"Thank you for coming in on such short notice," said Dr. Phillips as he took a seat behind his desk. "I realize you're all very busy."
"This is our other sister, Piper," Prue said.
"A pleasure to meet you," said Phillips. "Actually, it's probably a good thing you're all here. I can answer any questions you might have."
"What's this all about?" Phoebe asked. "All Prue said you told her was that it was about my test results."
"Yes," said Phillips. "When you were in for your examination the other day I noticed some things. That's why I had you take those additional tests. I was hoping I might be wrong. Unfortunately that's not the case."
"What is it, Doctor?" Piper asked. "You make it sound serious."
"It is," said Phillips, looking a little pained. "This is one of the hardest parts of being a physician. Delivering bad news that you know people aren't going to want to hear."
"Bad news?" Prue asked. "You said Phoebe just had the flu."
"That's the way it appeared the other day," said Phillips. "However, the results of the test are conclusive. Phoebe, I'm afraid you don't have the flu. You have a condition called subacute endocarditis. Many of the symptoms mimic those of the flu. That's why it was necessary to perform the additional tests so I could be sure."
"Endocarditis?" Phoebe questioned. "What is that?"
"It's a form of congestive heart failure," said Phillips. "There are several forms of endocarditis. The subacute form, which you have, develops gradually and subtly over a period of weeks to several months. It's an infection of the endocardium which is the smooth interior lining of the heart and the heart valves."
"What caused it?" Prue asked.
"Most likely," said Phillips, "it was caused by bacteria. It was most likely caused by streptococci or haemophilus bacteria. Bacteria are not normally found in the blood stream but can enter the body by various means such as intravenous drug use, cardiac catheterization and other invasive procedures, cuts, bruises and minor surgical procedures, dental procedures etc. In susceptible individuals, this is followed by blood stream spreading the bacteria and the infection of the inner lining of the heart and the heart valves."
"I had some dental work done just before I came back to San Francisco," said Phoebe.
"It can sometimes be difficult to determine the exact cause of the affliction," said Phillips. "We may never know for sure what caused it. At this point it doesn't really matter. Now, Prue and Piper have no need to be concerned. This type of infection is not contagious. But it is quite serious."
"How serious?" Piper asked.
"If let untreated," said Phillips, "it's fatal."
"What can we do about it?" Phoebe asked. "Are there drugs you can use to clear it up?"
"Ordinarily," said Phillips, "I'd put you on some antibiotics. If caught early it is completely treatable and recovery is excellent."
"So write her a prescription," said Prue. "We can get it filled at the pharmacy right away."
"I'm afraid it's not quite that simple," said Phillips. "I said ordinarily I'd prescribe antibiotics. Since this is an infection, antibiotics are very effective in treating the condition. And the antibiotics I'm prescribing will, in all likelihood, clear up the infection within a matter of weeks."
"So what's the problem?" Piper asked.
"I'm afraid we didn't catch it in its early stages," said Phillips. "The test results indicate you've had this condition for some time. Probably before you had your dental work in New York. It's caused a deterioration of the heart muscle. And I'm afraid it's very advanced."
"What exactly does that mean?" Phoebe asked.
"It means," said Phillips, "that while I can clear up the cause, the results are far more critical. Phoebe, you're heart is extremely weak. It is very possible that you could suffer a massive coronary at any time because of this weakness. And there is nothing I can do to prevent it."