Good Medicine
"Egad man! This is the worst case of 'cat got your tongue' that I've ever seen."
I shouldn't say that. I should really reassure the patient that everything will be fine. But it clearly isn't. I've just walked into the clinic, shouted "high everybody!" and my patient has remained silent.
"Um, doctor…"
"Don't speak!" I exclaim. "You'll only aggravate the cat more!"
The patient falls silent. He wants to speak, I know it. He wants to thank yours truly for coming to his aid. He wants to be a healthy human being. But Doctor Nick knows better.
"Now then…" I say, getting a flashlight while forcing the patient to open his mouth. "Do you have a cat at home?"
"Well, yes…" the patient says. "But the reason I've come is-…"
"Say ah."
"Um…"
"No, not um, ah," I say, examining the tongue for signs of feline. "Say it."
"Ah…"
"Hmm…"
"Um…"
"Be quiet."
I take a step back, weighing my options. The patient has kept saying um instead of ah…does that mean something. I've been unable to find any signs of a cat having got his tongue past my first observation, but if there's one thing I've learnt, it's that the first observation is often the correct one, as is the diagnosis. But this time…
"Cough for me," I say suddenly.
The patient coughs.
"Again."
He does so, before looking up. "You know doc, actually the reason I'm here for is-…"
"Again. Cough again."
The patient looks aggravated. I understand. But you can't take any risks in medicine. So if he has to cough a final time…cough quite hoarsely I might add…I…oh no…
"There, I've coughed," the patient says. "Now can we please get to-…"
"Nurse! Get in here! We have a code green!"
"Code what?! What on Earth are you-…"
The patient shuts up as a pair of nurses rush in, restraining him. He tries to let something out, but they've already gagged him. They're well trained, I note. They know what a code green is. And as I get my optic probe, I remind myself of what's at stake.
"Your cough," I say, walking over to him in a slow, no doubt comforting manner. "It's clear what you have-a case of a frog in your throat."
The nurses briefly remove the gag, which is enough to prompt the patient to open his mouth. He doesn't say anything though as the probe goes in. There's a frog down there, and I intend to find it.
Ten minutes later, I haven't. The frog's gone. Just like the cat. The patient is threatening to leave as well if I don't treat him-as if that isn't what I've been doing.
"So, tell me," I say. "In your own words, what's exactly bothering you?"
I listen carefully, looking for hidden signs. All his talk of tummy aches is a smokescreen, I tell myself. He's hiding something. If it isn't' a frog or a cat, then it must be something else. Something that I've overlooked.
"And, then, my stomach goes all light," the patient says. "Kind of that nervous feeling you get when…what?"
I stare at him. Of course. His stomach. It was staring me in the face all along.
"Doctor, what are you-…"
I sedate him. He falls down. I catch him. I rush to the phone and begin making preparations for surgery.
"Doc…you…?"
"Hush now," I say. "You'll be fine. A few hours of surgery and those butterflies will be out of your stomach."
The patient tries to say something but falls asleep. Good. A silent patient is a good patient, one that's easy to treat.
Now all I have to do is look up by old med school notes on how to do surgery.