Waiter

coffee

I read somewhere about endorphins artificially causing people to fall in love. Adrenaline, and then the presence of someone, can later cause you to feel that same rush whenever they come around again. This was probably not in a major medical journal that I read this.

Coffee increases adrenaline. I love coffee.

I need it lately. It may or may not need me.

I don’t remember what the surface of my desk looks like. It’s always covered in a pile of charts. Sometimes, on good days, I leave the office with just a single layer of papers, sticky notes, and refill requests covering it. On bad days…

Coffee propels me into a higher frequency oscillation. I dart in and out of rooms and my thoughts race just fast enough not to be bothered by the sheer impossibility of the tasks on my desk, or the puzzles awaiting in each of the rooms.

Inside the rooms, and in the waiting area, people wait. 5 minutes, 90 minutes. Mostly, they’re calm. Even the kids. Sometimes they wonder what’s taking me so long.

I wonder too. I’m moving as fast as I possibly can.

Maybe I do too much. Maybe we need to set a more reasonable agenda. Each patient has waited months or years to see me, the urgency’s there. But so are the other patients.

Waiting.

A man visits me for the first time. He’s anxious, heart racing, weak, edematous. He has double vision when he looks up.

The ER did part of my job for me. They diagnosed him with hyperthyroidism and gave him some methimazole, and told him to find a doctor.

Six months ago. He’s been out of the meds for a little bit.

I grab the retired neurologist with strabismus who hangs out with the residents on Mondays. Apparently I’ve forgotten the innervation of all the eye muscles. He’s nice to me and suggests an MRI of the orbit. Graves’ disease can cause eye muscle paralysis, apparently.

 A child has headaches. Turns out she recently fled another state with her mother, because her father was beating up her mother. In the shelter there are a lot of kids who don’t always share their toys. Now she had headaches. A man with diabetes forgot to see me for 4 months and now his foot almost rotted off. We decide we need to start insulin. A patient who visits me monthly for a tapering dose of the oxycodone he takes chronically arrives with a cut over his eyebrow from a road rage fight on the way to the clinic. We sew it up. I’m already late for the next appointment, with a young woman who is “having too much unprotected sex.” I provide an emergency IUD insertion at her request.

It doesn’t stop.

A longtime patient of mine comes an hour late to her appointment. I ask her to wait until the end of the day. She does. When we finally sit down she tells me her rib might be broken, because her husband kicked her. Two weeks ago. She went to the ER at the time but waited 12 hours and finally left without being seen.

She says she’s leaving him today. We make a plan, and a follow-up appointment. She says she loves him and he’s just really suffering from schizophrenia right now. But she promises she’s going to leave.

He needs her. She may or may not need him.

She loves him. Adrenaline.

I watch her turn the corner into the hall. Now it’s my turn to wait.