Episode 2: “Timing Is Everything”

The preceding episode may cause readers to think that Matt Sarisob, MSW, LICSW, is a repulsive, secretion-obsessed juvenile. However correct this may be, the reader should be cautious not to lose sight of her own Sarisobian proclivities. After all, aren’t we hard-wired to abide, and sometimes even enjoy, the smell of our farts? Don’t we occasionally bring the soiled toilet paper noseward to discern the constituent elements? Does not the human mind light upon sexual fantasies at oft-inopportune moments? The reader can surely relate to Sarisob’s predilections and doubtless relishes her own covert cheese-cutting, or the wetness-inducing memory of her tryst in the HVAC closet with that cute Maintenance guy.

Therefore it should come as no surprise that the other half of Sarisob’s double life is that of a highly-functioning citizen, respected at work and active in the community. Sarisob was beating his meat that chilly morning while waiting for the B-Line to bring him a short walk from Massachusetts General Hospital’s Yawkey Center, where he works as an Oncology Social Worker. Loved by his patients and colleagues, Sarisob has carved out a comfortable niche in his eight years at MGH. Only the keenly observant can descry his fart-centric behavior: in the way he suddenly ducks into bathrooms for longer-than-average visits, lingers over smells, and brings his fingers to his face more than is necessary and hygienic. The keenly observant have so far consisted of Sarisob’s parents, Monique and Roger, and a series of ex-girlfriends who gradually discovered that their soon-to-be-former beau was either unable or unwilling to change his personal habits. The ex- that stung Sarisob the most was Stephanie S., a fun-loving librarian at the Athanaeum whose classical music collection was even larger than his. Determined not to repel the willowy brunette, he was remarkably successful at keeping his smells to himself during their seven months together, and was shocked when she abruptly broke it off one morning during their ritual pre-work breakfast at the Fill-A-Buster restaurant. Stephanie, quieter than usual, barely touched her grilled bran muffin and diet Coke, although she did eat two of the three fried eggs. Her eyes beginning to well with tears, she said "Matt, look, I'm sorry—I think I need some time to think things over. I'm so sorry," and rushed out, covering her mouth as if she were about to throw up. He never heard from her again, and stopped attending the Victorian Literature book group that brought them together. To this day Sarisob wonders what it was he may have done that snuffed their flame, and will always feel a pang over losing the second woman he could have married. And the second woman he could have married breathes easier, having never told Sarisob about the months of anguished forbearance that led to her breaking point. Stephanie, you see, loved Mexican food, and decided that a man who couldn't eat so much as a Chile Relleno without turning the sumptuous bed that was her prized possession into such a toxic Dutch oven was not the man for her. She didn’t have the heart to tell Sarisob the extent to which he farted in his sleep.

Still chuckling over how he surreptitiously “pulled it off” on the platform, Sarisob made it to work a little after 8, with his customary blueberry scone and Peets coffee. (After testing all of the coffee chains, Sarisob found that Peets inspired the strongest laxative effect.) He took off his windbreaker and scarf and before doing anything else opened the bottom drawer of his desk, which contained, among other things, three pairs of chinos. Mindful that there was a not-insignificant probability that coffee, food, urine, shit, diarrhea, or semen might stain his pants during the workday, he had to be prepared to maintain his professional image. He keeps three pairs in the drawer because one particularly embarrassing day he had to change twice—and only had one pair in his desk! From then on, three pairs was the rule; even Sarisob could not conceive of having to change his pants four times in a workday. He withdrew a pair, and went to one of the two unisex bathrooms around the corner to change his pants. Sarisob loved these bathrooms: their proximity to his office, the heavy, sound-shielding wooden doors with locks that communicate “Occupied” or “Vacant” to those outside, and best of all the fact that his female colleagues use the same stalls, a thought that lent piquancy and potency to his near-daily work-jerk.

He returned to his office, settled in, and dialed up his favorite of Bach’s “English Suites”, the 4th Suite in F major as played by Glenn Gould, on his computer’s Windows Media Player. A classical music lover, Sarisob outfitted the computer with Altec-Lansing speakers and subwoofer, to better convey the dynamic range of his beloved Vienna Philharmonic. Between sips of coffee he opened the electronic medical record of his 10 a.m. new patient: Rick Landsman, a 53-year-old father of two, investment banker from Newton, being treated for Stage II laryngeal cancer. He has completed one-third of the prophylactic course of radiation therapy that followed his successful surgery. The most recent progress note from the referring radiation oncologist, Dr. Harry Morganstern (Sarisob’s bi-monthly bowling buddy) revealed the scenario that inspired many a head-and-neck cancer patient to see a social worker. Landsman dismissed the warnings about the difficulty he would have eating and swallowing during his course of radiation, the painful exhaustion, the hyper-inflamed throat, and insisted with pre-treatment bravado that he’d get through just fine by drinking liquid meals pureed in a Vita Mix. He fought against the surgeon’s insistence that he have a feeding tube, known as a PEG (percutaneous endoscopic gastrostomy) tube, surgically implanted into his abdomen to maintain his weight by taking liquid supplements through it when radiation side-effects make it all but impossible to swallow food. “Mr. Landsman has lost twelve pounds since his surgery,” Sarisob read from Harry’s note. “He reports acute pain swallowing, and discontinued taking meals orally three days ago. Mr. Landsman has begun taking Ensure via the PEG with extreme reluctance. Mr. Landsman and his wife report difficulty adapting to the PEG, so I am referring him to social work for a consult.” Sarisob had a pretty good idea how this arc would go: Mr. Landsman would spurn his offer of joining a support group, and work through his anger issues pretty quickly as he makes the shift from hating his PEG tube to accepting his PEG tube to, in many cases, loving his PEG tube. Once head-and-neck patients realize they can maintain their weight while enduring the hellish side effects of radiation, they begin to view the PEG tube as a savior rather than a freakish abdominal protuberance. More than a few patients actually preferred using it to eating and were unwilling to have it removed! Sarisob finished his coffee, took a bottle of odor-neutralizer from his desk, and hurried around the corner for his morning dump.

“Look, Matt, all due respect, but I could care less for this. It's all for my wife that I’m here,” Landsman said in a hoarse whisper later that morning. He was a slight man with close-cropped black hair and intense dark eyes. The tone of his voice, Sarisob divined when they met with a firm handshake, revealed that Rick Landsman was not one to suffer fools. “I don't belong here talking to you; you don't belong here listening to me. Well, I shouldn't say that—you probably spent good money to get your degree. But don't fool yourself: all you are is a necessity for me, another hoop to jump through.” He slumped in his chair dejectedly, tugged at the sleeve of his black nylon sweatsuit, and took a pull on his water-bottle.

“I understand that, and I'm flattered for the opportunity to be one of your hoops. But this isn’t about me, Rick—it’s about you and your wife getting through this. You’re a good man for coming here and helping put her at ease. It’s never easy to talk with someone—“

“—There’s nothing to talk about, Matt. There’s just me, the tube, and my painkillers. This fucking feeding tube is all I can think about, OK? (cough!) Last night I dreamed it was strangling me. Shit, I forgot to tell Dr. Morganstern to renew my Fentanyl.” He spoke slowly, slurring his words due to the Fentanyl and the mucus buildup that plagues head-and-neck patients.

“I’ll tell Dr. Morganstern for you, so consider it done. I know how painful this can be—but you have to know, Rick, it’s just temporary. You know the PEG is only here to help you through the radiation. And you know that if the radiation goes as planned you’ll have a 72% chance of long-term survival. Better than fifty percent, Rick—you know all this, Dr. Morganstern discussed it all with you. You’re on track to long-term survival!”

“I know, I know—my wife tells me that like 30 times a day. ‘You’re going to survive this, you’ll be there when our kids graduate from college.’ And all I can think to myself is it's gonna be a lot easier for you to survive it honey—you don't have a fucking tube (cough, hack!) sticking out of your gut! I don’t know, Betsy’s being a trooper...I’m a piece of work even when healthy. But she still flinches when she sees the tube, and I’ve had it for two months now. I hate the feeling that I have to hide it from her. (COUGH!) Hey, can you refill my water?"

Sarisob went out to the water cooler in the Social Work office and filled his bottle. When he returned, Rick took a sip and looked at him with greater attention.

“I’ll bet...” Rick said, nodding at Sarisob with squinted eyes, “you’re a Socialist.”

“Me—a Socialist?” Sarisob laughed. “I’m flattered! Why would you think that? ‘Cause I’m a social worker?”

Smiling for the first time in the session, looking down at his folded hands, he said: “Because of your concern for your fellow man. And I know how poorly paid social workers are (cough, hack, cough!) paid.”

“Ha, ha, yeah, well none of that’s so terrible, is it? I bring home peanuts, and make it a little easier for you to get back to work and make millions for your clients. Rick, I should let you know: my colleagues and I run support groups that could be helpful to you and/or the missus if she would like. Would you like more information on this?”

“I’ll run it by her, but I’m sure we won’t be needing that.” His demeanor hardening, he took another pull on the water-bottle and sat up in the chair. At this point Sarisob felt a little fart coming on, and considered releasing it in front of the patient. The fart was nudging at his anus, but the clinician’s instinct said to tighten his sphincter and save it for later. This was not the right time to fart in front of Rick Landsman. One of Sarisob’s, shall we say, unconventional therapeutic modalities was to allow himself a single fart in front of each patient, with strict requirements as to when to let fly. And he knew deep down in his colon that this was not the time. As it is with so much in life, thought Sarisob as he handed Landsman the support-group FAQ sheet for his wife, timing is everything.

Episode 1: “Cold Hands, Warm Heart”

Sarisob, cold and impatient, jumped on the balls of his feet. He needed to be at work earlier than usual, as he had a 10 a.m. new patient—a throat cancer pt. referred by Dr. Morganstern—and hadn’t yet read the progress notes. Feeling his calves stretching, he appreciated the exercise: a recent snowstorm had kept his bike indoors, and he hadn’t lifted weights in a couple of days. It was a January morning, well below freezing, and he cursed himself for forgetting his gloves. He breathed warm, visible air into his hands while bouncing in place.

The first to arrive at the Inbound platform—a narrow spit of concrete edging both sides of the train tracks—he figured he’d been waiting for a trolley for the past 20 minutes, although it was in fact only half that time. Several others were now waiting as well: a group of cute college girls, blonde, bundled in puffy parkas with “B.U. Terriers” headbands warming their ears; a pair of Brazilian men in painter’s outfits, both underdressed for winter; a woman with a vintage leather jacket and red hair, sporting those ubiquitous white headphones. Sarisob thrust his hands into his pants pockets, as his jacket pockets were poorly insulated.

Jumping less actively now, he felt the heat of his legs begin to warm his hands. All of a sudden, without realizing it, he farted—loudly. The jumping must have loosened a gas deposit in Sarisob’s colon. One of the Brazilians laughed at the ass-blast while the other pretended not to notice. Both of their reactions changed, however, the instant they smelled it. The one who feigned ignorance assumed an expression of shocked disgust and walked further down the platform, while the laugher, whose face was clearly given to expressing joy, took on a grimace of pure disappointment, shaking his head at the offender.

“Que pena.”

“Desculpe me, senhor. Eu tenho uma problema com meu colon.” Sarisob pointed to his ass.

“Valha-me deus!” the man exclaimed with a wave of his hands, picking up his lunchbox and following his friend. By now the gaggle of college girls smelled it too, and had begun to shriek. These girls knew each other as closely as college girls are wont to: they were aware of every rank smell and bodily eructation that each other were capable of, and knew that none of them could possibly have launched such an atrocity. Because Sarisob’s farts are his own recipe—a home-brewed form of biological warfare consisting of an entire head of garlic and a hearty squirt of chili-garlic sauce flavoring the shrimp-and-veggie stir-fry he has almost every night—the stench is 100% his own. The redhead with the headphones acknowledged the situation by lighting a cigarette and dragging deeply, keeping her eyes lowered.

The sunrise began to expand, bringing the prospect of future warmth. Feeling now returning to his numb hands, Sarisob decided to warm them further by gently playing with himself. His left hand grabbed for his penis, owing to its list, while the right hand fondled his balls. Two hands are better than none, chuckled Sarisob, as his member gained mass. He had neither shame nor fear, freely stroking the stiffening cock that rubbed painfully against his pantleg, because he was alone, having cleared the area with his industrial-strength flatulence. The wind-chill was biting out there on the corner of Commonwealth Avenue and Chiswick Street in Brighton, but Sarisob was creating plenty of heat in his chinos.

While he generally didn’t favor coming while standing up, Sarisob dared himself to come in his pants before the trolley arrived, thinking that that might hasten its arrival. It surprised Sarisob to think that he had never before beat off on a subway platform. (Often on the trolleys, but never on the platform.) Accepting the dare, he set to stroking the rim of his penis with his index finger and thumb. The delicious flesh-on-flesh masturbation was well-hidden, because Sarisob had cut the left hand pocket of his pants to enable moments like this one.

Thus engaged, he employed a Hall of Fame fantasy: his 8th-grade math teacher, Mrs. Silvia. He began getting hot as he always did when he bent Mrs. Silvia over her desk after class and gave it to her good. Her full, hairy Portuguese ass was hungrily swallowing Sarisob’s prick; after about a half minute, he didn’t have to do as much work. The heat in his loins began to concentrate, and he knew it wouldn’t take much longer.

Just then, the B-Line trolley pulled up with a loud squeal of brakes; he was oblivious to its arrival. The entrance to the second car eased to a halt right in front of Sarisob. Luckily, those gathering behind him had no visible evidence that he was stoking his erection. The door opened and an elderly couple alighted, shuffling by Sarisob as he grunted, feeling the heat rise into his balls and up the shaft of his cock. He imagined himself fucking Mrs. Silvia’s eager mouth, and felt his muscles clench, preparing for release. Stepping up and into the train, he disguised his grunting with a cough that sounded suspiciously like a laugh as he fell against the railing and held on, gripping it for dear life as the orgasm took hold. He lost the dare, but not by much.

“Looking for money—hang on!” Sarisob falsettoed the final two syllables at the driver—a rotund woman with hair extensions and a large mole under her ear—leaned over, and, groping into his pants found not money but a hot load of semen, spurting over his fingers and left leg.

“Ha, ha, one sec! Looking for...money,” he groaned, with a throaty bark.

“Come on, I gotta make the light!” said the driver, who failed to notice his suddenly-stained chinos. The delirium of orgasm fading, his unstained right hand fished around, but came up with only a quarter. Sarisob despaired that he didn’t prepare for this—he could’ve put the full fare in his non-jacking pocket just in case—and reached around for his wallet, which luckily was on his right side. As the trolley driver viewed him with increasing disapproval, he calmly withdrew his come-laden left hand from his pocket. Deftly cupping his fingers under into a loose fist to prevent detection, Sarisob managed to open his wallet and extract a dollar. Alas though, for all his careful effort he couldn’t prevent a large, thick glob of come from adhering to the edge of the bill.

“Sorry about that,” he said sheepishly to the driver, wide-eyed and twisting his mouth into a grin to divert her gaze from the sperm-glazed dollar being fed into the machine. As the dollar began to be sucked in, Sarisob saw that the machine was old and had poor suction. Due to its poor functioning, a sticky tendril clung stubbornly to the mouth of the slot. By the time the dollar was fully inhaled, a healthy mass of jism clotted the aperture. And then Sarisob’s grin became genuine. Those waiting behind him would now have to run his come-gauntlet to feed their dollars into the machine; furthermore, the T employee who removes the morning’s take will have to pull apart a few bills that are strangely glued together. Couldn’t have planned it any better, he thought, advancing into the car. He turned around to see the college girls gathered around the driver, searching their purses for money.