I glanced at my scut and tried to prioritize. My instinct told me that the only way I’d make it through the next six weeks without tearing my hair out from worry would be to throw myself even deeper into the job, to focus on the patients. Even this, however, presented a major problem: I was about to spend a month immersed in the world of HIV/AIDS patients while waiting to find out if I was going to become one of them. Each interaction offered a possible mirror into a future I was hoping desperately to avoid.
Based on my experience with David, I feared that I would ultimately internalize all of my patients’ symptoms—that an AIDS rash would become my rash, that the intractable abdominal discomfort would become my pain, and that the misanthropy, which was pervasive on the HIV floor, would become mine, too. Many felt uncared for, unloved, as though life had passed them by because of the stigma of their illness. It terrified me to think I might join this group. Insomuch as I had a plan, it was to do whatever I could to improve my patients’ health so that their condition might karmically rub off on my own.
First up on the scut list was the patient with the possible breast paraphernalia. I noticed that there was no information yet available on her. She had been admitted overnight and would be presented on rounds later in the morning. I trudged up the stairs and braced myself as I approached her room. It’s possible I was too close to this disease to treat it effectively.
“Hello?” I said, slowly opening the door.
“Hello,” replied a soft, deep voice. I found myself looking at a middle-aged black woman weighing no more than eighty pounds. She was wearing baggy scrub pants and a white T-shirt and had dozens of smooth bumps on her forehead and cheeks that recalled a textbook image of smallpox, a disease that had been eradicated in 1979, the year before I was born. They were different from the abscesses I’d seen on David—the sores didn’t appear to be filled with pus. They seemed like they’d been on her face for a long time and weren’t going anywhere anytime soon. What could it be? Measles? Chicken pox? Acne? She turned her head away from the door. “Who is it?”
“Dr. McCarthy,” I said. “I heard there was some excitement in here.”
“No excitement,” she said, still looking away.
“One of the nurses paged me,” I said, pausing to consider the proper phrasing, “because there was an item found in your blouse.”
“I’m not wearing a blouse.”
She wasn’t. “In your bra.”
“I’m not wearing a bra.”
I was miffed and let out a quick sigh. “I was paged because a nurse found something and wanted me to have a look.”
“Have a look,” she said, turning to me. I started quietly as we made eye contact. Her eyeballs were almost completely whited out, as if snow had accumulated on the sidewalk and no one had bothered to shovel it away. What could cause that? A few tumbleweeds drifted across the serene vista that was my uncluttered mind; my differential diagnosis consisted solely of glaucoma. Moranis could probably name thirty things that would cause her eyes to look like that.
“What am I looking at?” I asked.
“There,” she said, pointing to a stack of clothes, “probably over there.” She motioned to the corner of the room, which meant she might have some vision. I again looked into her eyes, hoping to find some clue that would tie everything together, that would explain the bumps and the eyes and the HIV, but I was stumped. I picked up a red and black plaid shirt and a pair of shorts. In the breast pocket of the shirt was a small plastic bag containing something resembling marijuana.
“It’s medicinal,” she said flatly.
“Is it?” I asked with optimism.
“Yes.”
“For what?”
She scoffed. “I’m blind. I’m homeless. I have AIDS. Want me to keep going?”
“What’s it for…specifically?”
I was fairly certain that medicinal marijuana wasn’t legal in the state of New York. Were there exceptions for AIDS patients? I should know this. “I want to believe you.”
“Then believe me.”
“Do you have a prescription for it?”
She leaned back. “And if I don’t?”
I wrinkled my brow. “I’m not sure. I guess I’ll have to…I’ll…”
She shook her head. “Why are you doing this to me?”
I looked at the green leaves in the plastic bag and sighed again. “You know I have to report this.”
The words sounded funny coming out of my mouth. Did I need to report this? I wasn’t sure. In medical school I had tended to a lot of admitted drug users, but none of them had brought the material into the hospital. This seemed more like a job for security than for an intern.
“You don’t have to.” She flashed a handful of yellow-brown teeth. “Please. Please don’t.” There was a note of desperation in her voice, and I genuinely wasn’t sure what I should do. Was I just another guy trying to make her life more difficult? Or was I a responsible intern, appropriately seizing and reporting banned items? And anyway, what was the point of taking away a blind, homeless AIDS patient’s marijuana? It seemed borderline cruel. Where did this fall on the spectrum of Do no harm?
I made a snap decision to hide behind the lab coat. “I hate to use this phrase, but I’m just doing my job.”
“Come here,” she said, waving me toward her. “Come here. Close.”
“We have rounds,” I said, planning an escape route and then aborting it as Benny’s advice flashed through my mind. If there was one thing that Benny had impressed upon me, it was the importance of giving patients my time and my full attention. It was the same thing Jim O’Connell had preached. Since my talk with Benny and then catching myself in the act of backing away from Peter Lundquist, I had willed myself to be more present with my patients. Even so, it was exceedingly difficult to do. Interns were needed in six places at once, and the pager never stopped buzzing. The day was highly scheduled, with meetings and rounds and note-writing, but it was also incredibly unpredictable. Chatting with a patient often seemed like a discretionary activity, even when it wasn’t.
I took off my white coat and sat at the edge of the bed.
“What’s your name?” she said.
“Dr. McCarthy. Matt McCarthy.”
“Matt McCarthy…M and M.”
“M and M, just like the candy.”
“And the rapper. Eminem.”
“Indeed,” I said. And just like the Morbidity and Mortality conference, I thought. “What should I call you? Your first name or—”
“Call me Dre,” she said, giggling to herself. “You’re Em and I’m Dre.”
“Excellent.”
She shook her head. “So why do you want to snitch on me?”
I almost snorted. She had found her way right to the heart of my dilemma. “I don’t want to. What am I supposed to do?”
Before I knew what was happening, she’d reached out her hands and put them on my face. One covered my left eye and the other pressed into my right cheek. The move left me frozen. No one had ever done something like this to me before. Her moist, callused hands moved across my face, briefly pausing on my eyebrows and lips. She smelled of lotion, something lavender. I hoped that whatever had caused the bumps on her face wasn’t contagious. The needle stick popped into my mind and I pushed it out. “I can tell you’re conflicted,” she said, sounding like a late-night television fortune-teller. “I can tell.”
“I’m not actually conflicted,” I said, leaning back slightly.
“Didn’t they teach you that the patient is always right?”
I laughed and she grabbed my hands, putting them on her face. She had innumerable keloid scars on her ears from piercings gone awry. What looked like little mushrooms on her earlobes were actually the results of skin healing improperly. I had seen it often in medical school and knew they weren’t contagious. But by the sheer number of mushrooms, I doubted that she had been informed of her condition and had tried to pierce the ears over and over again, which only made the condition worse. I wondered what she knew of her other medical conditions. Were we connecting here? In the hospital movie in my mind, touching her face would help me to know her in some unique, previously unavailable way. But in reality, it didn’t. It only made me feel bad for her. It made me want to know more about her condition and how I could help her get better.
“I think the saying is that the customer is always—”
At that moment, as our hands were on each other’s faces, Ashley had the good fortune to enter the room. “I was looking for my intern,” she said, looking up from her pager. “I think he— What the fuuuuck?”
Stunned by the scene before her, she did a pirouette and exited the room in one motion as I dropped my hands. I got up, squeezed the small bag of marijuana in my palm, and straightened my coat. “You’ll see me again.”
“No snitchin’!” Dre said as I closed the door. “Don’t do it, Em!”
As I walked toward the nurses’ station, a number of thoughts buzzed through my head. I’d just been pawed by a legally blind AIDS patient and was suddenly carrying about a hundred dollars’ worth of weed in my white coat. This wasn’t how Jim O’Connell would do things. I couldn’t imagine him seizing drugs from one of his patients. But I also thought that Jim might have appreciated some aspects of the exchange. Dre wasn’t the typical patient. Not least because of the mutual face massage, but also because of the undercurrent of humor in our conversation. This was the kind of patient I could see him reaching, the type he’d spend extra time with to make a connection. Why? What was it about her? I wasn’t entirely sure. I often had trouble predicting which patients would receive extra attention from Jim, but I felt confident that Dre would’ve been one of them.
I dropped the bag on the large wooden table and took a seat next to Ashley. “I had to confiscate this.”
“That’s some freaky shit, man,” she said, laughing. “I said you were the eyes and I was the brain. Clearly you’re also the hands.”