Free Fat by James Keene Page B

Italian beef with giardiniera.”
         “Or a deep dish Lou’s pizza.”  Imagining that cheesy deep dish pie was making my mouth water.  I suddenly got depressed thinking about the sack lunch I packed today of turkey and swiss on whole wheat with a side of sliced apples.  “Anyway Xander, you’re going great, just keep it up, and try to do a bit better on your food choices.”
         “Will do.  And no more ‘tutes, eh?”
         “What?”
         “Prosti-tutes.  I should cut down on handies from them too, right?”
         This kid was downright hilarious.  As he left the exam room, my pen bounced from line to line in his chart and every other word seemed to be “good” or “improved”.  His change happened in such a relative blink, to the point of puzzlement that it did not happen sooner.  With so much abject failure in the practice of medicine, even a glimmer of possible success makes for rainbows and bunnies.  Today’s Xander is what makes the slog through the hellhole of clownish patients worthwhile. I saw him now going on morning runs with his wife, hiking through the Grand Canyon, chasing kids across greenery, chasing grandkids across greenery, and spryly hopping into a hover car.  Before today, it seemed I wanted that long life for him more than he did.  Long live this new Xander.                     

 
     
     
     
     
     
    WATERMELON TOOTHPICK
     
     
     
         Every Fourth of July, the country club holds a barbeque for all the members and their families.  It is always a great spread, great fireworks, and a good time.  I haven’t been in attendance for a while, but somehow all my other plans fell through this summer holiday, so I went.  Albert, Kate and Xander were there as usual.
         “Dr. Grant!  Great to see you!”  Kate ran over from the buffet line and gave me a hug. 
         Albert and Xander were just finishing loading their plates, and they headed over towards me, faces lighting up and waving.  Xander was balancing two plates heaped with pulled pork and ribs peeking out under coleslaw, corn-on-the-cob and beans.  He was waddling.  It looked like every step was a battle of leg and ground, and the jackhammer shocks of his foot strikes unable to be dissipated by the matted grass seemed to be sending reverberations of pain back up to his already damaged joints.
         I hadn’t seen Xander in a few years.  He was old enough now to be able to decide to ignore the recommendation to see his doctor once a year, and certainly he’s old enough to not need a pediatrician.  Seeing him heavier and hobbling was surprising, considering the last time I saw him, he was an emerging jock and turning his way down a healthier path.  Usually high school football players add the pounds gradually after they stop playing, trading muscle for fat by continuing to eat and drink as if they were still in practices every day and with a teenager’s metabolism.  Xander did have an elastic brace on his right knee.  It was probably the result of an old football injury.  Probably the reason he had to stop football.  Probably the reason he was able to put on so many pounds so quickly.  Though probably not that serious of an injury because the brace he was wearing was only adding a whisker of additional support in relation to the body mass his knee was supporting on a step by step basis.  That injury had to have happened years ago in high school, so why still with the ineffectual brace?  Maybe for placebo effect?  More likely for show to provide an excuse and point of sympathy for being sedentary.  The injury was moot.  It was his obscene body habitus that was making him gimpy now.  
         Imagine supporting a marshmallow on a couple toothpicks – easy.  Now try balancing an apple, then a cantaloupe, then a watermelon on those same two toothpicks.  Joints and cartilage and bursas are amazing feats of anatomic engineering, but they