Excerpts from…

DINGS

A novel by Lance Fogan, M.D.


DINGS is available as print-on-demand at my publisher’s website, BookLocker.com, and at Amazon, Barnes & Noble, the Apple bookstore and at Booksamillion.  In addition, DINGS can be downloaded as an eBook at these sites.


Conner is failing third grade. His mom struggles to support and defend her bright, active son facing recommendations that he drop back to second grade. Because his dad is on a yearlong combat rotation in 2006-7 Iraq, everyone considers anxiety and stress to underlie his lack of school achievement. However, all of the adults in his life fail to recognize his blank-outs. Conner is too immature and inarticulate to understand—much less describe to anyone—the occasional episodes over the past year of confusion associated with unfounded fears, hallucinating foul odors, loss of awareness and infrequent wetting of his pants. Not until he develops a high fever that is associated with a convulsion does he enter into the medical system. At the local E.R., he gets a head CT scan and a spinal tap. His referral to a neurologist results in a diagnosis that shocks his family; it changes all of their lives. It’s epilepsy! Follow them on their clinical and emotional journey in dealing with his illness.


Excerpt from Chapter 1.

The parents are horrified to find their eight-year-old son in the throes of a convulsion in his bed.


…I dropped the phone. “Conner’s room!” We bolted down the hall. The dim moon through his bedroom window showed our little boy jerking and thrashing on his bed. I pushed past my husband. “What’s he doing? Conner, what are you doing?”

Conner growled. It was a drawn-out, high-pitched cry that sounded like something out of a horror movie.

“Turn on the light, Sam! Conner, what’s wrong?”

Our eight-year-old was on his back, his body twisted in the covers. His head, arms and legs trembled and thrashed; he moaned a long, drawn-out groan between clenched teeth. “Conner, honey. What are you doing? Wake up, Conner!”

“Oh, God! He’s having an epileptic convulsion. I’ve seen ’em before, in Iraq. My brother had one as a kid, too.” Sam bent over and grabbed at Conner’s flailing arms.

“What do we do? What should we do?” Red stains were on the pillow and red-tinged froth bubbled out of my son’s mouth.

“His lips are blue! He’s bleeding! He’s dying! Call Dr. Jackson. No! Call nine-one-one! Sam! Call nine-one-one! It’s an emergency. Hurry! Hurry! We have to get him to the hospital!”

“Stay with him!” Sam turned and ran to the telephone in our room. A few seconds later he was back. “Let’s get Conner in the car. We’ll take him ourselves. It’ll be faster. Let’s go!”

“Yes! Okay! Come on!” Conner had stopped thrashing. He unclenched his jaws and released a long, hissing sigh through foamy pink bubbles on his lips. I detected a faint odor—like urine.

“Conner? Conner, we’re taking you to the hospital, honey.” I stroked his damp forehead and pushed strands of light-brown hair away from his closed eyes. The only sound now was the rattle of his deep, noisy breathing and the roar of my throbbing pulse in my ears. I couldn’t tear my eyes away from the bubbles—pink soap-like bubbles frothing between my son’s lips.

“Ohhhh...” I knelt beside the bed and kissed his sweaty forehead over and over. His tiny hand felt cold and clammy in mine, yet only a few minutes ago he had been burning up with fever, coughing and sneezing.

Sam leaned over Conner. I had never seen my husband look so scared. “I’ll change and get some pants and a shirt on. You’d better get dressed, too, Sandra. We might be at the hospital for hours or...” Our eyes locked on each other.

“Yeah, as soon as you get back.” I pressed my lips. “I’m not leaving him alone.” I saw Grandma Audra’s face—my closest relative that I could recall ever dying. I sat down and cradled Connor’s head in my lap. My body rocked back and forth. Thank God he’s breathing. I heard Sam’s dresser drawer squeak and the closet slam.

When he came back, I left Conner to get dressed but I can’t remember doing it—only my shaking hands.

Sam lifted Conner into his arms. “He’s so light, Sandra.” Sam’s eyes glistened. And this was a man who had returned after a year of combat in Iraq less than two months ago. “Bring another blanket—a dry one. We’ve got to wrap him. It’s cold out.” Sam hefted Conner in his arms a couple of times and headed out of the bedroom. Conner’s bloody, red-lipped face flopped and hung down. I reached to steady his head…


Excerpt from Chapter 4.

The E.R. doctor performs a spinal tap to rule out meningitis in the feverish boy who had just suffered a convulsion.


…He injected the local anesthetic. “We’re lucky he’s still postictal; otherwise, we’d have a real fight on our hands,” Dr. Choy said as he looked up at the nurse standing opposite him over Conner. “This local anesthetic burns. It’s usually the most uncomfortable part of the whole procedure, you know.”

He placed the anesthetic syringe down on the tray and picked up the spinal needle. That needle could look a foot long to a patient, but it measured less than four inches. He pushed the sharp tip into the numbed skin, confirmed that his aim was correct and then pressed the needle deeper. It slid smoothly into Conner’s back.

Dr. Choy took a deep breath. No movement, no cries, no moans from his patient. At least I haven’t hit bone yet, he thought.  The doctor pushed the needle deeper until he felt the reassuring “pop” as it penetrated the thick, fibrous ligamentum flavum membrane that enclosed the spinal canal. He pulled out the hollow needle’s stylet. Colorless, clear cerebrospinal fluid immediately dripped out the end of the now-empty, hollow-bored spinal needle. The tension in the doctor’s shoulders dissolved as these welcome first drops fell onto a towel he had placed on the floor for this purpose.

He attached a long, thin measure-marked plastic manometer tube to the end of the needle and watched the colorless fluid climb slowly up the tube. The surface of the fluid undulated up and down slightly with each of Conner’s breaths. The fluid level finally stopped rising at the 140 millimeter mark; the pressure in the cranial cavity and spine was normal.

Samuel Choy mused at the similarities between spinal fluid and seawater as he watched the fluid: both liquids shared the same chemistry. This fact had fascinated him ever since medical school.

And, he recalled his grandmother’s sea stories. Grandma Liu grew up along the Pearl River in southern China. Her pet cormorant was trained to dive for fish for the family to eat and to sell. With her funny laugh and with a gesture of fingers around her throat, she had described how a tight ring around the bird’s throat prevented it from making the fish its own meal. He loved her stories from China.

The nurse broke his reverie from the opposite side of the bed. “If I ever need a spinal tap, Dr. Choy, I want you to do it.” His weak smile masked the pleasure he felt at the compliment.

He removed the manometer and placed a collection tube under the end of the needle. A few drops splashed onto his clogs. “The fluid looks clear. Good. It’s unlikely Conner has an infection,” he said to her. He collected three tubes of spinal fluid for testing. Then he pulled the long spinal needle out of the boy’s back.

“I’ll take the vials down to the laboratory. You won’t need me now, will you?”

“No. I have everything under control here. The orders are written. Go ahead.” He nodded at her, and she left.

Dr. Choy turned Conner onto his belly. He observed a red drop oozing at the puncture site. He wiped it away and washed off the antiseptic solution from the boy’s back with a damp towel warmed under the spout at the nearby sink. Then he dried the skin and placed a Band-Aid over the puncture, retied Conner’s hospital gown and rolled the boy onto his back. “We’re all done, Conner.”

Conner stared up with uncomprehending eyes.

Dr. Choy covered him with the blanket and snapped the bed’s guardrails back into place.


Excerpt from Chapter 13.

Conner’s friend, Michael, witnessed automatic swallowing movements associated with one of Conner’s unrecognized complex partial seizure blank-outs.


…Later, the brownies had cooled and I had poured milk into the children’s glasses. The kids were sitting around the kitchen table. Michael stuffed a thick piece of brownie in his mouth and mumbled, “Conner…mmm…already…mmm…had brownies, Mrs. Golden. He was…mmm…chewing and swallowing them when we were playing. He was acting really weird.”

“I was not!”

“Well, I saw you chewing something, Conner.”

“No I wasn’t.”

“You were, too!”

“Was not!”

They argued back and forth. I had no idea what they were talking about. I studied their faces for a moment and searched for a clue. Conner could not have been eating brownies; I had only just pulled them out of the oven a few minutes ago.

“Conner, you know the rules about eating in the den! What were you eating in there?”

“I wasn’t eating anything, Mom. I promise! I wasn’t.”

Michael coldly stared at him.

Conner pointed to huge chunks of brownie that Madison had dropped on the floor. “I’ll eat those, Mom.”

“No! Mine, Conner! Mine!” Madison yelled.

I bent down to clean the mess. The boys began laughing about something that happened at school. I poured more milk into their glasses.

I had no idea what Michael had been talking about, and their strange argument was soon forgotten.


Excerpt from Chapter 24.

The neurologist’s questions reveal Conner’s epilepsy.


…Dr. O’Rourke turned and addressed his patient. “Conner, have you ever blanked out when you’re thinking about something?”

“Uh, like…what?”

I looked at Conner. Sam did, too. Why did Conner say that? I got this uneasy feeling that Conner somehow understood what the doctor was hinting at. Sam’s mouth dropped open. He looked at me; his eyes narrowed.

The neurologist cleared his throat and leaned forward over his desk. “I mean, let’s say that you’re thinking about something, or watching a movie or a TV program, or someone is talking to you. Does it ever seem as though you suddenly missed what was happening? Like your mind went blank all of a sudden. I don’t mean daydreaming; everybody does that. When you daydream, your mind is still thinking of something—like you zone out—but you know it. Let’s say something is important to you and you are really paying attention.”

Dr. O’Rourke stole a quick glance at Sam and me. Then he looked back at Conner and continued, “And then, all of a sudden, the scene in the movie or on the TV screen has changed, and—” He clapped his hands once. “Suddenly you don’t know what happened, even though you were following the story really closely. Has that ever happened to you?”

Conner leaned forward in his chair and dug his fingers hard into the edge of the doctor’s desk. I saw white at their tips. “Well, um, sometimes I get these, uh…you know, I get this funny, this ding feeling. I don’t know, I—I—and then something else has happened and I don’t know what.”

What? Sam and I looked at each other. Our jaws fell open.

My body tightened and my voice was loud. “What do you mean, Conner? What ding feeling? What are you saying? When does this happen?”

He turned toward me. “A lot. When it happens at school Mrs. Dorsey gets mad at me.”

“Mrs. Dorsey gets mad at you? What do you mean? Why? What happens?” I grabbed his arm.

I looked at Dr. O’Rourke. He sucked in his cheeks and his lips pursed as he slowly nodded his head one time. His eyes moved down to my hand that gripped Conner’s arm. Otherwise, he maintained a placid expression as he watched us.

“She asks me if I…um…if, uh…I need more time to do my tests. Like that spelling test. She said I needed more time…um…to finish.”

“Did you finish? Did you need more time? Which was it?”

“I—I don’t know. I don’t know!” Conner’s chin quivered.

Dr. O’Rourke picked up his pencil and held it poised over his notepad. “What you’re telling us is very helpful, Conner.”

I released Conner’s arm and leaned back in my chair. As my legs straightened, my shoes kicked the bottom of the neurologist’s desk. What was he saying? None of this made sense.

Dr. O’Rourke licked his lower lip. “How often does this happen, Conner? This ding?”

Conner shrugged. “I dunno…I dunno. I don’t!”

“Well, what would you say? Does it happen every day? Does it happen every few days, or every few weeks or months?”

“I dunno. A couple of times, I guess.”

“Did it happen today?”

“No.” Conner sniffled.

“Did it happen yesterday, Conner?”

“No.”

“Does it happen a lot?”

 “It doesn’t happen every day…I think.” He shuddered and hiccupped back a sob. He looked at me. Tears started to roll down his cheeks. His chin trembled. When I leaned over to wrap my arm around his shoulders he sobbed louder. “I’m scared. I’m scared, Mom.” He wiped his cheek with his sleeve.

I stared out and couldn’t move for a moment. I was in slow motion. Everything was in slow motion. I took some tissues out from my pocket and began to wipe his tears. My ice-cold hand shook. “Don’t be scared, honey. You’re doing fine.”

My gaze darted between Conner and the doctor. Sam stared at our son; his cheek muscles rippled.

“Yes, you are doing just fine, Conner. This is very good, very helpful.” Dr. O’Rourke kept his gaze fixed on his patient. “Now, do you ever imagine that you smell something that’s not really there, that nobody else can smell? Do you ever get a taste that just came into your mouth without eating anything?”

Conner gave a tiny nod.

“Is it a smell or a taste, Conner?”

 “I think I smell something…um, uh…but I don’t know what it is.”

“Well, is it like something bad, Conner? Like, burning rubber? Something like that?”

“Yeah!” Conner’s face brightened. He nodded vigorously. “That’s it! That’s what it is. It smells like the things Daddy burns in the yard at work.” Animated now, he scrunched up his nose and his body rocked back and forth, as he nodded. “It’s gross,” he added.

I couldn’t believe what I had heard. I looked at Sam. What was Conner talking about? Why had he hidden this?

The neurologist continued, “And then what happens, Conner?”

“I don’t know!” Conner wiped his nose on the cuff of his shirtsleeve.

Dr. O’Rourke turned to me. “Have you ever witnessed one of his ding spells? Have you talked with his teacher about them?”

“I don’t even know what Conner is talking about. I’ve never seen anything like that!” I looked at Sam. “Have you? He’s never said anything about them to me.”