Tony Scott: Along Came COVID: Love and Loss in the 2020 Pandemic

“That’s not our problem. What happens to them if they don’t comply with what is usual and standard care we are not responsible for. Besides, she already showed up in ketoacidosis.”

“I can’t believe you think like that,” Ann said. “Don’t we owe them the best we can do under the circumstances? We should prevent every catastrophe we can.”

“Look, Ann, I’m the attending here. We do this my way. I don’t care what happens to patients who choose not to accept our advice and recommendations. That’s on them, not on us.”

“Whatever.”

“And another thing,” Brian said. “I don’t appreciate you extending rounds after I have left, like you have been doing. You are not empowered to make management decisions in my absence or without my approval.”

“Those rounds don’t make management decisions,” she said. “They are for teaching. We discuss the issues brought up in rounds and I facilitate discussions of the options, including ones we don’t practice here. There are well accepted practices that people use in other places, and our residents need to hear about them, discuss them, and understand why we do what we do the way we do.”

“They can get that information on their own. Let them do it.”

“No. They need to hear the discussions. On oral examinations, the proctors are going to expect candidates to discuss the pros and cons of several management strategies and the reason the candidate prefers his or her selection.”

“They can get that at meetings and on pod-casts.”

“Whatever.”

“Why do you always blow me off?” He was annoyed by Ann, both in being challenged on treatment choices and in her insistence on being instructive. “You always disagree with me.”

“A lot of times I’m not disagreeing. I am trying to get you to discuss other options. Our duty is not only to our patients, but also to our trainees. We need to model instructive as well as clinical behavior. We need to model logical thinking based on current unbiased information.”

“I do that well enough, I think,” Brian said. “There’s no end to what we could do, but a practical limitation on what we should do.”

“Whatever.” She walked away.

Faith was ushered into an examination room in the office building, expecting to get her IUD replaced. She had made a visit a week earlier where a good exam, cultures, and a pap smear were performed. She was here for test results and to have her current IUD removed and a new one inserted. They only last five years, and she was a little past that.

Dr Michelle Scroggins came through the door. Not knowing any of the faculty more intimately than putting names with faces, she had selected the chairman of the Ob-Gyn department somewhat arbitrarily.

“Hello, Faith,” Michelle said as she entered the room. “How is life treating you?”

“Fine,” Faith said. “I am getting into the residency pretty well, I like the patients, and I like our attendings.”

“I have heard that you are doing well. Emily says you are reading, assimilating, and asking a lot of questions.”

“I want to be an excellent obstetrician. I want to pack everything I can into my brain.”

“That’s a good approach,” Dr Scroggins said. “We have some tests to discuss.”

“Yes. I’m ready.”

“Your pap smear is normal, and your papillomavirus test was negative, so you don’t need another pap smear for three years.”

“That’s good news.”

“I’m afraid there’s bad news to go with it.”

“Oh?”

“Yes,” Michelle said, making eye contact. “You have the sexually transmitted disease chlamydia.”

“What?"

“You have chlamydia. I can give you a prescription for four capsules of azithromycin which you should take all at one time. There will be enough medicine for your partner. You should treat each other on the same day, then you don’t have to worry about reinfection or cure.”

Faith was stunned. She could feel tears well up in her eyes, part injury, part anger, part embarrassment. “I can’t believe this,” she blubbered. “I’m sorry. I’ll get it together. Do we need to test Brian?”

“No. Unless you have other contacts, there is no question he has it. Do you have another contact that I should include in your prescription?"

“No. We have been together seven years or so, and I have not had contact with anyone else.”

Michelle looked at her computer and typed a few characters and stroked the touchpad. “We should wait a week or two to change out your IUD, so we don’t infect your tubes. Make sure Brian gets treated.”

“I will. I’ll make another appointment. Or maybe you should remove this one now and I come later for a new one.”

“I can do that.”

The exam was brief, and against Faith’s expectation, removal was a breeze. She looked at herself in the mirror as she was dressing, wondering what had become of her marriage. She thought of Natalie’s opinion, about how disagreeable he had become, and of her father’s unenthusiastic attitude toward Brian. Listening to Brian’s interaction with Haley and Ann, she reaffirmed that his irritability was not only toward her. But it was still a problem.

A whirlwind of thoughts pummeled her brain as she drove home, changing her over from hurt and disbelief to anger. She went to the kitchen to fix dinner, usually a relaxing activity she relished. She added a glass of wine to the activity.

Half an hour later, Brian came through the door, dropped his book bag, and walked through to the bathroom.

Faith called out, “Dinner’s ready.”

He didn’t answer. She plated dinner and put the plates on the table. It was the good night, the one between the night-after-call and the night-on-call, and she wanted to go for a run. She sat at the table, hesitated, and started to eat.

Brian later sauntered to the table, sat, and sarcastically said, “Thanks for waiting.”

“I wanted to eat my food while it was hot,” she said. “I told you it was ready. I haven’t seen you for days. What do you do all day?”

“Today I was in the office. Yesterday I was in the office in the morning, and I read in the afternoon.”

“Where were you?”

“In the library.”

“Across the street?”

“The only one.”

“Did you remember I had my gynecology appointment today? I was supposed to get my IUD replaced.”

“I forgot.”

“Well, guess what? I can’t have it replaced yet because I have chlamydia!”

“What?”

“I have chlamydia. And you now need to tell me where you got it.”

“I don’t have anything wrong with me. Where did you get chlamydia?”

“Only from you, Brian boy.”

“Well, I don’t have it.”

“Jeez! How many times have you heard patients say their men denied they had it? Now get it right.”

“Well, I don’t have it.”

“Yes, you do.” She handed him a little bottle of pills. “Here is your medicine. I want to watch you take it. Then I want you to explain how you got it. Are you back with that woman you met in Dallas? Or is this a new one?”

“I’m not with anyone. I haven’t—”

“Stop! Now take your medicine.”

“If I don’t?”

“Then you’re on the couch until further notice — that is, if I let you stay here.”

“Are you threatening me?”

“Yes.”

He growled and stood. He grabbed the bottle of pills, hiked them in his mouth, and swallowed them with a swig of the iced tea on the table. “There.”

“Now tell me what’s going to happen. It won’t work if you just go out and get it back from her.”

“I’m telling you. I broke it off.”

“That’s what you said before. Why do I not believe you now?”