The Toothpick

            It was a small thing, tiny really, but big enough. It occupied the corner of a chile relleno burrito, a lone sentinel, standing tall, half-buried in salsa.

            I was in a hurry, and hastily cut the corner of the burrito and took a large first bite.  I don’t know if it was just bad luck, being too hungry to chew, or twist of fate, but I felt only the last, hard point of a toothpick before it slid down into my esophagus.

At first, the fact of it did not register. I had been anticipating this moment of peace and lunch so that I might brood a bit, pore over the bony meal of my life and sort it out.

Why, I wondered, was I still here at this university teaching the same things I have taught for thirteen years? And now, why had I suddenly ingested a hard, sharp, little javelin, and what was I to do about the way it lingered there past the edge of my throat?

            What a simple and idiotic thing to do, and, now done, it was apparently irreversible. I felt the toothpick in my throat, too far down to reach. I could not rely on my usual ways of locating it. Sight, sound, manipulation -- all useless. I could feel it instead only through fleshy layers of sensation, like trying to identify a face on the other side of a series of curtains, a Braille set of sensory codes.  I hoped that I was wrong about it being there and methodically but frantically searched my plate.

            What were the odds, I wondered, against a toothpick lining up perfectly with the throat and of passing undetected through the mouth? Minimal.  I had to be imagining.

I had to assess this situation.  I knew I had seen the toothpick in the burrito, so I could assume that I had brought it to the table.  I searched the lettuce, the rest of the plate, picked up and turned over the napkin, looked under the tray, and looked over the faux marble table top for the missing toothpick, but found nothing.

            I began to shake, to sweat, and, for the first time in a long time, to listen to the pounding of my pulse through my ears. It seemed startling that I actually inhabited a body, a movable machine made of fleshy gristle, blood, and gut. In that moment, a world opened up.

            I took stock: I could breathe.  I could swallow. And I wondered what to do next.  Should I stand up, scream, or call 911?  Should I sit and just hope my problem would go away. OK, a plan. I would take my tray to the rack, walk quietly across campus to my office, and call my doctor. As I stood, I felt the sensations again deep in my throat. I pictured the sharp little toothpick with the green plastic ruffles resting askew in the fleshy hose that led to my digestive tract. It was my secret, my burden. I felt utterly alone and vulnerable.

            Every breath came slowly, gratefully past my gullet. Beneath the panic I searched for calm. The fork on the plate jumped into giant relief along with hilarity of my predicament. On the one hand, I was no different from the rest. On the other, I could see things they could not, would not unless they too knew they might be breathing some of their last breaths.

I swung one leg out from my booth, then the other, stood up, grabbed my tray to carry to the rack. No one noticed that I hadn’t taken a second bite, that my plate was complete, soda still full. No one knew that I felt each step strike the floor, that I had to move toward someplace other than here because my dike had burst and the floodwaters of panic were threatening the nation of my body.

In fifteen minutes I was due to present on the merits of exit assessment at the steering committee meeting. I half wondered what they would think if I showed up, gagged in front of them and then collapsed forward onto the table.

I walked holding my neck straight, gait smooth. Thoughts of the meeting receded into a hazy background before disappearing completely. Light and depth to me seemed oddly intensified, visible for the first time. The mundane act of walking felt magical, sacred.  Am I the only one who sees the transience, the vulnerability of living, the gift of walking absentmindedly beneath the sun across a grassy mall on the way to nowhere in particular? I offer up a deal to circumstance.  If I live through this and get more time I will live better, not forget.  I swear.

          Here I am on the sidewalk. Walking is easier than I expected it to be. My throat doesn’t hurt much, but the shock of a sharp point on soft tissue has me shaking with adrenalin. I fairly vibrate along the sidewalk. And the sweat: my armpits are soaked and I can feel rivers converging along my spine; they run down the middle of my back. My heart sends surges of blood that wash through the veins in my ears like incoming surf. With every contraction another wave crashes. I wander quietly through the crowd on high alert swallowing involuntarily.

          I fumble with my keys at the office and enter. I sit for a minute before deciding to call my doctor. I dial the number and get his answering service. I leave a message, hang up, and sit back in my chair, propping my feet up on the desk.

          If I die soon, here at my desk, I think, no one would find me until Monday. I’d miss a meeting, fail to pick up the kids, and would not be there to improve the house. The phone rings.

          “A toothpick?” my doctor says to me after I tell him, “Let me look this up and get back to you.”

I sit again and feel my mouth getting dry as I dab at the sweat on my forehead with a paper towel. The meeting should be starting about now, I say to myself as I look at my watch.

          The phone rings again. “A perforated esophagus can be pretty dangerous. Let’s not take any chances. I want you to get to urgent care as soon as you can,” he says not sounding very convinced. “I’d hate to recommend you stay at work and have something happen,” he continues absent mindedly, justifying playing it safe.

           I hang up and wonder if I will be able to drive. My legs are shaky and my hands tremble as I lock up the office and walk to the car.

           Depressing the clutch, I feel tentative, like I am using too much or too little force and can’t decide which is right. I can barely pilot the vehicle that is my body, I wonder how I will handle a car.

           I ease into traffic and let habit take over. Don’t think, just drive I tell myself as I make my way across town. The only place that takes my insurance is a half-hour drive away. No one seems to notice as I join the others going wherever it is they are going.

           The pain in my throat is stronger now. My body seems to be reacting to it, pushing it out. I wonder if I should call a lawyer, go home and clean out my files, call my dad and make amends. Big questions slide in and out of the freeze frame of my awareness. Have I lived well? Initiate left turn. Left anything undone?           
         Cancel blinker. Is my house in order? Turn down A/C and crack window before getting out of the car. I see that I have wasted a lot time and have not been happy or very awake. I have been sleeping, selfish, and have made many mistakes. I’ve got to remember to wipe that bird shit off the hood next time I have a sponge. I’ve been mad most of my life at things I couldn’t control. I have been more of a pinball than a master of my destiny. Things haven’t gone the ways I wanted. Where is a cheap gas station on the way home?

         My hands are shaking on the steering wheel as I cruise the parking lot of the hospital looking for an empty spot. I find one and pop open the sunshade, slide it into place above the dash, rotate the visors to hold it fast as I realize I have not used my gifts very well or kept many promises.

         It’s now afternoon and the sun is hot. My face must be a little flushed I think as the doors to the waiting room swoosh open, releasing the cool breeze of a large teaching hospital. The triage desk has a clipboard on it where all patients are supposed to sign in. Under the category “Nature of Complaint” I write “toothpick” and then sit down.

        A mother and her two children play with giant plastic blocks in one corner while an old man sleeps, his head back and mouth open. A soap plays mute on the TV to the waiting room audience. I sit along the wall and watch vacantly while I study the foreign sensations in my throat. They seem to have shifted slightly and are further down my gullet.

         The nurse puzzles over my nature of complaint as she inserts a disposable thermometer under my tongue. “So you swallowed a toothpick?” she asks. “Uh Huh,” I say around the thermometer.

         “You have a slight fever,” she said. “That could be a sign of shock,” she says again with a little more concern. “We better get you over to Emergency. Can you wait outside until we call?”

         I return to my seat and monitor my throat. The sensations continue to shift.

         An orderly pushes through a set of swinging doors with a wheel chair, gets directions from the nurse -- who points at me --  and then wheels toward me. He motions me to get in with a little amusement and then takes me over to emergency, where I get stand up to take another seat.

         I can see a nurse behind a desk shuffling papers and looking at me. No one else in the Emergency waiting room, I notice, as I think of P. and wonder how she will handle all this if I am to die here from my small lapse of attention. The sensations continue to shift and I feel them pass close to my heart. I listen closely, aware of the tightness in my chest. I keep breathing until they ask me to come back to an examining room. I walk past a child wrapped in bandages and splints, asleep or drugged. Another orderly directs me to the eye examining room. Charts showing the anatomical structures of the eye stare at me.

        “Why are you here?” a harried looking young doctor asks as he breezes in carrying a clipboard.

        “I swallowed a toothpick.” He doesn’t believe me.

        “Are you sure?”

       “Would I be here if I weren’t sure?” I ask, more than a little irritated. He is unmoved and asks to look down my throat.

        He sees nothing.

        “I could feel it,” I said, “and the triage nurse said I had a fever because of the shock.” I felt this last bit would give me some credibility.

        “You don’t get a fever from swallowing a toothpick,” he said derisively. “And if you swallowed anything that made it to the gut, the gut will take care of it. Why, I’ve seen pins pass through, though it can be tricky at the other end.”

          “I felt something here,” I said pointing to my throat, hoping they might at least look or take an X-ray.

          “I think we’ll just let you sit here for a bit to see if anything happens,” he said before turning quickly away, whispering something to the nurse, and leaving as quickly as he had entered.

           “The doctor wants you to try swallowing some crackers, to see if anything is blocked.”      

            As I listen, the sensation descends from behind my heart to someplace lower. I can’t feel it anymore and feel normal again. I look around the room and hear a baby crying in the distance. An orderly passes the door pushing a cart piled high with freshly washed, stainless steel bedpans.

            It is the end of things where writers are most tempted to lie, and it is here that this account should twist in a way that will both surprise and satisfy and audience. In one scenario, I change my life based on a profound realization that I don’t have much time and begin to do only those things that hold great meaning. Perhaps I quit my job to paint the truth of the great gift that life is or I humbly teach to those who will listen.

            Another, more cynical ending has me forgetting the whole thing and carrying on as before, picking up where I left off, living habitually. I apologize for missing the meeting and double my efforts to define assessment.

            More than any of these, I thank the moment for the brief taste of a focused beam of attention, that fleeting, often scattered light that bounces randomly of the noise and distraction of circumstance. The consequences are often benign but are sometimes as traumatic as a chain-saw that slips and slices flesh to the bone or allows a toothpick to lodge against the soft tissue of the esophagus. I hang onto the laser of attention as long as I can hoping it will linger, illuminating the most mundane details of this crazy blessed gift called life.

            But epiphany is often short lived, and conditioning, thick conditioning, breaks the beam into fragments that ricochet and reflect again off the random tumble of a cascading mind. So the ending lands in a present both rich with possibility and laden with peril.

I decide not to wait for the doctor, and, sliding off the examination table, calmly walk out of the room, into the hall and retrace my steps back to the waiting room.

I will remember, I tell myself. I’ve been to the edge of something and been given a second chance. But even as I say this, the urgency of it begins to fade as the illusory distance between me and brink of mortality lengthens.

            I walk through the waiting room, past the place where a child lies sleeping, through the swinging doors leading to the hot asphalt west of the hospital, the light of a fading afternoon blinding me until I hold a hand, a thick visor, up to shade my gaze.