapping his knees sound like dropped fruit denting on the floor. “I forgot.”

“Sorry to rush you.”

“Of course. Nine-to-fives. I get it. Here. Go downstairs. They’ll get you sorted out.”

“‘Party Mix’?”

“Yes, ma’am. Have a ball.”

I hop down to the floor and put on my socks. When I’m almost done Rathburn pries himself into my peripheries. “Oh, hey, you have health insurance, right?”

“As long as my family’s plan hasn’t changed…”

“Oh, nope. Have it right here. Woof. You’re good. I just wholesale did not check before.”

A rush of blood to the head follows me to my feet. Rathburn’s fingerstained phone screen glows silver from Words With Friends. My yellow jacket scuttles onto my shoulders.

“Panacea,” I say.


“Going down, on the e in tench.”

“Oh, wonderful. Spell that?”


Rathburn’s shining teeth burrow into the nibble marks girding his pen. He clicks.

“Shit. Fourteen with the double letter. Barely made a dent.”

Enter Dawn once again. “What are you doing here?”

Rathburn answers before I get the chance.

“Well,” he says, straightening up and loosening his belt, “I have this rash in my southerlies that makes my crotch look exactly like the surface of the moon. Wanna see?”

“Let’s party,” says Dawn, and Rathburn drops trou. He’s right. In turning away, I am met with a cratered expanse reflected in the glass cover of the wall-mounted blood pressure gauge kissing my nose. For a moment I even see a man in there.

“Folliculitis,” Dawn decides. “You shaved, recently?”

“Yeah,” Rathburn replies, “there was no delaying it any longer. I’m just getting laid all over the place.”

“I bet,” Dawn murmurs.

“Oh, hey,” he blurts as Dawn examines him. “I think I’m wearing your coat.”

“So you are,” Dawn discovers, and ex-Rathburn disrobes, handing her a coat and a name.

Dawn says, “I’ll send you down to the pharmacy with a prescription for cephalexin. Should clear the lunarscape right up.”

“You’re a lifesaver.” The man pulls his pants back up and weaves his belt back into a hip-high embrace. On his way out he nods to me. “Good luck with your thing.”

Dawn Rathburn dawdles before me in her white coat, evidently perplexed, as footsteps plut away on the carpeted floor. “So what can I help you with?”

“Excuse me,” I ask, “Are you the doctor?”