Friday, August 05, 2011

Composure (flash fiction)

I received in the mail yesterday a challenge for a flash fiction contest, which resulted in the anecdote below.  The requirement was a thousand words or less.  I hope this little diversion brings a chuckle to your brain.


It was another day at the walk-in clinic in a poor section of Santa Ana where I struggled to communicate with Latino families, and where my Irish Catholic boss was the worst I’d had. He was building a bowling alley in his house while refusing to provide hand soap in the examining rooms, so I used to carry a bar around in my pocket to wash between patients. By concentrating on the needs of patients I was able to put the substandard working conditions out of my mind, though I later became so enraged that I quit.

A black woman in her mid-twenties pushed open the glass door of the entrance and came to the reception desk to register. She was neatly dressed in a yellow polo shirt and sharply creased jeans. Brand new Nikes completed her outfit. Her undyed curls were of moderate length, she wore eye shadow and mascara but no lipstick, foundation or blush. Maybe 5’4”, she was curvaceous without being given over to pulchritude. After a short wait the nurse took her to an examining room and recorded her vitals. In my long white coat with a stethoscope hung about my neck, the equivalent of a priest’s collar, I entered the room. I sat down on the swiveling stool while she sat high on the examining table.

“So what brings you into the clinic today?” I began.

A look of brief disappointment passed over her face, quickly deflating into a grim resolve. Lucent brown eyes fixed me levelly as she said, “I have a discharge.”

“Oh,” I said, in my professionally compassionate voice, not yet tainted by greed or constant overwork. I was too young for that and hoped I always would be. “How long have you had it?”

“About a week.”

“Is it getting better or worse?”

“If it was getting better you think I’d be here?” she said.

“It’s always wise to come in,” I said in mollification, hoping she did not think me too dense. “Can you describe it?”

She glanced at the crotch of her jeans as if this might remind her.

“It’s kind of yellowish and thick.”

“Any odor?”

“Doesn’t it usually smell down there, Doctor?” she said without embarrassment, though a smile pulled at her lips. I wanted to laugh but maintained my professional composure.

“Are you in any pain?” I continued. “Does it burn when you urinate?”

“Not really,” she said.

“Is intercourse painful?”

“I haven’t had any since this started.” She twisted her neck and rubbed it.

“Have you had any new sexual partners recently?” I asked routinely.

She gave me an emphatic “No!”, shaking her head in disgust.

“Well then,” I said, “We’ll have to take a look. The nurse will be in to get you ready OK?”

“OK,” she said, rolling her eyes. I left the room. When I returned she was up on the table with her pale heels in the stirrups, her legs spread wide and a blue paper drape lined with clear plastic covering her legs and groin. I pulled on my gloves, the nurse warmed the speculum and I gently inserted it in the bluish vulva before the pink vaginal folds all races have in common appeared. The discharge was obvious, thick and purulent, typical for gonorrhea. I looked up at the cervical os, and the discharge was ultimately coming from her uterus. I took a culture and swabbed a slide for a gram stain, but the diagnosis was not really in question. There are only so many kinds of vaginal discharge and this one was as old as the oldest profession.

While the speculum was still inserted she asked expectantly, “So what do you think it is?”

In my bluntly lighthearted manner I told her, “It’s not something you get from toilet seats.”

“So I assumed,” she said coldly. She tilted her head back and stared at the acoustic ceiling tiles, her lips pursed in disgust. (Being tall I could see her face above the drape.) “Damn!” she said. “Damn, damn, damn! And I trusted him! And he swore he’d been faithful! Damn his skinny little black ass!”

“I’m sorry,” I said, preparing to remove the speculum, when she blurted, “You know, Doctor, sometimes I wish you would just sew it up! See-oo-ww it up!”

I laughed so hard that the speculum clattered to the floor and the nurse joined in and finally Marie did, too, although her laughter was different, more a sarcastic confirmation than any belly laugh. Embarrassed but only slightly, I picked up the speculum and handed it to the nurse, my hand still shaking from laughter. I thought I might collapse on the floor. It’s the only time I remember laughing during a pelvic.



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