Ralph wakes up on the floor of the MedVan at a truck stop outside the city.  His pants are round his ankles, a necktie wraps his head.  A paper plate capsized crusts, a snuffed joint and some cigarette butts by his feet.  By process of elimination, he figures the source of his current headache is linked to the empty bottle of Old Granddad by his hand.  He does remember having pizza delivered to his van.  That took some doing but he managed to work out a good relationship with the team at DiOrio’s.  They have their hands in all kinds of things so they understand unorthodoxy. He’d been sleeping in his MedVan for something like three months.  His pride prevented him from disclosing to anyone that he’d forfeited his second (and final) house to pay off Shannon.  He’ll be goddamned if he’s letting her take his custom MedVan or any of his equipment; they’d have to kill him.  But, who knew how long he could keep going like this? Living out of a mobile ‘care’ unit.  Whenever that spiteful shrew Shannon needed her coffers refreshed, she placed that call.  The hotline bling that happens after all humanity fades away. Ralph was the stone she could always turn to for blood.  He had to figure out how to make it all go away.  He wasn’t at all succeeding in putting a stitch of this drama behind him.

He steadies himself on his feet and lurches toward the back of the compartment to a bulkhead of shelves.  The space under the sink contains three rows, three deep, of hand sanitizer in quart jugs.  He removes one taking special care to pull two forward.  Rotating stock is vitally important to him.  You can never have too little hand sanitizer, especially when you operate a MedVan that’s out of fresh, running water.  Temporarily.  Everything’s temporary.  He’s immediately cranky thinking about that crazy bitch shooting holes in both 18 gallon water tanks and finishing the clip into the four gallon hot water heater.  She lost her mind two weeks ago. They’re both lucky the whole thing didn’t go up like a really dumb version of 911.  She left a note saying, “Be thankful these weren’t in your cock.”  He tops off the 8 ounce sanitizer dispensers located at intervals in the front, back and middle of the van.  Removing his lab coat and shirt, he smears four generous gobs on his face, neck and torso.  He grabs an aerosol can of Lysol, “Crisp Linen,” expelling two short blasts in each pit, spritzes it down the front and back of his pants.  Looking at his lined and inflamed visage in a small mirror situated above the dusty, crusty utility sink, he sets a goal to shower today.  He’d accomplish this at The Flying F truck stop in Galena. Hopefully there’s enough gas to get to Galena.  There’s also a Y close but the problem is the people at the various YMCAs know him. Locally, he’d haunted them all.  Haunted would be the appropriate terminology. Through a chemically hazed brain, he doesn’t quite remember if he’d been banned from that Y for life or not. No harm in trying.  Worse they could do is turn him away in a humiliating flourish. The fact is, he needs to shower before his appointment with Sammy at six this evening.  Sammy has called out his hygiene before. “The new bedside manner is B.O.?”

Ralph needs to scrape up some cash before then.  He had very few adderall to sell, even less oxy. He needed to make some ‘housecalls’. Shake down Empress at Blert’s Pharmacy, a little quid pro quo in a life of Faustian bargains. Great. Then, he’d stop over at The Hive.  It was all so complicated. 

He drives the lumbering Medvan through the village of ‘San Margherita’ like an intensive care ice cream truck. It’s a shortcut but also a ‘scenic route’.  Here are the shirtless saggers and Confederate flaggers shambling along one convenient corridor.  John T. Bishop and Madison have just let out- along the sidewalks students flood the spaces between the indigent.  Hope swaggering past the hopeless.  Innocence and criminality comingling in an intoxicating way. He takes intentional wrong turns here and there lapping the low-grade desperation drifting in the spring air.  Maybe it’s just the air in the van and this perception a mere projection.  Whatever it is, it’s making him light headed because the blood’s rushing to his crotch; the yellow pills must still be metabolizing. Sometimes life’s a wondrous, heated mirage.  

He pulls into Berliner Park skimming the front of the van against the parking lot’s asphalt acclivity.  The park’s always an acceptable place for a MedVan to stop. No one questions it ever. If anything it seems folks are comforted by it.  The park has showers.  The park has paths.  The park has guys like him looking for relief.  He gathers up his toiletries and the new shirt he’d just bought and stuffs them in his leather medical bag. The sun screws into his scalpl as soon as he sets foot on the baked asphalt of the lot. Would anyone be concerned that the MedVan clinician was using the Berliner Park rec center to shit shower and shave?  Would anyone even notice?  A concern over appearances washed over him every once in a while. It seemed he was becoming something of a target for merciless and bigoted forces. Save for a Toyota Tercel, Berliner’s front lot is otherwise empty.  A couple is on the other side of the ball diamonds eating at one of the cement picnic tables, very involved in one another; they can’t see anything else.  If necessary– if he got lucky— he could always move the MedVan to the back lot for additional privacy.

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Thankfully the communal showers are empty.  He looks like hot, splattered mess. Nobody can see him this disheveled or trace him to the professional looking MedVan in the parking lot.  Maybe someone will recognize the MedVanHe’s still very proud of his mobile office.  He flexes it whenever he can. Even if it does have a few bullet holes in it.  He hasn’t figured out how to have that fixed yet no questions asked.  Sammy told him he knew of a body shop. 

“The MedVan is a custom vehicle!  I can’t just have any chop shop working on it!”  He’d argued. 

“Drive it over to Beauchamp Specialty Vehicles then!  You know so much!”

When he said this, Ralph got exasperated.  He was always frantically pressing buttons and constantly hoping for different outcomes than the ones he got.

                “I don’t have…”

                “A proper police report.  I fucking know! You’re like a damned broken record.”

                “Gimme some time.  Jesus Christ.”

                “Don’t bring Him into it.  You’re playing with enough fire, and he sure as shit isn’t goin’ to help you, now.”

Ralph will to have to deal with Sammy’s third degree this evening, no way around it. It’s the price he has to pay if he can’t generate some cash before then. That’s when he swallows his whatever’s left of his pride and asks the porn king for advances on treatment.  A lecture is guaranteed. Another on again off again quid pro quo arrangement. No sense in overthinking it now.  Maybe there’d be some new recruits to process.  New recruits.  One of the big reasons he remains sucking wind on this fly-pecked planet. 

He relishes this hot water- he gets it as hot as he can without scalding.  He opens his mouth under the shower head and swishes the rusty tasting water around. In his mind, he’s digging himself out of his life.  He scrubs his skin like he’s got something to get rid of or something to prove.  A man in his eighties enters the showers and acknowledges him in a non-invasive way.  The old man doesn’t try to strike up any sort of conversation with him and, for that small favor, he’s thankful.  He hopes the oldster doesn’t connect him with the MedVan.  The old man’s a rack of bones covered in liver spots. He has a band-aid on his knee that has fallen off and lies partially folded by the drain revealing a yellowed, brownish stain. Theold man makes zero attempts to retrieve it. In his mind, Ralph indicts and sentences him.  ‘I’m a good judge of assholes, because I am one.’  He says this more often than he should.

But, who among a degenerate populace can rightfully indict a doctor-0 after sufficient ablutions and mental negotiations- for doing whatever he needed to do to unwind?  A doctor’s life is stressor-laden.  What’s a little harm in circling a path less traveled looking for a morsel of solace?  Who’s blameless in the hunt for victims with which to enact their longings?   There’ve been some recent crackdowns, highly publicized busts, but this never curtails or eclipses overwhelming need.  He’d been ;pinched before, at Rhodes Park in the Hilltop.  It made a blip in the paper. He laid low for a while. Shifted some things around. Changed his hair style. It’s cool.  He’s learned what not to do, obviously, maybe.  Discretion has become easier for him since the acquisition of the MedVan.   The closed doors are wherever you are- they go wherever you go.  With a fluttering in his solar plexus, he navigates his cross trainers toward his favorite path.  The path that has always yielded the most bittersweet fruit.  The proverbial path less taken.  The path to the Island of Lost Men, by the culvert, the concrete and rebar waterfall.

He spots the figure laying a little off to the side of the path.  No one would rationally choose that spot- or that position- where the sun beats and the pavement fries.  As Ralph approaches the form, he discovers it’s a young man- a sandy blonde in his early to mid-twenties.  He’s got the wasted pallor of a junkie.  Ants crawl from the palm of his left hand up his arm. 

“Kid… hey…” Ralph bends, shaking a shoulder before kneeling beside him.  “KID!”  The kid’s glasses, still on his face, are shattered their wire frames crumpled against the uneven walkway.  Ralph rolls the boy over.  ‘HEY!  SON!  CAN YOU HEAR ME?’  The boy’s eyes roll like they’re detached.  He checks vitals.  Still breathing.  Still has a pulse.   Ralph looks around, the park is empty.  It’s 1:10 p.m.  While he feels like hell, he succeeds in pulling the boy up enough to drag him into the bushes, out of sight, unbuttons the boy’s pants and takes his shoes off. Terrible feet.  He’s got a wheelchair in the MedVan- Naloxone and sterioids.  He should probably call 911 but that’s not something he necessarily wants to get involved in.  Especially if this is an overdose— he’ll take his chances. These are the toughts of a brain coming off of shit. The opioid epidemic necessitates it.  He’s a licensed medical professional.  He’s got it under control.