Side Effects

By Chris Kassel
In five years, David Lieberwitz had never once missed a day of work. Anywhere. Didn't matter; he'd limped through shifts with fevers well into three digits, with ripped tendons, fractured bones, pulled muscles, infected eyeball membranes, savagely incapacitating influenzas, bronchitises; he'd shown up grieved, bereaved, drunk, hung-over, high on acid... bosses had wondered if he'd take a day off for his own funeral.... it was little enough to be proud of, of course, but there was no one to nurse him or lay guilt trips on him inside the flat, and nothing much on TV... so an hourly pogue on a budget might just as well gut it out... That was his philosophy.  Be a man. Bite the bullet. Until Monday.

By four forty on Monday afternoon, twenty minutes before his shift was supposed to start, he was curled into the tiny space beneath the cluttered counter in his kitchenette, wailing in fitful, infantile spurts, trying to lift his head out of the half-inch of perspiration which his pores had produced since he'd last been able to function. His floor looked like a pipe had burst beneath the sink.  He was congested to the point where a garage-worth of cinder blocks might have been piled on top of his chest; moments before, he had hacked out a thick mucous plug, which throbbed and contracted like a tormented snail a few feet away from his face. Pink wheals were spreading across his back, down to his buttocks, as tenacious as kudzu.  He was shivering like a wino with Parkinson's disease, which is why he had wedged himself beneath the counter in the first place. The uncontrollable body movement, when he pressed himself against the peeling Wal-Mart lamination, offered some relief from the itching.

Showing up for work would clearly be an obstacle. But one he intended, as always, to overcome. He took the first step. With a Herculean grunt, he rolled to the phone, managed to knock the receiver off the hook, and in several attempts, hammered out the 800 number on the Lanolyte bottle, which, he noted in disgust, bore no advisories as to mucous plugs and muscle spasms.

To his surprise, Mrs. Doosenberry answered the telephone, and on the very first ring.  "Of course it's me again, you silly goose." 

What were the odds of that?  "David," she confided gently.  "I'm it. The only operator ever on duty; the sole FDA advisor for consumer products in the United States. Perfect job for a widowed retiree with four grandchildren and a parakeet, don't you think? I work out of a two-bedroom bungalow in upstate New York, near Buffalo. Overworked?  Come on, dear, be realistic.  How many people... no offense intended... do you honestly think call a phone number on the back label of diarrhea medicine?  Or shampoo?  Or toothpaste?  I log a call about every six weeks, and usually, it's some pervert with insomnia. Again, no offense intended." 

None taken. Actually, David dredged up enough positive delight to briefly counteract his symptoms.  Which he then proceeded to describe in technicolor.

There was a faint, electronic clicking from Mrs. Doosenberry's computer. She went on:  "I've taken the liberty to initiate a profile on you, David Lieberwitz, tracking your current roster of medications and cosmetics, and calculating the possible adverse reactions you might expect.  While it's not part of the job, mind you, it's a little service I've worked up which comes in mighty handy when a concerned consumer such as yourself develops unanticipated side effects related to a specific agent, or to any combination of agents.  Understand, of course, that it's a useless exercise unless you are perfectly candid with me related to your product intake. Perfectly candid.  You must answer my questions honestly.  Remember; I'm here not to judge, but to advise. Without specific and truthful details, including ingestion quantities and specific SOBs... strength-of-brands... forgive the shop-talk... my cross-reference is useless.  It's the minor interactions that carry the punch, you understand?.  Remember the story of the flapping butterfly in Brazil causing a tidal wave in Borneo...?

The furious onset of a Richter-scale gut cramp doubled him up. A thin stream of projectile vomit spattered against the seepy wall, scurrying the roaches. "Help me..." he moaned. 

"Of course I'll help you, David.  But first, you must help yourself.  Okay, you took some Lanolyte, more than the recommended dosage, I'll bet. That alone was unwise, what with the beer and the Tectirol; understand, mixing alcohol and vermonyl with phenylpropagelanine puts approximately fifty percent of the male population at risk ten percent of the time. This particular combination decreases the blood's ability to clot normally, and can interfere with the kidneys ability to produce uric acid.  Obviously, you lucked out this time.  Next time, who knows?  Not to belabor a point; if you would have had the insight to ask my opinion, I'd have told you that the best thing going for your case of the Hershey squirts is Co-Phate II, which is totally phenylpropagelanine-free.  You don't need all those electrolytes anyway..."

Mrs. Doosenberry's voice was almost mesmerizing. David grew faint, fixing his gaze straight ahead.  As he watched, the watery wall stain grew fuzzy and multiplied.  In fact, the whole room did.  He retched again.

"Now, bleeding and urinating are not your problems," continued Mrs. Doosenberry.  "Cramping, sweating, and nausea are your problems. Coupled with body tremors, correct?  According to the spreadsheet, that reaction may be induced by a number of products, but especially by Prölong-12 Mentholated Throat Lozenges.  David, do come clean now.  Have you been popping Prölong-12s?"

"No.  I... swear it."

"That's strange. No mentholated lozenges at all?  You haven't noticed any blurred or double vision, have you?  You never mentioned..."

"Yes!" he cried.  "I can see four blurry pukes right now..."

"David..." she said, adopting a quiet, but scolding tone.  "David, David, David.  Naughty boy... you're a smoker aren't you?"

"Sometimes.  But not too much, Mrs. Doosenberry.  Only when I drink beer or take a dump..."

"I should have guessed.  What brand do you smoke?  Wait, don't tell me. Kool Mild..."

"Marlboro Green."

"Same difference.  It's the menthol that got to you.  Mr. Doosenberry too, God rest him. Angelosante's Disease... that's chronic pulmonemia brought on by flavored tobacco snuff... it took him out in 1986, same day as the space shuttle blew a gasket...  But that's another story.  Here's yours, David: Menthol is formed of a specific amino acid chain that breaks when it contacts both rhyphenoxylate and xatrophine simultaneously, resulting in a number of chemicals whose names I wouldn't even try to pronounce... suffice to say that one of their molecular structures is similar to peptic cholera... non-lethal peptic cholera, of course...  and your symptoms are a mimicry of that.  Fortunately, the worst of it is probably behind you."  She chuckled merrily at her own pun. "For now, a teaspoon of Arm & Hammer baking soda stirred into any commercial cola should neutralize the amino acids enough to get you on your feet and down to a pharmacy.  Some symptoms will persist for a day or two; here's what I would do if I were you:  For the nausea, try Nodyltone, but don't exceed 50 milligrams in four hours.  If you can't live with the body tremors, get some Chlor-Olfatron, which contains a mild levadopa... used to treat delerium tremens... but which may cause heart palpitations or offensive anal odors if inhaled excessively or used in conjunction with selenium sulfide shampoos. So, be careful.  Oh, if you choose to go with the Chlor-Olfatron, and if you should miss a dose, skip the missed dose and resume your regular schedule.  Never 'double up'. Co-Phate for the runs, of course, and as for the excessive sweating, personally I'm still big on Dri-Zine Aerosol..."

"Aerosol...?"  he countered, weakly. " Are you sure?  Isn't that bad for the environment?"

"Oh, the environment will be just fine, David, like always.  That fluorocarbon versus ozone layer myth was propagated by Democrats with an agenda.  Dri-Zine is less an environmental threat than cow flatulence. Don't, however, be alarmed by Dri-Zine's cyoantrylic agents, which may cause temporary sexual dysfunction..."

"You're kidding...!?"

"Temporary, David; meaning a week or less.  And only in about 2% of any given healthy user.  Any time you're dealing with cyoantrylics, the libido may be diminished; hence, its recommendation by the Federal Penal system and the U.S. Army.  Not the end of the world, David; trust me.  Anyway, that's why God invented Viagra."

"What about the itching?" he replied, petulantly.

"Itching?  What itching?  You never mentioned any itching."

"Well, it didn't seem... Anyway, my..  you know, my... my butt itches like hell."

"Hmmm..."  A cyber whir, and the tick-ticking of Mrs. Doosenberry's able fingers.  "That ups the ante. You've told me everything?  Everything?   Say! You don't have a hamster, do you?"

"No hamster."

"Well, then; I'm stumped.  Unless..."

"Unless...?"

"Oh, excess sweating may foster the growth of fungal spores.  Jock itch, you know, or athlete's foot.   Possibly, you may have contracted ringworm as well.  Safe and simple solution, based on your drug matrix, is aluminum sulfate. You've got a choice: Maxi-Strength AluGel, which contains alcohol for drying, or Seccoderm. But no more cigarettes, David; that's a prescription for disaster.  Bye, now."

She was gone, her voice swallowed by electromagnetic fog.  David held the receiver as his vision slowly cleared.  He glanced at the clock. Five to five.  Baking soda and Royal Crown, huh?  Cakewalk.  He might make it yet. In style, too, since he recalled having stocked the Ivanhoe shelves with both AluGel and Seccoderm.

**

Two months later, Tawni bumped into him in the Oxford hallway, as she was busy throwing the deadbolt to No. 18... she always threw the deadbolt exactly twenty-four times; a touch of ODC.  It was nine o'clock in the evening; she was maximum vamped, from her curly gold Donita Jones fingernails to her size thirteen pumps. 

David was exiting his own flat.  Tawni didn't recognize him.  He had a jaunty step; his hair looked full, thick, and blow-dried; he was fit and forty pounds trimmer, like he'd been hitting a gym; his complexion was toned, bronzed, and crystal-clear; his eyes filled with the lusty gleam of a healthy, horny manchild.

"Baby?  Who are you, and what y'all done with that fey bubba, David Lieberwitz?"

David did a deadpan run-way whirl for the full effect.   He was wearing a Paul Smith London wool suit and a stretch moleskin peacoat; he looked like he just stepped down from the showroom window at Brooks Brothers.

"Boyfriend, y'all looking so-o-o  fine...  Y'all got a fish on the hook tonight, or what?"

"A what?"

"A fish.. a woman... A...  Never mind.  You got a date?"

David nodded with shy self-satisfaction.  "You know Laquenda Murrow, from the market?"

"Laquenda Murrow?  Honey, Laquenda's my niece."  She conjured up Laquenda's image; an anorexic, fifteen-year-old, braindead Jada Pinkett wannabe with tacky green contact lenses.

"Me and her's going out tonight," David crowed.  "See, the sand nig... see, my asshole bosses finally promoted me to the produce aisle week, so I do dayshift, now.  Got me a real life."

"Man, I tell you what you got... you got it going on..."  She retracted the dead bolt all the way... she'd lost count, anyhow... and pushed at the door to No. 18.  "Come on in a sec, I want Gran'mama to see this!  Child; that is if her pacemaker can handle it!"

David grinned, nodded, and passed over the tiny threshold of No. 18; the first Oxford apartment he'd ever entered beside his own.  Amazing what a sense of self-respect could do for an interior, he thought.  His, no doubt, could use a makeover.  Tawni's apartment exuded love and tranquility; gospel music was leaking softly from the stereo, and the inner sanctum was all houseplants and pictures of Jesus.  Scrumptious scents wafted over him; oxtail soup and herbal tea.  He sniffed eagerly.

"Y'all want some tea, David?  Gran'mama swears by it; she brews it herself outta powdered corn silk from her brother in Kentucky."

"Mize well," said David.  "Seeing as I don't drink beer no more.  Beer's bad for your liver.  Plus, studies indicate that it can cause ankylosing spondylitis when mixed with the CBC inhibitors in Keen Antimicrobial mouthwash..."

"Beg your pardon?"

"This gargle I been using.  Called Keen.  Mrs. Doosenberry recommends it. You oughta try it.  More'n ten million bacteria in every drop of human saliva, dude. Swear to God. Mrs. Doosenberry told me..." David stood in the doorway to the kitchenette as Tawni poured the tea. He jerked a thumb toward the plastic soap dish. "You know what else she told me?  ...you leave your soap like that, all wet and shit with dish water?  You support the growth of bacteria, including microbial pathogens like Homococcus and Pseudomonas..."

"Say what?"

Gran'mama padded in from the radio room, wearing a size eighteen floral nightgown, looking somewhat glassy-eyed. She surveyed David with the squinty, suspicious glare of a projects survivor.  "Who you say that is, Lamarr?"

Lamarr was Tawni's real name. "Said it twice, Gran'mama; now, doll, pay attention."  Tawni gently touched Gran'mama's shoulder, steering her head in the right direction.   "Tonight, that ain't nothing but  hottest show in the city.  No, it ain't Rudolph Valentino; guess again.  That's David Lieberwitz, from across the hall."

Gran'mama pushed out her lower lip and scowled.  She looked like a cross between a pit bull a Jacques Cousteu mini-sub. "That fat, drunken honky in No. 16?  That retarded white-trash bagboy who's always bugging Emmy's gal Laquenda?  I don't believe you!"  

Any broader, David's smile would have hurt.  His teeth shone like gems... Oramint dentifrice and TuskLuster enamel buff... and he excused himself, somewhat grandly, so as not to be late for his tryst.

**

Twenty-four hours later, sashaying down the hallway, Tawni caught wind of a fierce odor emanating from David's flat.  Denial and Rive Gauche might get you past a backed-up drain, but this stench wanted attention.  Now.  It smelled like a Mexican slaughterhouse in mid-July. David's deadbolt wasn't in place; in fact, the door was partially open.

Tawni nudged it the rest of the way with the tip of her Dolce & Gabbana sandal.  The stink redoubled and smacked her in the face so hard it curdled her lip-liner. John Wayne Gacy's crawlspace couldn't have smelled that bad. If she hadn't seen David the previous night, she would have suspected that he'd been moldering inside his flat all month, like poor Mr. McGinty; a suicide on her block when she was a little boy.

But there was David, slumped into the polluted corduroy sofa, whining imprecations in staccato, throaty gasps.  At least, she surmised it was David; he was wearing an Ivanhoe apron which read 'Assistant Produce Manager Trainee' on the bib.  His body was swollen beyond recognition, big as a Lawnboy tractor; his face was a macerated mass of whitish, soggy tissue, and his hairless head resembled the smooth, discolored cap of a necrotic wood fungus. Draining, threadlike gashes crisscrossed his exposed arms; his eyes had shrunken into wads of bloated facial skin and looked like a puckered pair of anuses dumping out festoons of canary-yellow pus.  His mouth and chin glittered with a similar, festering discharge that was sluicing from his sinuses. The cushions beneath him were slick with rank-smelling bodily fluids which erupted at intervals, in sullen burps.

Vomit caught in her throat.  She was almost pleased; she didn't realize that she had any gag reflexes left.

David had seen her, and was pointing awkwardly but urgently toward a coffee table. His hand was thick and formless; it appeared that his fingers had melded together into a greasy, conical clump.  The table surface was littered with bottles, tubes, tablets, jars, childproof containers, phials, capsules, ointments covering every range of ailment, malady, and indisposition known to modern hypochondria: Precyse Medicated Mist, Dri-Zine Aerosol, Sktrach-Not Topical Balm with Amylbutocin, Keen mouthwash, Liquidex Rootbeer Flavored Diet Plan, Lytzzz-Out Sleep Aid with PPH, Dr. Pran's Fistula-B-Gone, Co-Phate, Co-Phate Plus, Maximum Strength Co-Phate Plus with Oxyphylosulfactamide, Sorbatine Benzohydroxocycaline Gyrocaps, Trantralac Undiluted Cough Calmer with Effervescent Elixodyne Pain Relief... 

For a moment, Tawni thought that David was prescribing; he appeared to be urging her toward a roll of Gripp-4 lozenges, which was used to control nausea.  But, he was pointing at a telephone with an 800 number scrawled on a scratch-paper, moaning, "Myrnax...  Myrnax..."

Tawni paced the room, wringing one hand, holding her nose with the other. "Honey, you don't need any Myrnax, believe me; you need to drag your drug-taking ass down to the clinic..."

A low roar arose from deep, desperate wells within his thorax.  He gurgled and gacked out the contents of his esophagus, then spoke:  "Oh God... I can't make it to any clinic!  I can't move.  I've got such a migraine, my head feels like it's splitting open."  Literally, it was.  A slow ooze of rancid juice dribbled from a rent which was forming in his forehead.  "I can't dial the phone...  You gotta help me.  Call Mrs. Doosenberry..."

"Mrs. Whosenberry?  Sugar, you don't need no Mrs. Nobody; I'm calling 911..."

"No!" he bellowed, with all the passion of which a human voice is capable. "They can't do shit for me, 'cept maybe make me worse by giving me some prescription crap that won't interact right with all the OTC's..."

"The OT...?"

"Look at me!" he shrieked.  "This all happened in the last few hours, after I got home from work.  One second, I was fine.  Next, everything started letting go..."  A pinkish wreath of steam belched from his split brow.  The sheer force of his howling caused several loose incisors to drop from his mouth like bloody, over-ripe mulberries.  "You gotta get Mrs. Doosenberry on the phone," he lisped.  "That's the number. She'll know what I should take. But first, I gotta come clean with her... I gotta 'fess up... I never told her about the Myrnax!" 

For all her pluses, Tawni was not one for crisis management.  She didn't 'do' blood, she didn't change diapers, and in a medical emergency, she was prepared to let anyone take charge, even the victim.  Hastily, clumsily, she punched out the 800 number with her curling gold ad-ons.

Mrs. Doosenberry's mellifluous voice responded at a single ring; as was her routine, she asked for the specific drug about which the caller had a question.

"Oh, it ain't me I'm calling for," Tawni cried hysterically. "Miss Tawni don't never put nothing from the medicine cabinet into her holy temple, 'cept for Hysmarin..."

"Hysmarin, eh?" replied Mrs. Doosenberry sharply.  "That's a very potent hormone, sir.  No concern for the side effects?  You should be! Bradycardia, iron-deficiency anemia, hypertension, bronchospasms, tinnitus, esophageal reflux..."

"Never mind, honey; you shoot estrogen because of the side effects..."

David's voice was growing weaker and more pathetic. "Myrnax...  Myrnax.... Tell Mrs. Doosenberry 'bout me and the Myrnax..."

"Look," said Tawni into the phone,  "I'm from across the hall.  I'm over here in No. 16, David Lieberwitz place..."

"Oh, David!  He's a sweetheart, isn't he? A nice Jewish boy, that's what Mother used to say.  I haven't heard from David in a coon's age... almost nine hours... How is he?"

"Not so motherfucking good, miss, if y'all forgive the ebonics.  Something's happening to him...  he's... falling apart!"

"No reason to panic, dear.  Just describe Mr. Lieberwitz's symptoms, and we'll find something on the shelves to put him right..."

"Symptoms?  Uh..."  Crinkling her nose, bending a bit closer, Tawni replied, "Lord almighty... it's like his head's blowed up to the size of a disco ball; there's a big crack down the middle of his forehead, and it's jacking out some kind of nasty goo...  Oh, Jesus H. Christ!  Something just fell out of his head and rolled behind the cushions."  She winced, glancing at down her sandal.  "And there's this funky dooky all over the floor..."

"What color's the dooky?"

"Color??  Some kinda... puce, I guess.  No... more like a mauve."

"Hmmm.  Bloody stool... A very severe allergic reaction, no doubt...  Any mucous discharge from the glands or fistula formation between the bowel and bladder?"

"...Myrnax..." groaned David.

"...any denuded flesh, draining sores, loss of nerve coordination, shortness of breath, drowsiness, disoriention as to time and space?"

"Yeah, all that shit..."

"Does the vomitus contained gastric juices or the fecal contents of the ileum...?"

Desperately, David raised a clumsy, suppurating limb. "Just tell her about the goddamned Myrnax," he croaked. "It's gotta go into my side-effects matrix before she can say what product can help me..."

Tawni didn't have a clue as to what he was talking about.  "Lady," he interrupted.  "David says to tell you he's been using Myrnax!"

"Come again?" replied Mrs. Doosenberry, momentarily silenced.  "Myrnax, the hair restorer?  Impossible, that was taken off the market years ago...  You must have misunderstood him.  Anyway, as I was saying, is the poor soul showing any signs of obvious psychiatric disturbances, petit mal epilepsy, seborrhea, gastrointensinal upset, noncancerous but festering liver tumors, pulmonary embolism, digital gangrene...?"

Tawni covered the voice part of the receiver.  "She says you can't buy no more Myrnax, honey..."

Mrs. Doosenberry went on.  "...scaling, rupturing nodules, large, flaccid scrotal erosions...?"

The cleft in David's skull was widening, and as Tawni watched, the living bone began to decompose in spasmodic shudders.  Brownish secretions were spewing from small lesions in his brow, making his head look like a molasses sprinkler.  His voice was clearly failing.  "At Ivanhoe... We stock it; goddamned boss buys recalled product, ten cents on the dollar..."

"...skin legions, conspicuous ulcers, patches of vitiligo, elevated or diminished calcium levels...?"

"It's Myrnax, all right, girl", Tawni howled into the phone.  "He's buying it close-out at Ivanhoe..."

"Oh, my.  My, My.  Black market...?"

"Naw, Chaldean.  So fucking what?  You mean to tell me the Myrnax is doing this to him? "

"Not at all, sir. Myrnax was a consumer fraud; it was taken off the market because it was utterly useless; the active ingredient was Di-hydrogen monoxide." She chuckled conspiratorially. "Water!"

Tawni was not up to the joke.  For one thing, it was over her head; for another, David's head was imploding into his shoulder blades.  She gaped in horror.

Mrs. Doosenberry continued: "No, Myrnax on the scalp is as safe as a squirt of Absopure.  And about as effective. David's condition is symptomatic of a total breakdown of the delicate balance we'd established within his personalized drug portfolio. You understand, the series of medications he was ingesting each can produce specific, identifiable adverse reactions, so we'd built up a menu of OTCs... over-the-counters, sorry; it's shop-talk... each remedy curing a specific side effect, forming a delicate, but perfectly symmetrical pharmaceutical circle, until he was not only perfectly healthy, but side-effect free!"

"Strangely," Mrs. Doosenberry frowned, "my database indicates that the only known chemical capable of upsetting this particular equilibrium is propoxychlorothiazine flumethicone, which is not contained in any currently available, or, for that matter, any obsolete OTC medication.  In fact, it occurs naturally only in Peruvian bat guano and hybrid Kentucky corn silk. No matter. You see, unfortunately, there's nothing available to help the poor dear. Nothing at all.  Alas, these are the days I dread as a professional.  According to my calculations, David will completely metastasize into side effects within half an hour. Meantime, try to make him comfortable... for the spastic rectum, try a spoonful of Co-Phate Plus... for the de-ossification, Might-E-Bone, but use the quick-acting tablets, not the gelcaps... for the digital gangrene and decaying gums, try..."

Her voice faded into high-frequency static, but it didn't matter.  Nobody was listening. Miss Tawni had fled the room, leaving the receiver dangling, and David had disintegrated into the sofa.