*A fictional column. All patients are composites. This is reflection, not medical advice. Full disclaimer at the end.*
—
Wednesday. 8:31 AM. Clinic was supposed to start at 8.
She is getting married on Saturday. It is Wednesday. She has told me this twice in two minutes, which is how I know it is the most important sentence in the room.
The lab report is on the desk, in front of her, turned slightly toward me as though she is offering it for inspection. The number is high. Not the kind of high that is dangerous. The kind of high that takes weeks of small adjustments to nudge back down. The kind of high that does not care about Saturday.
“I need it fixed.”
“By when?”
She looks at me as if I have asked the date of her own wedding.
I sit down. I do not have my coffee yet. I am, I realize, beginning to think of coffee less as a beverage and more as a person I am supposed to meet who keeps not showing up.
“Saturday.”
“By Saturday.”
“Yes.”
I look at her hands. They are not shaking. She has been told her hands will shake. She has been watching them for two weeks, so closely she has, by my estimate, lost the ability to remember what her hands looked like before the watching began.
We talk. I tell her the medicine takes weeks. Saturday is too soon. Saturday is not really about the numbers. She nods. She does not believe me. She believes the lab report, which is paper, which can be folded into a handbag.
She asks if I have ever been to a wedding where the bride looked tired. I say yes. I do not say it was most of them.
She leaves with a prescription and a follow-up in six weeks. The receptionist hands her a small printed card with a date in October on it, for a different test entirely. She does not notice. The receptionist, who has been doing this longer than I have, knows that a date on a card is a kind of medicine all its own.
—
11:14 AM. Patient seven. A boy, sixteen, with his mother. He has not been brought because he wants to be here. He has been brought because, six months ago, his school nurse weighed him on a Tuesday and a number went onto a piece of paper and the piece of paper followed him home.
He sits with his arms folded. His mother sits forward, the way other people prepare for a journey. She has notes. She has a list. She has, I think with a small sadness, more hope in this room than he does.
“He doesn’t eat. He doesn’t move. He doesn’t sleep.”
“I sleep,” he says, quietly, to the floor.
“Not properly.”
He shrugs.
The numbers in front of me are, in fact, not terrible. The numbers are a kind that, in a sixteen-year-old, are an early warning, not an emergency. He is, biochemically, a boy who is going to be fine if someone, sometime in the next two years, persuades him to walk most days and put down whatever he is holding when he is not hungry. He is, biochemically, a boy. He is not, in this room, a boy. He is a problem to be solved, and his mother has, with great care, brought him to the place where problems are solved.
I ask him what he likes to do.
He looks up.
He says, “Music.”
His mother opens her mouth.
I lift one finger. Gently. The smallest gesture I can make.
She closes her mouth.
He talks for nine minutes. He tells me about a song he is writing. He tells me he plays the keyboard. He tells me that he stopped going outside in winter because his fingers got too cold and now it is summer and the habit has stuck. He tells me, eventually, that he doesn’t really know how to start moving again. He says this last part to his shoes.
I write three things down. None of them are about food. Two of them are about him. One of them is about his mother. We make a follow-up in eight weeks.
When they leave, his mother thanks me. He does not. He looks at me, briefly, and nods once.
—
At 1 PM I sit at the desk and do not eat. The bride is married, in my imagination, by Saturday afternoon. Her hands do not shake. They were never going to. The number on the report is the same number it was on Wednesday. Numbers are like that. They do their work in their own time, indifferent to invitations.
The boy has gone home and back to his keyboard. He will, I suspect, come back in eight weeks looking exactly the same, which his mother will read as failure and which will, in fact, be the first sign that something has begun.
The coffee is cold. I drink it anyway. It tastes like a cup of coffee that has, by now, given up trying.
The afternoon clinic begins at 2.
—
**Disclaimer**
Doctor’s Diary is a work of fiction. All patients, conversations, clinical findings, laboratory values, treatment decisions, and outcomes described in this column are invented composites. They do not depict any real individual, living or deceased. Any resemblance to a specific person, encounter, or institution is coincidental and unintended.
This column is published for reflection and literary purposes only. It is not, and is not intended to be, medical advice, a clinical opinion, a diagnosis, a treatment recommendation, or a substitute for professional medical evaluation, examination, or care. Nothing in this column establishes a doctor-patient relationship between the author and any reader.
Do not start, stop, change, or interpret any medication, test, diet, lifestyle measure, or clinical management on the basis of anything written here. If you have a clinical concern, consult a qualified healthcare professional in person. In an emergency, contact your local emergency services immediately.
The author writes anonymously. The views expressed are personal literary reflections and are not official guidance from any institution, regulatory body, hospital, university, professional society, or government agency. Information may not reflect the most current medical consensus, guidelines, or evidence and is provided “as is” without warranty of accuracy, completeness, or fitness for any particular purpose.
The author, Hormone Insight, and its operators accept no liability for any action taken, or not taken, on the basis of content published in this column. By reading this column you acknowledge and accept these terms.
