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A piercing sound shakes through my head, my eyes open, and I'm in that weird place between sleep and awake. I see Al sitting on my chest staring at me.

Fuck, the dreams were back.

I went to the bathroom, thought I was going to get sick, and held it off. It was a shitty way to wake up and I had thought these things had gone away. Awhile back I got involved in some violent shit and though I didn't really think it bothered me much during the day, I'd get these really fucked up dreams at night. It made sleep unpleasant and something I think I unconsciously avoided, which ironically, made the nightmares more likely to happen. The self-prescribed medication in the white bottle with the brown label slowed them, but didn't prevent them. Stress brought them on, but I wasn't entirely sure what I was stressed about.

Regardless, I was up and the day had started, so I made some coffee and tried to get normal. The headache had dulled, which was the only bright spot of the morning so far, that is, until Al started to object to the birds flying around outside The Blue. This offended him to his core and he wanted the sparrows to understand his objection. The sparrows seemed to take a special joy in pissing Al off and continued to flit around the window. Al balanced between the top of a set of shelves and the back of chair and in terms of equilibrium Al was no Alvin Ailey. One particular sparrow must've given Al the finger or the wing or something because Al growled and then let out this long baritone bay. The sparrows didn't like the baying and flew away, which brought Al back to barking. It also changed his body position abruptly and the chair tipped over sending him ass-overtea-kettle to the carpet. He did a quick body roll, righted himself, and did that tornado basset move to clear the accumulated slobber from his jowls. Then he lay down and started to snore. With Al's morning exercise regimen complete and the noise reduced to his wood sawing impersonation, I was able to call the hospital. It was only 7:45 a.m., but I wanted to find out about Karl.

"Crawford Medical Center, How may I direct your call," The operator said. At first I was glad not to get an automated system with a menu longer than the Chinese take out place around the corner.

"Yes, I'm calling about a patient. His name is-"

"I'll transfer you to Family Services." The phone began to ring. And ring. And ring.

"Family Services, Michele speaking, how may I direct your call?" The younger but, no more friendly, voice said.

"I wanted to find out about a patient admitted-"

"Hold on. I'll transfer you."

I never had time to object.

"Crawford Medical Center, how may I direct your call?" The first woman said.

"I just spoke to you and you transferred me and now they transferred me back," I said.

"How may I direct your call?" She said.

"I just want to find out about a patient."

"Hold on I'll transfer you," and she did before I could scream.

I decided it would be best if I showed up there in person, which would make me late for work, but I could couch it in the fact I was visiting a client. The Michelin Woman would smirk about something, but I had become immune to her bitching at me.

Besides, I always welcomed an excuse to go to the medical center, because it gave me a chance to visit Doctor Rudy. Rudy was my landlord, well, sort of my landlord. An uncle of his died and left him the Airstream trailer I now call home. Rudy had no use for it and gave it to me. I knew Rudy because he worked the fights for the state boxing commission and we kind of hit it off. He wasn't your typical country club doctor-he was a regular guy.

At the hospital I stopped by Rudy's office before I went anywhere else. He had a small space in the office building adjacent to the hospital. When I came through his door, there he was like he always, hunched over his computer, next to a half eaten toasted coconut donut, and sweating. Rudy always sweated.

"Internet porn, again, Rude?" I said by way of greeting.

"Oh good. I was hoping someone would stop by today and borrow money, get me in trouble, or ask me to do something illegal," Rudy said without looking up from the monitor. He did push up the glasses that had slid down his nose. He had deep pit stains soaking through his shirt even though the air conditioning seemed to be at around forty degrees.

"What are you doing?"

"It's called work, kid. You oughta try it sometime."

"That's just plain hurtful. I thought you took the hippocrapical oath or something."

"Kid, let's get it over with. What do you want?"

"One of the guys got rolled in the park and I came to see him. Can you tell me what room he's in?"

"I'm glad I got a half million dollars in medical school loans. It qualifies me to be Duffy Dombrowski's personal receptionist," he said. "Give me the name."

"Karl Greene."

Rudy got out of whatever screen he was in and shifted to another. He exhaled heavily and muttered a few 'Come ons' to the slow hard drive.

"He left AMA," Rudy said when he found the name.

"What's that mean?" I said.

"Against Medical Advice. He split even though we told him not to."

" Hmm…"

"Look kid, I love you to death and would love to chat with you all morning but can I get back to work?"

"Yeah…sure."

Rudy turned toward the computer and exhaled again. I stood there thinking.

Rudy stopped typing for a second and turned toward me again.

"Hey, kid, I almost forgot. Do you know any fancy caterers?

I mean who does the clinic use when they got a big deal fundraiser?"

"Caterer? What's going on, you stepping up from Dom's Sub World?"

"Well, sort of. Marie and I have been talking, and I want to throw a shindig at the house. I'm having a pool put in too," Rudy said in a different tone. Marie was Rudy's one that got away. She didn't like Rudy's devotion to the medical profession and tendency to overwork.

"Well, well, well…" I said.

"Well, well, well up your ass." Rudy spun around to the monitor again. I took it that he didn't want to take shit for Marie.

"I'll ask at the clinic," I said.

"Yeah, great," he said without turning around. I headed out.

It was after ten when I got to the clinic. The Michelin Woman stood in the reception area hanging up a poster from the state about training on compulsive Internet porn addiction.

"You're more than an hour late, Duffy," She said, making sure the poster hung straight.

"I was at the medical center checking on Karl. He got beat up last night."

"We've spoken before about you becoming over involved with your clients."

"Yes, we have," I said and walked past her.

"I'm docking you an hour and eleven minutes."

"Swell…" I said. I headed back to my cubicle just to get away. By the time I got there Trina buzzed my extension.

"Your 10:30's here," She said.

"I don't have a 10:30."

"You're losing it Duff. You called Mr. Sprain yesterday to have him come in," she said, not feigning or hiding her annoyance at all.