A Tale of NiP and Doctor #2
“If I was going to spread a roll of velvet on this table,” Nilay leaned forward, “trace every inch of your measurements on it,” he smiled.
“And tailor it to you, then my career’s span would have made a difference to this appointment.
Sadly, my private couture is reserved for the select.
So why don’t you make this easy on both of us and call your boss? ”
The easy, bored expression on her face tightened. For the first time, she looked anything other than pitiful at him.
“Here’s what you can do, Mr. Patel — You can lay out your reports and consult with me, or you can walk out and find yourself another cardiologist. Dr. Shravan mentioned you’ve passed a mini angina 48 hours ago. If you so wish, the receptionist outside can refer you to another doctor.”
He blinked. She was suddenly not sneering or talking down to him. She was… cool. Professional. She was really the doctor?
Nilay found his hand inching towards the set of reports he had put down, ready to pick them up and leave the office when his heart gave a loud thump. Logically, he knew that thump did not mean anything. A thump was not an attack. And yet, cold sweat broke out on his forehead.
“Drink this,” she inched a bottle of Evian towards him. How did she know? She is a fucking doctor, that’s how!
“I’m good.” He picked up his reports and set them on the table between them.
The water was tempting but he felt better the moment she fetched the bunch and began to pull out the stacks from their respective envelopes.
So many papers, so many photographs, so many graphs and charts.
His entire life’s worth of school report cards wouldn’t be half as thick.
In two days, he had amassed a year’s worth of paperwork.
Nilay sat silently, the memory of Google search results and Rajiv’s explanations making his throat dry. Was he having another attack?
Nilay swallowed in a bid to wet his throat and get over this panic.
He was a man who thrived on control. Things never slipped out of his hands.
Not scissors, not his staff’s necks, and definitely not his own mind.
The bottle of Evian called out to him. But reaching for it would mean surrendering control to this tool of an egoistical doctor.
He needed her today, badly. Didn’t mean he would emasculate whatever little was left of his pride.
And… he swallowed again; his throat had begun to feel better. His heart was still thumping, but he knew it was the nervousness. What if… CABG… angio…
“Describe what happened on the night of the attack,” she set his reports down. That’s it? He gaped at them. That was a few hours’ worth of reading material! Was she still messing with him and was not the doctor?
“Mr. Patel?”
“You are done.”
“Excuse me?”
He eyed the reports — “Did you see them all? There was also an ECG and a stress test…”
“Yes.”
“Are you sure?”
Now, he was even more suspicious of her career span. She was one of Dr. Shravan’s assistants here, out to enjoy some professional highs by acting like a bitch and airily flipping reports to show her superiority.
“What happened on the night of the attack?”
Those words sobered him. He did not care who was on the other side — the words left his mouth without preamble.
“It was mild angina pain, not an attack.”
“It was.”
“How can you tell?”
“Your reports came and whispered in my ear.”
He was amused and annoyed and frustrated and angry in equal measure. She was joking about his heart attack?
Her face wasn't amused though.
Nilay leaned back, crossing his arms. “Then they should tell you what happened on the night of my attack too.”
“Tight chest and sweat, you took it for a case of heartburn and let it go on. Felt better after drinking a soda or an equivalent. Woke up refreshed but had the good sense of consulting your GP, or whoever it was that referred you here.”
Fuck, she was a doctor.
“I walked it off too,” he pointed, in a bid to keep on top of her.
“Probably saved you from a major attack.”
His eyes bugged.
“Really?”
“Was your soda cold?”
“I didn’t say I drank a soda.”
“Ok, Mr. Patel. I am not here running an investigation. If you want an accurate diagnosis and move on to a treatment plan, then you will need to be honest and not poke back. This is about your heart, not mine.”
He swallowed.
“A chilled Coke, and then a glass of iced water,” he deadpanned.
She took one of his reports’ pages and flipped it over to the blank side. Nilay stared in fascination as she picked up a pen from inside her bag. It was a Montblanc Meisterstuck. She couldn’t afford that on an assistant’s pay. She was a doctor, then.
“How long did it last at night?”
She began to write down something at the top of his sheet. He peered. Her handwriting was beautiful. Art. Impeccably curvy but legible even from the other side.
Mr. Nilay Patel
41/M
She wasn’t a doctor! Bingo. Doctors never had good handwriting.
“Did you feel the pain anywhere else? Jaw, shoulder, back?” She kept talking to him, her eyes on the paper in front of her.
She wasn't writing his symptoms or her questions, but weird-looking test names.
More tests?! The slither of fear that he had settled in the last ten minutes began to crawl up his neck again.
“Left shoulder had some dull ache in the morning,” he recollected.
“Any shortness of breath?”
“A little.”
“Palpitations? Sweating?”
He hesitated. She glanced up and her eyes moved to his forehead. It was damp. Nilay sat a little too straight and looked at her sharply. “You know everything anyway, don’t you?”
“It’s a pattern,” she said flatly. “Prolonged restlessness after an angina is expected.”
He shifted, restless again under her clinical calm.
“You should’ve come in sooner.”
“If you’d taken me in before the Agarwal couple, I would have been in soon,” he smirked, grasping the last slipping shred of control.
She rose to her feet, coming around to his side. “Unbutton your shirt.”
His smirked deepened. She did not react, plugging her stethoscope buds into her ear.
When had she grabbed it? He eyed the smooth movement, the practised ease so slick.
She was a doctor. And she wasn’t hard pressed on getting him to undress because she took the stethoscope to his back, making him push away from the seat.
Her hand came to his shoulder and held him steady. Firm for such a soft female.
“Deep breath,” she cued, pressing it. He followed, unable to challenge her on anything.
“Relax.”
She came back in front of him, her eyes commanding, quick, assessing. And his fingers automatically went to his shirt, popping the top two buttons open. He went to the third, but her words stopped him.
“That’s it.”
She was clinical, detached, but so firm in pressing the knob of the stethoscope to his chest, to his ribcage, asking him to breathe in, relax, long breath.
He stared in rapt attention as she rolled out a long pole from the corner with her foot.
When she unwound the blood pressure cuff from the top, he found himself taking off his cufflink and folding his sleeve up like he had done three times every day since his attack. Rajiv wouldn’t let him be otherwise.
Just as effortlessly, she wrapped the cuff around his bicep.
“You’re not sleeping properly.”
“Did the stethoscope whisper that to you?”
“The dark circles did,” she said. “And the elevated resting heart rate.”
She began pumping the machine. “Do you smoke?”
“No.”
“Drink?”
“Occasionally.”
She looked down at him. “Define occasionally.”
“On occasion,” he answered densely to hold his own. She did not take the bait. The cuff deflated with a slow hiss on his skin, and she quickly unwrapped it from around his arm. Without saying anything about the reading, she went back to her chair.
She made notations again on the paper.
140/90
He knew his BP was high. That wasn't new. This reading had been consistent through the last two days. Mornings were lower, evenings pretty much the same.
“Who is your GP?”
“Dr. Rajiv Kashyap.”
“What is he giving you for BP? Have you brought his prescription along?”
“One of the many whispers in there,” he nudged his chin at the reports she had spread out in front of her. A mess.
He was shocked to see how easily she found the prescription in that mess and began reading simultaneously while writing on the paper and talking — “Your blood pressure has been consistently up. The enzyme markers show minor cardiac strain. You are stable…”
He straightened. “That means it’s good. The worst has passed?”
“The premonition to the worst has passed.” The smooth pressure of her pen on paper punctuated the silence that was left behind.
“An angiography is what I would recommend at this point…”
“Anything but that.”
Her eyes rose, head still bent over the paper — “Mr. Patel. We don’t even know how many blockages there are yet. Are they minor or major.”
“But how do you know there are any blockages? Dr. Rajiv mentioned that the blockage may have cleared on its own if the episode was mild and I went back to normal immediately. There is a high chance that it has cleared.”
“Possible. But the fact that a failure happened is a testament to the fact that there was a blockage in the first place. I sense multiple blockages, even if minor.”
He hated her. Couldn’t she say there was nothing wrong? He was taking BP medicine, his pressure was going down slowly, he had gotten all these tests done. Couldn’t she ask him to control his stress and make this ok?
“An angiography is a minimally invasive procedure. Through a small incision in your wrist or thigh, a thin tube is inserted into your artery. Ink is injected into it to see how freely blood circulates through your heart. It’s just a test.”
“And then you will find half a blockage and ask to put in a stent or something and then it would be an angioplasty and then more than one ‘blockages’ would push me into a CABG at 40,” he scoffed. “I have heard the horror stories.”
She sat back. Stared at him. Again, the pity, but wrapped in scrutiny.
He hated her even more.
“Who is your GP again?”
“Dr. Rajiv Kashyap.”
“And he has been taking your BP thrice a day,” she pointed to the prescription and the covering letter attached for Dr. Shravan.
“He is also my neighbour.”
She thought for a moment, then capped her pen. “Angiography is the standard recommendation in your case. I wouldn’t take the risk of not finding out. But since you are so averse to the procedure itself, let’s try another way. Get a CT coronary angiogram. It’s non-invasive, and accurate. A scan.”
“Then why don’t they recommend that instead of cutting me open?”
“Because if there are blockages, an angiography can be immediately turned into an angioplasty by inserting stents. Recommended for high-risk patients.”
“I am not high risk.”
It was a question, disguised as a statement. She did not answer, and he hated her even more.
Her pen met paper again and she listed down more tests — “Follow up with these reports. If they come back low-to-moderate risk, then an alternate plan can be chalked out. Lifestyle, diet, regular check-ups. Six weeks. If your stress tests, lipid markers and plaque activity markers improve, we continue. If not, you will have to book for an angiography and possibly need an angioplasty.”
His thumping heart came to rest. Good. Lifestyle, diet, regular check-ups he could control. He just had to get this CT report to come out well.
“That’s fine.”
She continued to write, this time long names with time charts for medicine intake.
“I am changing your current BP medication. I am also putting you on a blood thinner. Your bad cholesterol markers are high, good cholesterol is as good as nonexistent. Cut red meat, occasional alcohol, and late nights completely. No caffeine after noon. Walk every day…”
“Walk? I gym…”
“Not for the muscles. For the good cholesterol,” she cut him off.
“Don’t gym for the next month. Walk instead.
60 minutes daily, non-negotiable. Replace your regular cooking oil with extra virgin olive oil.
Cut salt intake to less than 1 teaspoon per day.
Cut sugar and sugary foods. Add soluble fibre to your diet.
Oats, barley, vegetables, fruits. Heavily.
Start eating olives, rinsed off their cured salt, 5-7 a day… ”
He winced inwardly. She capped her pen, gathered the sheets and slipped them all into their respective folders before pushing them back to him, her prescription on top.
He eyed it. It was written on the back of his old report.
No letterhead. Just a sign at the bottom that could mean anything from Raita to KDrama.
Good handwriting, pathetic signature. And no letterhead.
“If you are a doctor,” he gathered the documents back. “Where is your letterhead?”
“Your GP will build out your prescription from this. Any other questions?”
“And who should I say wrote this?” He held the paper up, squinting. “Raita, KDrama or Dr. Kaapadia.”
“Kapadia.”
“Kaapadia, kaapad means cotton in Gujarati, Kaapadia are those who deal in cottons,” he corrected, because he was that petty, and had just been given the good news that he was not about to get an invasive procedure. And he had control to wrest from her.
“You may book your next appointment at the reception, Mr. Patel.”
“Hopefully not with you.”
“Absolutely not with me. Dr. Shravan will be back this weekend. I have written weekly follow-ups, but you can ask your GP to figure it out just as they would figure out the name there.”
“So you agree it’s illegible.”
“To you.”
His eyes narrowed. Why was he unable to intimidate her or pull her down to his level?
“There’s a 12 noon show at PVR,” he went for the kill. “Want to accompany me to stare?”
“We’ve established whose profession it is to stare.”
He cocked his head — “I make it a point of staring only at muses. Alas.”
Her cool, cutting face turned cold. She did not say anything back again. A buzzer sounded. And the door opened to Anu Madam.
“All done, Doctor?” She walked in genially, no doubt to escort him out. The medical version of a security escort. Nilay stared a beat too long at the woman… the doctor in front of him. Then, because he couldn’t pull anything more from her —
“I’ll be at the ticket counter, Doctor.”