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Confessions of a Coward,
and the Mysterious 'Dr. Singh'
by Ed Dewke

(a short story)

posted November 1997

What I was thinking when I stepped out of the psoriasis clinic and into the freezing, moisture less winter day, was how little warmth the clinic's ultra-violet light closet gave. No wonder, I thought, the healing is so imperfect. Light should have heat! I never broke a sweat in my thrice-weekly visits to the light closet. Its manmade sun was soulless.

There stood beside me a short slender dark-skinned man in an expensive topcoat, leather gloves, and, almost comically in contrast, an old Navy watchcap rolled down over his ears.

His breath steamed from his nostrils. His black eyes studied me.

"Yes?"

"Sir. Forgive my intrusion, please. You are a patient here at the psoriasis clinic?"

"Yes."

"My name is Sanjeev Singh. I am a doctor." He raised his gloved hand and offered a business card. It said, Sanjeev Singh, M.D., Ph.D. No address or phone number or logo. It was an old-fashioned calling card; the type people used to drop on trays servants carried from front door to parlor to announce visitors. I handed the card back to Dr. Singh. "What can I do for you?" I asked.

"If you have a moment, I would like to tell you about an experiment I am conducting towards a treatment for psoriasis. I am looking for volunteers —trial subjects."

He smiled and I saw his perfect and polished teeth.

In the warm diner, sitting before our cups of steaming coffee, Dr. Singh started:

"I have perfected a two-step treatment which, undergone a single time, will clear your psoriasis for at least three months and, more typically, from six to eighteen months. It involves no dangerous medications, nothing at all systemic, and, depending upon the severity of your condition, requires from five to eight hours in a single session.... Step one is immersion in a natural biologic mass which removes scales and breaks down lesions. Step two is immersion in a compound of my own devising, the active ingredient of which is a coal tar extract.

"If you will become a subject in my trial, you will undergo the treatment once and then let me examine you every other month for as long as your remission lasts. When the lesions begin to reappear, you may elect to repeat the process at no expense. Given the success of the trials, I hope to have my treatment commercially available in two years."

I asked, "Are you afraid the clinic might not endorse your experiment? Is that why you are soliciting volunteers outside?"

"The treatment will become, I believe, indismissable, and clinics such as this one will adopt it or go out of business. My fear is that they would block the trials, or at least take them out of my control."

"Is the treatment that radical, or dangerous?"

He paused, then said, "Radical, perhaps. Dangerous? No. However, I do require my trial subjects to be asleep for phase one."

This alarmed me. "Are you saying a general anesthetic is a part of your procedure?"

"No. That would be illegal. My subjects ingest a common sedative and the procedure commences when they fall asleep."

"May I speak to some of your subjects?"

Singh frowned and looked away from me. Finally, he said, "I have perhaps misled you. So far I have tested only one subject, and you are speaking to him."

"You are a psoriatic?"

"Yes. Severe. Eighty-percent effected."

All I could see of the little dark man was his face and his hands. Even now, shed of his overcoat and watchcap, he was wearing an impeccably pressed three-piece suit, starched white shirt with high collar, and a garishly fashionable bright-colored tie. No signs of psoriasis anywhere. His thick head of black hair—slightly askew from the watchcap—showed no trace of flaking scalp beneath.

As if sensing my examination, he withdrew a snapshot from a pocket of his suit. It was a picture of himself, naked except for his jockey shorts, pathetically covered by lesions, including most of his face. If it wasn't Sanjeev Singh, it was his awfully afflicted twin brother.

"That was me ten months ago," he said. "One week before the only treatment I've had since then."

If what he claimed was true, I was witness to a startling transformation.

"I'm impressed," I said. "By the way, my name is Ed Dewke."

He studied my face. Then he asked, "How do you spell that?" When I spelled it for him his frown went away and his eyes widened. "I know of you," he said. "I pronounced your last name ‘do-weck,' not ‘duke.' You are who I think you are? FLAKE something-or-other?"

I nodded.

Then his frown returned. "I am either most fortunate or unfortunate. I had not anticipated a prospective subject known to decry the vagaries of his affliction to the whole world."

"Does this mean our interview is over?" I asked.

"That depends," he said. "I will require from you a promise of non-disclosure."

"What if your treatment works? Wouldn't you want it disclosed?"

"Of course. But my way."

"My assumption, Doctor, is that you intend to get rich from your treatment."

He did not respond.

"At least confirm or deny it," I added.

"Mr. Dewke, I have sacrificed a considerable amount of income and amassed an even more considerable amount of debt across the period of time I have been perfecting my process. My labor warrants compensating, and I do believe that if my process is successful in removing the hideous symptoms of this disease from humanity, I will have earned what I might reap. Would you disagree?"

I sipped my coffee while composing my words. "Let me tell you what I have seen, Dr. Singh. I have seen manufacturers release products which they sincerely believe will help psoriatics. Indeed, some psoriatics may be helped for some period of time. But I have seen an awful greed behind the marketing of these same products, and perhaps this was out of the hands of the well-intentioned inventors. What I have seen is products priced high, sold quickly through expensive ad campaigns, so that the cost of research—if any—and the cost of marketing is swiftly recovered and the gravy train begins. But the truth is always the same. These palliatives help some of the people some of the time, and millions of dollars which might more meaningfully have effected a cure, are gone."

"So you advocate suffering until a cure is found?"

"No, not at all. I advocate money-back guarantees and a portion of proceeds donated towards a cure."

Dr. Singh sat back in his chair and sighed. "Would that the world worked with such beneficence, Mr. Dewke. Hardly a compound can be brought to market under such a scheme, I am afraid."

"Why not?"

"There would be too little profit. As you well know, most approaches to the treatment of psoriasis benefit, at most eight out of ten psoriatics—and them only for awhile. Perhaps one out of ten will find a remedy sufficient long enough to make of him or her a profitable client. And were money-back guarantees and donations a part of the equation, the income generated from the other nine people, who buy once or twice then never again, would be insufficient to maintain the product for those few who wish to keep on using it. Is that so difficult to understand?"

"We are talking margins. Profitability. The exploitation of suffering."

But Singh was not yet finished with his argument. "Besides, Mr. Dewke, the money-back guarantee you seem to think so fair happens all the time with prescribed drugs. Surely you have received many samples from your doctors over the years?"

"Yes."

"Those are try-before-you-buy arrangements paid for by the pharmaceutical industry."

"Then you see yourself and this new regimen of yours fitting quite nicely into the status quo."

"No! You mistake my arguments on behalf of the rest. My treatment is likely to work for all psoriatics. At least, that is my hypothesis. If you help me prove that, we shall see. But perhaps you can see how threatening my success would be to the ‘status quo' as you put it?"

"Let's table that issue for now," I said, shifting self-consciously in my seat. "Why this requirement for the patient to be asleep through your process?"

"It is ... for the comfort of the patient, not a requirement of the treatment."

"Why?"

"I am not prepared to disclose that," he said.

"You are asking me to submit to a treatment, while I am asleep, about which I know nothing?"

"That is precisely what I am asking. You must trust me."

"Tell me. Am I the first person you have approached with this proposal?"

He drew a deep breath and would not look me in the eyes. "No."

"Others have told you to go fish."

"Not always so kindly."

"Surely you understand how we feel? You sound like a mad scientist. Frankly, I'm surprised you have not been reported to the authorities."

He lowered his head in exasperation or shame. He muttered into the tabletop, "The treatment works and is harmless, but it is repugnant."

"It is what? I didn't hear you."

He raised his head. "I said, it is repugnant. It is a process which you would be unlikely to subject yourself to, until you had been through it once and found out how well it worked. Then, I believe, you would gladly go through it again; however, you would ask to sleep through it."

"Well, Doctor," I said. "You have already dissuaded me and I haven't a clue what's involved. If I could, I'd fetch your pole and bait right now."

"Let me ask you this, Mr. Dewke. Is there someone you trust implicitly, whom I could trust? Someone to whom I could disclose the process completely, and then you would trust them if they told you to go ahead and try it?"

"What if they told me 'don't do it'?"

"Then we would part company forever. I would only ask that your confidant not disclose my process, not even to you, especially not to you."

I looked at him in silence for close to a full minute. Finally, I said, "My wife."

"I must interview her."

"Of course."

*****

Clara Dewke is level-headed to a fault. She has a nose for malarkey and a natural defense against bad ideas. When I told her about my unsolicited meeting with Dr. Singh her unsurprising response was to laugh. "Forget about it," she said and strode off to the kitchen.

But I followed her. "I would like you to at least talk to him," I said. "I mean, what if he really is on to something?"

"On something is more like it," she suggested.

"What's the harm in talking to him?"

"A waste of time," she said. "We don't know this guy. He says he's a doctor. Anybody can say they're a doctor. You wanna be a doctor? Dr. Dewke. There. How does that sound?"

"I'm serious," I implored. "You're probably completely right, and no matter what he tells you, I probably won't go through with it. But think what a story this would make for Flake! If he's bogus, I could warn others—"

"Don't you have enough to do?" she asked suddenly. "I know I do."

"Thirty minutes. An hour, at the most."

"What's to be gained? You told me I can't tell you what I learn."

"Hey. If he's bogus, neither you nor I need to honor our commitment to him. We'll expose him!"

It took most of the evening, but finally she agreed to an interview. Dr. Singh had given me a phone number which he said was a service. I was to leave my number and he would return the call. I did this and he returned my call in about an hour. I put Clara on the phone, first admonishing her to be civil.

He did most of the talking. At one point I overheard Clara ask, "And you promise me this won't take more than an hour?" Sometime later she scribbled something on a notepad. Finally, she said, "I'll be there," and hung up.

"I'm meeting him at a diner tomorrow morning," she said, tucking the note she had scribbled into her purse. "He sounds like a lunatic."

"Well, what did he say? Obviously he had a lot to say."

"We're going to meet at this diner and he's going to show me some pictures and explain what he has in mind—if I promise not to tell anybody. He says if I advise you not to take his treatment it will be okay. But I'm to keep an open mind. That's what he said. An open mind. Sounds like a waste of time to me. That's it. Can we go to bed now?"

*****

The next evening, after Clara's appointment with Singh, I had to open the subject. Clara was behaving as if no meeting had taken place.

"Well?" I asked as we cleaned the dinner mess. "What did Dr. Singh have to say? Should I do it?"

"Forget it!" she said. "The man's a lunatic. It's not worth discussing."

"What is it? What does it involve?"

"It's horrible. But I can't tell you. That was part of the deal."

"Wait a minute! What if the next guy goes along with it? If it's that horrible, shouldn't we try to stop him?"

She raised her hands to silence me. "It's awful. Okay? It's disgusting and it's awful and I don't want you to do it. But I didn't say it was bogus or that it wouldn't work."

I sighed. "You mean to tell me you think this guy might be on to something yet you don't want me to go through it? He might be able to help my psoriasis and you don't want me to be helped?"

"Oh hell," she said. "Let somebody else try it out. If what he claims is true, you'll learn about it soon enough. There's just no reason for you to be a guinea pig."

*****

The next day I called Dr. Singh's service and left a message for him to return my call. Again, about an hour later, he called.

"I enjoyed meeting Mrs. Dewke," he said.

"You impressed her, too."

"Then you will do it?"

"Yes. When and where?"

We made arrangements. I wrote down the address, which was in an industrial park I knew, and set a date for the next week. I was to come at 9:00 and be home by 7:00 that evening, or earlier. I let all this transpire before dropping my ‘condition' on him.

"I will undertake the treatment," I said, "so long as I do not sleep through phase one."

There was a moment of silence on the other end of the phone. Then: "Surely Mrs. Dewke did not recommend this."

"Do you accept my condition?"

"I cannot believe that is what you want."

"That or no deal, Doctor."

"What did Mrs. Dewke tell you?"

"Nothing. She kept her promise."

"Did she suggest you be awake for phase one?"

This time I paused. "No. That's my idea."

"Have you shared it with her?"

"No."

"I think you should discuss it with her."

"No need. I've made up my mind. Now it's your turn to decide."

"Frankly, Mr. Dewke, I do not think you will go through with it."

"Why? Does it hurt?"

"Psychologically, perhaps—"

"You said it was repugnant. I'm prepared for that. You want to immerse me in horse shit? I'll just think about ponies. How bad can it be?"

"Mr. Dewke, except for a breathing apparatus, you have to be completely submerged in a biologic mass that is, for most people, quite frightening ... and you have to stay immersed for several hours. Psychologically, it could be excruciating. I know this. I have been through this myself."

"Are you saying I will be frightened out of my mind? Or tortured?"

"More importantly, you will be stressed and, as you know, stress works against the very thing we are trying to accomplish. You do believe, don't you, that stress exacerbates psoriasis?"

"How stressful can a few hours dipped in shit be?"

"Mr. Dewke! We are not talking about ‘shit'—"

"Then tell me what we are taking about."

"You have convinced me of one thing."

"What?"

"Your wife did not tell you about the treatment."

"Of course she didn't."

"We would not be having this conversation if she did."

*****

Of course, that same day guilt set in. Despite my wife's good judgment, I was preparing to undertake something probably stupid. I am a dolt. What can I say? I could not tell Clara what I had done, but I knew my total silence on the subject would make her suspicious. So, for the next few days, I would periodically prod her, surreptitiously to get more information. She grew irritated by the prodding, but also, I think, unsuspecting.

A week later I was with Dr. Singh in his modestly appointed office in the industrial park. I had come prepared for the treatment, but with no promise it would be given to me. Dr. Singh had agreed merely to talk further.

"I have tried to find other subjects," he said to me from across his desk. "I have tried very hard the past few days," he added, "in hopes that I would find someone and could tell you to go back home and forget we ever met. I am inclined to say that even now," he said, and drummed his fingers on the desk. "But I believe I have come up with a compromise."

"I'm listening."

"You may or may not be able to endure phase one awake, but I am almost certain you could not do so completely unprepared. So, I wish to prepare you. I will give you a small sample of what the full treatment would be like and, if you find it unendurable, we can reconsider your sleeping through it, or you can elect to leave."

I did find relief in this proposal. But he wasn't through. "You must promise me that you will write nothing about this procedure, good or bad, for at least two years."

"What? No scoop?" I was teasing, but Singh was not in the mood.

"No scoop!"

"Well, what if it works and you go public in the interim?"

"You will know and then you may write about it."

I nodded my agreement.

He opened his middle desk drawer. I was afraid he would draw out some non-disclosure agreement for me to sign, so I said: "Unless I determine your treatment to be cruel and inhuman and maybe dangerous. If I thought you were putting people's health or lives in jeopardy, I would do my utmost to shut you down."

He removed his hand from the drawer, clenching something I could not see in his palm.

His face tightened. "Who is to make that determination, Mr. Dewke? If I say my treatment is harmless and you say it isn't, who is correct? By what measure are you going to determine if my treatment is harmless?"

"By my own experience, I guess."

"If you choose to go through with it."

"Of course."

"But what if you don't?"

I did not know what to say. Singh took advantage of my moment of silence. "You see? It is a quandry. No, sir. I must ask that you say nothing at all. You must make me that promise or our meeting is over."

In my mind I held my fingers crossed. My promise, I knew, was only as good as the Doctor's ethic, which it seemed only my promise would reveal. So I made that promise, and a moment later he opened his hand.

He held a small vial, the cap of which had holes to admit air. I spied a fleck of something inside the vial. There was a magnifying glass on his desk and he handed both the vial and the glass to me. "Look closely," he said. "Meet my little soldier in our war against suffering from psoriasis."

Inside the vial was a tiny light brown spider, no larger than a common tick. I counted the legs to make sure I was observing a spider and not a six-legged insect. Even with the glass, it was difficult to see detail on the little arachnid. "A spider?" I asked.

"Yes. An unnamed species."

"Unnamed?"

"So far, yes. It will probably bear my name somehow, as its kind have been engineered by me."

"You created a spider?"

"I genetically engineered a new breed. Not such a feat, I assure you. Happens all the time."

He was silent until I lowered the glass and looked back at him. "Okay," I said. "Tell me the rest."

"This spider eats flakes," he said.

I had not begun to contemplate the Doctor's assertion when I said, "He'd have to be a good bit larger to do me much good."

"Or," Singh said, "have several million brothers join him in the feast."

I looked at Singh, epiphany dawning. "No—"

"Quite. Phase one is immersing you in a chamber filled to brimming with these spiders."

At first my mouth worked but no sound came out. Finally, I was able to say "You've got to be kidding."

"Are you sufficiently horrified, Mr. Dewke?"

Repulsed was the right word. My constant itching from psoriasis unbelievably worsened that instant. "You mean to stick me in a whatever, filled up with these things, and let them munch away at me?"

"Rather unscientifically stated but to the point."

"You're nuts."

"Sane enough to have anticipated your reaction. Wouldn't you say?" He seemed pleased with himself, as though vindicated.

I realized my pulse was racing. All I could think was, Clara would not tell me this?

"Now let me tell you about the preparation I have concocted," Dr. Singh said, either not noticing or choosing to ignore my anxiety. "I see you have flaming lesions on both your hands. I propose that you allow me to subject just one hand to my critters"—that's what he said, my critters—"and you can judge for yourself whether or not you could endure the full phase one."

My mouth moved silently some more.

Singh continued: "Mind you, Mr. Dewke. Allowing my critters to descale the lesions on one hand will not prove anything. I know this. I have tried this. This is not a treatment you can embark upon piecemeal."

"And why," I stuttered, "is that?"

"I'm not sure. The skin is a single organ and psoriasis is a root condition. I believe some certain percentage of a problem must be addressed and that, if you address less than that percentage, you are wasting your time. Does that make sense?"

I nodded. While he was speaking my eyes had wandered back to his critter in the vial. I believe it moved inside its glass cell, but that could have been a trick of light. As far as I really knew, the thing could be dead.

Singh opened another drawer and this time withdrew a document. "This is a report by a colleague of mine," he said, "an entomologist who has studied my spider and certified, here, that it is non-poisonous and non-toxic."

I took the sheet and scanned it. "Oh fine," I said. "What makes your critters stop eating when all the flakes are gone? What stops them from eating all my skin?"

"They are genetically predisposed to find living cells undigestable."

I didn't buy that. "Even my healthy skin is covered with a layer of dead cells I'm quite fond of," I said.

"Quite true," Dr. Singh said, "and you will sacrifice some of those cells. I monitor to ensure you do not lose too many. The spiders are drawn to the lesions because the tissue there is easy to harvest. Like ants or honeybees, there is a biochemical communications accomplished within the colony that alerts all the individuals to where the feeding is easiest and they will, for the most part, ignore your healthy skin on their way to the psoriasis lesions."

"What's this for-the-most-part mean?"

"If the entire colony becomes traumatized, they will feed wherever they find themselves."

"And what might traumatize the entire colony?"

"A thrashing, anxious patient, for one. Which is why I would prefer for you to be asleep. Panic inside the chamber is not good."

"What's this chamber you're talking about?"

"A slightly modified sensory deprivation chamber. You may recall the experiments that were popular in the sixties? People would float in a saline solution without light or sound for hours on end?"

I recalled. The Doctor went on. "You can pick them up relatively cheaply from institutions that have outgrown the fad. It was expedient for me to do so. It works just fine. As I've said, I've been through this myself."

Though my pulse had slowed, now I felt sweat pooling in my armpits. Involuntarily, I shuddered. I think the Doctor noticed. He smiled his best bedside manner smile and asked, "Do you feel up to the test?"

"You mean—a hand?"

"Yes."

"If it's not supposed to do my psoriasis any good, what's the point?"

"My hope is that it will give you a sense of what it feels like to have the critters on your skin, eating the flakes. Hopefully the experience will desensitize you. Perhaps you will be able to undertake the full treatment awake or—and this is more likely—you will decide to sleep through it."

"Or," I jumped in, "I will decide to be gone in a flash."

"There is that possibility, too."

I was not ready to make a decision, or perhaps I was and just denying my fear. "How did you come upon this—this treatment?" I asked.

"A combination of anthropology, entomology, genetics and an itching desire—no pun intended—to alleviate my own suffering," he said. "Purgation of skin lesions by insects has been practiced probably since prehistory. There are people in Africa that practice it to this day. All sorts of creatures are happy to consume our dead skin, but I found none that were easy to—to domesticate."

"Oh! These fellows are pets, are they?"

"No. But nor are they wild. Remember, none exist outside my colonies. They serve but one purpose and that is to make you and me and, someday, all psoriatics, feel better."

"Right now I'm feeling anything but better," I said.

"See how much easier it would have been to let me do this my way?"

"What is that? You would have put me to sleep then stuck me in your spiders' den without my knowing it? Later I would have woke flake-free and grateful?"

"More or less."

"That's not how we practice medicine here," I said. "There are rules about being forthcoming."

He shrugged, "Tell that to the thousands of people taking placebos, or who are about to undergo surgeries with names they cannot pronounce, or who, in comas, do not even know they are being treated. But enough." He stood up suddenly and came around from behind his desk. "Let me show you what I have in mind for you."

With me sitting and him standing close to me, he did not look like such a small man. I doubted my command of the situation. Despite the quiet that surrounded us, I had a flash that others might be waiting just beyond the door of his inner office: perhaps two very large and burly men in white smocks ready to grab me and drag me to that awful chamber. But I shook the thought from my mind and stood myself. My perspective improved. I was ready to follow him.

*****

On our way to another room in the Doctor's offices a phone rang. The Doctor paused and so, of course, did I. His message machine answered first, then I heard a familiar female voice, the operator from his service, say he received a call. The operator left the name and number. The Doctor blinked, then continued on to another door through which we both passed.

I saw a plexiglass box atop a high table, next to which was a backless stool. As I drew closer, I saw that the clear box was filled with Dr. Singh's critters. They were packed in: a biologic mass indeed! Unlike the single specimen in the vial in his desk, this batch of spiders were teeming. With my eyes as close as I felt comfortable bringing them to the box, I could see them moving. Thousands of them; perhaps hundreds of thousands of them. The Doctor moved the box slightly so that I saw another of its six sides. This side had a round hole over which had been fixed a slit rubber drum. It was immediately obvious that I was to stick my hand inside the box through this aperture.

We had been silent for nearly a minute, my eyes frozen to the clear box and the horrifying life thriving and looking very hungry inside it, when finally Singh said, "Would you excuse me long enough to make a call? It would be good for you to have a moment alone with our friends to further consider our next step."

I nodded and the Doctor left me alone with his critters.

There is a stupidity about grown men when they are deathly afraid. It's as though fear is mind-numbing. Dr. Singh had not been gone a minute when something compelled me to stick my finger into the box. Was it pride? Did I think by sneaking this experience I might find it tolerable and therefore come off more heroic when the Doctor returned and I would stick my whole hand in there? I don't know. It was a stupid, compulsive thing to do; yet I did it. I gently nudged my right index finger into the hole.

I felt them. At first it felt like sticking your finger in the bathtub drain while the water is running out. But it was dry, and in a few seconds I could feel the randomness of the movement. Too many tiny spider legs to make out anything distinct, but then I felt a concentration of activity at the edge of my fingernail ... no ... more precisely, beneath my finger nail, where the psoriasis-swollen bed of my nail was so obvious.

I tried to concentrate solely on this sensation at the end of my finger. What I felt and what I imagined could not be separated. I sensed hundreds of tiny mandibles pulling ... tugging ... cutting. How many times did I catch myself chewing away at this same tissue with my own teeth? But this was entirely different. I thought I could feel minute particles of my nail bed being pulled away, devoured. At the same time, but gradually, I sensed the nibbles on the top of my finger, over the two psoriatic knuckles I had so blithely offered up.

Perspiration from my forehead was stinging my eyes and I moved to wipe it away. Did I imagine this, or was my slight movement enough to disturb the spiders on the finger of my other hand? It was as though, for an instant, they stopped what they were doing. Carefully, I wriggled my finger ever so slightly. Then I felt the movement again, much stronger, much more seemingly aggressive ... a few perhaps imagined stings ... the ouchful tearing we psoriatics sometimes feel when we peel away a not-yet-ready-to-be-shed flake. Altogether, what I sensed seemed suddenly frantic, as though the spiders knew before I did that I was about to chicken out and they must feed harder, faster, for they were certainly about to be denied their dinner.

I panicked and jerked my finger from the box. Of course, a few of the spiders were still there. I shook them off violently, unheedful of where they were flung. Then I inspected my finger. I should have looked at it closely before I stuck it in. Perhaps, in so doing, I would have had an image to compare with what I saw now. As it were, I could tell little from my inspection. I could not see what had been removed. In fact, I couldn't see that anything at all had happened. But I remembered the feel of it. And I began to imagine the whole of me in there....

Quite, quite impossible. Absolutely out of the question.

Dr. Singh returned. He seemed excited but disturbed. It took all my stamina to try to look unchanged, to disguise my panic. My mind raced to find an excuse. Yes, even at that moment I was too vain to simply admit I did not want to go through with this. But then, a miracle happened.

"Mr. Dewke," the Doctor said. "I think that today is not the day for you to decide to do this. You are sworn to secrecy. I do not want you to feel pressed into this. Perhaps you should go home and discuss this further with your wife. If you still want to proceed, you have my number."

Try as I might, I know it was impossible not to display the relief that overwhelmed me. It was ludicrous to act affronted, so all I did was shrug. In fact, I could not be ushered from that room fast enough. There were spiders lurking about, spiders that I had shaken off my finger. Perhaps, I realized in horror, they were still on my person ... in my hair ... beneath my clothes. My skin crawled as I hurried from the room and the Doctor hurried after me.

"You will not forget your promise, Mr. Dewke?"

At the outer door to his offices I took great gulping breaths of air. Could it be possible that I had not breathed for several minutes? I felt flushed and drenched in perspiration. For a moment I thought I had wet myself. "You will not forget your promise, Mr. Dewke?" he repeated.

I looked at him. I knew that I would never forget his face. I imagined that I would have nightmares involving him. "No," I said. I was able to make my voice sound almost normal.

*****

November, 1998

All that I have recorded here happened a year ago. I have honored my promise to Dr. Sanjeev Singh across these months, but not because of any good reason. In short, I have been embarrassed by my cowardice. What do I know about Dr. Singh or his arachno-therapy? What could I have said about it, and who would have listened?

About a week after my flight from the Doctor's office I stopped shaking when I thought about it, and a week after that I felt compelled to follow up. I believed I might actually reschedule a visit, this time exposing my own hand. But I will confess a part of me was relieved when his answering service reported they no longer serviced him. Dutifully, nonetheless, I asked about forwarding information. Equally relieved, I learned he had left no forwarding instructions.

For weeks I contemplated his last minute change of heart. I believe I know what turned him around in my case. Undoubtedly that phone call he left me to answer was from another subject, probably one more amenable than I. I could not remember the name I overheard the operator leave on Singh's message machine—only a certainty that it had been a woman's name.

It made me feel strange to think a woman might go where I feared to. Of course, if she was that much more desirable a subject than myself, she would have agreed to Singh's proposition. She would have slept through phase one, perhaps never learned what in fact she endured.

In the months passed since my encounter with Sanjeev Singh I have had nightmares. It is not his well-groomed dark-skinned face that haunts me in those dreams; it is, of course, his critters. Some nights I wake certain they are upon me between the sheets, but always it is the persistent itch of a flaming psoriasis lesion. On the days following these nightmares I have been tempted tremendously to write about this, to post my experience on my web site in some glib fashion, hoping someone out there might make a connection and e-mail me with recent news of Singh and his spiders. But, as I have said, it wasn't the honor of my promise that kept me silent, but the embarrassing explanations (or risky fabrications) that would no doubt become necessary if I opened this can of ... spiders.

But then, last week, I received this e-mail:

Dear Ed: I have been a visitor to your web site for a long time, but this is the first time I have written. My name is Danette and I live on Mauritius, an island nation off the coast of South Africa. I am 27 and have had P since I was 13. Years ago I went to Capetown to see a dermatologist and he told me what I had was P. My doctor at home talks sometimes to other doctors on the continent, and we have tried many expensive medicines, including shots, but nothing worked for long. But I am so excited now! 3 months ago a new doctor came to Mauritius and HE found ME. I tried his new treatment which happens in two phases and takes almost an entire day. Right after my treatment I had NO FLAKES. A week later my lesions were pink, and a week after that they were GONE ENTIRELY. I have been flake free for three months without using any medications. I wish that I could tell you more about the treatments, but I was asleep for phase one and when I woke up I was in a bath of cool but not cold coal tar goo. I'm not sure what all it had in it. Dr. Bali, who invented this treatment, says it is not performed in America yet, but he hopes it will be soon. It is the only thing that has worked for me. I haven't had three clear months since I was 12, so you can imagine how overjoyed I am. I know it is not a cure, but for me it has certainly been the next best thing! I hope you may all have an opportunity to try it, soon! Sincerely, -Danette

"Dr. Bali." Now you, my readers, know as well as I who Dr. Bali is. And it is up to you to judge me for this disclosure. I hope that Danette will not be horrified in retrospect if she reads this. Or any of the other Danettes out there, for I am sure there must be several by now.

Now, when I scratch my lesions until they bleed, I consider the price of knowing. But knowing what? Perhaps it would be more correct to say the price of knowing FEAR. Do not be troubled by any of this, my cousins, if you are approached some day about a two-phased treatment, the first phase of which you must sleep through, but the whole of which will clear you for a year or more. Ask or do not ask any questions. Do not tell me how it turned out for you. Leave me guessing. Please. -Ed Dewke

*****

NOTICE: This is a work of fiction. The character, Dr. Sanjeev Singh, is fictive. If, perchance, there is a real person out there somewhere who resembles Dr. Singh, it is my sincere hope that I will never, ever meet him. The e-mail from Danette in this story is also fictive. If there is a real "Danette," you have my utmost sympathy.

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