AN: This is a cut scene from Chapter 14 of Something of Our Own that can also be read standalone.
Please note my depiction of hospitalization for alcohol withdrawal is fictional and dystopian. I left out a lot of the standard monitoring and treatment because I highly doubt that's what Haymitch experienced in 13. I also doubt it was his detox alone that kept him in seclusion for a month…
So with that, happy holidays happy reading! :)
Triage Note, signed by Nurse Alara
Pt presented to triage with complaints of facial lacerations and trauma to the left eye. Pt stated, "Doesn't matter how it happened." Pt reported he was sent here upon arrival to the Hangar via hovercraft.
Height: 5'10" Weight: 201 lbs
Vital signs: T 37.1, HR 91, BP 152/88, RR 18, sO2 99% on room air
Left eye examined. Laceration noted to eyelid, with dried and oozing sanguineous drainage. Sclera red but intact. Pupils equal and reactive. Vision intact.
Lacerations x 10 noted to bilateral face, from eyebrow to jaw. No active bleeding. Cleansed with antiseptic solution and sterile gauze. Butterfly bandages applied to 4 lacerations with deeper wound beds.
Noted hypertension. Pt stated, "We just started a war and my district is on fire." Pt became impatient and expressed intent to leave. Smell of alcohol noted to Pt's breath.
Belongings searched by security. Small bottle of spirits found. Informed Pt of law regarding prohibited substances. Alcohol confiscated per contraband protocol. Pt began to argue with security.
Attempted to obtain a blood and urine sample but Pt refused. Informed Pt of protocol for active alcohol use. Pt expressed refusal to comply with this. Notified Dr. Billmore. Received orders for involuntary admission.
Note 1, signed by Nurse Milo
1400 Pt admitted to the seclusion unit. Pt changed into a gown independently. Clothing and belongings stored in safe per policy. Door secured and locked. Notified Dr. Billmore of Pt's arrival.
1410 Observed Pt pacing. Pt beat fist on the door window and stated, "This is fucking ridiculous. There's a war starting right now! I can't be stuck in here like this."
1445 Dr. Billmore to unit.
1530 Observed Pt sitting in cot with head in hands. Offered water. Pt stated, "Go to hell."
Admission History & Physical, signed by Dr. Atom Billmore
This is a tired and unpleasant but otherwise well-appearing 41-year-old man with a known history of alcohol use, being admitted for alcohol withdrawal.
Pt's initial complaint was facial and orbital trauma. Facial lacerations did not require stitches and orbital trauma was ruled out. No other complaints besides "this is a waste of time and a pain in my ass." Pt requested I call "Plutarch." Informed Pt that I received clearance to admit him from our Madame President.
Pt is a poor vs. uncooperative historian. He denied any medical history. Surgical history known to include extensive abdominal surgery. Pt reported "that was years ago."
Pt admitted to "a few" alcoholic beverages in the past week. Pt declined to answer when asked about typical alcohol consumption per month. Pt reported "there's nothing else to do" when asked of his purpose for drinking alcohol. Pt admitted to experiencing withdrawal symptoms in the past but denied seizures. Pt denied any other substance use in the last year.
Pt laughed when asked if he had thoughts about harming himself or others. When pressed, Pt denied these thoughts within the last 3 days.
Review of Body Systems
General/Constitutional: Alert and oriented to person, place, time, and situation. Vital signs stable. Denies fever, chills, fatigue, or chest pain.
Cardiovascular: (+) Hypertensive. Heart sounds normal with no murmur or gallop. No edema present.
Respiratory: Lung sounds clear to auscultation. Respirations regular and unlabored with symmetric chest expansion.
Skin: (+) Butterfly bandages noted to face, for multiple lacerations. Skin otherwise intact.
Gastrointestinal: Abdomen rounded. Bowel sounds active. No fecal incontinence observed or reported.
Genitourinary: No deformities or surgical alterations. Bladder not distended. No urinary incontinence observed or reported.
Musculoskeletal: Good strength and range of motion to all extremities. No amputations or contractures.
Neurological: Pupils equal and reactive. No numbness or tingling. Normal gait. Speech attested to be baseline, with regional accent present.
Hematologic: (+) Positive blood alcohol level. Labs consistent with chronic alcohol use and malnutrition. Electrolyte imbalances outside of normal limits but noncritical. No leukocytosis or anemia.
My impression is that Pt developed chronic alcohol use of his own accord and will transition to sobriety with time and little to no intervention. No other medical problems present to be addressed this stay. Pt is mentally oriented and does not meet criteria for psychiatric evaluation. Pt is at risk of delirium and seizure.
Plan to withdraw in seclusion until medically stable and publicly functional for an expected stay of 5 or more midnights.
Status FULL RESUSCITATION in event of cardiopulmonary arrest.
Note 2, signed by Nurse Ray
2200 Pt's hair cut to community standard. Pt toileted and bathed independently. Gown reapplied, in compliance with daily laundry ration.
2230 Lights Out.
2235 Pt knocking at door window. Pt requested "some reading light." Informed Pt that he could not have reading materials at this time. Pt requested for the hallway lights to be kept on. Informed Pt this was not in compliance with Lights Out.
Note 3, signed by Nurse Milo
0600 Lights On. Pt found awake, lying in bed with arms over head. Pt asked this nurse whether he was being discharged. Informed Pt that there was no discharge order at this time. Pt's reply obstructed by arm position. Pt declined breakfast. "I just need some rest."
1300 Pt ate 50% lunch. Pt asked whether "the rest could be saved for later." Informed Pt of food containment and waste protocols. Pt verbalized understanding in an abnormal tone. Tray removed.
1330 Dr. Billmore rounding.
...
Note 4, signed by Nurse Ion
1900 Pt requested updates on several named individuals he reported arriving with. Unable to update due to patient confidentiality. Pt stated, "That tells me enough." Pt requested television access. Informed Pt fulfilling this request would break seclusion protocol. Pt stated, "So I'm just supposed to stare at the walls? That's rich." Sought clarification for this. Pt replied, "It's a figure of speech. You people really have been living under a rock." Reinforced facility structure to correct present misconception. Education successful; Pt with no other questions.
2130 Pt requested "something for jet lag." Notified Dr. Billmore. No new orders.
2230 Lights Out.
Note 5, signed by Nurse Orla
0600 Lights On. Woke Pt for breakfast but he pushed this nurse away and stated, "get the hell away from me" and "don't do that if you value your life." When questioned, Pt clarified, "It's not a threat. Just don't do that again." Pt diaphoretic with elevated respirations. Mild hand tremor noted.
...
Note 6, signed by Nurse Ion
2200 Observed Pt pacing. Pt suggested several ways to get more light into his unit. Reinforced seclusion protocol and that no exceptions were allowed.
2220 Pt found pushing his cot into a corner. Pt stated, "Just let me do this. I'll even say please." Uncertain of furniture arrangement protocol; to be addressed with the primary team tomorrow. Pt requested, "How about I put it back before the doctor comes in? No need to dig through the rulebook." Warned Pt against staff-splitting behavior and reinforced this would be addressed tomorrow. Pt stated, "Whatever. Fine by me." Pt sat in bed with his back to the wall.
2230 Lights Out.
0000 Heard Pt talking in low tones. Pt alone in unit.
Note 7, signed by Nurse Sulivan
0600 Lights On. Pt found out of bed, sitting in opposite corner of unit. Pt holding a makeshift weapon made from a toothbrush. Pt appeared defensive when questioned. "It's just to get through the night. Wasn't going to hurt any of you." Pt could not explain himself further. "I'm not thinking straight. Haven't slept all night." Security notified. Weapon confiscated without event. Notified Dr. Billmore.
Progress Note 3, signed by Dr. Atom Billmore
Pt had a makeshift weapon on his person this morning. Spoke with him about this being a safety violation and grounds for criminal charges. Pt was adamant that he had no plan to use this against staff or himself. Pt reported needing something to protect himself. Informed Pt that the seclusion unit was highly secure and that only assigned hospital staff could gain access into it. Pt reluctant but verbalized understanding. Final warning on this matter issued.
Paranoia suspected. Delirium tremens noted to hands.
Pt in active alcohol withdrawal. Continue plan of care. All toiletries must be accounted for after each use.
Note 8, signed by Nurse Ray
2100 Pt requested "anything at all" to help him "get through the night." Informed Pt of standing orders to not notify Dr. Billmore for oral sedative medication. Pt stated, "Call the doctor. I want to talk to him." Request denied.
2200 Pt waved toothbrush in front of this nurse's face before returning it. "There. Happy? Go lock it up or whatever you have to do." Pt toileted independently. Pt asked, "Do you need to take account of all the bath tissue I use, too? Or how many times I take a shit?" Informed Pt this was not necessary. All toiletries turned in and accounted for.
2230 Lights Out.
2245 Commotion from unit. Found Pt with overturned cot. Pt tachypneic and diaphoretic with marked body trembling. Upon seeing this nurse, Pt stated, "Leave me alone! You won't help anyway. They need me out there but instead I'm stuck in here with a bunch of fucking robots!" Pt threw a pillow at the door and attempted to cover the door window with a blanket. Window shuttered per request.
2250 Pt arguing with nobody present in unit. "Shut up," "Get out," and "I'm sorry" heard multiple times.
2255 Pt's continued yelling and mishandling of cot yielded multiple complaints across departments. Verbal warnings unsuccessful. Notified Dr. Billmore of community disruption. Received order for one-time dose of benzadol, with intramuscular route. Attempted to administer benzadol but Pt stood on cot and kicked at this nurse, stating, "Don't you dare! Get away from me!"
Security called in to hold Pt down*. Pt began to scream and thrash, shouting "no" repeatedly. Benzadol administered intramuscularly to Pt's right thigh. Pt placed in four-point restraints. Pt belligerent, threatening staff and mistaking us for Peacekeepers. Attempts to reorient to time and place unsuccessful. Seclusion unit cleared.
*Pt dealt multiple injuries to security personnel in this process. See triage notes.
2355 Pt drowsy, attempting to get out of one wrist restraint. Restraint reapplied. Pt stated, "Fuck you. Goodnight." Pt did not open eyes on command after several attempts. Pt with regular chest fall and good perfusion. All restraints in place. Neurovascularly intact distal to restraints.
0100 Pt somnolent with slow respirations. Pupils equal and reactive but dilated. Pt responsive to pain.
0430 Pt wet with urine. Gown and linens changed.
Note 9, signed by Nurse Sulivan
0600 Lights On. Pt found coughing with vomit on his gown. Restraints removed and Pt sat up. Airway cleared. Gown changed*. Pt more responsive and compliant at this time.
0630 Breakfast held due to vomiting.
*Daily laundry limit maxed.
Progress Note 4, signed by Dr. Atom Billmore
Pt exhibited agitation overnight requiring four-point restraints and benzadol. No seizure activity noted by nursing staff, but possibly auditory and/or visual hallucinations.
Met with Pt out of restraints. No agitation noted; benzadol therapeutic. Periorbital discoloration and facial pallor noted. Further assessment limited due to Pt's demeanor and refusal to speak to me. Urinary incontinence and emesis this morning per nursing staff.
Informed Pt and nursing staff that tantrums, delirious or otherwise, will not be medicated going forward. Benzadol only to be used in the event of sustained seizure activity, in order to prevent dependence and/or drug-seeking behaviors and to minimize use of controlled medications. Restraints discontinued. Minimize direct care to circumvent further staff injury.
Pt remains in active withdrawal. Resuscitation status under review with the Board.
Note 10, signed by Nurse Garrick
2100 Pt with growing restlessness and tremor. Pt stated, "We'd all be better off if I just had a bottle." Informed Pt that it was his decision to use a prohibited substance that brought about his present circumstances. Pt expectorated onto the door window.
2230 Lights Out. Pt heard yelling in frustration. Reinforced quiet hours.
0000 Crash heard in Pt's unit. Pt found standing on cot with ceiling vent grate on the floor. Pt stated, "My bad, I'll put it back. Everyone go back to sleep." Security to bedside. Pt became defensive. "I said my bad! I'll put it back! Oh, you fuckers." Pt removed from unit by security. Grate replaced. Cot fixed to floor. Pt transferred back into seclusion unit. Pt beat and kicked at door. Security nearby.
0100 Observed Pt lying in bed on his side, looking at this nurse through the window. Door window shuttered.
Note 11, Nurse Milo
0600 Lights On. Pt found upside-down in cot with his arms over his head. Pt already awake. Asked Pt about breakfast. Pt stated, "I want to go home."
Progress Note 5, signed by Dr. Atom Billmore
Pt reported having worse nights than days. Nursing staff also reported worse nights than days.
Spoke with Pt at length about community expectations and standards. Informed him that Lights Out will continue through discharge and that he will not be discharged until he can comply with this. Pt verbalized understanding.
Pt exhibited diaphoretic pallor to skin and worsening tremor at time of my exam. Scattered bruises and abrasions noted to knuckles.
Pt remains in active alcohol withdrawal. Pt also remains publicly disruptive. Status change by order of the Board: NO RESUSCITATION in event of cardiopulmonary arrest. Otherwise, continue the plan of care.
...
Note 14, signed by Nurse Ray
2100 Observed Pt standing by door. Moderate hand tremor present. Pt with many questions. Pt disoriented to time and situation. Pt appeared frustrated by this, as evidenced by him yelling at and slapping himself.
2200 Pt vomited into lap while toileting. Pt required minimal assistance bathing. Security nearby. Gown changed. Pt complained of a headache and being "on fire." Pt febrile. Informed Pt the bath would help reduce body temperature. Pt stated, "Hope so. Not like you'll do anything else about it, right? I'm not worth one little pill." Reviewed plan of care. Pt responded, "I'm right, is all that tells me."
Note 15, signed by Nurse Orla
1300 Pt ate 25% lunch. Pt asked this nurse whether he "had any visitors." Reinforced seclusion protocol. Pt stated, "I know that. Just curious if anybody's tried to stop by anyway." No record of visitors. Pt did not respond. No other questions at this time. Tray removed.
1330 Observed Pt vomiting.
...
Note 18, signed by Nurse Garrick
2000 Pt hostile to any and all hospital staff from door window, mistaking for Capitol torturers despite attempts to reorient to place and situation. When offered water, Pt told this nurse to "suck my cock." Pt then began to insult this nurse. Door window shuttered.
2230 Lights Out.
0000 Pt found beating fist against door, calling for help. "Let me out! There's something in here!" Seclusion unit determined to be empty.
0030 Observed Pt hiding under blanket in cot.
0100 Observed Pt hiding under cot.
...
Note 20, signed by Nurse Ion
0200 Observed Pt standing by door without his gown on. Urine noted on the floor by his feet. Soiled linens beside cot. Janitorial staff notified. Linens replaced*. Attempted to apply a new gown but Pt ran out of unit into hallway. Pt held down and transferred back to his unit by security. Door secured and locked.
0300 Observed Pt in bed with eyes closed, partially covered by gown. Groaning vs. moaning heard with frequent position changes.
*Daily laundry limit maxed.
Note 21, signed by Nurse Sulivan
0600 Lights On.
0700 Pt ate 5% breakfast before vomiting. New gown held, in compliance with daily laundry ration.
Progress Note 10, signed by Dr. Atom Billmore
Pt with an elopement attempt overnight. Pt reported no memory of this. "I can't tell what's actually happening and what's a nightmare. Starting to think it's all one in the same."
Pt complained of inability to "keep anything down." Reminded him that this was an expected symptom that would resolve with complete transition to sobriety. Pt responded, "That doesn't fix everything, you know." Uncertain of meaning. Pt did not elaborate.
Pt hyperaware and often appeared distracted during our conversation, tracking and flinching at nothing. Hallucinations persist. Reinforced that there was nothing with him in the seclusion unit except himself and hospital staff. Pt stated, "Don't remind me."
Assessment limited as Pt would not stand up from bed. Pt sitting in bed with blanket in lap, as he had maxed his daily laundry limit.
Pt remains in active alcohol withdrawal. Continue plan of care.
…
Note 23, signed by Nurse Orla
0600 Lights On. Observed Pt to be asleep, as evidenced by snoring. Breakfast held.
1230 Pt lying in bed with eyes closed and even chest fall. Lunch left in room.
1330 Pt ate 50% lunch. Pt stated he was awake before. "Thanks for that, though." Uncertain of tone. Pt rolled his eyes and clarified, "That wasn't sarcasm."
...
Note 25, signed by Nurse Orla
0700 Pt ate 100% breakfast.
0800 Pt permitted to ambulate around the hallway once daily with nurse or security escort. Pt ambulated with standby assistance. This nurse in attendance. Pt told this nurse, "Don't worry, I won't make a run for it." Pt voiced discomfort with his unsteady gait. "Getting weak just in time for a war."
0815 While ambulating, Pt stated, "I don't know, I kind of miss the cell." Escorted Pt back to his unit per this request. Pt reported that "nothing gets past you guys."
1300 Pt ate 50% lunch. Pt asked this nurse whether he "had any visitors." Reinforced seclusion protocol. Pt stated, "I know that. Just curious if anybody's tried to stop by anyway." No record of visitors. Pt did not respond. No other questions at this time.
...
Note 27, signed by Nurse Orla
1030 Butterfly bandages removed. Lacerations healing and well-defined, with no signs of infection. Pt remembered pushing this nurse. "Can't remember if you deserved it, but probably not." Pt thanked this nurse for "actually talking to me to my face."
Notified charge nurse of suspected staff-splitting behavior. Assignment changed, report given to nurse Qin.
...
Note 33, signed by Nurse Qin
1000 Pt found ambulating with unassigned nurse in hallway. Nurse identified herself as Verbena. Reminded Nurse Verbena that this was in violation of seclusion protocol, as the interaction was outside of her patient assignment*. Nurse Verbena stated she was "new here" and did not know "all your rules." Pt escorted back to seclusion unit by this nurse and security. Nurse Verbena directed to charge nurse.
*See disciplinary form.
…
Note 40, signed by Nurse Garrick
0200 Pt called out what sounded like multiple names. Observed Pt lying in bed with gown, pillow, and blanket thrown off. Pt tachypneic with labored breathing. Uncertain whether Pt awake and/or agitated. Informed Pt none of these names were there or permitted to visit. Pt did not respond.
…
Progress Note 21, signed by Dr. Atom Billmore
No new complaints today. No events or issues overnight. Pt stated feeling "good enough" and asked about discharge.
Spoke with Pt at length that while he may be out of active withdrawal, he remains publicly dysfunctional, as evidenced by his persistent noncompliance with Lights Out. Pt at high risk of schedule errancy and public disruption if discharged at present. Pt argued that the night shift staff were not errant. Informed Pt that staff rotated shifts each month and were allotted schedule accommodations for their essential service to the district, and that they could tolerate Lights Out.
Pt then asked whether he would have to speak with "a shrink." Informed Pt that this was not related or necessary, as his medical presentation was the physiological result of a wasteful and irresponsible proclivity that he had the means to enable for years on end, and his insomnia an unresolved symptom of withdrawal. Pt verbalized understanding and had no other questions.
Developing jaundice noted. Delirium tremens resolved.
Pt in protracted stage of withdrawal. Benzadol discontinued. Continue plan of care.
...
Note 53, signed by Nurse Qin
0830 Attempted visit by "Plutarch." Plutarch requested to "drop off some reports" for Pt. Plutarch provided the correct waiver. His request to visit was denied. Reports given by this nurse to Pt. Pt smiled in an abnormal way and stated, "Thanks, you're a doll." Reinforced boundaries of clinical relationship. Pt stated, "Don't flatter yourself. I'm not that bored." Door window shuttered.
Note 54, signed by Nurse Ion
2100 Observed Pt sitting in bed, reading through reports.
2230 Lights Out. Pt heard groaning.
...
Note 62, signed by Nurse Ray
1800 Pt permitted television access for special broadcast. Television brought into seclusion unit. Warned Pt of repercussions in event of damage to district property. Pt laughed and responded, "What, you'll take it away and I'll be right back where I started? Don't let the door hit you on the way out, my friend."
1830 Pt sitting on bed, watching television. Pt appeared troubled. Offered to turn television off. Pt declined, stating, "Leave it." Before this nurse left the unit, Pt asked, "They both hate me now, don't they?" Unable to answer.
Note 63, signed by Nurse Milo
0600 Lights On. Pt found awake, sitting in bed. Obtained repeat labwork and vital signs, per Dr. Billmore. Pt stated, "Been a while. That a good sign?" Unable to answer conclusively at this time.
0700 Pt ate 100% breakfast.
0730 Dr. Billmore to unit.
0800 Discharge order in. Pt bathed and changed into standard uniform independently. Belongings returned.
Discharge Summary, signed by Dr. Atom Billmore
This is an unpleasant and ill-appearing 41-year-old man with a history of chronic alcohol use, who has been transitioned to sobriety.
Received orders from our Madame President to discharge Pt at once, under the condition he is "acceptable enough" to serve in the war effort.
Vital signs: T 37.4, HR 83, BP 136/90, RR 18, sO2 100% on room air
Height: 5'10" Weight: 170 lbs
Review of Body Systems
General/Constitutional: Alert and oriented with no complaints.
Cardiovascular: Normotensive. No edema.
Respiratory: Lung sounds unremarkable. No signs of distress.
Skin: (+) Jaundice to skin and sclera. Periorbital discoloration. Mild skin atrophy to face, secondary to weight loss and dehydration. Facial lacerations healed. Abrasions and bruises to hands healing.
Gastrointestinal: Abdomen flat. No fecal incontinence observed or reported within last 5 days.
Genitourinary: No urinary incontinence observed or reported within last 5 days.
Musculoskeletal: (+) Decreased strength to all extremities.
Neurologic: (+) Residual hand spasms.
Hematologic: (+) New anemia and increased liver function levels. Negative blood alcohol level. Electrolyte imbalances remain abnormal but non-critical.
Further workup or prescriptions waived at this time.
Pt deemed by myself to be medically stable and publicly functional to a suboptimal but acceptable degree. Pt to be discharged to Command, as ordered by our Madame President.
Pt in agreement with discharge plan. No questions. Pt stated, "Good fucking riddance."
Doctor Antony Olsen sits back and sets the papers aside. He takes off his glasses, folds them, and taps them to his bottom lip.
It's not worse than he thought. In fact, it's about what he expected.
What's hard to believe is that they not only recorded and signed everything so diligently, but sent it to him when he requested it.
Shaking his head, Antony moves on to the other stack of papers that will go into his H. Abernathy file. It wasn't hard to get Haymitch's medical record from the Capitol, either. Antony skims through the first few notes, from his time as a tribute and then as a new victor. Extensive abdominal surgery, indeed. The time of intubation and of the first cut are the same.
Antony had a clinical rotation under the signed trauma surgeon, who told him over lunch once that Haymitch almost died on the table. He didn't need to be told Haymitch wasn't the one the trauma team was prepared to receive. Nevertheless, that was a delectable part of the tale for Doctor Lunt - how, despite the mixup, she and her team still pulled him through in the end.
No postoperative ileus, either, she'd bragged over their salads. Though, between me and Ruby Holbrook, we left quite a mark. Plastics ran out of time on that. What a waste!
Had Haymitch seized and aspirated at the height of his delirium in Thirteen, he very well could have died there - in restraints, on a metal cot drilled into the floor. That would have been a waste. Antony hates to know Billmore would disagree with him on that.
He can imagine what led to the full-resuscitation status being revoked. A noncompliant Mockingjay, perhaps, or merely the transition to sobriety proving to be too troublesome, too inconvenient, expending too much of their resources for his worth by their calculations. Antony doesn't have a copy of anything on the matter. Perhaps the Board burned all the files when their Madame President was deposed. No matter; it's the new medical board, the one they both answer to now, that he'll report Billmore to.
After this, Antony has no idea what he'll find in Katniss and Peeta's medical records. He only just got approval from the new administration, as their cases are still classified. He's been warned the one on Peeta is massive, and parts of it will be blacked out. So long as Peeta knows his allergies and his triggers, Antony can take his time to comb through that when it comes.
He wouldn't be surprised if those three files alone take up their own drawer in his filing cabinet, whereas there's hardly anything else for the rest of the district. The single front-and-back page physicals from Thirteen only tell him how fast their hearts were beating, how stressed and starving their bodies were, when they were scared and displaced last July, and that won't do much for him now.
Prior record or not, Antony has his work cut out for him here. He welcomes that, though. He'll be glad to care for these people in the way they deserve.
It'll be new for him and them both. As a medic and then a doctor within the Peacekeeper Corps, he's closed deep scratches inflicted by cornered girls and lashes from Heads who got licked by their own whip, treated their syphilis and nightmares. Now, he'll serve the ones they dealt so much suffering to for years on end. It's more than right; it's overdue.
As Antony gathers all the papers together and slots them into the file marked H. Abernathy, he braces himself to take on whatever comes his way in this valley. And right now, that means the man from the notes who hasn't been answering his calls.
Because Haymitch now has a doctor that will meet him where he's at, no matter how unpleasant, Antony slips his glasses back on and takes up his medical case.
Time to make a follow-up visit.