Snow and frost sculpted mazes in the streets; I struggled through the wind, fluid freezing in my joints, unpaved sidewalk sliding below my shoes. I was skating on a pond in Transylvania; the desolate snowscape wrapped around the hill crowned with the dark building, speckled but starkly rising. Maybe there were vampires in there, but my hands tingled with warmth as I opened the metal handles.
The guard glanced but said nothing. I felt immediately lost; words soliciting directions died in my throat. At one end of the vestibule, elevators chimed. A few seconds later, I followed a woman in blue scrubs and pink sneakers zigzagging through the third floor rooms. I did not get a chance to look at her, so I kept my eyes on the shoes; they directed me when she failed to do so vocally. Suddenly ceasing to move, she gestured strongly as she almost pushed me into a room. It was very much like the ones we used for practice, but this time, it would not be practice.
I sat on the padded table instead of the chair; it seemed more comfortable. I watched snow begin to fall, and my eyes started to wander. The ophthalmoscope seemed familiar in its steel and black plastic, but the size was larger than usual, and the metal more chrome than my faded secondhand instrument. In fact, everything in the office seemed used but spotless, even the hand sanitizer dispenser. I sat alone for a very long time.
She walked in then, bright-toothed smile topped by wide black glasses, stylish but professional. “Hi, Lorenzo. I’m Alice, and I’m your nurse practitioner today. What brings you in today? How are you feeling?”
I struggled to find the right words. “I am doing okay. I am…” She encouraged with a smile. Should I say I have trouble breathing, and I’m coughing, have pain when I breathe, and a sore throat? Or, should I say I think I have a lobar pneumonia of the right upper lobe, with common cold viral co-infection? “I’m having a hard time. I’m coughing and my throat hurts.”
She said some irrelevant comforting words. She probably did not actually care; we are all taught to say these things to comfort the patient and make them more compliant. But, that in itself was warming; she was treating me like any other patient. Perhaps, she did not know?
Alice, the nurse practitioner, asked me to take off my shirt, and I did as she asked. Starting with my face, she palpated, searching for tenderness and lymph nodes, with fingers far more nimble and certain than mine ever were. From point to point, she listened to lungs, auscultating the L-shaped pattern on my back and my chest. “Your lungs are clear actually, so it’s probably not anything serious like pneumonia.”
I tried to look as if I’d never heard of pneumonia before. In fact, I started to think that she did not really know or if she knew, she did not show it.
“Pneumonia is an infection of the lungs, but you don’t have that.” She said it slowly and certainly, reassuring me of her ignorance.
“So what do you think it is?” I asked more loudly, wanting her attention instead of trying to avoid it.
“You most likely just have strep throat, which is an infection of the throat. It is easily treated. You don’t have to worry. I’ll just give you some antibiotics, and take a bit of your sputum to the lab. Here, take this and go spit in it at the sink.”
I hawked up the deepest reserves of phlegm I could find, the thickest I could get, and I filled the little plastic sample vial up with green spit and handed it to her. It was her problem, not mine.
“Okay, just take this prescription and get these antibiotics. Take them three times a day, and I’ll call you tomorrow with the results to let you know whether you should come in or not.”
I shook her hand and left the room as quickly as possible after putting on my shirt. I’d never been happier to walk into a blizzard.
She had treated me like a normal person and not a medical student.
Contributing Writer Emeritus
Yale School of Medicine
Lorenzo R. Sewanan grew up in Paramaribo, Suriname, and moved to Queens, New York, when he was sixteen. After graduating from Trinity College in physics and in engineering, he enrolled in Yale School of Medicine as an MD/PhD student. As a child he used to invent worlds of imagination, and now, he wants to bring inner worlds, his and others, to papers and words.