Product/Progress Sheet by Alex Pruteanu

Wednesday, February 6, 2013



Right now the problem is: proximity to the cabinet which holds all the cleaning supplies. Two
mouthfuls of lye-based commercial solution and a way we go. The bottles beckon mostly at
night. Right now the problem is patterns. Everything is patterns. There is no chaos. What we call
chaotic is a failure to recognize a monotonous series of actions. There are patterns within the
patterns. Patterns on top of patterns. Patterns askant of patterns. History is a pattern. We are
copies of poorly-made copies. Diluted generations. Repeating and exacerbating mistakes. Kaiser
Wilhelm with a foreshortened arm. Czar Nicholas II with dwarfism. There are no variables.
There is no free will. There is only the inevitable.
How I feel is, I’m the rabbit going under the speeding wheels.
Only I’m on Citalopram.
40 milligrams.
Pink, oval, scored tablets.
Washing soda is an excellent choice for helping drains stay clear because while it is alkaline—a
pH of 11—it isn’t as caustic and damaging as the commonly used lye-based commercial product.
It’s good for the pipes.
So strike that second sentence on potassium carbonate liquor and its virtues.
Two mouthfuls of washing soda and a way we go.

Right now the problem is constant manufacturing of product.
Product placement.
New and Improved.
And clichés.
Been there done that.
He’s as good as anyone.
“That little monkey gets loose, doesn’t he”
The problem is commodity cycles: cutting lawns, washing cars, inane pleasantries thrown from
one sidewalk to the other. And the bumblebees are back. Pollinating little white flowers barely
opened on gaunt, brown fingers of a strangling vine with tiny, evergreen leaves.
Everything is laid out in the planner on the counter.
The problem is, sometime in between doing chores, I’ll forget to kill myself. There are products
for that, too: cholinesterase inhibitors. They’re used for Alzheimer’s. Donepezil is taken once
daily. Vitamin E, estrogen, selegiline and a mixture of ergoloid mesylates. There are heavy side
effects with most of these. So I’ll just stick with writing on the back of my hand in black sharpie.
Don’t forget to use new blades.
Everything is so derivative.
A reference to a reference.
You chisel yourself in the mirror, based on what GQ says. Bits of flesh chipped away daily,
along with a morning shave. What I really could use right now is a chemical peel. That’s what
Vogue recommends for forty-one-year-old men with saggy facial skin.
And Decleor cream.

Progress Sheet

DOB: 07/01/1969

Notes and Consultation


Patient presented with depression, suicidal tendencies, SOB, dry mouth, coughing, wheezing,
fatigue, insomnia (16 years running), auditory illusions, possible signs of schizophrenia or bi-
polar disease.

Vital signs:
Weight: 216 lbs.
Blood pressure: 128/78
Pulse: 59
Respiratory rate: 18
Temperature: 97.9

Review of systems: Constitutional: WNL, Eyes: WNL, ENT: sore throat, nasal congestion,
Pulmonary: SOB, coughing, wheezing, CVS: chest pain, palpitations, GIS: faint abdominal pain,
GERD, GUS: WNL, Muscular/skeletal: no sign of osteoarthritic changes, Skin: WNL,
Neurological: fatigue, anxiety, hallucinations, insomnia.

P.E.: Head: NC/AT. Point tenderness over frontal and ethmoidal sinuses
Eyes: WNL
ENT: pharyngeal congestion without exudates.
Neck: supple, JVD present, no thyromegaly, no lymph adenopathy
Lung: bilateral Rolls Ronhai moderate to severe inspiratory and expiratory wheezing, bi-basilar
CVS: S1S2 present, heart RRR, 2/6 SEM at the base and apex of his heart
Abdomen: no guarding, no rigidity
Skin: WNL
Muscular/skeletal: no osteoarthritic changes, tibial and pedal edema 1+, PPP
Neurological: cranial nerves II-XII intact, no focal deficit, DTR present, there is severe fatigue,
anxiety, insomnia, depression.

Assessment and Plan: 1. bronchitis, 2. bronchial asthma, 3. allergic rhinitis, 4. severe insomnia,
5. depression, 6. anxiety

Plan: Albuterol neb in the office X1, Singulair 10 mg. once/day, Ambien 15 mg. recommend:
Selective Serotonin Reuptake Inhibitors
recommend: psychiatric evaluation and analysis
recommend: cessation of alcoholic consumption (patient estimates 1 liter of wine/day, various

alcoholic drinks in addition)
recommend: cessation of smoking (patient admits to recurrent but somewhat infrequent use of
menthol and clove cigarettes)


Since emigrating to the United States from Romania in 1980 Alex Pruteanu has worked as a day laborer, a film projectionist, a music store clerk, a journalist/news writer for the U.S. Information Agency (Voice of America English Broadcasts), a TV Director for MSNBC and CNBC, and a freelance writer. Currently he is on staff at NC State University.

Alex has published fiction in Pank Magazine, BRICKrhetoric, Camroc Press Review, Airplane Reading, The Legendary, Girls With Insurance, Trick With a Knife,, Slingshot Litareview, Thunderclap Press, F Magazine, Specter Literary Magazine, Connotation Press, The Monarch Review. He is author of novella “Short Lean Cuts,” (Amazon Publishing) available as an e-book at Amazon and Barnes & Noble, and in paperback at Amazon.

© 2013, Metazen.

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