Jon Pastor 19 October 2003

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“You can pull your trousers back up, Mr. Levinson.”
Mr. Levinson, a 67-year-old retired CPA, gladly acted on Dr. Les Shyson’s
instructions. After fastening his belt and making sure that his fly was zippered, he turned
and addressed Les.
“So, doc, can you do anything for me?”
Les had peeled off his latex-free, powder-free surgical gloves – he was horribly
allergic to these and a number of other agents – and had just finished drying his hands.
He wadded up the paper towels and took careful aim at the hazmat bin that his nurse,
Hannah, had opened in anticipation; the shot ricocheted off the doorframe and rolled
under the examining table. As usual. Hannah, intimately familiar with Les’s general
clumsiness and his total lack of any skill at any sport, had already started toward the table
as the wad of paper hurtled toward the basket.
“Well, Mr. Levinson, your prostate is a little enlarged. Have you changed anything in
your diet? Any new medications?”
Mr. Levinson thought for a moment. “New medications you would know about. New
food – no, Sadie hasn’t cooked anything new in years. Roast chicken, roast beef, roast
lamb, roast salmon; if you can fit it in an oven, she roasts it.”
“Are you sure that you haven’t changed anything since the last time I saw you?”
After another thoughtful pause, Mr. Levinson snuffled and coughed, then smacked his
forehead. “Of course, it’s allergy season. I started taking allergy medicine about two
weeks ago.”
Les nodded; he’d suspected as much, he’d seen a dozen patients in the last week with
the same complaint: difficulty urinating, difficulty stopping. “Do you remember the name
of the medication you’re taking?”
“Yeah, it’s whatchacallit, Sudafed Plus. Little white pill, tastes terrible.” He
grimaced, to emphasize this point.
“That’s what I thought. Most likely there’s nothing wrong with you. Sudafed Plus has
a decongestant in it, and that can cause the symptoms you’re experiencing. It’s pretty
common – I’ve seen a lot of it since the end of the Summer.”
Mr. Levinson, who had come to the office with an almost comical expression of
concern, brightened visibly at this news.
“What you need is the regular Sudafed, the little red pills. And,” Les smiled, “they’re
coated – no bitter taste.” He scribbled a few notes on the bill, checked off the right
procedure codes, and handed it to Mr. Levinson “You just take this to Mrs. Keefe, and
I’ll have Hannah bring over some samples.”
“Hannah is who?”
“I mean Miss Speranza,” Les said, with more nonchalance than necessary. This
escaped Mr. Levinson completely, obsessed as he was with his prostate. He believed in

Copyright © 2003 by Jon A. Pastor

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maintaining professional decorum, outwardly at least, and his staff always referred to him
as “Doctor Shyson.” While he called his bookkeeper and receptionist, both married
women with grandchildren who came with the practice when he took it over two years
before, by their given names, he always referred to them as Mrs. Keefe and Mrs. Farrell,
respectively. With black-haired, green-eyed 20-year-old Hannah, hired last February,
fresh from a two-year nursing program at Jefferson, this policy of public formality was
convenient: it wouldn’t do to seem too familiar with her, particularly in the case of his
wife, who hadn’t been pleased when Les hired a nurse who “looks like a spic bimbo and
dresses like a hooker.” The fact that Hannah came with strong recommendations from the
head of the Nursing school on top of a 3.9 cum, and was by far the most qualified
applicant for the position, persuaded Mrs. Shyson to drop her objections, but not her
prejudices.
As Mr. Levinson shuffled to the cashier’s office, Les returned to the examining room.
He tore off the sheet of paper that Mr. Levinson had been lying on and unrolled six new
feet of fresh, clean paper. At least something is fresh and clean in this hellhole, he
thought. Among the many proctologist jokes his patients – the cruder, or most nervous of
them – told him was “I bet this can be a pretty shitty job sometimes.” If they only knew.
Fortunately, the words “fresh” and “clean” brought Hannah to mind, and as if in
response to his thoughts she opened the door and leaned in to tell him “Your wife is on
line 6.”
“Thanks,” he replied – and then, after glancing quickly up and down the corridor and
seeing nobody, gave her a more-than-friendly kiss. And put his hand squarely on her left
breast.
She let the kiss linger for a few seconds, then broke it off and gently pushed his hand
away, looking down momentarily before flashing a mock-shy smile. “You’re bad.”
She smelled of citrus – probably her shampoo, Citre-something. Whatever it was, for
a moment it overwhelmed the permanent faint pervasive disinfectant scent of the exam
room. He grinned “I know, but...”
“No buts – it’s too dangerous with other people here.” She thought for a few seconds,
and then burst into a fit of giggles. “No buts! A proctologist’s office with no buts! Get
it?”
No buts. That would be a relief. He rolled his eyes melodramatically, and she
regained her composure. “Your wife. On 6.” A pause. “You remember your wife...?”
She winked and withdrew, closing the door behind her. His heart was racing, partly
because Hannah turned him on faster than any other woman he’d known, and partly
because it would be hard to explain to his wife why he was hyperventilating.
When he’d regained his composure, he picked up the receiver and punched the
blinking button for line 6. “Hi, hon, sorry I kept you waiting, but I had my hands full.”
This was code for “I had my finger up someone’s rectum”: she was less than thrilled
when he’d changed his specialty from ORL to urology/proctology. It was just too hard to

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make it as an ORL, what with the big practices at Byrn Mawr and Presbyterian, and he
didn’t want to give up private practice – not yet. He’d met Dr. Silverman, who was in his
early seventies at the time, at a party thrown by a colleague to celebrate his wife’s 40th
birthday, and they’d hit it off despite the difference in their ages. Les had been in search
of a mentor since his father died, right after Les’s graduation from Columbia twenty-two
years earlier, and Dr. Silverman was starting to think about retirement and was looking
for a protégé. Too good an opportunity to turn down, what with the demographics in the
area – lots of baby boomers, starting to obsess about their prostates and colons. So Les
had dug into his savings, gone back for the additional coursework, the residency, the
internship, and came out the end of that sausage-grinder just in time to take over Dr.
Silverman’s practice.
He was doing quite well professionally, but was miserable. He was sitting on a gold
mine of persistently hypochondriacal, obscenely well-to-do people with no external
worries; they turned all of their discontent and fear inward, and he could do as many
rectal exams and colonoscopies as there were half-hour appointment slots in a day. That
was the good news. The bad news was that he found himself longing for mere halitosis
and pus-filled inner ears. Every day was an unending sequence of performing on
strangers nauseating and humiliating procedures that he’d have been uncomfortable
performing on his wife. Or Hannah.
The situation at home was no better. His wife had been happy when he was sticking
tongue-depressors down throats and otoscopes into ear canals and nasal passages, talking
about tonsils and sinus congestion. Now that he spent his days snaking six feet of fiber-
optic into people’s ascending colons, extracting little pieces of flesh out of those sewage-
pipes for biopsy, she seemed disgusted by his touch – as though scrubbing fifty times a
day with Povodine were not enough to cleanse the stain of ordure. At parties, when she’d
had too much to drink – that is, at every party they’d attended since he donned the glove
– she mocked him: “Yeah, Les had his thing up a lotta asses today” and “Les is starting t’
do rectal exams without using his hands.” At the MacMillans’ last weekend, she’d
announced loudly that he was dropping his old patients and becoming “proctologist to the
queers.”
He thought of the old joke about the boy reporting his father’s encounter with a
fencepost. The kid says “He fell off a horse onto it and it went right up his asshole.”
“Billy!” the teacher scolds him, flustered, “you mean rectum.” “Rectum?” Billy hollers,
“Hell, it damn near killed ’im!” This was damn near killing him: from the disgust and
embarrassment of his work life, to the coldness and scorn at home. The only redeeming
element in the whole depressing predicament that was his life had just left the room, after
a kiss and a goose.
At first he listened more or less attentively to his wife’s monologue, and grunted
assent at appropriate times, but his attention waned as she whined on: Alex, his 9-year-
old son, had missed the school bus this morning, and she had to throw on clothes and run

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out with no makeup, for God’s sake. And since Les had taken the Accord, she had to
drive the fucking Cherokee, which was making all kinds of noise... Probably the rear
differential, he mused, and that reminded him of a web site he’d encountered the previous
week: an outfit that did differential work and referred to themselves as “proctologists to
the cars.”
As his wife’s litany of crosses she had to bear – major and minor, real and imagined –
droned on, he started to free-associate. “Proctologist to the cars” led, naturally, to
“proctologist to the stars”; which led to the view from the beach on the second night of
the urology conference at Sea Pines in Brewster, Mass, away from city lights, the sky so
dark that the Milky Way was like a net of pearls cast across the sea-dark heavens; which
led to the stroll with Hannah that led to the ramshackle fence behind which she knelt
suddenly, looked up with the starlight dancing in her eyes, and told him – just as he’d
told hundreds of patients – to drop his trousers. He did.
That was only the first of what were now too many rendezvous to count: one or two
at different conferences, some at her apartment, and more than once – on nights when his
wife met with her book club and the kids were at sleepovers he’d cleverly arranged – in
the examining room in which he now sat, listening to the coda of his wife’s song of woe.
He visualized Hannah at their most recent tryst, lying on the table he now leaned upon,
her moist lips parted, her eyes glistening with desire, like the heroine in one of the
romance novels his wife consumed like popcorn. He knew that Hannah was infatuated
with the idea of a relationship with a man twice her age, spiced by the thrill of the
forbidden and the satisfaction of screwing his bitch of a wife every time she screwed him.
He also knew that the infatuation wouldn’t, couldn’t last forever – but while it lasted...ah,
an oasis of fragrance and beauty in the cesspool of his life.
He was jolted out of this reverie by his wife’s snarl. “Les! Are you paying attention? I
asked you when you’re coming home.”
“I don’t know, I’ll ask Mrs. Farrell to check the appointment book,” he temporized.
“Let me put you on hold and get her.” He stabbed the intercom button quickly, cutting off
his wife’s knee-jerk objection in mid-sentence. “Celia, what does the rest of the afternoon
look like?”
“I’m pretty sure that Mr. Levinson was your last for the day. Let me check.” He heard
her nails clicking on her keyboard, and then “Yeah, he was the last. You’re clear for the
rest of afternoon.”
He thought for a moment. “You and Clara can take off then. I’ll close up after
Hannah finishes autoclaving the instruments.”
“Hey, thanks Dr. Shyson. You sure?”
“I’m sure. There’s no point in all of us hanging around with nothing to do.”
After thanking him again, she hung up. He took a deep breath, exhaled slowly, and
punched line 6. “Sorry, hon, I’ve got a packed schedule, and a couple are new patients
who’ll need full histories. I don’t think I’ll make it home before 8 or 9.”

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“If you’re so booked, how come I’m stuck with a lousy Accord and that crappy
Jeep?”
He saw his chance. “We can go look at the Lexuses on Sunday, how’s that?”
She knew that she was being bought off, and upped the ante. “I want to look at a
Hummer.”
Hoping that she hadn’t figured out why she was being bought off, he conceded the
hand. “Yeah, we’ll look at the Hummer too. The new one. Yellow.”
There was a moment of dead air on the line. “Well,... okay. I’ll see you when you get
here. And don’t think I’m going to let you off the hook for that Hummer.”
She’d bought it; he relaxed. “I promise,” he replied mechanically, his mind already
moving ahead to the next four hours in the exam room. “Love you, Hannah.”
By the time he realized what he’d said, the receiver was sitting in its cradle. There
were perhaps 30 seconds of ominous silence, in which he hoped against hope that she’d
been so intoxicated by the thought of several tons of status symbol that she’d misheard
that last word.
The phone rang: line 6. It occurred to him that Hannah didn’t know about the early
closing, and would see no reason not to answer. After eight rings, there was silence again,
and he began to relax; but his heart started to race as he heard Hannah’s clogs clomping
down the hall. He saw the knob turn and the door peek open. Hannah’s head appeared.
“Your wife. Again. On 6.” She winked and blew him what he knew to be a last kiss; then
he lifted the receiver, like a loaded pistol, to his ear.

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