Experimental Medicine

Our head nurse dropped a pile of charts with a slam upon my keyboard. The heap was so heavy that it depressed the equals button causing endless double-dash symbols across my username text entry field.

“Daphne, this machine will lock me out if I put in the wrong password too many times,” I said feeling anxious. “You could have hit the enter key by accident.”

I knew I was being overly anxious about something small, but I’d grown accustomed to using what I was familiar with. It was a coping mechanism I’d learned.

Instead of deciding to be contrary, Daphne flashed me a charming smile with teeth so white I couldn’t help but envy them. She’d been bleaching them and with her copper-shaded lips, the contrast brought the sheen out more. I loved my chocolate mocha lattes too much to keep up that level of gleam, though I did try.

“Well, the system is down so don’t worry about being locked out,” she assured me.

“Ah, of course. That’s why you’re using physical charts.” She glanced at me with a look of expectation.

When I didn’t respond she said, “I thought you’d be happy with this analog way of doing things.”

“Well, I guess that is a plus,” I muttered feeling slightly annoyed that she was right about me. Was I an old-fashioned woman despite my young age of twenty-nine? I hated to admit it but yes, that was me.

“The bad news is, we have several new patients coming in.”

I swiveled around in my chair as she sped off. I lifted the stack of charts and set them beside me amongst the rest of my “analog gear” of pens, stickies, and notepads.

I watched a sudden flurry of nurses as they began grabbing the folders from my desk. Each were dressed in the scrubs of their choice, with some taking the more traditional medium-blue or teal-green outfits, while others opted for multicolored with flowers or symbols on them.

Before my eyes the mound became smaller and just like that, I was already feeling better. Having this much support was unusual with the shortage of medical staff over the past year. Several were faces I’d never seen before.

I silently thanked whoever sent them over and picked up the rest of the manila folders bringing them over to the nurses’ check-in station.

I glanced at the line of patients feeling my anxiety mounting. Over twenty people were waiting, and it was only growing. With a deep inhale and promise to use my mindfulness, I put myself into work mode.

Just begin with one and go from there. We’re here to help.

After waving my hand and smiling, a person approached the desk. An emaciated woman just under five feet in height, stepped up. She had snarled golden-yellow hair, and what appeared to be lupus on the malar region based on the lifted, somewhat scaly rash on her peach tone skinned.

She glanced at me with little affect on her face. Flat affect to be exact.

She must be going through a lot.

“Okay, let’s begin with your name,” I said.

“It’s Janet Castillo,” she said resting her forearms on the desk, the bracelets on her wrists tinkling against the wood. I could see how small her wrists were and with any loud sound elicited her startle response. When she smiled, I noticed that her teeth were chipped and stained.

I flipped through the manila folders and located her chart, noting that Janet was in the hospital for drug rehabilitation.

Methamphetamine addiction, no doubt.

“Okay, Janet. I’m Doctor Mumbua. I’ll show you to your room, get you more medication, and then we’ll meet in the side office.” I motioned with my hand toward the hallway to my right.

Janet nodded, her pupils in a permanent dilated state. If she rode in an ambulance over, she’d have already gotten some anxiolytic medication on the way, but I’d be sure to give some more to help her balance out. Clearly, she hadn’t had much sleep and we needed to work on that.

But before we could do that the first step was to get her settled in. I checked our resident assignments and saw that 602 was open. I led her there and showed her in. She glanced around assessing her surroundings, eyeing the place with suspicion.

“This is where you’ll sleep,” I said pointing at a single bed with a newly creased sheets and a clean velvet comforter then followed up with, “Obviously.” I felt socially awkward saying that, but it got her to crack a smile. Encouraged, I continued, “The bathroom is here.” I motioned to the small room with the metal mirror.

No glass allowed in patient rooms.

“We don’t—” I began but she cut me off.

“When can I smoke a cigarette?” Her voice had a U.S. southern accent which was par for the course given that this was South Carolina.

“Um, you won’t be able to, but we’ll give you a nicotine patch.”

“Can’t have that. Makes me break out in welts,” she insisted, overselling the itchiness of imaginary hives. I could tell this was going to be a point of contention.

“When you had a patch did you feel like you couldn’t breathe?”

“No. It’s just I can’t quit cold turkey like that. Besides, I need a place to pace.”

“I can relate to you. I smoked many—”

“You can’t relate. You ain’t from the USA and... you’re black.”

I stifled the urge to ask why so often were southern U.S. residents prejudiced especially since most of those states had black populations of fifty percent or more. Instead, I held my tongue and took the high road.

“Alright, I’ll be back with your medications and maybe we can try a patch again. Perhaps a bit of diphenhydramine will take care of the hives. It would be experimental, of course. We don’t want you breaking out.”

“Don’t fuckin’ bring one back. You’re just tryin’ to pad the insurance bill.”

I wanted to assure her that an antihistamine was hardly padding the bill, but I hid my agitation, gave her a polite smile, and left the room.

Once I was obscured from her view, I dashed around the corner to the west facing floating office hoping to find Dr. Van Graan. My bet was that she’d listen to a white man, though she may balk if she found out he too was from the same country as me.

He’d never let on, though. It was his habit to fake a U.S. accent. I could see some advantages but wasn’t sure why he bothered. I liked how he sounded.

I crossed my fingers that he was on site.

Gently, I tapped the back of my hand against the pine door of the east floating office. I couldn’t see anyone in there with the frosted windows obscuring my view. However, it wasn’t long before I could hear his designer shoes tapping on the tiled floor.

He opened the door with one smooth motion, immediately staring at me with his sky-blue eyes. There was a hint of sun on his light-olive toned cheeks. Maybe he’d been to the beach recently.

“Yes, Esme?”

“It’s Doctor Mumbua...” I began, trailing off then changed my tune. If I wanted a favor I probably shouldn’t lead with chiding.

After resetting I continued, “I’m hoping you can take a new patient.” I handed him Janet’s chart. “I’ve done a basic assessment which you’ll see in my notes.”

Leaning against the door frame he thumbed through the folder slowly, licking his finger as he lifted each sheet of notes and ICD-11s. Not the best practice while working in a veritable germ factory, but he did use an abnormally high amount of hand sanitizer. So, there was that.

I watched as he tilted his head noticing that he had so much gel in that not one of his ash blond hairs were out of place. Not that this was out of the ordinary. It sometimes simply amazed me how he kept it that held in place with the humidity.

He continued to skim through every page, glancing at me with each turn. I felt like he was assessing and perhaps even judging me. I couldn’t say anything about it to him, though. He earned his grandiose attitude around me. I had followed him from our home country to the U.S. so I could be his fellow. In fact, I followed him wherever he went.

I’d admired him ever since I met him in medical school. At first, I thought I gravitated toward him because we were from the same place, but it was more than that. Dr. Van Graan was a legend on multiple continents. For the most part, I studied under him for practical reasons—I wanted to gain some of his skills.

Besides, we had been in the trenches while our country had been destroyed over apartheid. It was a horrible experience.

As he continued to look at me, I grew ever more self-conscious. It was like he could see straight into my soul with those eyes, but I couldn’t get a read on him. In fact, I hadn’t ever seen him be emotional about anything. But I couldn’t say I felt closed-off to him. In fact, he was one of the only people I felt safe with.

He was so unlike his wife Ada, who wore her heart on her sleeve, sometimes too much. There were a few times I had witnessed her shouting and waving her hands at him in dramatics while he said nothing.

I admired how he would stand there and take it without a reactionary impulse to argue back. She could be quite animated with no regard for her self-respect

He wasn’t a pushover, just too stubborn to allow her to influence him into reacting. Plus, she was a Vietnamese model. I couldn’t hold it over his head if he’d rather keep the peace ergo, keep this beautiful woman in his life. Among those reasons, I felt for Ada—I suspected he’d be a hard man to be married to.

Suddenly, he glanced over my head. I turned around to see what he was looking at.

“Is that her?” he asked, a tinge of his native accent coming through.

You can’t fool me, Doctor. I know where you’re from.

Janet was standing in the doorway clenching her fists. I wasn’t sure if she was going into a true meltdown or if she’d stage one hoping to be let outside for that cigarette.

“Yep,” I confirmed.

“Any reason why you can’t do it, Doctor?” he asked. When I turned back to him, I looked in his eyes. They were penetrating.

“I’m not a psychiatrist,” I said with exasperation. Immediately, I regretted making that frail excuse.

“Anyone can prescribe medication, Esme. I’ve done it as a D.O. for god’s sake. It’s merely an assessment. If you can’t do that, then why are you here?” While his words were harsh his tone wasn’t.

“She’s made it clear that where I’m from and the color of my skin disqualifies me to provide her with adequate medical attention,” I said, with a wry smile.

The doctor clenched his jaw once. One thing he did become angry about was prejudiced people. They had no idea what a living civil war was like. It was astonishing that they’d be so loose with their views when the threat of that reality could come to realization any moment.

“Send her in,” he said. I wanted to see a smile from him so we could experience our shared contempt together, but I couldn’t get one out of him. Sure, I’d watched him smile at patients, but he didn’t engage in commiseration or bonding time with me.

After I began walking toward Janet, she promptly opened her mouth to protest but then Dr. Van Graan called her name. There was something about how he spoke that people listened to. There wasn’t too much bass in the vocal cords or attitude. He just had a way of comforting people when he wanted to.

Janet proved my assumption about the doctor as she closed her mouth and stood at attention. She made her way toward the office as I stepped aside. He ushered her in, his bedside manner already making her smile. He was great at faking empathy.

As I turned around, I felt shameful. I knew that I wasn’t only handing Janet off because of her comment. Patients like her made me nervous not because I didn’t think I’d understand them, but that they’d see something in me that I’d hidden as well as I could. I was afraid they’d see I was a hypocrite and a criminal.

Updated: Feb 6 2024