Comfort Zone

Chapter 7

A change of antibiotic and increase in steroid dose had stabilized Ms. V over the weekend, and Miriam stopped by to see her and Lisa Phillips before office the following Monday morning. The weekend had been hectic for both Ms. Phillips and doctor, the former undergoing the battery of tests and treatments that the latter had painstakingly researched and ordered.

Miriam, though, unlike her ill patient, had carved out a few hours for R&R and grudgingly accepted a blind date, courtesy of a neighbor. While she was discouraged to find her date's eyes constantly wandering to blond, barely-clad women in the vicinity, she did appreciate the flower market next to their meetup Starbucks, even treating herself to a bouquet after they parted. Her consolation prize for the failed date was upgraded by the addition of sunflowers, her favorite.

Miriam was reminded of her excursion by the masses of bouquets filling Ms. Phillips' room with fragrance that morning. The patient herself, however, was missing, having gone for still another test.

"How did she get HIV?" Ms. Phillips' nurse asked, and Miriam considered feigning deafness. The staff frequently asked her that. Miriam knew that the questioner might have a strictly scientific interest, or be compassionate (there go I but for the grace of God...), but sometimes suspected it was judgmental ("she probably did something bad and this is the consequence") or prurient, interested in the details of unsavory acts. She sometimes thought about saying her patient was exposed while working with orphans with Mother Teresa's successor.

Don't judge, Miriam always lectured herself at these times.

"We don't know," she said.

She noted that her patient's white blood cell count was still very low, despite several doses of filgrastim. Filgrastim was a powerful injection that stimulated the bone marrow to churn out the infection-fighting white cells called neutrophils. The treatment had always worked for Lisa Phillips before, but it didn't seem to be doing its usual magic.

Miriam remembered walking on Biscayne Boulevard years before, cars shooting by, when a small black dog, maybe a Scottie, suddenly ran into the street. A few people stopped, and they all watched in horror while the dog ran in circles, dodging traffic for a short time.

We couldn't stop the small dog any more than the traffic. All we could do was stand by uselessly and watch that dog running to its death. That's how I feel about some of my patients.

She was with a patient in the office going over the proper diet for what felt like the gazillianth time when right in the middle of "eat green, leafy vegetables," she discovered she was thinking of donuts. Bavarian cream, to be specific. And not only was she thinking of them, but formulating a plan to swing by Dunkin Donuts on her way home and pick up two at least. The puzzled look on her patient's face penetrated her sugar jonesing fantasy.

"Any questions?" she asked.

"Yes. What's Bavarian cream spinach?"

I can't do this anymore, Miriam thought. My mask's slipping. I was never a do-as-I-say-not-as-I-do doctor. I bet Ursula Taylor doesn't eat donuts.

That thought made her think about the abnormal chest x-ray, and the CT scheduled for later in the week; hopefully she'd soon call the other doctor with good news.

"Spinach from any country will do," she said firmly, "and plain is better than cream." No, cream is much better, she thought.

The patient looked away and shook her head, slumping into her seat.

"I just don't know how you do it, Dr. Gotlin. You stay so slim, don't smoke. How did you end up you, and I ended up me? You have such discipline. I bet you make a big salad and bring it for lunch, while I keep making excuses. Well, that's it. I'm hopping on the discipline train starting now."