Team Kaiser
by Bensiamin
Chapter 10
"Yes, and seizures aren't limited to epilepsy," Cassie said, "but that's where most people know them from."
She looked at her son. "Your hunch about this was right, the symptoms only in one eye, the absence of all the migraine symptoms. I'm not a doctor, so it's not my place to say it's epilepsy, but I know a seizure when I see one. This needs to be assessed by a neurologist, not a headache doctor. How do we proceed?"
Roger's Mom said, "We have an appointment next week with the headache specialist, but I can call on Monday. What shall I ask for?"
"For a referral to a neurologist."
Roger's Mom nodded her head, and David said, "I will also call Stuart Winslow, the former student I told you about who's the ER doc at OHSU, and ask for the recommendations he offered."
Cassie nodded her head in agreement, and he continued, "Do you want me to call the ER right now and see if he's on duty?"
She nodded. "The sooner the better."
David headed for the phone and came back in five minutes. "He's working today and with a patient, but he'll call in the next half hour."
Roger looked around and said, "I'm getting tired. I'm going to go lie down." Jerrod stood up and took his hand and said, "Come on, selle. I'll go with you." He smiled at his Mom and silently said 'thanks.'
They all watched the boys walk out of the living room and down the hall.
"My god! Epilepsy? How can this be?"
Cassie turned to Roger's Mom and said, "Let's not jump ahead to an epilepsy diagnosis. I said he had a mild grand mal seizure. He needs a complete work up before there's a definitive diagnosis, and before there is one, no one should be jumping the gun and panicking."
Roger's Dad pulled his wife close to him and said, "Cassie is right. We're so fortunate she was here today, that she and Julius came out for Christmas, or we might still be going in circles. Now we have a better understanding of what is happening. We are not waiting for our doctor to do the usual thing. We are doing what is best for our son. Immediately."
Julius spoke for the first time. "What I just saw with all of you was extremely distressing to watch. My heart goes out to you who are closest to Roger. I don't know how I can help, but I will. I don't practice in Oregon, but if you need anything on the legal side that I can assist with, I'm here for you." He paused and swallowed hard. "I'm so proud of my son. I've never given him the benefit of the doubt about a lot of things, but the way he comports himself, the depth of his affection and love for your son, the way he cares for him is… it's just… it's quite striking." He suddenly felt self-conscious, stood up and said, "May I get a glass of water?" Roger's Mom nodded and Julius headed for the kitchen.
"Thank you, Julius," Roger's Dad said, and then turned back to the rest. "We will get to work on this immediately on Monday." That's when the phone rang. They all looked at David and he nodded and went to answer. They could tell by the nature of the conversation that it was the ER doc.
Julius heard the phone ring as he drank his water. He felt his emotions completely stirred up after what he'd said, trying to express some of the emotion he was feeling. He suddenly felt for Roger and Jerrod again, and stepped into the hall where he could see David just to his left on the phone. He turned right to where he assumed the bedrooms would be, and the first door he came to was Roger's. When he looked in, his heart leapt. The two boys were laying side by side on the bed, Jerrod on his back, leaning against the pillows, and Roger on his side next to him, asleep with his head on Jerrod's shoulder, an arm draped across his chest. Jerrod saw him in the doorway and lifted a finger to his lips. His Dad nodded and smiled. Then Jerrod did something he never in his life thought possible. He reached over and patted the side of the bed next to him. His Dad understood and walked in quietly and sat down on the bed taking his hand.
They looked at each other, quietly exchanging feelings, and Jerrod watched his Dad lift his hand up and kiss the back of it. For some reason, instead of being surprised or shocked like he would have been six months ago, suddenly this seemed normal, desirable even. He found him self quietly saying, "I love you, Dad."
Julius said it, too, and Jerrod watched tears form in his father's eyes. It suddenly hit him that they had been too far apart for too long. He lifted his hand away from his Dad's and held his arm up in the air, the kind of gesture one makes when they are asking someone to come close for an embrace. Julius hesitated for just the smallest fraction of a second, and then turned on the bed and laid down with his head on Jerrod's other shoulder. Jerrod wrapped his arm around his Dad's back and hugged him close.
They said nothing, just laid together, father and son and boyfriend. After some time had passed, Jerrod didn't know how long, he saw Cassie appear in the doorway. He looked at her and smiled. She beamed, blew him a kiss and turned and went down the hall. After a while longer Julius stirred and said, "I love you, Jerrod. I should get back with the others." He kissed Jerrod's forehead and carefully disengaged himself and walked back to the living room.
Cassie anticipated that he'd feel embarrassed, and as he walked into join them, she said softly, "That was one of the most beautiful sights I've ever seen."
Julius looked at her and smiled, looked at the Roger's parents and David and Jackson and said, "You all know what my problems have been. What I just did is something I should have done many times, starting many years ago."
He sat down next to Cassie and David said to him, "One of the wonders of human relationships is that it's never too late to start. You and Jerrod will do just fine." He paused, then went on, "In the meantime, my doctor friend confirmed everything Cassie said, and I got her on the phone with him."
He looked at Cassie and she said, "When I told him that I'd observed Roger have a seizure and lose consciousness, he said that given Roger's age, he strongly recommends that he see a pediatric neurologist. Not to waste time with a generalist because there are a number of conditions than manifest differently in children and youth and he felt it was very important that he see a pediatric neurologist ASAP. When I asked him what he thought it could be, he said he had some ideas but would only be guessing. He's going to call a pediatric neurologist at Doernbecher, who he knows well, and try to get Roger in early next week."
Roger's Mom added, "That's the same hospital where the boys have been doing dog therapy work."
Julius nodded and smiled, "Very good progress. That's very good to hear."
"Speaking of dog therapy," Jackson said, bringing reality home, "Kaiser has been in the Durango for an hour now. I need to let him out and then we should head home so I can feed him. Jerrod can drive home in the Cherokee when Roger wakes up, and then one or the other of us will drive you and Cassie back to the hotel."
Jerrod got home an hour after everyone else, and they were gathered in the kitchen. David and Cassie were preparing dinner while Jackson and Julius sat at the table nursing a drink. Kaiser was lying under the table with his chin on Jackson's foot. He high-fived everyone and said he had to hit the bathroom, when he came back he sat down next to his Dad, leaned under the table to pet Kaiser and said, "Roger's back to normal and doing fine after a long nap. What's the plan?"
"The plan in easy," Jackson replied. "We decided to have dinner here, and David and your Mom are whipping up spaghetti with Bolognese sauce. Shortly I'll be making a salad, and I suggest you pour yourself a glass of wine, since you've earned it, and join us." Jerrod took the suggestion, checked if David and his Mom needed their wine topped up, and sat back down at the table."
He grinned at his Dad. "Have you made the Kaiser cut, yet?"
His Dad looked confused. "Look under the table," he said.
Julius leaned over a bit and looked under to see how Kaiser was lying.
"That's unusual."
"When he does it to you, it means you're totally accepted and entitled to all the rights and privileges of living in this house."
Julius smiled meekly. "I probably won't make it. I've never been much of an animal person, as you know."
Jackson had started chuckling, and said to Julius, "Don't count yourself out. Kaiser isn't just really good at reading people, he's also pretty good at softening them up and getting into their heart."
"You mean there may be hope for me?"
"Look what he did for me last summer," Jerrod wryly added, "so anything's possible."
"When you were here in September, did we tell you the story of when your son turned the corner?"
Julius shook his head, and Jackson could see Cassie listening more intently as she stirred the Bolognese sauce. Jackson looked at Jerrod and said, "Is it okay with you?"
He nodded and Jackson went on. "It started when we brought Kaiser home and tried to get him to sleep in the garage. We borrowed a nice dog crate with a really soft dog bed, and put him out there the first night and about 2:00 AM he started howling. That's when we realized he really was a 'people dog,' and didn't appreciate being stuck out somewhere alone. So, we moved the crate into the kitchen, over there where his bed is. We left the crate door open and we realized something else a few mornings later when I came out here and there was no Kaiser. I looked in the obvious other places, and finally as a last resort looked in Jerrod's room, and Kaiser was in there sleeping next to Jerrod on his bed. It was picture perfect. Kaiser was curled up in front of him and Jerrod had his arm over Kaiser."
Julius was quiet, processing what he'd been told. Jackson went on, "Jerrod didn't take him in there. It was just that sometime during the night he decided being alone in the kitchen was too far away from his people, too, so he moved."
From the stove, Cassie said, "That's so sweet."
"It is. But that's not the moral of the story. Kaiser could have gone anywhere he wanted in the house. On the couch in the living room, in the study, in our bedroom, but he went to Jerrod's room and jumped up next to him on his bed. He made his own decision."
Julius said, "Go on."
"Well, this was soon after we found him, and shortly before we decided to keep him, when Jerrod was still struggling with some issues. One of them was self-worth. I don't think Kaiser was rejecting David and me. After all, it was Jerrod who found him and was training him. Kaiser's action that night sent a very singular and strong message."
"And that was," Julius asked, still sounding a little like a lawyer in court.
Jackson looked at Jerrod and smiled, clearly wanting him to answer the question.
Jerrod hesitated, and flushed as he felt the emotion rise, but managed to clearly say, "That I was okay. After all that stuff in school and in that fraternity last year, that I was okay."
Julius had an expression on his face that was a mix of surprise and empathy. "But why would you ever doubt that?"
Jerrod swallowed hard and felt his Mom come up and place her hands on his shoulders. "'Cause of all that stuff I was dealing with. And a lot of it I did to myself, but I just didn't believe in myself anymore. I was listening to David and Jackson, and they were trying to help, to get through to me, but I wasn't really hearing them. It took Kaiser to break through, like Jackson said, and I realized I was okay."
He wiped his eyes and said, "It sounds kind of silly now, doesn't it?"
"No, darling," Cassie said from behind him as she kissed the top of his head. "It's not silly at all. Sometimes breakthroughs in understanding happen because of the simplest things."
The surprise was gone from Julius' face, and what was left was empathy. He swallowed and said, "If you and Roger can be totally honest and transparent with Roger's parents about your relationship and his health condition, then I think it's past time those same dynamics apply to our family. Your Mom and I have talked a lot since September, and I accept that a lot of why you didn't fully accept yourself was due to me. So, I want to apologize for that. I said in the car that morning when I took you to the airport to fly back to Portland, that I want to be a better father, and I meant it. What you did earlier when you waved for me to lie down next to you, while you were holding Roger, was something I'd never in my life have conceived to be possible. But something happened to me after that. I guess it was like Kaiser lying down next to you. Like I said, I know I haven't made your life easy these last few years, and I certainly wasn't understanding or supportive when you tried to explain to us that you're gay, and I presume I was only barely tolerant when we were here in September. So, here's what I want to say to you, and I want your Mother and David and Jackson to hear it. Even up to this afternoon you had every right to still feel resentful and not fully accepted. But you didn't. What you did for me this afternoon was the single most astonishing experience of unconditional love I've ever had."
Jerrod was looking directly at his Dad as he heard the words, and when the emotion rose, the tears came, too, and he reached out for his Dad's hand. "Thanks, Dad. I meant what I said when you sat down next to me and Roger. I love you."
"I love you too, son." Cassie leaned over and kissed the top of Jerrod's head again and went back to the sauce on the stove, knowing if she didn't, she'd be in tears, too.
They were all quiet, processing what had transpired, and then Julius turned to Jackson. "Thanks for telling me that story. Or, more precisely for recounting what happened. It's something I'll never forget."
Jackson smiled back and said, "As Cassie said, sometimes it's the simplest things that accomplish the breakthroughs in understanding. Now it's up to you guys. And, with that, I see David about to put the pasta in the water, so I think I'm going to go prepare the salad so we can eat."
When dinner was over, they all moved into the living room, and Jackson put Poets & Angels, Ottmar Liebert's flamenco guitar holiday album on the stereo. They talked about a wide range of things, and one that Julius gently approached was where Jerrod was thinking about going to college?
Jerrod hesitated, and his Dad said, "I'm asking about what you are thinking. I'm not asking what you think your Mom or I want."
"It'll be with or near where Roger goes."
His Dad smiled. "That makes perfect sense to me."
"Really?" Jerrod couldn't keep the surprise out of his voice.
"Really! We're not going to press you about your career path or choice of schools. What you've demonstrated in the past six months is a level of maturity and decision-making ability that exceeds most college students I've met and even many law school graduates. Your Mom and I have talked about it, and we'll support whatever decision you make."
"Thanks, you guys. You don't know how good that makes me feel." He felt Kaiser stir and said, "I need to take him out for a few minutes." When he came back in the living room, his head was still spinning with the evening's conversation and now this revelation about college. He walked over to the couch, stepped between it and the coffee table, and carefully sat down between his parents. He put an arm around both of their shoulders, and said, "Thanks. Thanks for being here for Christmas, and for what you've said tonight. I love you guys."
That got him a hug from his Dad and a kiss from his Mom. David and Jackson were watching from the armchairs adjoining the couch, and Jackson saw something else happen. Kaiser had figured our that with three people on the couch there wasn't room to get between it and the coffee table, where he usually would lie. Instead he circled twice at the end of the coffee table, and comfortably settled down on the carpet with his chin on one of Julius' feet.
Roger's parents insisted that he stay home and rest on Sunday, after his seizure on Saturday. Jerrod, David and Jackson met Julius and Cassie for brunch at their hotel, and then everyone including Kaiser loaded in the Durango for a drive to show the Burgoynes the Oregon coast. It was a typical December day with intermittent rain, though the cloud deck was high and allowed decent views of the majestic shoreline. They drove straight west to Gearhard and walked the smooth sand beaches, then drove north to Astoria so they could see the mouth of the Columbia River. Even though he now considered himself 'an Oregonian,' this was also Jerrod's first trip to the coast, and the view at the top of the Astoria Column was as spectacular to him as it was to his parents. As they walked around the viewing platform at the top, David and Jackson both recalled the first time they brought the church camp kids here to visit that first summer twenty years before. They visited the Maritime Museum and then drove back to Portland along the Columbia River, then down the Willamette to Portland and back to the hotel.
On Monday, Jerrod and Roger met up to walk and work Kaiser in the early afternoon, both of them still cautious after what had happened during Saturday's event. Roger's parents had invited everyone to dinner at their house that night, hoping they had news to share about seeing a specialist, and to plan the week. At Roger's insistence, Kaiser was included, so it was a fully loaded Durango that pulled up to the Astren home.
After everyone had settled in, David announced that he'd had a call from Stuart Winslow, the ER doc, and that Roger had an appointment the next morning with the pediatric neurologist at Doernbecher.
"How did that happen," Roger's mother asked, as the boys looked at each other questioningly?
David smiled and just said, "It's the network. I know Stuart well from college, and he knows Frank Yanowitz, that's the neurologist that Roger will be seeing. So, Stuart called and asked for a favor, and apparently Dr. Yanowitz worked him into the schedule. So, we need to decide on the plan for tomorrow."
Roger was the first to say, "I know Mom and Dad have to go, but I want Jerrod to go with me. He's seen almost all of these events. I think that's important." That pretty well decided it. Julius said he could easily spend the day on the phone with his office on current legal cases, and Cassie said she would occupy herself downtown, but only if they all got back together Tuesday night.
Cassie asked Roger's Mom to tell her about the Samichlaus figure on the mantle, and they heard the story being told about Roger's birth on the feast day. Roger and Jerrod then slipped off to Roger's bedroom to do some catching up, leaving the men to fend for themselves when the ladies departed for the kitchen to finalize dinner.
The next morning Roger's parents picked Jerrod up at 8:30 AM, and they drove up the hill to Doernbecher. They checked into Neurology and after a short wait were shown into an exam room, where after a further wait, Dr Yanowitz appeared. He was a middle-aged man of medium height with sandy hair and glasses. He was fit and had a bounce to his step and an engaging personality that matched his smile and friendly eyes. He introduced himself, put everyone at ease, described the conversation he'd had with his friend Dr. Winslow, and then proceeded to ask Roger to tell him his story from the beginning. Roger started but made clear that Jerrod was the more objective observer. He handed Dr. Yanowitz his journal and said, "Jerrod and my Mom made me keep a log of each event." Then between the two boys they walked him through all the events up to Saturday's seizure.
Dr. Yanowitz listened carefully, asked a number of very specific questions, among which, to Jerrod's satisfaction, was one that focused on symptoms in one versus both eyes, and then said, "Dr. Winslow described his conversation with the RN who was present for the seizure." He looked at Jerrod. "I presume that the nurse is your mother?"
Jerrod nodded and then described how she'd laid Roger flat after he lost consciousness and sagged against her, how only his right side had jerked and how she'd held Roger's head against her chest to prevent it from being injured. He smiled. "That lady knows her business and did all the right things."
He paused and looked at all four of them. "Right. Thank you for all the detail, and kudos to you both for the log. All that documented information is very helpful in narrowing down the possibilities. First, you all know full well by now that this is serious, and Jerrod's mother was right that this is not migraine syndrome even though some of the symptoms might have appeared that way. I'm going to do a basic physical exam, and I expect it to be perfectly normal. Then, Roger, you're going to get two other tests while you're here this morning. First, you're going down to the Ophthalmic Department where you'll get a visual examination of the retinas in both eyes. They'll have to dilate your pupils, so you'll be sensitive to light for a little while, but you'll be inside so that's not a big deal. Then you'll go to the Neurology Lab and get an EEG. That's an electroencephalogram."
He paused for effect and said, "It's a big word but not that scary. They won't even have to shave any of that cool head of blond hair you have." He grinned and Roger smiled back. "That will take a couple of hours, and then you'll come back here. Check back in with the receptionist and have her let my nurse know you're here, and then we'll sit down and talk about the results. Sound like a plan?"
Roger nodded and smiled, liking Dr. Yanowitz's attitude, and his parents thanked him for getting the testing going so quickly. Both tests themselves didn't take that long but both involved waiting to get in, and Dr. Yanowitz was right that it took almost two hours before they were back. The Neurology receptionist had them sit in the waiting area, and about ten minutes later Dr. Yanowitz's nurse came out and led them back to his office. He greeted them, had them sit in some plain chairs and then sat down at his desk, which was a plain office model pushed up against one wall. Jerrod realized that it meant he, the doctor, was sitting on the same side of the desk as the patients and family, and when he was talking to them, even when he was looking at papers or x-rays on his desk, it seemed like he was part of a group discussing the situation. Jerrod liked him even more.
"Give me just a minute to look over these results," he said, and two minutes later looked up and swiveled his chair toward them to see Roger very studiously looking at a framed poster on the other wall.
"That's a pretty cool poster, isn't it, Roger?"
"Yeah. I know who Sting is, but that's a signed poster. Who's Branford Marsalis?"
Dr. Yanowitz chuckled. "You're probably just young enough to have missed Sting's jazz period, which was ten years or so ago. Branford was the saxophone player in the band that toured with Sting after they released that album, Bring On The Night. That was also the name of the tour. I play sax too in a local jazz band, and I got to know Branford through a band mate who grew up in New Orleans. His brother is one of the best trumpeters alive, and they both come from a very musical family and are wonderful people. Anyway, that's how I came to have that poster that Branford signed for me."
"Wait, you're a doctor and you play in a band?" Roger sounded seriously confused.
"Yeah. We doctors have lives, too you know. Do you only go to school, or maybe do other things too, like ski?" He grinned and Roger smiled back at him. "I get it. Sorry, it just hadn't dawned on me before. I think it's pretty cool actually."
"Well, I'm glad. Maybe you'll come hear us play sometime. Meanwhile, we have some slightly more serious matters to discuss." He paused and picked up some papers and turned back to them and said, "These are the ophthalmic exam and EEG results. They're just what I expected. First, the ophthalmic exam rules out a torn retina or any other structural anomaly in your right eye that could cause the visual symptoms. Second, the EEG shows abnormal electrical activity in the occipital region of your brain, which could be the cause of your symptoms."
He paused again and looked at Roger and then his parents and then Jerrod. "Are you following what I'm saying?" Roger and his parents nodded, and Jerrod said, "Can I ask a question?"
Dr. Yanowitz nodded and Jerrod said, "My Mom told me about rule out, so you're eliminating some things and confirming others as you work your way to a diagnosis. Is that it?"
Yanowitz grinned. "It looks like some of your Mom's genes made it down to you. Yes, that's exactly what I'm doing. We've eliminated a torn retina, and the presence of seizure with loss of consciousness combined with the abnormal EEG almost certainly eliminates migraine syndrome, and points at the abnormal electrical activity as the cause."
Jerrod felt a feeling of dread, and glanced at Roger, who said, "What's left?"
Yanowitz looked back and forth at both of them and smiled when he asked, "Do you two often complete each other's thoughts?"
They both blushed, and Jerrod stammered, "No, not all the time."
"Don't get me wrong. I find it very intriguing! So, Jerrod to follow your line of reasoning, we're now left with the question, if not torn retina or migraine but affirmative on the EEG exam, then what are we dealing with. We have to do one more rule out, and then we almost certainly have a diagnosis."
"Really?" He looked at Roger, a huge smile breaking across his face. Roger responded in kind.
"You have to understand, Dr. Yanowitz, that these two have been in the middle of this worsening storm for two months and were beginning to think there was no solution."
"Oh, I understand completely. It's much of the work that I do. So, let me tell you right now what I think we're dealing with. I am pretty certain that the condition you have, Roger, is what we describe as Benign Childhood Occipital Seizures or BCOS. You can also think of it as a mild form of epilepsy. The word you all should focus on is 'benign.' I'll explain why in a minute. BCOS is associated with the abnormal electrical activity in the occipital lobe of your brain. It is a condition that usually manifests at a younger age, but can begin as late as your age. You have shown most of the typical symptoms, and as you know some are the same as migraine syndrome. It develops over a period of time, and where it's different is the unilateral seizures, meaning one-sided seizures, and loss of consciousness. You also said you seldom had a headache afterwards, and that's the case in about thirty percent of patients. Now, with all that said, here's the good news. This condition is what we call 'self-limiting' and patients almost always experience remission within two to three years."
"Really?"
"You don't think I'd kid you about something like this do you, not with your parents present?"
"Well, no, but it's just such a relief, I mean… after all this stuff…"
Jerrod took over. "We've just been so scared as it got worse and worse that that's what it was going to be. You know, worse and worse…and…"
"Well, let me relieve you of that concern right now. We've got one more test, and that rules out the other possible cause of the symptoms. You'll be coming back on Thursday morning for an MRI. The MRI results rule out structural abnormality in the occipital lobes, in other words a lesion or growth. If the MRI is clear, then the resulting diagnosis is BCOS. Are you with me so far?"
Both boys nodded, and Jerrod so badly wanted to hold Roger's hand, but he just flashed him a smile and resisted.
"Good. Now, there's one more thing. Remember what I said about benign? Let me say this again. This is a treatable condition, and virtually every patient outgrows it—that's what I mean by self-limiting. We also have a variety of anti-epilepsy drugs, and one of the older ones is effective in mild epilepsy and also has fewer side effects. I didn't miss what you were both saying about every three days, and I know today is the third day since the event where you had the seizure. If you weren't here talking to me, you'd probably already be worrying about what's going to happen this afternoon. Am I right?"
They both nodded, somewhat somberly, and Yanowitz continued. "So, were going to start you on carbamazeprine right now and see if we can prevent today's event. If the medicine does that, then we'll have yet another very important confirmation of the diagnosis."
He handed Roger a pill container and a bottle of water and said, "This is a starter prescription. Take one tablet now, and another before you go to sleep. The dosing is twice a day, so you take one when you get up or with breakfast, and the same around dinner time in the evening." As Roger swallowed the pill, he went on, "For most patients with epilepsy, this is a starting dose and is increased until the symptoms come under control. I don't think we'll need to do that, and I'm hopeful this dose will work for you. You'll probably feel drowsy and maybe a little dizzy the first day or two, till you're used to it, so limit your activity. You may experience dry mouth or nausea, but that should pass. The most important thing is that it will almost certainly stop the symptoms. What do you think about that?"
Roger broke into a wide grin, and looked over at Jerrod and then his parents and back to Dr. Yanowitz. "I think that's fabulous. As in the best news in months."
"Alright then. Here are your orders for the MRI at 9:00 AM on Thursday." He looked at Roger's parents and continued, "It's important he take it easy the first few days while his body gets used to the medication." He looked back at Roger. "Promise me you'll take it easy. Nothing strenuous. We don't need you getting dizzy and falling over and banging your head on something."
Roger nodded. "Can I go on a walk with Jerrod and his dog?"
"Certainly. I've heard about that dog, and a modest walk will be good for you. Okay. I've got other patients to see. So, on Thursday after the MRI is completed, come back up here like you did today. I'll get the results right away and we'll have another consultation and go from there. Do we have a plan?"
Roger was still grinning. "You bet. We have a plan. Thanks."
The word ecstatic wasn't too strong to describe the emotion in the car on the drive home. When they got to the Astren's, Jerrod pulled out his cell phone and called his parents, and Roger called David and Jackson. Roger's Mom made them lunch and then announced that she was so emotionally wrung out she needed a nap, and her husband smiled in agreement. Roger announced that he and Jerrod were doing the same thing, then they were taking Kaiser for his walk. The nap was more like a cuddle characterized by relief blended with hope, but they did both fall asleep for a while.
When they woke up, Jerrod was spooned up next to Roger, his nose smelling the boy scent emanating from his hair. Roger felt him stir and said, "Hi, liebling. Guess what?"
"I love you and I've got a hard on. Can you feel it?" He thrust forward a little so Roger could not ignore it sliding against his crack through his boxers. "Oh yeah, I can feel that." He giggled. "However, as good as it feels and as much as I want to watch you slide it inside me, and then feel it deep in me, that's not what I was asking about."
Jerrod was kissing him behind his ear, softly licking the top of his neck, and whispered, "the medicine worked, didn't it?"
Roger nodded, and then turned in Jerrod's arms, and his blue eyes were moist. "It did. Nothing yet, but the days not over yet. It's late, Jerrod, after 3:00 o'clock. If we're going to walk Kaiser we've got to get moving."
Roger's parents wanted him close by, and were serious about the instructions to take it easy, and insisted that he sleep at home. Jerrod wanted to argue but decided that it was better to go along and make them happy. They'd been through an emotional time, too. He drove Roger home after the walk and then picked up his parents and they all walked to the Sellwood Grill for dinner.
Both boys found the phone call later was hardly adequate for the relief they were feeling and the emotion they wanted to share, but had resigned themselves since Roger was okay to stay over with Jerrod the next night. Roger reminded Jerrod what he'd said earlier, and that he expected his boyfriend to make wild love to him the next night.
"No worry there, selle, trust me. I wonder if the meds will affect you, you know like make it hard to get it up and stuff?" He giggled and Roger softly said, "You'll have to conduct an experiment, liebling."
David had invited everyone, including Will and Sam with Eric and Kim over for dinner, and once again the dining room table would be fully extended, and while he made sure everyone understood there was one more test to come the next day, that all signs were that they now knew what Roger's condition was, that it was treatable and he would outgrow it. Everyone understood there was still one more hurdle for Roger to clear, but while that was sobering, it didn't quell the feeling of relief and joy they all felt.
When the dinner party broke up, Jerrod and Roger drove the Burgoynes back to the hotel, ending the evening with a very pleasant good night. When they got back home, they found Kaiser laying on the floor in front of the couch, between David and Jackson. They spent a little longer talking to them, and then said, "We're heading down to our room."
Roger grinned and said, "Jerrod has a promise to keep." He wiggled his eyebrows and pulled his boyfriend by the handout of the living room, Kaiser following along behind. Roger was clearly feeling the energy that accompanies freedom and liberation, and literally held Jerrod to his promise to make wild love to him.
When they woke the next morning, Roger was spooned up against Jerrod and pulled him tight. Jerrod smiled to himself as he felt the hug, and said, "Morning, selle. How are you feeling?"
"I'm feeling wonderful, just a little sore, but the good kind. You know, the kind that comes from being wonderfully fucked by the boy you love." He was stroking Jerrod's chest and slid his hands down to run his fingertips into his pubes and rub the base of his cock. "It's so wonderful when you're in me."
Jerrod leaned around to kiss Roger and said, "It was wonderful, and the good news was that you didn't have any trouble getting hard and had a pretty great orgasm, too."
Roger hugged him tight. "A pretty perfect match up," he sighed. "You don't think the medicine will do anything, do you?"
"I don't know, but I say we talk to Dr. Yanowitz about it. He's a cool dude. If we can't talk to him about it, we can't talk to anyone."
Roger's parents picked both up in time to be at Doernbecher by 9:00 AM, and he was in for his MRI half an hour later. He'd been warned that he'd be lying in the tube for at least thirty minutes, maybe as many as forty-five, while a complete scan of his brain was conducted. Jerrod hugged him before he went in. "Nervous?"
"No. forty-five minutes laying in a tube is nothing compared to the shit I've been getting. This'll be a cake walk. I figure I'll pretty well just nod out and like take a nap." He grinned and then the attendant took him away. An hour later he was back, and the attendant told his parents that Dr. Yanowitz had asked the on-call radiologist to read the results ASAP and that they should give it an hour before he got the results. Jerrod called home to fill David and Jackson in, and then his parents to let them all know things were going well, and they were all waiting in the reception area when the nurse came out to get them.
Dr. Yanowitz greeted them at the door to his office with a large envelope under his arm. He showed them in and smiled broadly. "I'm thrilled to be here to give you the good news. The MRI is clear. Let me show you." He stood up and placed a few radiology transparencies under the clips of the radiology light box on his wall.
"These are just a few of the many pictures. Most are on the radiology computer, but the radiologist printed a few of the critical occipital area for me, and his report is no structural anomalies or lesions. If you look here," and he drew circles with his fingers, "these are the occipital areas, Roger, and they are entirely normal anatomically. That leaves the electrical anomalies that are associated with BCOS. Now, my big question for you: what happened on Tuesday after you started the medicine?"
Roger had been looking with great seriousness at the images of the inside of his skull and the cross section of his brain, and slowly looked over at Dr. Yanowitz with a wry smile on his face. The smile widened, and he said, "Nothing."
"Wonderful. And side effects from the medicine?"
"I felt a little tired in the evening, and my parents made me stay home and take it easy," he glanced at them and grinned, "and we took it easy yesterday, too, just like you said. I haven't had any nausea or dry mouth, or even dizziness. Just the tiredness, like not a lot of energy."
"That's just what I hoped you'd experience with only the starting dose. You're young and healthy and have an active metabolism, and I can tell you to expect that within a few days, no later than a week, your body will have adjusted to the meds and you likely won't feel the tiredness at all. If this dose controls the symptoms, in a few months we can look at reducing the dose a little, and then reduce it a little more to see if you can get by with less. That's called titration, and the idea is to get you to the minimal dose required to control your symptoms so that the medicine doesn't interfere with the rest of your life."
Roger smiled at him, then looked at Jerrod and caught his eye, lost control and giggled.
"Am I missing something, or was that a private joke?"
"Well, it was a kind of private joke, you know, about how the medicine effects the rest of your life and certain other body functions." He glanced at his parents.
Roger's Mom had been paying attention and said, "Roger, dear, Dr. Yanowitz has given us the best medical news possible. Would you and Jerrod like a few minutes alone to talk privately?"
"Thanks, Mom. That would be great."
When the door closed, Yanowitz ginned at them and said, "I think I can guess where this is going, but as the patient, you need to initiate the conversation."
Jerrod moved his chair closer to Roger, who took his hand. "You may have already figured out," Roger said, "that we're boyfriends. Our parents know and accept our relationship. So, we want to know if the epilepsy medicine causes side effects beside tiredness or dizziness?"
Yanowitz smiled and said, "Remember what I said about you two completing each other's thoughts? That's when I was pretty certain. And, for the record, I mean that in the most positive and respectful way. Totally apart from the fact that gay relationships are legal and protected and all that. It is quite apparent to me that you two are amazingly close and connected, one might say deeply in love. I think that is wonderful. Okay, are we clear on that?"
They both nodded, and Jerrod added, "Thanks for saying that. It's really encouraging."
Dr. Yanowitz then said, "What you're asking about is general sexual dysfunction caused by medicines. It usually falls into two major categories for males: loss of libido or the drive to have sex, and/or erectile dysfunction meaning difficulty in achieving and sustaining an erection. Are you with me? Any questions?"
They shook their heads. "Good, you understand the terms. In order to know how to talk to you both, I need to know if you are both sexually active with each other?"
They both said yes. "That's fine. Now, I'm going to share some facts, but the context is important. One half to two-thirds of men with epilepsy manifest sexual dysfunction compared to the average male without epilepsy. There are big variables in there. Most of those men with epilepsy are older, they've been on anti-epilepsy drugs longer, and they're usually taking higher doses. Remember what I said about you taking the starting dose, Roger?"
He nodded and said, "I didn't notice anything after that."
"Meaning," Yanowitz asked, "that you've had sex since you took the first dose, and you are not aware of any change in libido or the ability to achieve an erection?"
"That's right."
"Good. I'm glad we can be this candid and that you two aren't embarrassed to discuss it. Continuing on then, the fact is you are young and healthy, you've just started the drug, and you're taking a low dose. I'm hopeful that you won't experience it at all. Now, that said, you're going to be on this medicine for probably two or three years. There are newer epilepsy medicines, but I don't think they offer any additional benefit for your condition. The fact is that there is a chance you may develop some loss of libido or some erectile dysfunction. What I can tell you from my experience is that if it happens it is 'some loss,' not complete loss. Are you both hearing me about the difference?"
Roger nodded and Jerrod said, "I think I am, and I really appreciate that you can talk to us like this about it."
Yanowitz grinned and continued. "Here's the deal. Remember I said in a few months we'll try lowering the dose? And that you're almost certain to outgrow it, probably in two to three years? The point is that if there is some sexual dysfunction, it should be limited, and when we stop the medicine it will end."
He paused, then said, "You're with me on that? If it happens, likely it'll be a mild case, and it'll end when you outgrow it."
He waited till they both acknowledged what he said. "I'm being very repetitive about this because it's important that you both grasp these facts in case it happens. It's temporary, okay? And if it happens, we may be able to reduce it with lower doses. But if it happens, something else important has to be part of the equation."
He looked at Jerrod and said, "It's obvious to me that you two love each other. If some level of sexual dysfunction happens to Roger, you need to be able to adjust, to compensate, to help him. It's usually difficulty getting or maintaining an erection. That means the partner needs to be sensitive to that possibility and willing to do the work to overcome it. That's all. My sense of your relationship from our short time together is that it won't be a problem, but often it helps to just talk out the details."
Jerrod smiled at him. "I understand what you're saying, and trust me, I can make any adjustments necessary. He's my soulmate. There's nothing I wouldn't do for him."
Yanowitz sat back in his chair, smiled at them and said, "You two just made my day. It's pretty refreshing to hear people be able to speak about each other that way."
"I grew up back east where my parents still live. I live here with two guys who have been together for twenty years. One's a psychologist and they both have worked with gay kids for that long. They've done a lot to help us understand our sexual identity, accept it and be able to talk about it."
"I assume that's David Ayers, Dr. Winslow's friend. You two are lucky guys."
"We are," Roger said, "and we have supporting parents, although mine wouldn't have wanted to be part of this conversation!" They all laughed, and Jerrod said, "Dr. Yanowitz, I like you a lot. Can I ask you a question?"
He nodded, smiling wryly.
"Tuesday and today were amazing. I mean what's happened with the tests and getting a diagnosis and meeting with you and having this conversation and it all happening so fast. All of it is amazing, compared to what we've been dealing with, with Roger's family doctor and trying to get answers and finding out what's wrong. So, my question is 'Why are you doing this for us?' Getting Roger right in on Tuesday, seeing us twice, scheduling the MRI. I mean we know you're cool cause you play sax in a band and all, but you've never met us before."
Dr. Yanowitz's smile had widened as he heard the question. "You're right I haven't met you before this week. But, and this is an important but, I know something about you two that I didn't know before Roger became my patient."
"What, that we're gay?"
"No, though that has no bearing at all on what we're discussing now. David, who I assume is your guardian, knows Dr. Winslow quite well, and apparently shared an important piece of information with him. Namely that you two and your dog are one of the therapy dog teams right here at Doernbecher. So, the answer to your question is simple. We take care of our own. And if all this works out the way I think and hope it will, you two will owe me big time. And I plan to extract repayment from you in the form of special treatment for my neurological patients who would benefit from therapy dog work!"
Jerrod and Roger looked at each other and burst out laughing.
"That is such a cool answer," Roger said. "We can promise your patients will get the best dog therapy."
"Maybe before this goes any further you need to meet Kaiser. We don't have our schedule yet for January, but we're hoping it'll be on Sundays. Should we bring Kaiser down to meet you?"
"No need for a special trip. Let's do this, when you get your schedule let me know. Here's my card and it has my mobile number on it. You let me know. I'm not usually here on Sunday, but I'll drop by to see you guys and meet Kaiser. Is that a deal?"
They nodded and he said, "Okay. Back to this consultation. On your way out you need to schedule an appointment with the receptionist for a one-month checkup."
As they stood up to leave, Jackson handed Dr. Yanowitz a card and said, "Here's our card. David's partner is named Jackson, and he's in marketing and did them for us."
Before they left the hospital, Jerrod called his parents and gave them the good news, then did the same with David and Jackson. On the drive home the boys thanked Roger's parents for the private time and told them that the epilepsy medicine did cause sexual dysfunction, but that Dr. Yanowitz thought it wouldn't be a problem in the lower dose and because of Roger's age. They were relieved, and his Mom commented that she was glad they'd given them the private time with the doctor. "I guess I'm old enough there are some things I don't need to know!"
That afternoon they met Sean and his Mom at the park and had a more subdued than usual walk and work out, but it was adequate for Sean, who was typically overjoyed to be with Kaiser. Jerrod's parents had delayed their flight back after the seizure, but had now re-booked and were leaving the next morning.
Roger's parents had insisted that they all come to their home for a diner to celebrate the diagnosis and good news that accompanied it. The invitation included Kaiser, and Roger brought the dog bed from his bedroom out to the living room. Everyone was happily conversing; the mood being framed by the days good news. Roger and Jerrod had volunteered to be bartender and waiter, and were actually enjoying that part of the work. They finally settled in with the adults with a glass of white wine apiece.
After dinner, when they had washed the dishes and cleaned up the kitchen together, they all moved back to the living room and when they were settled, David looked at Jackson and asked if he was ready. Jackson said, "Two minutes," and slipped out the front door to the Durango, and came back in with a box that he carried into the kitchen. It looked suspicious, and everyone was looking around curiously when they heard the sound of clinking glass from the kitchen, to which David said, "We only ask for your indulgence for a minute or two."
Within two minutes, Jackson reappeared in the doorway to the kitchen and nodded to his lover.
David stood before them in front of the mantle that held the figurine of Samichlaus and said, "I'm going to temporarily assume the role of master of ceremonies, because this occasion calls for it. The last couple of months have been a roller coaster ride, mainly for Roger and Jerrod, but by extension for his parents and the rest of us that love these two boys."
He paused for effect and then went on. "With that said, it is worth noting the place in the calendar during which this has taken place. Tonight, most people gather to celebrate the arrival of a new year, and I submit we all appreciate the arrival of 1998. However, we are celebrating something far more meaningful. This figurine is Samichlaus, as St. Nicholas is known in Switzerland, and his feast day is December 6, which is Roger's birthday. You are all familiar with the Astren's regard for Samichlaus and his feast day as a result of Roger's being born on that day after years of striving to bear a son, and how that son, sitting right here, is seen as a gift, the family schatz or treasure."
He looked at Roger and said, "I'm sorry if I'm embarrassing you, but it is part of the reality, and a little embarrassment never hurt anyone!"
Everyone laughed except Roger, who smiled and blushed.
David went on to explain that Samichlaus Day is part of a larger time frame that all needed to understand. "The Feast of St. Nicholas, Samichlaus in Switzerland, which occurs on December 6, initiates the festivities and anticipation of Christmas, or more specifically, of the Feast of the Nativity of Christ. That festal period is divided into three parts: the Forefeast, the Feast itself, and the Afterfeast. The Forefeast runs from December 20 to December 24, The Feast itself is celebrated on the 25th, and the Afterfeast of Nativity runs from December 26 until December 31."
He looked around to make sure everyone was following what he was saying. "So, today is the 31st, the close of the Afterfeast. If we were practicing members of one of the liturgical churches, this evening we'd be in church celebrating a service to close the Nativity Feast. Instead, we are here, all of us collected together and bonded in love and appreciation of each other. Among the things we celebrate are the lives we share, the bounty we enjoy, the love at work among us, and specifically today the definitive diagnosis we received about Roger's condition."
He paused again, allowing the import of his words to settle in. David no longer regularly preached sermons, but he still knew how to speak from the heart.
"Our families have all grown not only closer together, but more interconnected because of these two young men. Their love and commitment is something special that we've all come to admire and appreciate. What Roger has gone through has been particularly distressing, it's tested all of us in various ways. I think it's fair to say we've all passed the test. Most importantly, and overwhelmingly the thing to celebrate tonight at the close of the Feast, is one of the symbols that is part of where it began on December 6."
He turned to the figurine of Samichlaus on the mantle and continued, "The donkey with Samichlaus is carrying a bag of brightly wrapped gifts for children. Like the gifts distributed by St. Nicholas himself in 4th Century Myra (which is in Turkey, for those that don't know!), they are given freely to those in need. Not only did the Astrens receive Roger as a gift, but Roger has been especially fortunate to receive today a gift freely given, the diagnosis that not only is his condition treatable, but he will outgrow it. I think I can certainly say for all of us that the gift he, and by extension all of us, received feels something like a gift given by Samichlaus to a child who had no expectation of receiving anything."
He paused again and said, "I don't preach much anymore, and I don't want this to sound like a sermon, but I am struck by the alignment of dates and events and think we should all take notice. On top of that, we have something truly wondrous to celebrate and rejoice in today. Thanks first, to the Astrens for having us here for dinner this evening. And to cap this celebration, I point you to my partner who recently discovered that in Switzerland, Samichlaus is not limited to figurines."
He smiled at his soulmate in the doorway, who walked in with a tray holding eight glasses and eight dark brown bottles.
"Oh my god," Roger's Mom exclaimed. "I haven't seen that for fourteen years, since we moved from Switzerland. Where did you find it?"
Jackson just grinned knowingly and set the tray down on the coffee table.
David continued, "It turns out that Samichlaus is so deeply a part of Swiss history and culture that one of their best beers, and one of the finest in the world is Samichlaus Bier. It is a Doppelbock, meaning it is double strength, dark, rich and aged ten months, and truly worthy of being part of the festal celebrations."
Jackson, with help from Jerrod, then helped everyone through the process of opening and pouring their bier into the engraved Samichlaus glasses he'd bought so that at the end everyone had a wondrous looking glass of dark beer with a creamy froth on top. The word Samichlaus bier glinted from the engraving on the side of the glass.
"So," David said as he raised his glass, "I give you Roger, at the close of this festal period, and Samichlaus and his practice of giving gifts to those in need, and particularly the gift that he gave this family and this young man this year."
Afterword
Thanks for reading the second installment in the Kaiser, Jerrod and Roger series!
For readers that aren't beer afficionados, Samichlaus bier is a real thing. It was developed by the Hürlimann Brewery in Zurich, Switzerland, is one of the strongest beers in the world at 14% alcohol, and is only brewed one day of the year, that being December 6, the Feast of Samichlaus. It was first brewed in 1979, and I've taken editorial license with that date, allowing Roger's Mom to remember it before she moved from Switzerland.
Hürlimann Brewery closed in 1997, so the Samichlaus bier drunk in the story would have been brewed in December of 1995 or 1996. Fortunately for serious beer drinkers, this special beer returned in 2000, brewed by Scholss Eggenberg in collaboration with the original Hürlimann brewers and using the original recipe.
The picture is in the public domain and provided here under the doctrine of ' fair use ' which is believed to apply.
Jerrod and Roger are past a major personal crisis apiece, and settled into their senior year in high school. What's ahead during the remainder of this school year? That will have to be seen!
Many thanks to my editor, Michael, for the time and effort to proof and edit this story and make it a much better read.
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