She's Not a Fan

Chapter 20

Sarah met up with the Teen Clinic at the downtown location and arrived with a waiting room full of patients. 

She ushered in a young woman named Kelsey Deville, who came in with a complaint of constipation.  Sarah went over the usual advice about staying well hydrated and increasing the fibre in her diet.

“So, let me get this straight,” Kelsey said, popping a bubble as she chewed her gum.  Her hair, dyed a brilliant purple, was pulled back into two ponytails.  A blue bomber jacket didn’t quite meet the top of her loose cotton pants and the waistband was rolled down to reveal the silver stud in her belly button.  “You want me to eat more fibre in my diet and make my sh... I mean stools bigger.  Because bigger stools,” she emphasized, having just learned there was a polite word she could use, “are easier to pass than pencil-thin small ones.”  She looked skeptical.  “Are you sure about that?”

Sarah tried not to laugh.  Kelsey actually had a good point.  “Yes, I’m sure.  It is better for your bowels if your stools are bigger.  And the best way to get bigger stool is to eat more fruit and vegetables, and have whole wheat bread instead of white bread.  Could you do that?”

“Sure, sure.  I can try.”

Kelsey left the office and Sarah thought there was probably a fifty-fifty chance she would actually take the advice.

The rest of the afternoon and evening were filled with routine visits.  A young male came in with a sore throat and fever.  Hmm.  Viral infection?  Strep throat?  Infectious mononucleosis? 

“Hi Matt.  I’m Dr. Jain.  You came in with a sore throat?”   

He looked pale with dark circles under his eyes. He was slouched forward with his head in his hands, almost struggling to stay awake.  “Yeah.  Hurts to swallow.  Hurts to talk.  Can’t eat and don’t feel like drinking.  It’s been going on for a week and getting worse.”

“Any other symptoms? Nausea?

 “Some.  Threw up over the weekend.”

“Are you sleeping more than usual?”

“Yeah.  I can’t get out of bed in the morning and I’m back in bed wiped in the afternoon.  Sleeping close to sixteen hours a day.  I need to work.  Man, this sucks.”

His throat was red with white patches on his tonsils and the lymph nodes in his neck were swollen and tender.  And he had an enlarged spleen.  Likely mono, she thought, and helped him sit up again.

“I think you probably have infectious mononucleosis, mono.  It’s a viral infection so you don’t need antibiotics.  We can do a blood test to be sure, but you should assume you’re infectious until the results are back.  It’s important to rest.”  

She warned him about the risks to his spleen.  “Your spleen is larger than normal so it can be injured more easily.  It sits up under the rib cage on the left side so you have to avoid any vigorous activity that could put it at risk.  Where are you working?”

“Stocking shelves at the grocery store,” he muttered.

“Can you take time off?”

“With a doctor’s note.”

“I can write one for you.  It’s also important to keep drinking fluids even if your throat is sore.  Ice chips, popsicles work too.  You don’t want to get dehydrated.”  She wrote a note, and arranged for the blood test and a follow-up appointment.

It was a long afternoon and evening.  It felt like every visit took twice as long as it should have, but finally the last patient left. 

As she finished charting, Hank came in to secure the loose equipment.  “You’re all done here, girl,” Hank said cheerfully in his booming voice.  He moved efficiently putting supplies and medical instruments back into storage for the drive.