Archive of Our Own ^beta

Chapter Text

balcony risk

As always, the lecture hall was well filled, this time even a little above average - probably because there was a rumor that there would be another particularly... colorful case discussion today. Marco Newgate, now 58, stood at the lectern as usual, the sleeves of his white coat rolled up, a tired smile on his face and an espresso in his hand, which seemed more symbolic than functional. He let his gaze wander over the rows of students and sighed softly when he saw the tense anticipation on their faces.

"Well," he began dryly, "today it's about one of my oldest private case observations - about 25 years ago, and the patient today has expressly allowed me to discuss his then... artistic form of expression in a medical-psychiatric context. As always, the names will remain anonymous, but those who can put one and one together will be allowed to combine at their own risk."

Some laughed quietly. Marco raised his eyes, sipped his espresso and began.

"It was one of those legendary parties at a friend's house - a wild summer evening, open windows, cheap wine, loud music, too many people in too small a space. I was 31, freshly finished with my specialist training. And I was - let's say - in a brand new relationship. Two months, right at the beginning. The young man in question had just turned 18. An artist, highly sensitive, highly talented, very much in love - and completely overwhelmed by alcohol."

Marco paused for a moment. A grin flitted across his face.

"I remember telling him earlier, 'You don't have to drink to belong.' He said, 'I'm just having a glass.' I said, 'Then please don't take the third glass of vodka from that amateur DJ with dreadlocks.' - Well. Guess what happened?"

Some of the students laughed.

"It was all harmless at first. He was sitting on the couch, drinking from a plastic cup and discussing the aesthetics of the unfinished with a potted plant. I found it charming, even though I suspected at the time that it wouldn't end well. Then - I was in the kitchen looking for water - I heard him talking. Loudly. In a firm voice. I came back into the living room and there he was, standing bolt upright on a small side table that groaned menacingly under his weight, his arms raised like a museum guide on coke, talking... to no one in particular."

Marco leaned against the desk, resting his forehead in his hand.

"He was giving a speech. An exhibition opening. Welcomed his imaginary guests - including, and I quote, 'the delighted Italian press, my former lecturers at the Academy of Emotional Perception and a group of Japanese art students who really appreciate my work with pencils on toast'. I swear to you, I didn't make that up."

The students laughed out loud. Marco raised his eyebrows.

"I said, 'Ace, get down from there' - oops. I mean, 'the young man'. He turned to me, bowed, and said, 'Ah, my critic from medical school. I've been expecting you.' - And then it happened."

Marco paused for a moment. The mood tipped with anticipation.

"He turned towards the balcony. Our friends had lived on the third floor, but the house was on a slope. Meaning: the balcony wasn't high - maybe two meters up to the garden, soft with grass and an inflatable pool. And then he said, in a serious voice: 'I have to fly now. The world is waiting for my visions.' And before I could say 'No!', he ran off - and jumped. Elegantly. With his arms outstretched like an ill-prepared superhero."

Marco closed his eyes briefly.

"I immediately went after him. I screamed. Thought he was going to break his neck. I jumped in after him. I landed on the edge of the pool. He was lying in the pool. Completely wet. Looked at me. Smiled. And said, 'I think I need a new muse'."

Laughter filled the room.

"He hadn't hurt himself. A few bruises. My shoulder was bruised. I was angry, panicked, relieved, stunned. And in love. Very much in love."

Marco looked up. Became quiet for a moment.

"We didn't talk much more that evening. The next day, I let him philosophize about hangovers and art. And later, much later, we made a few rules together. First and foremost: no more vodka at parties. And: no more balcony scenes with an audience."

He grinned.

"What do we learn from this, ladies and gentlemen?

Firstly, alcohol in combination with an exuberant artistic streak can lead to acute overconfidence.

Secondly, measures such as balcony flight attempts can end quite harmlessly - but they don't have to.

And thirdly, if you ever date someone who speaks to imaginary people from an art gallery - hold their hand; and keep an eye on the balcony."

The students clapped and laughed. Marco drained his espresso, grinned and muttered: "And best wishes from the Italian press."

Chapter Text

Belly flop off the cliff

Marco had his hands in his coat pockets as he leaned slightly against the lectern, his voice dry as the humor for which his colleagues either admired or shunned him. "Before we get to today's case, a quick disclaimer: this is not a medical role model. If you want to take anything away from this story, please do so only as a cautionary tale. I was seventeen, so was my best friend Thatch, and our brains... well, let's just say they were developing." There was quiet laughter here and there in the classroom. Marco paused for effect, then raised his eyebrows. "The case has the charming title: belly flop off the cliff. Diagnosis: prepubescent recklessness, severe bruising, loss of any remaining dignity."

"The whole thing happened on a way-too-hot summer day - somewhere on the coast, where our families were spending a chaotic multigenerational vacation. Thatch and I, in shorts, barefoot, driven by the hormonal excess of youth, stood on a rocky outcrop above the glittering sea. Below: azure blue water that sparkled invitingly towards us. What you couldn't see from above was the fact that it was low tide at that very moment. And we, in all our youthful brilliance, had set our minds on taking the legendary jump of the year."

Thatch, Marco continued, had proclaimed himself "King of the Skies" with oversized sunglasses and a towel cape before he dramatically spread his arms and sprinted off. "His landing was... acoustically impressive. I mean, the water splashed like a burst pipe in the pathology department, but the impact sounded like a wet carpet on concrete." Marco rolled his eyes. "What did I do? I went after him, of course. In perfect synchronization, of course. Unfortunately, my angle was worse and instead of landing feet or bottom first, I heroically threw myself belly first into the disaster."

A collective gasp went through the rows of students. Marco nodded. "Yes. The pain was biblical. I felt like my diaphragm had decided to spontaneously quit. When I resurfaced, I saw Thatch floating on his back with a look on his face somewhere between 'I see dead people' and 'Mom come get me'." The colleagues next to Marco giggled quietly. Marco continued: "Of course the lifeguard came. Of course there was a big crowd. And of course we both tried to look cool, despite our trembling knees and pained faces. I think I said something like, 'I did it on purpose, belly flop training'."

He shook his head slightly. "The result? Two massively reddened torsos, bruises in places I didn't even know you could bruise, and a ban from both families from ever going near a cliff again."

Marco looked across the rows. Some students had tears in their eyes from laughing. Others noted "preclinical behavior warning" with serious faces. "So, what do we learn from this?" Marco crossed his arms.

"A: Teenagers are capable of anything.

B: Adrenaline is not intelligence.

And C: It's never a good idea to deliberately slap medically relevant organs on water."

He looked to the side, at Dr. Reimann, who grinned inconspicuously. "Any questions about that?" A student cautiously spoke up. "Dr. Newgate, do you still have... late effects today?" Marco exhaled audibly. "Only every time I meet a teenager with sunglasses and a towel in the pool, I get a psychosomatic stomach ache."

The laughter made the classroom shake. And Marco - standing there, 48 years old, with a dignified amount of gray hair at his temples and the ever-so-slightly annoyed look of a man who has survived too many night shifts - couldn't help but grin.

Chapter Text

911

“So,” said Marco, clapping his hands once and looking around at the group of half-asleep medical students gathered in one of the clinic's large seminar rooms on this Monday morning. “Let's imagine you're called to an emergency. What do you do?”

A murmur went through the group. Some rummaged for pens. Others stared intently at their coffee cups as if the answer might be in them. Finally, a student with a serious look on her face spoke up.

“Um... I would... well, I think I would... call 911.”

For a moment, there was complete silence. The two other senior physicians—Dr. Reimann, chief physician of the intensive care unit, and Dr. Kessler, anesthesiologist—looked at Marco in unison. He raised an eyebrow, breathed audibly through his nose, and let the answer hang in the air for a moment.

Then: “You are 911.” Pause. “If you call someone at this moment, then at best the doorman. He can give you a parking token, but he won't save the patient.”

Quiet giggling in the group. Dr. Reimann grinned crookedly. Kessler muttered, “Good start, Marco.”

Marco continued, now with his arms crossed: “You all have five years of theory behind you. You know what a heart looks like, how to read an ECG, and why a patient stops breathing. If you don't start thinking like doctors now, it's going to be a very expensive cup of coffee for the general public.”

A student spoke up hesitantly. “So... first we secure the area?”

“Bravo, lifesaver number two,” Marco said dryly. “Don't step in high-voltage current, don't climb into burning cars, don't pull patients out of moving trains – unless you're the star of Mission Impossible. After that?”

“Check consciousness, breathing, circulation!” a female student called out. Marco nodded.

"The famous ABC rule. Airway – Breathing – Circulation. There's no point in splinting the leg if the patient isn't breathing. Unless you have a penchant for corpse care."

In the background, a woman with a strict bun and black blazer moved almost imperceptibly – the clinic director. She stood against the wall, holding a tablet in her hand and quietly taking notes without interfering.

Marco went to the whiteboard and drew a rough stick figure with a huge X on its chest.

“Let's assume your patient is unconscious, not breathing, no pulse. What do you do?” He looked around the room.

“Cardiac massage?” someone asked.

“Right. And don't stroke it! I don't want any chest compressions with tender loving care. 100 to 120 times per minute, five to six centimeters deep, arms straight, shoulders above – imagine you hate the sternum.”

Dr. Kessler laughed quietly. “That's what I always say.”

“With which song?”

Silence.

Dr. Reimann grinned. “Stayin' Alive by the Bee Gees.”

Marco laughed. “Exactly. Or if you like it dark: ‘Another One Bites the Dust’ by Queen also works rhythmically. But better the first choice.”

Marco pointed at him. “See? That man knows what he's talking about. And now honestly – how many of you have done this on a real person?”

Four hands went up hesitantly. Marco snorted.

“Good. And how many of you think it's as easy as it is with Phantom Freddy from the simulation center?” All the other hands went up. Marco sighed.

“Freddy doesn't scream, Freddy doesn't have a chest like a brick, and Freddy doesn't throw up in your face while you're doing it. Welcome to reality. Freddy is a liar.”

Now everyone laughed. Even the clinic director raised one corner of her mouth.

Marco stepped aside, leaving the whiteboard to Dr. Reimann, who was now drawing an ECG. Meanwhile, Marco turned to a small group in the corner.

"Do you know what happened to me once? I was a third-year resident, at two in the morning, alone in the emergency room. A man is wheeled in—circulatory collapse, blood pressure barely measurable. I rush over, everything by the book—until I realize I'm about to intubate a woman. Wrong patient. I noticed just in time. Since then, I always double-check the name tag."

General laughter.

“Remember: emergencies are loud, fast-paced, chaotic—and you have to keep a clear head. And if you can't...” Marco paused dramatically. “...then learn how to. Because you have no choice.”

The clinic director made another note.

After a good hour of theory, a digression on hyperkalemia (electrolyte imbalance), and a little competition in interpreting an ECG, in which a student surprisingly outperformed Marco, he said appreciatively, “If you keep this up, you'll soon be taking over my job.”

The student blushed. Dr. Kessler patted Marco on the shoulder. “That was another Newgate special today.”

Marco shrugged. “I'm like coffee—bitter, hot, and you only realize later how awake it makes you.”

A quiet laugh came from the corner. The clinic director stepped forward briefly and said, “If all our senior doctors taught like that... I would need less aspirin.”

Marco turned around and bowed slightly. “I'll take that as a compliment, Dr. Fox.”

“It was one,” she said. “Even if it hurt.”

Marco grinned.

Chapter Text

nut cake

The seminar room was unusually full today. The sun was shining through the large windows of the clinic, birds were chirping outside, and inside, Marco stood in front of the whiteboard with a mischievous grin.

“So, before we do anything medical—this,” he said solemnly, “is the real reason why you are all here today.”

He took a black pen and wrote in large letters on the board:

Ace's moist nut cake

– 200 g ground hazelnuts

– 100 g flour

– 4 eggs

– 150 g sugar

– 1 packet baking powder

– 1 tsp cinnamon

– 125 ml oil

– 100 ml milk

“Seriously?” muttered one student.

“Seriously!” confirmed Marco, raising his index finger. “I present to you: the best nut cake west of the Rhine – and east of common sense.”

Dr. Pohl laughed quietly. Even the clinic director, who was discreetly standing at the back of the room today, raised an eyebrow curiously.

“Background: garden party at my parents' house. Sunshine, good mood, my husband baked this cake. Everyone was happy – until...” Marco paused dramatically. “...Aunt Leni ate a piece.”

A few students were still laughing. Marco raised his hand again. “Now it gets serious. Because exactly three minutes later, she almost fell off her chair with sweating, hives, and shortness of breath. Diagnosis?”

“Anaphylactic shock!” came the reply, quick as a shot.

“Yes.” Marco turned around and demonstratively deleted the word “hazelnuts” from the recipe list.

“Leni was allergic. No one knew. She never had it tested. She always said, ‘I just get a little itch in my throat.’ Spoiler: It wasn't just a little itch.”

He clicked on the first slide: Anaphylaxis – Pathophysiology, Triggers, Emergency Measures

The pathophysiology of anaphylaxis is a complex immune reaction triggered by an excessive release of inflammatory mediators, primarily histamine.

“What happens during such a shock? Who can explain it to me?”

“Massive IgE-mediated immune reaction,” began one student. “Histamine release leads to vasodilation, increased vascular permeability, bronchospasm – drop in blood pressure, shortness of breath, circulatory failure.”

A massive IgE-mediated immune reaction is an excessive allergic reaction mediated by immunoglobulin E (IgE). This reaction often occurs very quickly after contact with an allergen and can lead to severe, potentially life-threatening symptoms.

Histamine: is a tissue hormone and messenger substance that performs a variety of functions in the body. It is involved in allergic reactions, inflammation, blood pressure control, digestion, and the sleep-wake cycle.

Vasodilation: is the dilation of blood vessels.

“Very good. And what are typical triggers?”

“Food, insect bites, medications, contrast agents.”

Marco nodded. “In this case: hazelnuts. She took a bite—and then it happened suddenly. Her face turned red, her tongue swelled up, her pulse was 140, and her oxygen saturation was 84 percent. I've never seen anyone so desperate and angry at the same time. She screamed, ‘I just wanted a little piece of cake, damn it!’”

Laughter. Then Marco became serious.

“I had my emergency kit in the car. Lucky me. What would you have done if you had been there?”

“Initial measures: EpiPen – adrenaline i.m. (intramuscular), 0.3–0.5 mg in the thigh.”

“Yes. Adrenaline is a lifesaver. Always. Anyone who starts looking for antihistamines at that moment might as well go and make a wreath.”

Antihistamines: medications that relieve the symptoms of allergies

A student asked, “What then?”

“Lay the patient flat – in the shock position if possible, administer oxygen, administer fluids. And: call an emergency doctor! The reaction can be biphasic – meaning it can occur again even if the symptoms improve.”

“What about cortisone?” someone asked.

“It takes time to work, but it helps in the long term. But it won't save your life in an acute case. Adrenaline saves it. Fluids save it. Air saves it.”

He clicked to the next slide: Symptoms by severity

“Aunt Leni had at least grade III: hypotension, dyspnea, laryngeal edema. I accompanied her myself in the ambulance. By the way, she complained in the ambulance that my husband had baked a cake that was too dry.”

Hypotension (low blood pressure), dyspnea (shortness of breath), and laryngeal edema (swelling of the larynx) can be signs of a severe allergic reaction known as anaphylaxis or anaphylactic shock.

Dr. Pohl cleared his throat. “I wasn't there at the time, but I know the cake. And I say: anyone who doesn't react to that is probably dead.”

The students laughed. Marco grinned.

"What do we learn from this?

First: always ask if anyone has allergies – even at a garden party.

Second: cakes can be deadly.

Third: If you don't have an EpiPen handy, you have a problem."

He turned back to the whiteboard.

“And fourth—what do I do with the cake now? I still have five pieces of it in the refrigerator. Who isn't allergic?”

Almost all hands went up.

“Good,” said Marco. “Then let's talk about biphasic reactions. Please monitor your circulation – and come to the kitchen later. Case discussion with pastries.”

The clinic director at the back of the room couldn't help but smile. She whispered to Dr. Pohl as she passed by: “I love this guy. He brings cake – and saves lives.”

++ ++

The group of students followed Marco through the stairwell of the internal medicine department. He walked briskly ahead, his stethoscope loosely around his neck, his coat open. Next to him walked Dr. Pohl with a coffee mug that said “Adrenaline Inside.” Marco was in a good mood today.

“We're about to take a little excursion into reality,” he said over his shoulder. “Remember: anaphylactic shock after eating nut cake, blood pressure in the basement, oxygen saturation in the gutter. And all because of one damn bite.”

A student asked cautiously, “How is she doing now?”

“She's alive,” Marco said dryly. “And how. She's in room 412—and has about the vocabulary of an educated chainsaw. I'll tell you right now: if she likes you, she'll insult you. If she doesn't like you... well, then... she'll insult you too.”

The group laughed. Marco stopped in front of the door and turned around.

“Aunt Leni. 72. Lives alone, has four cats, plays bridge, smokes secretly, and reads the magazine “Pharmacies Review” as if it were a medical journal. She loves Ace—and hates his cake. Now please behave like doctors. Or at least like people who can pretend to be doctors.”

He knocked on the door.

“Leni? Visitors!”

“If it isn’t emergency medicine incarnate!” croaked a voice from inside. “Close the door, there’s a draft – and I’m only lying here almost dead!”

Marco entered, followed by the group. Sitting on the bed was a small, energetic woman with wild gray hair, a lilac cardigan, and an expression on her face that conveyed scorn, curiosity, and undisguised joy all at once.

“Holy insulin shock,” Dr. Pohl muttered quietly. “She's awake. And snappy.”

“Those are medical students,” said Marco, standing next to Leni. “Today's topic is anaphylaxis. And I thought: Who better to talk about it than my own charming aunt, who almost killed herself with a piece of cake?”

Leni put her hands on her hips. “Charming is good. I'm lying here, looking like a crumble cake in intensive care, and you drag me to class? What's next, Marco? A live lumbar puncture at dinner?”

The group laughed cautiously. Marco remained unmoved.

“Leni, tell us: what was it like when you realized you were allergic to Ace's cake?”

“What was it like? It was like someone had stuffed cotton wool down my throat and an elephant was dancing on my chest at the same time. And then the sweat—I was suddenly wetter than your father when he goes jogging.”

Marco nodded. “Sounds like phase II. Shortness of breath, circulatory failure, skin reaction.”

“Yeah, and you rammed a needle into my thigh like I was a beef fillet. Do you know how much that stings? I cursed you – but inside, because I couldn't talk anymore!”

A student timidly raised her hand. “How quickly did you start to feel better?”

“Well... adrenaline works,” Leni growled. “Ten minutes later, I had enough air to yell at Marco again. And then suddenly I was lying in the ambulance with a guy who called me ‘granny.’ I almost bit his radio.”

“She complained in the ambulance that the cake was too dry,” Marco interjected. “Despite the allergic shock.”

“It was!” she shot back. “Tell your husband that oil is no substitute for taste.”

Marco grinned. “At least she kept her sense of humor.”

“I kept more than my sense of humor. I took the packet of hazelnuts with me. As evidence. And to blackmail Ace.”

Dr. Pohl shook his head. “I don't know whether I want to love her or preserve her for research.”

Another student spoke up. “Looking back, would you say you had symptoms before?”

Leni looked at her. “Yes, but I ignored them. It was just a scratchy throat, a little stomach ache—nothing dramatic. I thought I was just sensitive. And you know what annoys me the most? That Marco was right. He told me years ago that I should get tested.”

Marco crossed his arms. “So, are you going to do it now?”

“What do you think, you medical know-it-all? I now have an allergy passport—and an EpiPen. And your father promised me that only rice cakes will be served at the next family celebration.”

Marco laughed. “At least we won't kill anyone with those.”

He turned to the group. “Okay, folks—that was real medicine. Real life, real patients. Not always with textbook faces and last names ending in -itis. Remember: react quickly, think critically—and if necessary, listen to Aunt Leni.”

“If necessary?” said Leni indignantly. “Always!”

The medical suffix “-itis” usually indicates inflammation.

Examples:

• Arthritis: inflammation of the joints.
• Bronchitis: inflammation of the bronchi.
• Gastritis: inflammation of the stomach lining.

++ ++

Room 412 was bathed in golden afternoon sunlight. Aunt Leni was sitting half upright in bed, wearing a new cardigan in a daring peach tone, and looking at her freshly painted nails as if she were in a spa hotel instead of the internal medicine ward.

The door opened.

“Leni?” came a soft voice.

Her face lit up instantly.

“ACE! My favorite person in this whole hospital ruin! Come here, let me take a look at you.”

Ace entered, dressed entirely in soft shades of blue, with a small basket in his hand. Inside: a small jar of homemade jam, a book about cheeky cats, and—no cake.

“I've learned my lesson,” he said with a smile as he sat down on a chair next to her. “No baked goods today. Just love.”

“Thank God,” said Leni dryly, but she immediately reached for his hand. “Your cake almost sent me to the happy hunting grounds – but I'd bite into it again anytime if you look at me like that.”

Ace laughed. “You're even flirting in your hospital bed.”

“What can I say – you either have charm or you don’t. Tell me, how are you? And Marco? Did he scare the students again today?”

“He taught them about your case – and your quote about the elephant on your chest is probably exam material now.”

Leni grinned broadly. “Very good. Maybe I’ll get paid as living teaching material.”

At that moment, there was a knock at the door. It opened and Marco entered – his coat half open, a coffee cup in his hand, which he held like a trophy.

“I have a ten-minute break and thought I’d check if my aunt is still alive or has adopted the nursing staff in the meantime.”

“I'm not just alive, I'm thriving! Your husband is here, that's worth at least 30 points on my joie de vivre scale.”

Marco stood by the window, took a sip, and looked at the two of them with a soft, barely visible smile.

“You actually look rested,” he said.

“Well, after three days of oxygen and the worst tea west of Siberia. But now that I can breathe again, it's not so bad.” She looked at Ace. “By the way, he raised me like a chick. Every morning he checks my vitals and asks if I can breathe. I almost thought I was his patient—until I saw him giving instructions during rounds.”

Marco sat down at the foot of the bed. “I don’t give anyone instructions. I’ve just become cautious. After you... I am with everyone.”

Ace reached out his hand to him. Marco took it, firmly, briefly, as he always did when feelings became too big for words.

Leni looked back and forth between the two of them. “You two are so cute. I’ll tell you what: when I’m old... really old... I want to move in with you. I won’t eat nuts anymore either.”

“You can eat anything as long as you survive,” Ace said gently.

“And Marco will cook,” she added pointedly. “Then at least I'll know I'm not allergic – just annoyed.”

“I'm not a bad cook,” Marco defended himself.

“No, just a very... purposeful one.”

She laughed brightly. Ace carefully placed the blanket over her legs and smoothed out a crease. Leni looked at him lovingly.

“You know, kiddo – for a moment I thought that was it. But then I saw you in my mind's eye. And I knew: if I die now, you'll miss out on my gift for next Christmas. And that wouldn't be fair.”

Ace leaned forward slightly and kissed her gently on the forehead.

“Then just stay with us for a long time.”

“Of course. I still have so much to do—like finding out if I'm allergic to almonds. You have to keep life exciting.”

Marco snorted softly, stood up, and tucked a strand of hair behind her ear with a surprisingly tender look.

“You stay just the way you are. Snappy, loud – and full of life.”

“And you stay my dearest, much too tired nephew,” she said, patting his hand lightly.

Ace and Marco stayed for a few more minutes until Leni’s eyes slowly closed.

As they left the room, Ace said quietly, “She loves you very much.”

“And you a little bit more,” said Marco, putting his arm around him and kissing him on the temple. “I'm not surprised. Me too.”

Chapter Text

Handbags and childhood memories

The classroom was—let's say—excited. Maybe it was the coffee, maybe it was the fact that Dr. Marco Newgate had taken his place at the lectern today without his usual briefcase, but with a very expressive facial expression. And when Marco wore that expression—a mixture of amused satisfaction, quiet bewilderment, and a hint of subliminal trauma processing—the students knew: this was going to be a case discussion with human depth. And maximum embarrassment. For someone else.

“Today,” Marco began, glancing over the twenty medical students gathered there, “I want to tell you how life put me in the right place at the right time – with a very ironic sense of humor. And how emotional baggage, handbags, and misplaced childhood memories can become medically relevant.”

He crossed his arms.

“We're talking about: my mother.”

A reverent murmur went through the room. Marco's mother – a notorious former emergency doctor, legendary in professional circles for her ability to give away knitted socks and make diagnoses in Latin rhyme while performing a full tracheotomy – was something of a mythical figure among the students.

Marco sighed dramatically.

"My mother had her weekly senior painting class that Wednesday morning. Watercolor, Level 2. Theme: ‘Inner Landscapes.’ I was on my way to the clinic when my cell phone rang. It was my mother. And when my mother calls me, it's not to chat.

It's to give orders."

He raised one eyebrow.

“Marco, dear, I forgot my handbag. Could you please bring it to me quickly?”

Marco took a deep breath.

“Well. The things we do for our mothers. So I went back. Grabbed the bag. And headed to the community center.”

He paused meaningfully.

"What I didn't know was that the class had already started. So I walked in the door—just as sixteen senior citizens were painting the outline of a water lily leaf in perfect unison.

Silence.

My mother turned around. Smiled.

I—unfortunately already slightly in work mode, half an ear tuned to the clinic radio—lifted the bag, took two steps into the light, and said..."

He leaned forward.

"VERY LOUDLY.

Here, sweetheart, you forgot your gym bag."

The silence in the room was deafening.

A student burst out laughing.

Marco raised his hand.

“No, no—let that sink in. You have to know: my mother forced me to carry a blue cloth bag with a clown face sewn on it as a gym bag for a whole year in third grade. Because it was ‘practical and individual.’ Of course, I was teased about it every day. Twenty years of therapy later—revenge.”

He smiled smugly.

“I swear, one of the painting grandmas almost knocked over her water glass laughing.

My mother, on the other hand...”

He made a face as if someone had bitten into a lemon.

“...addressed me formally as ‘Dr. Newgate’ for three days.”

Another student chimed in, laughing: “But... where's the medical part of the case discussion?”

Marco pointed to an imaginary spot on the table.

"I had just left the community center when I saw out of the corner of my eye a woman from the class stumble—along with her easel.

So I turned around, quickly to her—

She sprained her leg, scraped her hand, circulation gone.

The whole program.

I laid her in the hallway in the recovery position, removed the watercolor paint from her face, put a bandage from my first aid kit on her – and then calmly explained to her how to pad the joints of your big toes when you're over 70 and paint barefoot."

He looked around the room.

"And then – while I was helping her up – she whispered to me:

Your performance earlier... was great art.

And I swear by everything that is sacred to me – she painted a portrait of my own mother for me afterwards.

With a gym bag."

Loud laughter filled the room.

Marco raised his index finger at the end.

"Lesson of the day:

Always carry a mini emergency kit with you, even if you're just dropping off a bag.

Never underestimate the vindictiveness of a child with a sense of humor and a long memory.

And above all:

If your mother has ruled with medical expertise and unwavering authority for decades—

seize the moment.

And say:

Here, sweetheart, you forgot your gym bag.

Loudly.

Clearly.

With dignity."

He bowed.

"Next week: A kettle, a catchy tune by ABBA, and an almost lethal dose of lavender tea.

And now, please: Get out. I need to mentally prepare for my next dinner with my mother."

Chapter Text

lavender tea

The seminar room was full even before it started - it always was when Dr. Marco Newgate gave one of his legendary case discussions. Not only because of his clinical expertise, but also because of the stories, which often oscillated somewhere between drama, marital crisis and disaster management.

Today, however, Marco seemed... slightly tense. Elias Reimann, intensive care physician and faithful companion through the turmoil of hospital and life, was standing next to him as usual. The students had their coffee cups ready to hand - which was good. They would need them.

Marco adjusted his glasses, looked at the expectant audience and said dryly:

"No knife in the back this time, no resuscitation in the elevator, no exploding catheter. Today we're talking about lavender."

A small, puzzled pause.

"And about how you can almost sedate your husband with home-picked highland lavender from Styria."

A suppressed giggle went round the room. Elias discreetly pursed his lips.

"I wasn't there, by the way. I deny all responsibility."

Marco nodded.

"That's true. Unfortunately."

He took a deep breath.

"So. My husband Ace - artist, kind, sensitive - had one of those evenings a few weeks ago where he wanted to talk. About us. Our time. Our closeness. Our feelings. I, on the other hand, had 48 hours of double shifts in my bones, my mood was in the 'technically dead' range, and my brain was on slideshow mode."

Renewed laughter in the room.

"I nodded, mumbled, pretended to listen, and ducked into the study with my laptop. In the middle of an email discussion with IT. Spoiler: They wanted to explain to me again why a drug program from 2002 is no longer getting an update."

"And Ace?" someone asked.

Marco sighed.

"He's calmed down. Just like he does: he made himself some tea. Lavender tea. From Aunt Leni. Collected it herself. In Austria. She said it was a particularly 'concentrated variant' that was only given in doses, even in the monastery. I didn't take it seriously at the time. My mistake."

"ABBA was also involved," Elias interjected dryly.

Marco nodded.

"Yes. Ace ran a playlist. First The Winner Takes It All, then Chiquitita, then Knowing Me, Knowing You. I thought it was artistic processing. In truth, it was an elegant form of passive-aggressive cry for help."

A student spoke up.

"How much did he drink?"

"A liter. Maybe more. I wasn't there. I only noticed when our dog Teddy scratched against my door, whimpering. At first I thought he just wanted to play - until he started barking incessantly. And that's the highest alarm level for Teddy."

"And then?" asked a student excitedly.

Marco wiped his face.

"I find Ace on the sofa. Pale. Pulse slow. Eyes half closed. The cup still in his hand. I reflexively checked breathing and pulse. Blood pressure? Probably 70 to nothing. Breathing shallow. Consciousness clouded."

"And?" came out of one mouth.

"I wanted to call the ambulance. I really did. I already had the phone in my hand. And then he mumbled: 'I'm... still alive... you emotional block of ice...' - and then he smiled."

A murmur went round the room.

"I stabilized him. Water, legs up, cool compress on his forehead. Poured away the tea. Found the lavender packet - with the handwritten note from Aunt Leni: 'Only for severe insomnia - a pinch is enough! It was half the tin."

Elias shook his head.

"Aunt Leni once gave a farmer a three-day nap with this tea. Including the tractor idling."

Laughter.

Marco raised his hands placatingly.

"Ace felt better after a few hours. We talked. Really talked. I listened. And later accepted ABBA with headphones."

A student raised his hand.

"What do we learn from this - medically?"

Marco nodded.

"Lavender contains linalool - has a calming, relaxing effect. In concentrated form, it can lead to sedation, circulatory depression and clouding of consciousness in sensitive people. Especially in combination with exhaustion, low blood pressure or on an empty stomach."

"And non-medicinal?" asked a student mischievously.

"That spouses shouldn't drink teas from Austria if they've been emotionally ignored. And that IT problems can be life-threatening at some point - albeit in a different way than expected."

Elias grinned.

"Since then, by the way, Marco has a new safe word."

Marco grimaced.

"'Tea time'. And when Ace says it, I listen. Right away."

The seminar finally dissolved into general laughter. And even if it was only marginally threatening from a medical point of view, this case would probably remain the most memorable for the students: a lavender tea, a forgotten moment - and the reminder that sometimes even doctors just have to listen.

Chapter Text

Conflict between two generations – between pathology and practical common sense

It was one of those clear late summer days that began with a gentle promise: sunshine, silence, lake. Nothing that would explode, collapse, or cause an allergic reaction.

Marco had rented a boat – a cozy dinghy with a small cabin, room for six people, and two sun loungers on the bow. Ace had prepared iced tea, packed banana bread, distributed sunscreen, put on a wide-brimmed hat, and said, “Nothing will happen to us today.”

Aunt Leni was the last to board. In one hand she held a red thermal bag. In the other... an old GDR (German Democratic Republic 1949-1990) first aid kit.

“What's that?” Marco asked suspiciously.

“Emergency equipment,” said Leni. “In case you're too slow again, nephew.”

“I'm a senior physician in the emergency room,” Marco replied dryly.

“And I used to work in pathology,” Leni countered. “I know how it ends when you're too late.”

Ace decided to sit down on the stretcher. “I don't have a good feeling about this.”

The first hour was quiet. Marco steered the boat, Ace read a book, and Leni calmly sorted gauze bandages, antique bandage scissors, and a glass ampoule of “pure camphor oil.”

“Camphor oil?” Marco asked skeptically.

“For circulation and willpower,” said Leni. “If someone collapses, I rub it under their nose. It helped my head nurse in 1979 when she had a cardiac arrest in the lecture hall.”

“That wasn't a medical procedure, that was aromatic assault,” Marco growled.

Leni shrugged. “She woke up. What more do you want?”

The discussion escalated when Ace got sunstroke, which made everyone more agitated.

Nothing dramatic – but he turned pale, sat down in the shade and muttered quietly, “I feel dizzy.”

Marco was immediately by his side. “Okay, lie down. Legs up. Shade. Drink. And don't forget your cap again, sweetheart.”

“I was just about to get it...” Ace muttered.

“Typical,” Marco grumbled. “Thermoregulatory unstable, but good-looking.”

While Marco was trying to carefully position Ace, Leni arrived with a cold washcloth, a glass of sage tea, and—the camphor oil.

“Move over, boy. I have experience with sunstroke.”

Marco looked up. “What's this? It's circulation—I've got it under control.”

“You overheated him,” said Leni. “You put him in the blazing sun.”

“He lay out there voluntarily!” protested Marco.

“Then he doesn't have good guidance. You're his husband, so take responsibility.”

Ace raised his hand. “I'm lying right next to you and I can hear you.”

“Then see how it's done properly,” said Leni, pulling Marco's shoulder to make room.

“He needs fluids, rest, and cooling,” Marco said slowly. “Not aromatherapeutic exorcisms.”

“Camphor has been medically recognized for centuries,” Leni replied. “Paracelsus has...”

“...also administered mercury,” Marco hissed.

“And you give people 5mg of diazepam (a drug that has a sedative effect, among other things) in the butt when they twitch.”

“Because it's indicated!”

“Because you panic when someone else twitches other than you!”

Ace sighed. “I just want a wet cloth and some peace and quiet.”

They both ended up bent over him: Marco with his stethoscope and headlamp (which he always had in his pocket), Leni with a glass full of herbal tea and a dose of resistance from her youth in gynecological pathology. Ace lay between them, over-cared for and under-protected.

“His pulse is slightly accelerated, but rhythmic,” Marco said matter-of-factly.

“His aura is too weak,” said Leni.

“We don't treat auras,” said Marco.

“That's why your staff is always so pale.”

“Because we work night shifts!”

“Then give them vitamin D!”

“Because of pale skin?! That's not therapy, that's cosmetic opinion!”

After half an hour, Ace was stable again, hydrated, his face slightly red—whether from sunstroke or the argument remained unclear. He smiled.

“I love you both. But I swear, if you argue one more time about the effect of lemon balm tea on blood pressure, I'll throw you both overboard.”

Aunt Leni sighed. “Tell him I was right.”

Marco grumbled, “He's lying down, drinking water, wearing a hat now – that was my plan.”

“But I covered him up!”

“With a woolen cloth! It's 36 degrees!”

Ace got up. “I'm going swimming. Carry on. But please, only with gloves and clinical disinfection.”

Conclusion of the lesson Marco held afterwards at the clinic:

Recognition & first aid for sunstroke and heatstroke

– Difference: sunstroke (local) vs. heatstroke (systemic)

– Symptoms: headache, nausea, neck stiffness, impaired consciousness

– Measures: shade, cool the head, fluids, if necessary, lying position with upper body elevated

– NO camphor oil, NO alcohol on the forehead, NO esoteric remedies.

– Take patients seriously, ignore friendly aunts.

Chapter Text

“Ticks, flashlights, and self-diagnoses—when parents are doctors and know the internet”

The lecture hall is full. Three chairs in the front row are occupied today: Dr. Reimann (intensive care), Dr. Evans (internal medicine), and Dr. Struss (infectious diseases)—all with coffee cups and mildly curious looks on their faces. The clinic director stands at the edge of the room, occasionally jotting down notes in a small book that looks suspiciously like “Quotes for the New Year's Reception.”

Marco stands at the front, a picture of erythema migrans (erythema migrans, also known as “wandering redness,” is a typical skin change in Lyme disease infection) on the screen, nice and big, circular, red with a central lightening.

Next to it: a photo of his father standing on the terrace, shirtless, a magnifying glass in his hand, staring at his upper arm. The photo is obviously copied from a family chat.

He smiles resignedly.

"Before we begin:

I love my father.

He was a fantastic emergency doctor for decades.

But, since retiring, he has been a magnet for medical disasters.

And unfortunately also: a passionate Google symptom researcher."

He turns to the screen and points to the picture.

"Last year in July.

I receive a WhatsApp message with this picture at 6:42 a.m.

The text reads: 'Lyme disease. I know it. I analyzed the bandage. Consultation required. Call me.'

No good morning. No smiley face. Just the seriousness of the situation."

Quiet laughter in the room.

“I call back. He picks up on the first ring—which means he already had his cell phone in his hand, probably on speaker and with Google search history open.”

Marco imitates his father:

“Marco. I was bitten by a tick. The edge is reddened. I have a slight chill. I need doxycycline (broad-spectrum antibiotic). At least 200mg. Preferably today.”

Me: “Dad. How do you know it was a tick?”

He: “I changed the bandage during the night. The center was red underneath. Typical. Tick.”

Me: “Did you see the tick?”

He: “No, but I compared pictures. It's classic.”

I sigh. I ask, “How long have you had it?”

Him: “Since yesterday. But the redness is already clear. And I felt something working in my skin.”

Marco looks around.

“What is your first reaction when an older relative confronts you with something like this? Diagnosis by picture, no tick seen, but complete symptoms googled?”

A student speaks up:

“I would try to take a thorough medical history and remain calm. But I would steer the conversation toward a clinical examination as quickly as possible.”

Marco nods.

"Good idea. But it doesn't work with my father. He thinks I'm biased.

That's why he sent an email to our family doctor at the same time. With a picture attached."

His colleagues laugh quietly. Dr. Evans exclaims, “Classic!”

"So I stop by his house after work.

He's sitting in the garden. On the table are two encyclopedias – ‘Infectious Diseases Worldwide’ and a slightly yellowed copy of Manson's Tropical Diseases.

There are also three printouts from the internet with the headline: 'Tick-borne diseases that should not be ignored!

And all because of... a mosquito bite. With an ointment reaction."

He clicks to the next slide: a close-up of the arm – slightly reddened, no central lightening.

"I ask him if he's sure it's not an allergic reaction.

He says, 'I can feel it. It's systemic.'

Me: ‘Dad, that's Fenistil. And you're scratching yourself constantly.’

Him: ‘I know my body.’

Ace, who has been sitting in the living room the whole time and really just wants to make breakfast, calls out: ‘Marco, why don't you just give him antibiotics? Then you'll have some peace and quiet.’

Me: 'That's not evidence-based.'

Ace: ‘By the way, I'm about to cook scrambled eggs. Without ticks.’"

A student asks:

“How did you proceed in the end? Did you take a blood sample?”

Marco nods.

"I did a rapid test. Negative.

Then I called his family doctor—she just said, 'Ah, Dr. Newgate. I've already calmed him down with a prescription – vitamin D and Fenistil.

He was angry for two days because I didn't give him Doxy.

But the symptoms completely disappeared two days later."

Colleague Dr. Reimann interjects, “What about repeat offenders in the family? Do you now make family visits with an emergency kit full of psychological conversation strategies?”

Marco grins.

"We've developed a family system:

If someone in my family Googles a symptom, they first have to tell Ace what they've found.

Ace writes it down, makes a cup of tea – and then says, ‘Please tell Marco in a calm voice. And no screenshots.’

That reduces the stress level by 40%."

Question from Dr. Struss:

“And what if it had been Lyme disease?”

"Then we would have treated it. But not based on a WhatsApp diagnosis.

And not with a flashlight examination on the terrace."

Conclusion:

Marco closes the image.

"What have we learned?

– Mosquito bites sometimes react noticeably to cortisone.

– Even former emergency doctors are not immune to self-diagnosis.

– And: No good medical decision starts with a WhatsApp message at 6:42 a.m."

He looks around the room.

“Questions, comments, anecdotes of your own? I'm sure at least one of you also has a diagnostician relative with too much internet access.”