Wednesday, November 22, 2006

The Diagnostic Process, part 2: Denouement and Prognosis

I guess I need to finish the story, and it's sort of fitting I would post this on Thanksgiving Eve.

I resisted the temptation to turn to Dr. John, and say, "See? I told you!," because he looked so uncomfortable. The two doctors left the room again, leaving me to gloat in relative solitude. In a moment he returned with a prescription in his hand.

Standing before me with a sheepish grin, he said, "Here, this is a 'script for an anti-viral which should still be effective."

"What's the downside of the drug?" I asked.

"Downside?" he said, truly perplexed.

"I mean, what are the potential side effects? And more importantly, what good will it do? I don't want to take a prescription drug if it really won't change the course of this much," I say, looking him dead in his eyes.

He looks away. Then his gaze returns to me, he's still holding the paper before me. "Well, the virus might last seven days if you don't take this, and five if you do."

"Then I won't take it," I say, reaching for the tendered paper, "unless I don't feel better in a week. Then I'll fill it, because I'll be all worn down," I chuckle, more because I feel like it's time to let him off the hook.

He says, "That's fine, good choice." Then, he makes the statement that makes me understand he's got real potential to be a healer. "I'm sorry I don't have more time to spend with you today, but please make a follow up appointment, and I'd like to know how you came to have a two year old in your life." He smiles broadly and extends a hand to shake.

I take it, returning his smile. "Well, you're not getting away without seeing his picture." Releasing his hand, I reach for my checkbook where I carry Ben's latest picture. As I show it to him, he is satisfyingly appreciative.

"He's darling," he says. "It really is a pleasure to meet you," he says.

A few minutes later, as I am waiting to pay my co-pay in the lobby, John walks out the door and comes up to me. "Could I see that prescription?" he asks.

I hand it to him. He crosses something out, and writes a note in the margin. "I made a mistake," he says, "I wrote it for 100 milligrams, and if you do decide to take this, it should be in a dose which might actually help. It should have been 1000."

This young doctor has, in the space of ten minutes, said two things that distinguish him from so many young professionals, catapulting him into the rare class of people who will acutally help others. He has said "I'm sorry," and "I was wrong." I want to jump up and hug him and tell him to call his momma and tell her he's going to be a great doctor. Instead, I smile and thank him, feeling deeply grateful that someone at this clinic made a good hiring decision, again.

As I write this, my shingles are almost gone. I didn't fill the prescription. And the prognosis for Dr. John is good.

There are many things to be thankful for tomorrow: a good job with health insurance, healers, family, and the passing of a discomforting virus. If every child could be loved and we could just find peace, it'd be pretty close to a perfect world.

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