Monday morning came without warning. As I was getting ready to leave for work, I was looking for my briefcase. “Luisa, have you seen my briefcase?”
“You left it on the table by the door.”
I went over there and saw that it was right where she said it was. “I have this crazy brief that I have to fax to the court and then hopefully set a continuance. Are you still going to your meeting?”
“Si,” she simply said.
“Okay. I’m going to grab a granola bar and head out to work.”
Luisa looked at me with her hands on her hips and head to the side. That “you’re about to get in trouble” look. “Did you forget something?”
“No, Mi Amor (my dear).” I started walking to her.
I pull her into my arms, said a blessing over her, and then kissed her on the forehead. “I will call you later. Let me know how the meeting goes! I love you.”
“Okay, I love you, too,” she simply said.
Off we went on our separate ways. We lived off Smith Street a block from Calhoun Street, which led to MUSC (short for Medical University of South Carolina; this is a teaching hospital in Charleston). I was off to Broad Street to the Charleston County Courthouse. Parking was always difficult. This time of year was worse; tourists were out like flies on a magpie. (You’re probably asking yourself, what is that? I’ll let you find that out for yourself.) We Southerners, whether black, white, Protestant, Jewish, Geechee, and so on, all draw from Southern idioms. It’s just in the culture here.
It was a short drive for Luisa to get to her “meeting.” She drove into the parking garage, feeling very nervous about what might happen. She parked, then crossed the garage to the clinics. There she took the elevators to the neurology clinics. She went to the front desk to sign in. “Hi, I’m Luisa—”
But before she could get her last name out, the nurse came out to get her. “The doctor is waiting for you.”
Luisa was amazed at the service. As she was escorted to room 404, her mind started running wild. “What if…?” Then she realized suppositions led to nothing but worry and lack of faith. “Venga lo que Venga (Whatever comes, comes). God is in control.”
The nurse then left her and shut the door behind her. She knocked on the doctor’s office. “Your next patient is here.”
“Thank you.”
The doctor walked into her room and hugged her. “Luisa, what brings you here today?”
But before she could explain the reason, she said, “Please don’t tell Jose that I am here or have been in to see you.”
The doctor was my husband’s brother. Tall, olive complexion, dark hair, Ladino to a tee. The difference was, he had a Southern drawl in his speech, but he could speak Spanish so beautifully that women would swoon and be knocked off their feet. He had married right after med school, to his father’s dissatisfaction. His wife was a Southern lady, blonde, and from a prominent Charleston family. The accent, formalities, and the charm of politeness that was expected of her would make you think that she was fake. But on the inside, she was a Southern girl with a big heart. She was also brought up to marry and give her daddy grandchildren.
We didn’t socialize much. I didn’t tolerate the charm that seemed so fake. I hated it for my brother-in-law, but I loved Iglesias (nicknamed after the singer Julio Iglesias). Jose would always tell me that at least he kept the Spanish language and honored our parents. As for his children, they were raised Southern and he would tolerate his father-in-law. Iglesias didn’t care whether the man loved him or not. But he did come to respect my brother after a near family tragedy.
They were at his in-laws’ house one afternoon. His wife’s sister was there with her children. Typical afternoon, the ladies would gather in the kitchen and gossip about things that they hadn’t already talked about that week. The men would grab a “cold one” and sit in the den talking about sports, hunting, fishing, and so on. Iglesias was a cultured man and hated animal-killing sports. The only sport he truly loved was sailing, which his wife did not enjoy.
So the afternoon went on and suddenly, one of the children came in running and screaming that one of the other children had fallen in the pool and wasn’t moving. Immediately, Iglesias jumped out of his seat, ran to the pool, and jumped in. The child was facedown, not breathing, but not yet blue. Iglesias turned the child over and started CPR. The other men jumped in to help them get out of the pool. There he resumed CPR, breathing and chest compressions. Suddenly, the girl coughed and water came out of her nose and mouth. She started crying. By then, the whole house was gathered around the pool. The women were upset, some crying, the men not sure what to do. The grandfather came over and told Iglesias, “Thank you for saving my grandchild.”
Iglesias looked him straight in the eye and said, “I didn’t do it for you. I did it for her!” At that moment, his father-in-law realized that his judgment of him being a Spanish Jew was over. He had just saved a child! Iglesias got back to the task at hand. “Someone bring me a phone, now!” One of the ladies handed him a phone. He dialed 911.
“911, can I help you?”
This is Dr. Iglesias Sanes. I need an ambulance at 611 Battery Park right now. I have a young girl, near-drowning, victim.” They finished getting the information they needed. Then he asked to be patched to the ER nurse’s desk.
“ER nurse’s desk, this is John, charge nurse.”
“John, this is Dr. Sanes. I am at the site of a young near-drowning victim. I was able to revive her. I need you to get my team there ASAP. And call the resident neurologist that is on call. Tell him that if he is not there within thirty minutes, he doesn’t need to show up on Monday. I have called an ambulance and will be arriving with her.”
“Yes, sir. I will take care of this for you.”
As Iglesias ended the conversation, he heard the sirens. He sent someone to the front door to let them in. They came to the backyard with the stretcher. They found Iglesias kneeling with the child beside him. “Dr. Sanes, I’m John, one of your paramedic students.”
He got straight to the point. “John, she was found facedown in the pool. I was able to revive her, but I don’t know how long she was in the water. She is yours now, but I will ride with you. My team is waiting for us in the ER.”
As John and the other paramedic got her on the stretcher, he looked around at the stricken family. “Y’all are lucky that Dr. Sanes was here. He has seen more than his fill of drowning children, and his care for them is remarkable. Will someone please get him a towel?” As Iglesias got the towel and started drying off, John turned to him, “Doc, I’ve got some extra scrubs in the back that you can use.”
“Thank you so much, John.”
The family was stunned at the authority and respect that Iglesias had during the entire situation. That family had just witnessed a miracle and they were all eating crow. They would never treat Iglesias differently again. He would forgive them for the smugness; all he cared about was his children and his wife. Now she and her family knew that they had a hero on their hands and she had a real man. Word eventually would spread how Iglesias saved the old man’s grandchild. Many took Iglesias’s side when they realized how he had been treated in the past. They would never forget how Iglesias saved the girl. Like we say in the low country, we either like you or not. Iglesias was now loved, and his wife had now begun to see him as a different man.
“So, Luisa, what can I do for you?”
“I’ve been having these headaches on and off for about two years, but now I get very tired more easily than I think I should. I’m having to lie down and rest frequently and the headaches ease up.”
“Do you want me to send you to a headache specialist?”
“No, I’ve come to you and really want to see only you,” Luisa told him emphatically.
“Well, thank you for that, Luisa. Are you still dealing with that respect issue?”
“Yeah, but it’s not as before.”
“Okay, let’s get started with your exam then. I am going to need you to get on this patient table and let me see what’s going on.”
As Iglesias went to wash his hands, he asked Luisa, “How is my brother doing?”
“Silly as always. But, Iglesias, he does miss you. Will you please call him? Since Papa passed away, he has been taking your distance very hard.”
Iglesias looked very serious as he contemplated what she just told him. “Yes, I’m sorry. I’m very busy, but that is not an excuse.”
“Please, don’t tell him that I am here.”
“I won’t. Doctor-patient confidentiality is the number one rule in medicine!” He dried his hands and walked back over to the exam table. “Now, let’s get started. Point to where your headache starts.” Luisa points to the front/top part of her head. “Ah, that is the frontal area. Does it stay there or does it move?”
“No, it stays in the same spot.”
“Okay, what time of day does it start and how long does it last?”
Luisa thought for a short moment. “It usually starts in the afternoon, sometimes in the late morning. The length depends on what I’m doing and if I’m able to rest.”
“Are you under any stress?”
“The usual stress of life, but nothing to do with Jose.”
Iglesias placed his hands on her head and moved it back and forth, up and down. “Does any of that hurt anywhere?”
“No.”
“Does your upper back hurt when I touch here on the side of your spine?” he asked while pressing several areas on her spine.
“Yes, a little bit on the right side.”
“Okay.”
Luisa looked at Iglesias with a puzzled look on her face at his exam so far. “Where did you learn that type of exam?”
“In China.”
“China?” she said with a sense of wonderment in her voice.
“Yes. I studied a course in Chinese medicine specializing in Neurology. My professor didn’t know. But it has helped open a new world to me and my patients.”
Luisa looked at him, impressed. “Have you always wanted to be a doctor?”
“Not really. But Papa always insisted that every Jewish family should have a least one ‘Maimonides.’ So that is what I did.”
“Iglesias, you know I’m married to a law Maimonides.”
“Yeah, I remember,” he said as they both laughed at that.
Iglesias reached into the drawer and pulled out a penlight. “Okay, Luisa, look straight at the light. Good, your pupils are reactive to light and accommodation.” He then asked Luisa to open her mouth. “Say ah. Very good, no pustules or exudates.”
Luisa looked at him, a confused expression on her face. “What does all of that mean?”
“It means that your eyes do what they are supposed to do when the light shines in them, and your mouth and throat do not have any sign of infection.”
“Okay, good.”
“Have you had any gall bladder problems? Do you still have your gallbladder?”
“No, I haven’t had any problems. Yes, I still have it.”
“Are you having any resentment issues?” Iglesias inquired.
“Why do you ask?”
“Because of where you are having the headaches. It is part of the gallbladder meridian; the emotion that is associated with it is resentment. So are you resentful of something or someone?”
She thought about his question. “You know how to put a girl on the spot.”
Iglesias got a very serious look on his face. “Luisa, right now I’m not your brother-in-law. I’m your doctor. Por Favor.”
Luisa made a contrite expression. “Yes, I am holding on to some resentment because I can’t have children. And because I can’t give that blessing from God to Jose.”
“Are you blaming God?”
“Since when did you get religious?”
“I’m not religious. My brother and I have talked about God, but life just got in the way.” He looked down at the floor, then back up to Luisa. “So are you blaming God?”
“No, I’m not mad at anybody, especially God,” when she said this then she started to cry.
“Luisa, I’m so sorry!”
“No, it’s okay. I needed to let all of this out.”
“Is it okay for me to continue my exam?” Iglesias pulled out his stethoscope and listened to the arteries in her neck. “No bruits noted in the neck.” Then he started to feel around on her neck with his hands. “Retro-auricular, no lymph nodes noted.”
Luisa tilted her head to the side with a slight smile on her face. “Do you always dictate your exams?”
“Yes, it saves time for me. They type it up later,” he responded. Then he continued the exam. “Left supraclavicular, nodule palpable. Right supraclavicular, no nodules noted. Right and left subclavicular, no nodules noted.”
Iglesias tries to continue the exam with no pauses so that Luisa would not catch the palpable node statement, but Luisa noticed. “Iglesias, you can slow down. I know what you’re doing.”
“You’re a pretty smart chick, for being my brother’s wife.”
“I think he picked me well.”
He continued the assessment, listening to her heart. “Heart regular rate and rhythm, no gallops, rubs, or clicks noted.” He moved the stethoscope to her lungs. “Now, take a deep breath in and exhale slowly.” Into the recorder, he said, “Right lower lung clear.” Back to Luisa, “Breath again.” He repeated this process to assess all of her lung fields. “Left lower lung clear, left upper lung clear, right upper lung clear.”
Iglesias put the stethoscope down. “Now, let me check your pulses.” He started assessing different areas on her arms than she was used to.
“Is that the Chinese thing again?”
“Yes.” He placed a finger on his lips as if to tell her to not speak.
“Left pulses kidney chi weak. That would explain the fatigue.” He looked at Luisa and said, “I am talking to myself.” They both laughed at that.
Iglesias then had Luisa lie back on the table. “Take a deep breath in and I am going to push my hand here on your abdomen. Now, exhale. Let me know if you have any pain.”
“It is a little tender there, yes.”
“Okay, I am going to do the same on the other side. Inhale, exhale. Any pain?”
“No.”
Iglesias dictated, “Right upper quadrant, tender to palpation; left quadrants without pain.” Then he placed his right hand on the top of her abdomen and his left underneath her. “I am going to palpate your kidneys.” He started pressing around. “Ah, there’s the kidney. Do you have any pain there?”
Luisa responded, “No pain”
“Okay, now I am going to check the left kidney.” He repeated the same procedure from the other side.
Luisa immediately had a change in her expression. “Ouch, that is tender.”
“Okay, I’m sorry.” Then he dictated, “Right kidney without pain; left kidney positive for pain.” He turns his attention back to his assessment. “I am going to check your groin for lymph nodes. You don’t need to undress, though.” He started pressing on her right side, then moved to the left. Again he dictated, “No nodules noted in the right groin; left groin no palpable nodule.” Iglesias then gave Luisa his hand to help her sit up. “I am going to get my reflex hammer for the next part.” Then he tapped lightly on her elbows, knees, and ankles. “Elbows, good; knees, good; ankles, good.”
As he puts away the reflex hammer, he asked, “Luisa, have you been doing your monthly self-breast exam?”
“Honestly, no.”
“Okay, I am going to need my nurse for the next part of the exam.” He went to the door and called for his nurse to come into the room.
As she walked into the exam room, Iglesias said, “Luisa, this is JoAnn. She is the woman that likes to tell me what to do.”
JoAnn gave him a stern look. “Dr. Iglesias, my mother told me to watch out for you before she passed away. And that is what I’m going to do. You understand?”
“Yes, ma’am,” he said with a contrite tone. “JoAnn, please get Luisa into a paper gown for a breast exam.” He left the room for them to have privacy.
JoAnn turned to Luisa. “Let me wash my hands, then I will help you into the gown.” After she dried her hands, she reached into the cabinet and pulled out a gown. As she helped Luisa into the gown she said, “That man out there, he helped my mother using acupuncture when she had her stroke. I’m so grateful for him! Mama loved that man and he loved her sweet potato pie.” She had a smile on her face with that last part. “Now, as for his wife, let’s just say the peroxide queen knows not to come around here when I am working.” They both heard a knock on the door as they finished putting the gown on.
“You can come in, doctor,” JoAnn told him.
“You still don’t care for my wife.” He said this as more of a statement than a question.
“Nope, not now, not never, not even when Jesus comes back!” JoAnn was very adamant in telling him that.
Iglesias turned his attention back to Luisa. “Okay, now I am going to do a manual breast exam just to check.”
“Okay,” Luisa said as JoAnn helped her to lie back once more on the table.
“Luisa, is this area tender?”
She grimaced a little as he pressed. “Yes.”
He dictated, “Right upper breast quadrant tender, palpable nodule.” Then he turned back to Luisa. “We are done with the exam. I am going to order some tests for you. After I get the results, we will talk about them.”
Luisa had a very concerned look now. “Is it bad?”
“I don’t have all of the answers right now, so it is best to wait until we get everything done to discuss it.”
“But you know something.”
Iglesias turned to her with a soft but firm look. “You know, I make no suppositions. Let’s just wait for the tests.” Then he turned to JoAnn. She was pulling out her notepad and pen, ready to take the doctor’s orders. “Let’s get a CBC, CMP, SMA 20, thyroid functions, CA 125, CA 15-3, CA 27.29, CEA, urine, CT with and without contrast of head, neck, chest, abdomen, and pelvis. Also, she will need a mammogram. Can you call Dr. Bill Jenny for a Gyn consult?”
At that, JoAnn stopped writing and looked up. “Now you know that I don’t like that redneck man!”
“Okay, then who would you recommend since I am ignorant in that department?”
“Dr. R.”
“You mean Dr. Richardson? You mean the man that you wished you had married had he not rejected you in your mind?”
JoAnn gave him a sour look. “Dr. Iglesias, really!”
“Go ahead and call him for an appointment as soon as possible. And all of the other tests are STAT for today, not next year. And if anyone has anything to say about it, tell them I will personally go visit them!”
“Yes, Mi Capitan (my captain).”
Iglesias looked at her, amused now. “JoAnn quit hanging out with those Caribbean nurses!”
“Say what?” JoAnn said, laughing. Luisa joins in with her.
JoAnn left the room to start calling and getting Luisa’s orders together.
Luisa turned to Iglesias and said, “I really like her.”
“She’s my right hand. Nobody messes with her, not even the vice president of the hospital. If she finds something wrong, she has no problem going to his office and ‘cook his grits’ until he does something about it.”
“So what happens next?” Luisa got a very serious tone now.
“Let’s get the tests completed and then we will talk more.”
“Iglesia, you already know what’s wrong. I can see it in your eyes.”
“Please, let’s wait for JoAnn. She will be with you all day through these tests.”
JoAnn walked back into the exam room. “I will help you change, and then we will go get these tests done.”
Iglesias asked JoAnn, “Did you have any trouble with scheduling?”
“That crazy woman in CT scheduling tried to give me a little. But when I told her who I was, she changed her tone. ‘Oh, yes, Mrs. JoAnn.’ I told her not to make me come down there and show my face. She said, ‘Okay, Mrs. JoAnn, no need for that. I will open the rapid CT room and call the tech.”
“Okay, good. Thank you, JoAnn.”
JoAnn helped Luisa change after Iglesias left the room. He returned a few minutes later with the signed orders for the tests.
“Luisa, you have never before called me Iglesia—singular.”
“I saw your eyes!” Luisa said with lots of emotion.
“JoAnn, I am going to lunch. Before you go with Luisa, can you call the chief resident and tell him that he’s late with the morning-round report?”
“That doctor is in trouble. He’ll never give Dr. Sanes a late report again. Jesus, save him.” JoAnn threw her hands up in the air with this.
As they walked out of the office, JoAnn stopped and made the call to the resident. Then they started toward the elevator. Luisa turned to her and asked, “Is he in that much trouble?”
“Dr. I., that’s what I call him sometimes, is up for Chief of Neurology after the current chief retires. All of the residents know Dr. I. plays no games. His patients come first, but not before God, of course.”
The elevator door opened and Luisa asked, “God?”
“Yes, God. That man has found God and he prays with his patients.”
“How? When?”
“Some time ago, when he and your husband had a long talk in Dr. I’s office.”
Luisa looked very confused. “You’re kidding!”
JoAnn pressed the button for the ground floor. “It was right after he married the peroxide queen and her devil father came in and started running his mouth. Dr. I called his brother, and he came right over. I thought that Jose was going to pay a visit to the old man. I don’t know if he ever did, but after the brothers talked, Dr. I came out a different man.”
Luisa lets out a long breath of air. “I never knew that. Jose never told me.”
“You know how these Spanish men can be!”
They both start giggling as the elevator reached its destination. They exited and started the walk to radiology. They reached the reception desk. Without looking up, the receptionist said, “Can I help you?”
“Young lady, look at me when I’m talking to you.” The lady looked up at her with a puzzled look on her face. “First of all, you’re about to lose your tonsils in just a few seconds. Do you hear me?”
The receptionist looked up at JoAnn. “You don’t have to be rude.”
JoAnn looked over to Luisa. “Please excuse me.” Then she looked back to the receptionist. “Listen here, you skinny little thing, I am JoAnn, Dr. Iglesias Sanes’s nurse.”
The lady stood up immediately and apologized. “Oh, I’m so sorry.”
“I better not ever catch you being rude to a patient or anyone else, or you will make an unexpected trip to the ER.”
“Yes, ma’am.”
As JoAnn started signing the form for Luisa, Dr. Rosen, the radiologist, walked by. “Oh, hi, Joann.”
“Hey, Dr. Rosen. That young thing just about made me call on Jesus.”
Dr. Rosen looked over to the receptionist. “Mary, you don’t want to cross JoAnn, just letting you know.”
JoAnn had a look of smugness on her face now. “Don’t forget what I said.”
Mary looked very apologetic. “Yes, ma’am.”
“And just to let you know, I don’t have a Madea complex, I AM THE original Madea !” She started walking down the hallway to the rooms. “Mrs. Luisa, come with me.” They both made their way down the hallway. “These children nowadays have no manners, such disrespect!”
Luisa snickered at that. “JoAnn, you are too much!”