Alice LaPlante - Turn of Mind

You are awakened by a crack of thunder, the sound of drumming against the window, on the roof. Outside the window you see gray and wet, but it is still warm. You see that you are already dressed, shoes even. You must have been on call.

Those days as an intern, learning to jump up from the soundest slumber, ready to slice. No transition from oblivion to hyperawareness. You are aware of an empty stomach, but when you go downstairs the refrigerator is dark and empty, and a sour smell emanates from it. In the pantry some dry cereal, stale. Rat droppings on the shelves, holes chewed in the bags of pasta, the cracker box.

You catch sight of the clock still ticking above the sink. Eight forty-five. The clinic opened at 8 am. You are late. You stuff some cereal in your mouth, run to the front door. You do not have your car keys, you must take a cab. You walk swiftly down the street toward Fullerton, where the cabs stream past day and night.

You are already soaked from the warm rain. The first two cabs are occupied, but then you are in luck: The third one stops. To the New Hope Clinic, you say. Address? he asks, but you can’t remember. He punches the name into a small machine mounted on his dashboard. Chicago Avenue, he says. Okeydoke.

He is dark, handsome. A Palestinian flag is draped over the front seat. His cell phone rings and he spits out a string of guttural sounds, hangs up. You brush off the water as best you can and try to relax. Chicago the gray lady. You don’t mind.

Sometimes you want the outside world to match your interior reality, you said to James once, trying to explain why you loved thunderstorms. Another boom overhead and a streak of lightning on the right. Awesome, says the taxi driver, and catching your eye in the rearview mirror, he smiles.

The taxi pulls up in front of a low gray building. Seven seventy-five, the man says. You reach for your purse. You begin searching around the backseat, you pat your pockets, you are frantic. The man looks more concerned than alarmed. You work here ? he asks. Or a patient? You are a doctor, you explain, and the man nods like he expected as much. Perhaps you can borrow it, he suggests. I will wait.

You run through the rain to the front door. The waiting room is full of people, many more people than there are chairs. Jean is at the front desk, checking in a woman with a crying infant. When she sees you she looks startled. Dr. White! she says. What a nice surprise! Aren’t I on the schedule? you ask. Then, without waiting for an answer, you say, No matter. Clearly you need me. I’ll be ready in ten minutes.

You walk into the back area and are surprised at all the strange faces . A medium-size dark-skinned man stops you. I’m sorry, he says, staff only here. His name tag says dr. aziz . It’s okay, you tell him. I’m Dr. Jennifer White. Apparently there was a schedule mix-up, but it looks like you could use the help.

Dr. White? he asks, but you are already at the back sink, washing up. You go to the wardrobe, take a white coat, button it over your dress. What do you have for me? you ask. The other doctor hesitates, then shrugs. Room three, a rash, could be shingles, could be poison oak, he says. The chart is on the door.

You give a quick knock for courtesy, then enter the room. The woman is perhaps thirty, African American, a fine strong frame. But she is holding on to her left side and her face is in pain. Let me see, you say, and she reluctantly lets go. You pull back the blue hospital gown to see an angry rash with raised red bumps and blisters that have erupted on the skin in a band that reaches across her belly and around her back.

Does this hurt? you ask.

Yes. It started out as a kind of tingling. But now it hurts. Badly.

You look. Some of them have become pus-filled, others are still in the early stages of formation. You motion for her to turn over. Nothing on the other side, just this broad swath down the right side of her body, her hip, thigh, and buttocks.

What is it?

Herpes zoster. Known more commonly as shingles, you say. I’m going to prescribe one of the antivirals. Acyclovir. It should decrease the duration of skin rash and pain. I hope we’ve caught it early enough. Also apply cold compresses to the rash three times a day. Above all, do not scratch or you risk infection.

How did I get this? You called it herpes. Did I get it from my boyfriend?

No, not at all. Shingles is caused by the same virus that causes chickenpox. You know, what you had as a child.

You are looking for your prescription pad. It’s not in your pocket. You excuse yourself and go out into the hallway.

Excuse me?

Yes, Doctor?

I have misplaced my prescription pad. Can you get me one? You turn and nearly bump into another woman wearing a white coat. She does not have a name tag on. She looks frazzled. She examines your face with curiosity. Are you Dr. White? she asks.

You nod, yes.

I recognize your photo. I didn’t realize you were still involved in the clinic. I thought you’d retired. Dr. Tsien still talks about how much you are missed at the hospital. She frowns, opens her mouth, closes it again.

You don’t follow all of this. I come here every Wednesday, you say.

But today’s Thursday.

You pause, think. I must have had a conflict this week, you say.

Everyone has been very grateful for your help. That a doctor of your caliber would work here pro bono has always meant a lot to us. Not to mention the other contributions you’ve made, of course. She still has a bemused look on her face, as if trying to remember something.

You turn to go. You face a bewildering mass of doors. Where were you? You pick a door at random and go in. An older man is sitting in his underwear. He looks surprised. Is something wrong, Doctor? You tell me, you say. What brought you here today?

The man looks uncomfortable. As I told the other doctor, I’m having trouble going to the bathroom.

Does it hurt? Or do you have urgency but no voiding?

The second one. I think. I try to piss and nothing comes out. It hurts.

Any erectile dysfunction?

Excuse me?

Do you have trouble maintaining an erection?

No, of course not. The man doesn’t look at you when he says this.

Liar, you think.

How long have you had this dysuria? you ask.

This what?

This urgency but no voiding.

About a month. It comes and goes.

Any blood in the urine?

He hesitates, then says flatly, No.

Any pain or stiffness in the lower back, hips, or upper thighs?

Maybe.

My guess is prostatitis, you say. Then, after seeing his reaction, you add: Relax, it’s not cancer and it will not lead to cancer.

Is it curable ? he asks.

Sometimes. Sometimes not. But we can almost certainly relieve the symptoms, you tell him. We’re going to start by taking a urine sample to rule out bacterial prostatitis.

There is a slight knock at the door. A woman is standing there. Dr. White? she says. There is a cab driver who says you owe him money. He’s kept the meter running, so it’s up to sixty-five dollars now. What should I do?

I didn’t take a cab, you say.

He says he drove a doctor here, a woman, and he described you. Perfectly. What should I do? He won’t go away.

I’m busy here, I have roomfuls of patients to see, can’t you take care of this?

He’s really quite insistent.

Very well. You turn to the man. I’ll be right back.

You follow the woman out of the room and nearly bump into a dark-skinned man going in.