The first thing I notice are the dark circles under Mr. Jones's eyes.

It's 4:30 pm on a Wednesday during my third year of medical school. I'm in the fifth week of my family-medicine rotation, and we're deep into our daily routine: triage, history, physical examination, differential diagnosis, present the case to the attending physician, repeat.

Mr. Jones is a new patient. His face and belly are round, his arms and legs lanky. His unkempt facial hair and calloused hands reflect a life of physical labor that has worn him down. According to his chart, he's just started an office job. Slumped apathetically in a chair in the corner, he seems apprehensive and hesitant to talk to me. Understandably so: I'm a stranger with the word "student" attached to my name.

"I can’t remember how long it's been since I've seen a primary-care doctor," he begins.

 

Paula Mahon ~

If you had told me thirty years ago,
when I took call on endless sleepless nights
on incandescent AIDS wards full of fear
on which I tried to do the healing work
of drawing blood and packing leaking wounds
and viewing films of microbes gone berserk
in lungs and brains of patients wasted frail
to postpone certain death from HIV,
if you had told me then that I would see
a family with an AIDS tale just as bad---
today, two parents with disease but well,
their uncontaminated child, alive--
my doubt would equal that of Didymus
who disbelieved the Resurrection tale.
Like he who needed proof with sight and touch,
I'd need this scene to change my mind as much.

As a nurse, I was brand new to labor and delivery--and I was on my third night shift in a row. Walking back from a quick break, I was called over by the charge nurse.

"You have the next admit from triage," she told me. "She's a live one--and so is her family. They're carnies."

"What's that?" I asked, bewildered.

"You know, the people who do the circus and carnival circuit--gypsies," she said, innocently using a term that is now considered derogatory, but was then often applied to the nomadic ethnic group known as Roma. "She's going natural."