[Reader discretion advised. Aspects of this story may disturb some readers.]
I always wish I could capture this moment when I meet a new patient. I have tried different means, but they never preserve the raw essence of it. Intuitively, we both know that she will be under my care for awhile—probably the duration of her life. This collision of worlds, patient and doctor’s, creates an unfathomable bond. I stand in the corridor and take a deep breath, mentally affixing my expression: professional, slightly detached. I smooth my lab coat and give a gentle, rhetorical knock on the door.
As I turn the knob I take her chart from the rack on the door. I force myself to focus on the folder and not look at her. Not just yet. She needs to know her place in this relationship. I close the door with the heel of my right shoe, reveling in the soft click as it kisses the door frame. Perfectly executed. After years of practiced routine, this little nuance sets an authoritative tone; the patient immediately knows that I come to our little exam table with gravitas, and more importantly, that I am in control of every aspect of this encounter.
I wait for my cue to make eye contact and speak. It usually takes an average of twenty seconds of tense silence for my patient’s breathing to increase to near hyperventilation. Today, she takes forty five seconds. Impressive. I write this down in her chart.
“Hello, Ms. Reynolds, my name is Dr. Sade. It’s a pleasure to meet you.” I note in her chart how vulnerable she looks on the table: the open front exam gown, the paper cloth draping over her thighs, the brutally cold florescent lighting beating down on her. She is shivering. “I hope you don’t mind if I record our discussion…it helps with my dictation later.” I engage my digital recorder.
“Well, we need to get a thorough medical history on you before we begin…mind if I have one of your cigarettes?” I reach over and pull her pack and lighter from her purse,”Thanks. So, Ms. Reynolds, what’s your age?” I light one of her skinny, white cigarettes. She gives me a pathetic look, and then frantically fixates on the door.
“Now, I understand this situation is upsetting, but you are going to need to properly communicate with me so that I may treat you. I’ll ask again, how old are you?” I lean toward her and briskly rip the duct tape from her mouth. She whimpers like a dog and squeezes her eyes shut, forcing out the tears. Her response is somewhat disappointing.
“Not speaking to me yet, hmm? That’s okay; I have devised my own methods for determining the age of my patients. It’s quite accurate.” I open a drawer on the examining table, and she begins to squirm and sob as I remove a pair of latex gloves. “Do you have any latex allergies? If you refuse to cooperate with the medical history portion of our visit then we might as well move on to your physical…”
I can’t help but pause to savor her reaction. I bite the inside of my cheek as I watch her eyes widen and dilate. I taste my blood when I see her pulse throbbing wildly on the side of her neck. Pace yourself, Doctor. I grasp her bruised, bound wrist into my hand and calculate her heart rate. 125, it’s a good start. I draw a deep, exhilarating drag from the cigarette.
I pull the instrument stand to my side. I lower it so that she may see my choices. I watch her reactions intently as I casually graze my hand across the selection of surgical tools; I pause over the scalpel…
“No, no, no! Don’t do this!”
Now we’re getting somewhere. ”Hmm, that sounds vaguely familiar, but I need to hear the magic word...”
She begins to thrash and scream for help. As the skin on her wrists succumbs to the scraping shackles, the sight of her blood sends me over the edge. Fireworks explode behind my eyes.
“Oh, God, help me! No, please don’t hurt me, mister! Please!”
The blood and the power mingle on my tongue, “You’re getting warmer…try again. Tell Doctor Sade the magic word.” I take a long pull from the cigarette, the cherry swells. I open the front of her gown and crush it into the hollow below her collarbone.
Her cry was ear blistering perfection, “Ow!”
I shudder in ecstasy. Ahh, the magic word.
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