Had it been anything other than what it was, it would have been beautiful. The texture was that of heavy cream as was the color – white with just a hint of gold. It was thick, luminous and, when she held it up to the light, the tiny drop on her finger shimmered.
Hannah reached again to her left butt cheek and gently squeezed. At first, she was astonished. Then repulsed. Finally, nauseated. Gagging with the stench, she examined the fluid in her hand. With the last squeeze, the cream gave way to something more like egg yolk and then blood. The fluid, an infection, flowed across the white curve of her bottom and down a slightly bronzed thigh. She vomited into the sink.
Nothing in her experience prepared her for the smell. The odor was that of rot and decay, but sharp, pungent, acrid --more alive than dead – the hot breath of a scavenger. The smell arrived with the fluid, but grew in power. Hannah continued to retch, heaving over the sink, hanging onto the rim. She pushed away the thought that sense of smell is dependent on taste.
Hannah rinsed her mouth and attempted to sit on the edge of the bathtub. Standing quickly, she winced as she gently and tentatively probed her left cheek. It felt swollen and even the gentlest touch provoked radiating streaks of pain. Considering the swelling, she decided there must be more pus. She squeezed again. Thick fluid erupted, quickly filling her hand and then over-filling it with blood. She gagged again, but had nothing left to vomit. The volume of fluid was astounding, but after her legs quit trembling she felt better.
For more than a week, she had looked forward to this moment. Last Tuesday, she had been showering when she noticed an itchy tightening. For two days, surreptitiously in public, she’d scratched her butt like some middle-aged buffoon in a sitcom.
The itch finally emerged as a hard, round pimple-like bump. By Friday, it had quadrupled in size and sitting was difficult. She tried to pop it by squeezing, but it was too far below the surface. She carefully sterilized a needle and tried to lance it. All she accomplished was the letting of a little bit of blood and further assault to her pain-ridden butt.
She contorted her body, twisting and turning, in front of a mirror. As far as she could tell, it wasn’t a splinter or something else equally as simple.
She was miserable.
Sitting was especially painful. Hannah called in sick on Monday and then called her mother. “Why, honey, it’s just a boil. Get a needle and poke it.”
“Mama, I’ve already done that.”
Myra heard the frustrated tears in her voice. “Did you try bacon?”
“Get some bacon that’s nearly all fat, spread it with mustard, and apply it to the boil. Works every time.” Myra, in fact, did not know if it worked, but that’s what her mother had always done for Myra’s brother and a positive attitude was the best cure. “I’ll bring some over.”
Myra attempted a few jokes, but quit when her daughter snarled. Hannah felt ridiculous and, though she could see the potential for humor, the pain was too much for quips. She was face-down on a beach towel spread across the bed, and Myra was doctoring her with mustard, bacon, gauze and first aid tape. “Honey, that’s a good sized boil. No wonder you’re miserable. I’m going to get you some aspirin and water and then I want you to sleep. Just remember that a good sense of humor aids healing.” She puttered around the apartment straightening things up until Hannah slept.
The bacon-mustard poultice was a complete failure.
On Tuesday, she called in sick again. When she hung up, she immediately called her general practitioner’s office. When she asked to get in that day, the appointment clerk passed her on to Dr. Conley’s nurse. Hannah, who knew Becky fairly well, explained the situation and even managed to laugh about it. Becky, with a giggle in her voice, said, “Oh you poor thing. Get your butt and your boil in here about 2 and we’ll get you fixed up.”
Lying face down on the examining table, her butt sticking out between the edges of the paper gown, Hannah clenched her teeth and let Dr. Conley probe. The flashes of pain as she gently palpitated the boil brought quick tears to her eyes. At one point, Hannah gasped.
“Hannah, it’s very deep. There’s not much I can do. I’m going to refer you to a dermatologist. No more bacon, okay?”
Hannah’s disappointment could be read in her face, read in the way she held her body, read in the way she tried to cover her butt with the paper gown suddenly hyper-conscious of what she must look like.
“Hannah, it’s going to be okay. I’m not the right person to excise something this deep. With any luck, it will burst internally and your body will take care of it with no further ado. Take warm baths and Tylenol for the pain until we get you in to see Dr. Eggle.”
Dr. Eggle’s appointment clerk offered an appointment for three weeks hence.
“Yes, that’s the best we can do. I can add your name to the list of people to call in the event of a cancellation, but Doctor is very busy. It is prom season, you know.”
“Prom? This is an emergency.”
“A simple boil is hardly a dermatological emergency. Put warm compresses on it and with any luck it will open and drain in the next day or so. Remember, we require 24 hours notice of cancellation or we will bill you for a missed appointment.”
Hannah threw the phone down.
Most likely due to Dr. Conley’s prodding and poking, the boil was even larger and more painful. She took Tylenol and poured a beer. She discovered that she could, if careful, lie on her side. She called her mom to update her on the day’s events, forcing herself to laugh about the spectacle she must have been on the examining table. The beer seemed especially cold. After the second beer, she fell asleep on the sofa.
She wanted to call in sick the next morning, but didn’t want to explain the nature of her illness. Hannah figured she couldn’t miss more than two days without a detailed explanation.
She explored the boil in the shower. She was sure it was bigger. The pain took her breath away. Dressing proved a challenge. She rummaged around in her underwear drawer until she found the what-was-I-thinking thong. Uncomfortable as it was, it was better than the constriction of her other choices. She caught herself in the mirror. The boil, blazing in its angry red fury, stood in high contrast against the lacy straps of the black thong. The sight was as revolting as mouse turds on a crème puff.
She went to work and, as much as possible, stood or shifted her weight to her right cheek. By the time she got home, the boil was enraged and her back ached. She sat in the bathtub and cried.
The boil felt mushier. It was no longer rock hard, but the pain increased to a constant throb with periodic shudders of red-hot agony. Hannah couldn’t bring herself to try lancing it again. She decided this was indeed a dermatological emergency, prom be damned, and prepared to go to the emergency room.
Her spirits lifted now that she was taking decisive action. She drove with purpose, smartly parallel parking a block from the E.R. entrance, and striding to the double doors – only wincing now and again.
At the reception desk they took her insurance information and asked the nature of her emergency. She was pleased with the explanation she’d come up with during the drive. “I have a badly infected abscess on my hip that is very painful.”
Three hours later, she had not even made it to the triage station. Her knees ached from standing. She had observed her cohorts in the E.R. carefully. It seemed that those in the worst shape were called first and taken to the cubicle marked Triage. From there, they were ushered into the E.R. or sent back to the waiting area. Tears of frustration welling, she went to the receptionist to make sure of her place on the list. The receptionist said, “Yes, ma’am, but as you can see we’re very busy and some of these people are very ill or hurt.”
Hannah waited another hour before leaving.
She slept fitfully that night. The next morning, the boil opened releasing the stench. After washing the vomit, the pus and the blood down the drain, she showered and wrapped a towel around her. Gingerly, she sat on a kitchen chair. It hurt, but not nearly as bad as it had. Though weak and nauseous, she was happy. She sipped her tea and tried to decide if she should bandage the burst boil. It began throbbing again and soon the stench arrived. When she stood, she was horrified to see a pool of blood and pus on the kitchen chair. The back of her towel was bright red and near dripping.
She cleaned the kitchen and bathroom with bleach. The boil would periodically release another round of fluid along with the stench. She told herself that things would get better now. Her body just needed to expel all of the infection.
She called in sick. Her apartment reeked of the stench and bleach. She sprayed air freshener only to find that the apartment reeked of vanilla-scented stench and bleach. She opened windows.
Four hours later she was still cleaning up fresh batches of pus and blood. She called the dermatologist’s office. This, too, did not qualify as a dermatological emergency. She was advised to sit in a warm, not hot, bath. Hannah argued, attempting to explain the sheer amounts involved. She received the curt reply that boils were noted for producing large amounts of pus.
After the bath, she clenched her teeth and squeezed. The stench was unparalleled. She vomited her tea. The boil, the pain, the stench - it was all just cruel. Gagging and retching, she lay on the bathroom floor and squeezed, twisting her body to squeeze from different angles. She squeezed and she gagged. She squeezed pus. She squeezed blood. She didn’t stop until she squeezed something that looked like cottage cheese. “Aha,” she thought. “That’s it. I’m done.” The cool tile of the bathroom floor felt good against her skin. Eventually, on shaky legs, she stood and cleaned the bathroom. She taped a gauze compress to her butt. After calling her mother to share the good news, she fell into bed. For twelve hours, she slept the heavy, dream-laden sleep of the feverish.
When she awoke, her thoughts turned to her butt. The pain had returned but was now compounded by a badly bruised feeling. She had a headache and her mouth was sore from stomach acid. She slumped in front of the mirror. Besides angry red, her butt was black and blue with tinges of orange and yellow. She was sure she was running a fever, but had neither the strength nor the inclination to find the thermometer. After considering the odds of getting fired, she called in sick.
She couldn’t decide if it was an improvement or not, but in the shower the boil oozed yellow pus and blood without any help from her. Nearly screaming with the pain, she swabbed it with alcohol and put on a new gauze compress. On her stomach, she sprawled on the bed and tried to decide what to do. She called Dr. Conley’s office and made arrangements with Becky for an afternoon appointment. By the time she got there, the Tylenol had taken the fever down and Dr. Conley thought the worst of it was over. She dressed the wound and gave Hannah an antibiotic cream to use. Hannah was encouraged to keep her appointment with Dr. Eggle.
The fever and the pus returned that night. Hannah forced herself to go to work. She told her supervisor about the badly infected abscess, but did not offer a location. It was clear to everyone that she was sick and in pain.
The amount of work that had piled up on her desk was of sufficient urgency to almost take her mind off her butt. The fever came and went, but Hannah found eating near impossible. The pus would build up, the boil would erupt and the stench forcibly robbed Hannah’s stomach of anything she’d managed to eat. She slathered her butt in antibiotic cream. Every day, she called the dermatologist’s office for news of a cancellation. It seemed to Hannah that the receptionist got progressively ruder.
She called the other dermatologists listed in the phone book. None offered an appointment sooner than what she had. That is was prom season signified something akin to her trying to get a last minute airline reservation for the day before Thanksgiving. On her lunch hour, she prowled drug stores looking for miracle cures. She bought colloidal oatmeal, cortisone cream, and topical painkillers. She also bought gauze pads, first aid tape, and antibiotic creams. She bought vitamin compounds for healthy skin and she bought immune system boosters.
The boil oozed and dripped. With every emission, the stench lingered. People on elevators gagged. Shoppers at the drugstore quickly went to other aisles. Hannah’s co-workers avoided her office. Whispering stopped when she walked in, but resumed after she passed by. She became reclusive, her actions furtive. She quit making eye contact and tried to be invisible. She changed the gauze pads several times a day, but the stench permeated everything. Occasionally, the blood and pus would leak through to her clothes. She would wash it out as best she could in the employee bathroom. She carried antibiotic soap in her purse.
With a week to go before her appointment, she had a moment of clarity. “This is ridiculous.” She drove to the medical complex where the dermatologist was housed. Walking across the parking lot, she practiced what she would say. She would be firm and insistent. She would refuse to leave until examined. Across the parking lot, in the elevator, and down the hall she practiced her speech – preparing for different scenarios. The office door was locked. The sign next to the door informed her the office was closed on Wednesday. She pressed her forehead against the cool glass and cried quiet tears of misery. She felt the boil give way and pus drip down her leg. She fought the stench, not wanting to vomit in the hallway.
She went home and lay face down on the bed. She didn’t bother to clean herself up or call in sick.
Her misery was complete.
She quietly sobbed. Sometimes, she turned her head and looked out the window thinking about life before the boil. She did not call her mother. She had no sense of humor left.
Her skirt had dried to her butt and she couldn’t bear the pain of peeling it off. She considered showering with the skirt on, but instead went back to bed. She stared out the window at the streetlight through the night.
The next morning she drove to the dermatologist still wearing the same clothes. She did not practice her speech. It took all her concentration just to drive. When she got on the elevator, many of the passengers chose to get off. The few that remained gagged. The boil opened again when she leaned against the wall.
She was too early. She pressed her face against the cool glass while she waited for the door to be unlocked. Finally, she heard a voice she recognized as the receptionist’s. “What…?”
Hannah’s knees collapsed and she fell to the floor. The boil exploded spewing pus and blood in such amounts that even Hannah would have been surprised, had she any strength left for emotional reactions. She heard the receptionist vomit. She heard the other patients arrive. She felt herself being lifted on a gurney. She heard the paramedic gag. She realized her skirt was soaked. She felt the needle slide into her vein.
She remembered rolling past Triage, but not much after that – a succession of bright lights, people asking questions, the delicious darkness of Demerol. In the moment before unconsciousness, she noticed the pain now existed outside of her.
Hours later, she was awake enough to hear, but opening her eyes took more strength than she had. She wasn’t sure if it was a nurse or a doctor, but she heard someone say, “The patient was brought in through ER with a temp of 104.2, borderline low blood pressure, and what has been preliminarily identified as a bad episode of hidradenitis suppurativa. We’re waiting on more labs. Right now she’s badly dehydrated with an elevated white blood cell count. The area of infection has been lanced, excised, stitched and treated with topical antibiotics. Bandages every four hours. We’ve got her on saline and an antibiotic drip. Fever is down. She should be coming out of the Demerol soon and she can have pain meds every four hours.”
She drifted back to sleep, but a dull ache awoke her. She meditated on the pain. It was different. “I could live with this.” She opened her eyes and reached for the water. The sun was up, but she had no idea of the time. She stared out the window until a nurse came in.
The chatter annoyed her, but she answered the questions. The nurse gave her pain pills and Hannah gave her mother’s phone number when asked. Someone brought her chicken broth and jello, but she went back to sleep.
When she awoke, her mother was there. Myra looked worried yet angry.
“Honey, why didn’t you call me?”
Hannah raised her hand off the bed and then let it drop.
“Baby, I would have helped you. Your fever’s down, your white blood cell count is approaching normal, they’re letting you out in the morning.”
Hannah drifted back to sleep.
By morning, she felt lucid and much better, if weak. Her butt was heavily bandaged, but she managed to shower. It took some doing to put on the jeans her mother had brought. She enjoyed being able to sit. It hurt, but in a manageable way. She ate her toast and scrambled eggs. She was savoring the orange juice when a woman came into the room and pulled Hannah’s privacy curtain.
“Hannah, I’m Sheila with Patient Support Services. I have some questions I’d like to ask you. Are you up for it?”
Hannah said, “Sure.”
Sheila started with the questions. How old are you? Where do you work? Do you live alone? Previous medical history.
And then, “Hannah, why did you wait so long to get medical attention?
“Hannah, our records indicate that you went to E.R., but left shortly after registering. You were very sick and clearly needed medical attention…”
Understanding dawned on Hannah. “You think I did this to myself? You think I just let myself get sicker and sicker? That I don’t have any sense?”
“Hannah, I didn’t mean to make you angry, what I’m trying to say is that….”
“Listen, you don’t know jack about what happened. It was prom and I called and I called….”
Hannah started screaming. She tilted her head back and howled three weeks of frustration. She stood up and threw her glass of orange juice and then her giant mug of water against the wall. She turned to Sheila and screeched, “You pretentious little bitch. You have no idea…” but Sheila was headed for the door and calling for help. Hannah continued to scream up and down the scales of frustration and degradation. She screamed her anger and she screamed her rage. She sang a wordless dirge of pain and dismissal. The festering boil of professional apathy exploded and Hannah keened an aria of betrayal. The pus rose up again and again, the stench of arrogance filling the room. Hannah vomited, moaned, and finally fell silent. Lanced. Spent.
She lost track of events. She found herself in restraints on a gurney and headed for the Psych Ward. Her throat was raw, her face tear-stained, her blouse covered in vomit. She felt the salty tears drying, tightening her skin. Her hair was damp. She felt the sedative numb her body and brain. She went to sleep.
Several days later she was fired for job abandonment. The following day, Dr. Eggle’s office mailed a bill for the missed appointment.
That Saturday night, girls with beautiful skin preened at prom.