Last patient of the day, and of the work week! I was finishing what felt like my Thursday Night Endurance Test, after which I could go home to my family, and eventually to bed.
As on so many Thursdays, I was running behind. My final appointment was with a new patient, Ann Miller. Before entering the exam room, I did some fact-finding.
My heart rate increases, and I feel color coming into my neck and cheeks. I’m not a clinician: I say this phrase inside my head as I take a deep breath, trying to slow my heart, which feels like it might beat out of my chest.
Then I say—this time out loud, to the person sitting across the exam table from me—“I’m not a clinician,” before continuing with, “… but on your physical exam I noticed something out of the ordinary, and I’d like to have one of our physicians take a look at you.” I wait and smile my warmest, most empathetic smile.
“If we are in an end-of-life situation, can I be with him?” I asked Lisa, the veterinary technician. She’d brought Alex, my springer spaniel, to my car after his oncology re-check.
COVID protocols had upended vet appointments. I’d park in a numbered space and text the receptionist. A tech wearing PPE fetched Alex. I’d wait in my car for the oncologist’s call, praying for continued remission.
“He looks good; I don’t find anything of concern,” I’d hear, and breathe relief. But as the months since chemo went by, the possibility of recurrence grew. The prospect of not being present to say goodbye, for Alex to feel safe and loved to the end, haunted me.
“Yes, we do allow clients to come inside then,” Lisa answered.
Prior to COVID, the waiting room overflowed with somber pet parents cradling grey-muzzled dogs; dogs with shaved abdomens, amputated limbs, or coats moth-eaten from chemo. So much innocence and vulnerability, love and fear. I’d feel guilty witnessing these sad tableaus, when Alex’s report read, “No evidence of disease.”
During his year-long treatment, I’d come to know the oncology staff. I wondered how they coped, day after day, treating pets with life-limiting illnesses, knowing that each case …
One of the most interesting aspects of being an ophthalmologist is the daily need to interpret what patients say they see.
Is it a flash or a floater? A gray spot or a fuzzy, broken line? Perhaps a shining area in the upper corner of your vision? Or maybe two images side by side? And what does “blurred vision” mean to any given person?
The exam room bears an odor; it’s a musty sweetness, not unpleasant, but one that I know well–fetor hepaticus, a sign of severe liver disease.
My patient, Ms. Atkins, slouches on the exam table, brooding. She’s thirty-four years old, and an alcoholic. She is joined by her mother and her five-year-old daughter, Mari, who skips to my side, long braids bouncing off her shoulders.
They’re pounding out the broken sewer line beneath the street
at the intersection of major roads by our house, day and night
men and women move earth, drill new wells to control groundwater,
lay pipe, footings the size of shattered memories to bypass
the damaged places.
“As I hang up my uniform, she will put hers on,” my uncle proudly told my aunt when I announced my plan to attend medical school under the auspices of the US Air Force Health Professions Scholarship Program.
Two of my uncles had illustrious Indian Army careers–one as a brigadier general and the other as a lieutenant colonel–but my own military potential was less obvious. I was a stereotypical “girly girl,” a flop in sports and the last one picked for any team in gym class. So when I told people I was joining the Air Force, the reactions were amusing.
Walking to the clinic, I pass a school where children gather in their crisp school uniforms. I admire their superhero lunchboxes, beaded purses, and colorful barrettes; I notice how tightly the younger children hold their older siblings’ hands. Next I pass an abandoned church, with stained-glass windows that shine on a sunny day, with wildflowers and weeds covering its front yard, with its earth-colored stone walls.
Arriving at the clinic, I admire my patients’ homes, standing out boldly among the drug houses. They are painted bright colors, and many have yards full of flowers and vegetables. One of my patients, in her bathrobe and slippers, is sweeping her front steps as her obese cat sits on the stoop, observing the scene and obviously not impressed. Even though she lives across the street from this clinic, she prefers to see me at the downtown office, so she can stop by McDonald’s on her way. Where else can she get such a large meal for so little money? I suppress my worries: Is her blood sugar in the 400s? Is her blood pressure still elevated? Did she see her cardiologist? Instead, I chat with her about her cat and her ailing back …
“Estoy cansada,” my client says as she drops onto my couch, settling herself inside the dip that holds her body every week.
I close the door to my therapy office and sit across from her. “I’m sorry you are tired, Anita. Tell me about your week,” I say. Then I sit quietly until she is able to focus.
She tells me that she sleeps all day, that her body hurts everywhere, and that her adult son never visits her despite the sacrifices she made to keep him fed and clothed growing up.
“You are a good mother,” I say. I know this because she also tells me stories about him—how happy, polite, and generous he is with others and how much they laugh together when he calls her on the phone on Sunday afternoons. I sit in silence, waiting until she looks up at me, her lip quivering.
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