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The Storyteller and the Stethoscope

Across each time zone, hidden from the light of day, hundreds, perhaps thousands, of people lie awake, unable to fall asleep. Some suffer from insomnia. Others are light sleepers and have their sleep interrupted by the loud TV or stereo downstairs. Some made the mistake of drinking an extra-large latté after dinner. A handful might even be on the run, whether from the police, a rival gang, or assassins sent by a mysterious power broker. And then there’s me, lying in bed with a throbbing, swollen thumb, cursing my own tired stupidity.

Just a few hours earlier as I was getting settled to sleep, I quickly reemerged from my comfortable bed and the warmth of my girlfriend’s company to close more doors in my suite and muffle the loud, rumbling bass of my neighbor’s music. As I slammed the door with disapproval, contempt, and weariness, I didn’t notice that I had placed my thumb between the door and the frame. It’s often said that paper cuts, however small, are so much more painful than large gashes and scrapes on much less sensitive parts of the body, like one’s shins or arms. If paper cuts expose the nerve endings in the fingers to the harsh air, imagine what it is like to have those nerves crushed and dozens more compressed by rapid, internal hemorrhaging.

Despite the pain, I decided not to go to the off-hours, college Urgent Care facility. The last time I went there, I had been punched in the face during an intramural soccer match, leaving a wide enough gash on my eyebrow to require stitches. However, I had to wait four hours before I received any care, even though I was one of two patients in the facility. I was not pleased. I ended up disinfecting the wound myself in the men’s room and using paper towels to stanch the bleeding while the nurses chatted the hours away. This time, I decided that it would be better to wait for the normal outpatient service to return in the morning.

Yet, here I was, lying on my back, restless, frustrated, and angry at just about everything that popped into my head. Angry that the urgent care facility was a joke (e.g. I wouldn’t be surprised if the first question they asked was, “Were you drinking?”, closely followed by “Are you pregnant?”). Angry that it was too ridiculously cold outside to venture out in the middle of the night to seek substandard care. Angry that despite my excruciating pain in my hand that felt like it was throbbing as loudly as the bass next door, my girlfriend was sound asleep beside me, oblivious to my state of misery. I started feeling sweaty and feverish and had difficulty deciding whether to keep the covers on to stave off winter’s bite or shrug them off to cool the delirium.

By the next morning, my nail bed of my thumb was, in full, the darkest shade of violet. My anger had subsided, but my feeling of stupidity was reinforced by my girlfriend’s concern and question, “Sweetie, why didn’t you wake me?” Somehow, biting my tongue about a jammed thumb didn’t seem so manly as it might have at 3 in the morning. We immediately went to the student health center as soon as the evening shift was over, and I was promptly seen by a doctor who came up with a quick solution: a cauterizer. He explained that the trauma to my thumb broke blood vessels that were pouring their contents under my nail. He was going to relieve the pressure on the nerves in my thumb by burning a small hole into the nail to drain the blood. If there was no damage to the nail matrix, it would simply grow out and my thumb would be back to normal in a couple of months. My girlfriend, in a more keen and cheerful mental state than myself, asked the doctor, “What is the Matrix?” I smiled in appreciation of the joke, but sadly the doctor didn’t recognize it and instead answered with a quick medical explanation. Well, at least I was in a stable enough mental state to appreciate jokes now. The procedure went without a hitch, and the pain was relieved instantly. For the next several weeks, I occasionally stared at the hole in my nail with the comforting observation that it was progressing forward to the edge and would soon be gone. And also, I would think to myself, “Well, that was easier than expected.”

She means business. As soon as the young man in the white coat calls her name (”Stacy R.?”), she jumps out of her seat and instinctively leads the way back to the clinic. She suddenly realizes that she’s walking ahead and turns back to make sure she’s walking in the right direction. “This way, right?” “Yes, Ma’am!”

The young man introduces himself and a young woman in a white coat as medical students: he explains their roles, and assures her that the attending physician will be arriving soon. As soon as the first student pulls out his pen, Stacy launches into a rapid-fire recall of her chief complaints and history: she’s a young, recovering heroin addict with an annoyingly itchy (fungal) infection on both feet, among a laundry list other complaints. She’s a mother of one but divorced. She’s also a war veteran: honorably discharged for medical reasons. As the first student is frantically jotting down the details, she continues on with the real kicker: an accident during the war left her unconscious, and when she woke up, she was amnesiac and couldn’t recognize her own family. Her husband promptly divorced her and took their five-year-old daughter with him, and when she finally regained her memory some time later, she plunged from her straight-shooter life into despair and drugs. Now, a year later, she’s trying to get back on her feet again, with a promise from the courts that if she cleans up her act, she can have her daughter back.

Having told her story and seemingly inspired some empathy and eagerness to help, she’s happy enough to put up with the students’ double-examination. “Do her radial pulses feel weak to you?” the male student asks. “Heh, they’re fine,” his more experienced partner replies. “The four heart sounds sound good, but what’s the one that sounds like ‘Kentucky’ again? S3, right? I thought I heard one.” “Nope, her heart sounds good to me,” she says.

Eventually, the students finish their examination and present the case to the attending physician. “Do you believe this story? What sort of husband leaves his wife like that? Don’t get me wrong, she might be telling the truth. Maybe I’ve just been in this business too long,” she says. The first student replies, “Eh. I haven’t been in this business long enough.” They go in to see Stacy again, and the attending interviews her: her story checks out exactly as the students described it. The physician counsels her to address the issues one at a time: she’s still early in the detoxification and rehabilitation process, and there will be plenty of time to address the less immediate issues during subsequent appointments. Stacy is eager to have everything sorted out at once: she doesn’t want to waste time getting her life back on track. Nonetheless, she defers to the doctor’s recommendations and goes home with topical cream for the fungal infection. On the bus ride, she repeatedly thinks to herself to keep her eyes on her goal: I want my baby back.

I want to say a million things. I want to shake your hand again, redo our brief conversation, asking all the right questions and saying all the right words of encouragement. Hearing my friend choked up on the phone brought me back to that day, only a handful of months ago, when I ran into you at a coffee shop I frequent.

In the same way that all everyday tragedies begin, I have to admit that I didn’t know you well: maybe it’s an attempt to relieve myself of the responsibility of feeling overwhelming grief, or maybe it’s an acknowledgment that whatever I feel is felt a thousand times worse by someone else, someone closer to you. Nonetheless, with my backpack slung over my shoulders, full of medical school books demanding my time and attention, I walked into that coffee shop, shook your hand, and made small talk, happy to see a familiar face. As I always do, I asked “How are things going?”, and yet this open-ended question didn’t elicit the response that I, standing as a shadowy intruder in the memory of that day, so desparately long for. Or perhaps, as I dissect away the fragments of that memory, my preoccupied self, listening to your response, didn’t listen closely to the hesitation in your voice, the clues in your statements. Perhaps your humor and gregariousness masked your pain.

How could I have known that your father committed suicide half a year ago? Perhaps that was the reason why you were taking time off, and in my long absence from the world I once felt I reigned over like a prince, responsibility-free but respected and adored, I did not receive the news. Instead of staying to chat, I adhered to convention: a few friendly statements, getting the general public-safe idea of where we are in our lives, and then parting ways to return to our preset schedules. I probably went to the other side of the coffee shop to study Anatomy, or perhaps I was leaving the coffee shop when I spotted you or you spotted me. Would my time have been better spent if I sat down with you, asked you more about your life, and heard your story? My retelling here is lacking in detail, because I’m lacking the paint with which to paint your portrait.

Each day I get closer to becoming a doctor, I wonder what the effect of each death will have on me: will I become desensitized over time? There’s a certain sadness to diseases of the body, but these deaths carry a mixture of random chance, personal choice, and sometimes a blow to one’s professional self-concept. However, diseases of the mind, particularly in the mind of a friend, can make one feel at a loss as a person: it feels like a personal failure, not a professional one. People die all the time, and sometimes we feel more strongly about some than others. I’m not an explicitly religious person, but I do believe in a god, heaven, and hell. I believe that heaven is in the memories of those we have loved, those who have loved us, and every person we have touched in some way: they remember us, and we live on through them. Hell is being forgotten or being remembered in a bad light. If this is the way it is, I know where you’re headed, with your humor, your good nature, your creativity, and your warm, generous welcome. It is the deaths of good people that hit us the hardest, that hurt us the most.

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