Our rural clinic recently decided to shut down their X-ray machine for good.  Too huge, too clunky and, frankly, just too darn scary.  X-ray equipment – especially the old stuff of Maytag, Depression, Hoover Dam, Manhattan Project era – weighs in the neighborhood of about a billion pounds.

This one, as The End approached, made this guttural spin-zap clunking sound that could put a frown of consternation on Oppenheimer’s face.  The whirring, clacking mechanics required to create a basic chest X-ray sounded so drastic you could practically see the sun-flare levels of ionizing radiation shooting out of the machine toward your squishy, pithy, helplessly exposed chest.

So, the machine needed to go.  Even out here in the woods, we have our standards.

Here in town, when you need something moved, you call “Buck”.  In a land of trucks, Buck managed to procure just the right one for moving seemingly-solid iron equipment put together along side cotton gins at the turn of the Industrial Revolution.  Stuff like our X-ray machine.  Buck would show up reliably.  Reliably late, but reliably.  If you needed something cleared out on Tuesday, you could expect it gone by Friday.  Maybe Saturday if the creeks are running high and salmon’s on the move.

So, you could count on Buck.  Just don’t touch his hat.

The Hat is one of those tall-front white foam with red nylon netting around the back models.  The proverbial truckers hat.  The netting has grease spots scattered in various places and yet – miraculously – the white part seems to have weathered the years without many significant stains, other than a sweat stain you can see around the brim in the right light.  The bill was folded over so completely you might wonder if the guy felt like he looked out through a tunnel when he wore it.  The logo was of some motorcycle engine company I’d never heard of.

The Hat, one could argue, links Buck’s soul to his physical being.  Perhaps the way to look at it is that Buck’s soul has been clamoring for freedom since birth – as if Buck emerged from the birth canal and, laying there in all the slimy glory of new life, his soul looked around and shrugged, “too bright and loud out here, let’s go back.”

Since then, Buck’s restless soul occasionally makes a run for it straight out of the top of his balding head.  Just as it clears the final layers of his scalp, ready to emerge gloriously from a few remaining scraggly scalp hairs, said soul rams into a greasy once-red netting that contains just the right amount of “give” to cause a whiplash, thus flinging his itinerant life force back into his head and, sadly, back into mortality yet again.  Sorta the rural America’s version of Sisyphean existential back-country angst.

So, you can understand why, perhaps, Buck went into florid cardiac arrest when his hat was knocked off as he moved our multi-ton ancient X-ray equipment.  Right there in the back kitchen, Buck dropped to the floor with crushing sub-sternal chest pain.

Hurriedly wheeling our (also quaintly dated) EKG machine over and sticking the little suckie cups on his chest (old timer docs know these machines well) revealed not only ST elevation (bad) but tombstoning (real, real bad).  Buck’s heart was dying…and Buck was soon to follow.

As quickly as it can happen in these parts, an emergency crew was summoned and Buck made his way to the hospital a few towns away.  Unnoticed by any of us, Buck’s ever-important hat lay forgotten, crushed (even more than usual) and forlorn on the floor near where the EMT crew unceremoniously scooped him onto a gurney and into the ambulance.

Early the next morning, before our first patient, suddenly there came a tapping, as of some one gently rapping, rapping at our back door. `’Tis some visitor,’ we muttered, `tapping at our back door – Only this, and nothing more.’

Our back door, the one that opened to the kitchen, the kitchen where Buck collapsed yesterday, leaving The Hat.

And there he stood.  Buck.  Pale, a little weavy, back in his denim.  “Come to git my hat.”  He said, looking squarely at the 3 of us staring fish-faced at him from the doorway.  One of us fumbled around the kitchen until we found the precious object; numbly handing it over and feeling strangely guilty.  “Thanks.  Guess I’ll get on back to the hospital now.”  He said, his entire head visibly relaxing as he pulled The Hat into place.

Shortly after, we received a call from the hospital, “Your patient, Buck, left the hospital early this morning,” squawked a voice on the line.  “He pulled out his own IV’s, his foley catheter (NOT pleasant if done yourself) never got his cardiac catheterization and we’re not even sure how far his cardiac enzymes have elevated because the 3rd set haven’t even been drawn yet.”

After suggesting that Buck would, it appeared, return to their cardiac ICU – hat in hand, as it were – we hung up the phone to see if he’d made it out of the parking lot.  Sure enough, Buck was slowly climbing back into his truck.  A moment later, it rumbled away, a dull red spot just visible in the rear window, driver’s side.

(Note:  Much of this story embellished for fun, and to protect “Buck” from vicious small-town rumors.  But The Hat and Tombstones are God’s honest truth)