Impossible Diagnosis
All vital signs stable. Strength and sensation intact. Regular rate and rhythm. Clear to auscultation. Reflexes brisk and normal. The astute clinician cuts through the crust of apparent normalcy. All that should be a given. Waste of his time. The kind of guy who prefers a final Scrabble rack with, say, z-k-q-v-u-c-i-u over your standard s-t-r-l-n-e-a-i. Make something out of nothing. Find the hidden triple word score. Zero in on the impossible diagnosis. This is when he’s at his best. Calm, cool, comfortably avuncular in his well-worn green leather chair, dangling a pipe. Tell me about Massillon when you were a boy, he says. Do you remember the rashes? On your elbows? After your parents would fight? And then divorce? You thought it was divorce? It was envy, wasn't it? That drove you to do most of what you did? To have what everyone else had and keep what was yours? Now he grasps the wrist and takes the pulse. Marks the heart rate getting faster and faster.
1/14/25
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