2023

I fell, and I didn’t think I’d be able to get back up.

I’m not even sure I wanted to. But I did. Bruised. Broken. Not done.

Outside, I was rough—scarred, dented, not the kind of thing anyone wanted to look at, much less carry home. I wasn’t shiny or firm. I wasn’t fresh. I was a rotten apple.

My computer chimed a familiar DING, and my patient’s face flashed up on the screen. They were seated in their car, parked in the driveway of their grandchildren’s home, before they went inside for a visit. My patient eagerly declared, “Today is the day!” A broad smile graced their face. “I’m ready,” they said.

Susanna came into the U.S. fighting the mosquito-borne viral disease chikungunya. Her thin body, wracked with fever, shivered and fought off the infection; her family back in her home country called around for a PCP who would see her. They found me and scheduled an appointment. I knew the signs and symptoms of chikungunya, and I knew the hard mass I felt in her belly was something else.

She was diagnosed with cancer two days later and started chemotherapy as soon as she recovered from her infection.

In September, I was called back for dermatological surgery after a biopsy on my left calf revealed a severely dysplastic nevus—a result of the hours I spent tanning in the 1990s.

I canceled my morning clinic while I had the procedure. The surgeon took what she needed and stitched me up. The medical assistant put on a bandage and told me to keep the leg elevated for 12 hours.

It starts as a dull sensation just below my rib cage, as if someone is trying to blow up a balloon inside me. Despite the expanding discomfort, I try to focus on my breathing. Without the ability to fully exhale, it’s difficult to calm my nervous system and avoid the dark places my thoughts are taking me: It’s an abdominal aortic aneurysm, gallstone pancreatitis, a perforated ulcer!