Normal S1, S2

I wake up and head to the hospital.

 

First patient of the day - COPD, CHF, a typical slew of diagnoses.  We chat about his medications, symptoms that just won’t go away.  I ask him about smoking and drinking, the usual.  Ask where he lives, who he lives with.  His face grows somber.  “I’m alone,” he says.  “Ever since my wife died six year ago.”

 

“That must have been difficult for you,” I say.  We pause a moment.

 

I ask him about allergies to medications.

 

The next patient visit goes well until I mention his Hepatitis C.  How his recent medication has effectively cured him.  He stares at me, face reddening, eyes beginning to furrow.  “How do you know I have that?" he asks in a rage.  I tell him I read his medical chart to prepare for the visit.

 

He doesn’t want a med student perusing his medical history.  He tells me his medical problems are between him and his primary doctor.  I tell him it’s within his rights to choose who he wants as a provider, same way a female can refuse a male doctor for the sensitive female exam.  He tells me to get out.

 

I leave the room and my attending finishes the visit.

 

I get paged down to the ER.  One of my patients has just come in.  I run down the hallway and sprint down the stairs.  When I enter his room in the ER, I ask what brings him in, giving the illusion I’m not breathing hard.

 

“This,” he says, lifting up his jeans and revealing…  A scab.  Not broken open.  Not inflamed.  Uninfected.  Probably healing there for at least a week and a half.

 

So I chat with him and his wife about their recent vacation to northern Minnesota, about the new medication he has started.  No side effects.  I secretly congratulate myself on my medical student success.  I tell him not to use the ER for this in the future.  “You have my card,” I tell him.  “Just have a nurse page me and I can swing by and tell you if it’s urgent.” He laughs and we shake hands.

 

His wife grabs me as we’re leaving the room.  “You’re his favorite reason to visit the hospital,” she whispers to me.  She squeezes my arm softly.  I grab some instant disinfectant and walk outside.

 

Since I’m already in the ER, I talk to one of the docs and he gives me a new patient.  An older male with new onset chest pain.  His wife sits with him in the corner of the room.  I take a history and physical, relay pertinent findings to the attending physician.  When I return to the room, I ask an innocuous question or two: “How has your week been?” “What are you doing this weekend?”  She mentions church.  I ask which one.

 

She tells me about the church they attend every Sunday.  About their pastor.  About the afternoon two year ago when a voice spoke to her as she drove down the highway.  A voice that wasn't there.  How she panicked that she was having delusions.  That she was becoming a schizophrenic.  That the voice told her to have her husband call his sister.  The estranged one.  The one he hadn't spoken to in twenty-seven years.  To have him call because it was her birthday.

She didn’t know her husband’s sister’s birthday.

 

After an hour of pleading, she got her husband to make the call.  The husband’s sister cried on the other end of the line.  They talked for an hour and twenty minutes.  That Christmas, the whole family got together.  They took a picture, with the Christmas tree in the background.

 

Why me, she asks.  I stand there in the ER room silently, unable to articulate a reply.  Why me, she asks, when I’m ordinary?  Just an ordinary woman.

 

I tell her I don’t know, but I appreciate her entrusting her story to me.  I listen to her husband’s heart again.  Regular rate and rhythm.  Normal S1, S2.  No murmurs, rubs, or gallops.  I leave the room.

 

The rest of the afternoon, I work with my hospitalist team.  Admit a patient in atrial fibrillation, post-surgery.  Medical co-management.  He mainly talks about his girlfriend, thirty years younger.  I ask him about his book, sitting on a bedside table.  It’s a Norwegian mystery.  “Rather depressing and a bit morbid,” he remarks with a chuckle.  “Like all Norwegian fiction.”

 

At 7pm, I walk to my car in the emptying parking lot, only a star or two visible through the city’s haze.  The radio plays the same generic pop hits.  I walk through the white hallways of my apartment, open my unlabeled door, eat a frozen pizza, watch an episode of Netflix.

 

As I lay in bed about to fall asleep, I suddenly hear her words in my head.  “Why me?  An ordinary woman?”  A shudder goes through my body.  I sit up in bed.  Get a drink of water.

 

I go for a walk around the block and stare at the lights of the city, blinking vacantly.  The night is cold.  I tighten my jacket.  A couple walks by holding hands.  I return to my apartment.

 

The next morning I wake up and return to the hospital.