Choke

Choke by Chuck Palahniuk

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Authors: Chuck Palahniuk
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hand, tight.” She said, “And don’t think.” She said, “Just run.”

Chapter 16

    The next patient is a female, about twenty-nine years old, with a mole high on the inside of her thigh that doesn’t look right. It’s hard to tell in this light, but it looks too big, asymmetrical, with shades of blue and brown. The edges are irregular. The skin around it abraded.
    I ask her if she’s been scratching it.
    And is there any history of skin cancer in her family?
    Sitting next to me with his yellow legal pad on the table in front of him, Denny’s holding one end of a cork over his cigarettelighter, turning the cork until the end is burned black, and Denny says, “Dude, for serious.” He says, “You’ve got some weird hostility tonight. Did you act out?”
    He says, “You always hate the whole world after you get laid.”
    The patient falls to her knees, her knees spread wide apart. She leans back and starts to pump herself at us in slow motion. Just by contracting her butt muscles, she tosses her shoulders, her breasts, her mons pubis. Her entire body lunges at us in waves.
    The way to remember the symptoms of melanoma is the letters ABCD.
    Asymmetrical
shape.
    Border
irregularity.
    Color
variation.
    Diameter
larger than about six millimeters.
    She’s shaved. Tanned and oiled so smooth and perfect, she looks less like a woman than just another place to swipe your credit card. Pumping herself in our faces, the murky blend of red and black light makes her look better than she really is. The red lights erase scars and bruises, zits, some kinds of tattoos, plus stretch and track marks. The black lights make her eyes and teeth glow bright white.
    It’s funny how the beauty of art has so much more to do with the frame than with the artwork itself.
    The light trick makes even Denny look healthy, his chickeny wing arms coming out of a white T-shirt. His legal pad glows yellow. He curls his bottom lip inside, biting it as he looks from the patient to his work, and back to the patient.
    Pumping herself in our faces, yelling against the music, she says, “What?”
    She looks like a natural blonde, a high risk factor, so I ask, has she had any recent unexplained weight loss?
    Not looking at me, Denny says, “Dude, do you know how much a real model would cost me?”
    Back at him, I say, “Dude, don’t forget to sketch her ingrown hairs.”
    To the patient, I ask, has she noticed any changes in her cycle or in her bowel movements?
    Kneeling in front of us, spreading her black-polished fingernails open on either side of herself and leaning back, looking down the arched length of her torso at us, she says, “What?”
    Skin cancer, I yell, is the most common cancer in women between the ages of twenty-nine and thirty-four.
    I yell, “I’ll need to feel your lymph nodes.”
    And Denny says, “Dude, you want to know what your mom told me or not?”
    I yell, “Just let me palpate your spleen.”
    And sketching fast with the burned cork, he says, “Do I sense a shame cycle?”
    The blonde hooks her elbows behind her knees and rolls back onto her spine, twisting a nipple between the thumb and forefinger of each hand. Stretching her mouth wide open, she curls her tongue at us, then says, “Daiquiri.” She says. “My name’s Cherry Daiquiri. You can’t touch me,” she says, “but where’s this mole you’re talking about?”
    The way to remember every step to a physical examination is CHAMP FASTS. It’s what they call a
mnemonic
in medical school. The letters stand for:
    Chief Complaint.
    History of Illness.
    Allergies.
    Medications.
    Past Medical History.
    Family History.
    Alcohol.
    Street Drugs.
    Tobacco.
    Social History.
    The only way to get through medical school is mnemonics.
    The girl before this one, another blonde but with the kind of hard old-fashioned boob job you could chin yourself on, this last patient smoked a cigarette as part of her act, so I asked if she had any persistent back or abdominal pain. Had

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