Yesterday in clinic played out like an avant-garde French film, or maybe like a David Lynch short. Aside from the general strangeness and chaos and circular dialogue...
How often are you breastfeeding the baby?
Yes, but how often? How many times a day?
Yes, but how many times in one day? In the morning? In the nighttime? Every two hours?
...there was just a weirdness permeating the fabric of the day. For instance, just before lunchtime, a new patient showed up unannounced, an eight year-old newly immigrated from the Dominican Republic, and our attending was asking if one of us could squeeze her into our schedule. "I don't think it's anything," our attending said, "Mom says just a school physical and some forms to be filled out. I'll even help you fill out the school form after you examine the patient." Mariah gamely agreed, and walked into the exam room where the patient and her mom were waiting.
Several minutes later, she walked back out and came up to me. In a low voice, she said, "She's a dwarf."
She's a dwarf. The patient's a dwarf.
Aargh! The classic last-patient-before-lunch dupe! I knew there had to be something more! "Only a school form" my ass!
She's a fricking achondroplastic dwarf.
(Starts frantically flipping through Smith's)
This is such a French film.
Later, I had another patient, a six year-old also fresh from the Dominican Republic, also here for "Just a school physical and shots." She was not a dwarf, my crack diagnostic skills told me right off. She just looked pretty normal. I was talking with the mom, asking her about the kid's past medical history, any prior hospitalizations, problems during pregnancy and birth. All no, no, no, nothing, nothing, nothing. So I had the kid hop up on the table and start examining her. Only when I reached over to take her wrist for pulses, I noticed that there was no wrist. Nor was there a hand or an arm. Just a gigantic plastic prosthesis.
Oh, she has no arm.
I see that.
(Taking off the prosthesis to reveal a hypotrophic limb stump)
It was like this when she was born.
Ah. You might want to mention that next time.
I suppose that's nice, that the mom was so nonplussed by her child's missing limb that she even forgot to mention it to her doctor. But Christ, a little advance warning would have been nice. I set her up with her lab tests and shots, and referred her over to our Rehabilitation department so that they could help with her prosthesis and fit her for a new one when she outgrew the current.
So between the dwarf and the girl with no arm, it was a surreal end to the week. Leaving the clinic, I half expected to see mimes playing tennis on the sidewalk or some other such thing. But instead, I saw my patient and her mom walking down the street to the subway station. They were holding hands, the little girl with her elbow bent upwards and the mom holding on to the flesh-colored prosthesis. It was cute.
Currently watching: "Seabiscuit." Not to give away the ending, but...he wins! And triumphs over adversity! Actually, I did enjoy the movie, especially the PBS-like Ken Burns narration, even if it did give the story a sense of pseudo-gravity that I'm not sure it necessarily warranted.