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I’ll walk you to your car

My first practice was in a tough neighbourhood. Now rapidly gentrifying with many fancy restaurants and condos, it was a place where many of the inhabitants were on welfare, and a good number were involved in crime.

In those days, I was a bit of a naïve young woman, my French was not fluent, and in my English grade school, I had certainly never learned the distinctive dialect of St. Henri. For my first six months, I came home every day with a giant headache from trying to understand what was being said to me. Then, slowly the language seeped into my brain. I began to understand the complicated lives of my patients more and more.

The convenience store owner was robbed so many times that he now kept a revolver under the cash. There were sex workers who came monthly for their STI checks. They were often in the same waiting room as the nuns who lived in the convent across the street from the brothel. Both groups of women would eye each other with suspicion. Arlette, one of my patients, once told me a story about a fight she had with her husband, “I hope my Dad doesn’t find out. He’ll kill him!” she said.

“Well, maybe it would be an idea if he gave your husband a good talking to,” I said.

“Dr. Perle, you don’t understand who my father is,” she said, naming a Montreal mobster so prominent that even I had heard about him. “The least that will happen is that he’ll knee-cap him! I don’t want to be a widow!”

Then there was Réjean. He had a lined, anxious face and slicked back patent leather black hair. He wore tight jeans, motorcycle boots and had a cigarette pack twisted up in the sleeve of his T-shirt. He looked like a combination between early Mississippi and late Las Vegas Elvis.

He was worried. He was convinced that he had heart disease. Whenever he drank, which was often, he would go to the ER with searing, burning chest pain. When they would tell him that his heart was OK, Réjean would bust up the place, causing such havoc that the police would be called, and he would spend the night in the drunk tank.

Réjean lived with his three sons. Two were adults, and the youngest was a pale, sad-eyed boy who clung to his Dad whenever he came with him to the office. “His mother, she’s no good,” Réjean told me, miming sticking a needle in his arm. “It’s just me that has him.”

After a time, I learned that Réjean and his older sons worked for Arlette’s father as enforcers and that he was connected with the Hell’s Angels. But somehow, to me, in my naiveté, he was a sad, anxious man trying to do his best for his family. A social worker following the youngest son called me once to make sure that the boy was seeing a doctor and that Réjean was sending him to school. She did her best to disabuse me of that fantasy. “You have no idea what is going on in that house!”

His reflux was getting worse and worse. He never took Tums and found antacids unhelpful. He was vomiting coffee grounds and sometimes blood. I was beginning to think that he would need stomach surgery. Then I heard of a new miracle drug called Cimetidine! It was a highly effective medication for ulcer disease and reflux. To get it, he needed to have a gastroscopy and have it prescribed by a Gastroenterologist. It is hard to imagine this in the present day when PPIs are handed out like holy water. So I called my favourite GI specialist and begged for his help. “He’s really not doing well,” I said. “Could you please see and scope him soon?” The GI agreed, and after the date he missed, because he was in jail for beating up a cop, he was placed on an H2 blocker and began to do better. His pain improved. He was drinking a bit less and was better able to keep food down. He was very pleased with my care.

One evening, I was just finishing up my late clinic when Réjean walked in. He was pacing around the waiting room, and my secretary called me out of my office to see him. “Are you finished yet?” he demanded.

“Almost,” I said, “but what do you care?”

“Hurry up,” he growled. I rolled my eyes and finished my last patient.

“I’ll walk you to your car,” he said.

“Excuse me?” I replied.

“Either you let me walk you to your car, or I will bring it here!” he insisted. “I don’t need keys for that little shit box you drive!”

Deciding that letting him walk me to my car was preferable to him breaking in and hotwiring it, he walked me down the street. Then, I drove home, wondering what was bugging him.

The following day I found out that there had been a street battle between the Hells Angels and the Rock Machine. It had happened about half an hour after I left.

I was grateful.