Chapter Four
Rylee
Monday
The doctor’s office was freezing cold.
Yes, it was March, and while one day smelled like spring and felt warm with burgeoning hope, the next smelled like a snowstorm was ice skating down from the north.
Yesterday, Washington, D.C., was glorious. Today? Not so much.
Rylee Jones had dressed appropriately for the ice-spitting drizzle.
But here in the doctor’s exam room, she sat as requested: stripped down to her underwear, a pink napkin of a “modesty garment” stiffly resting on her shoulders and wrapping her torso, sitting on the padded table, her bare legs dangling from the side.
Honestly, the rooms should be warm enough to keep the patients’ toes from turning purple and skin from stippling with goose bumps.
And, if nothing else, the doctor should be heading through the door to make the discomfort short-lived.
But no.
Rylee had been shivering for forty-five minutes now.
With her coat hanging up in the lobby, Rylee had resorted to draping her sweater dress over her legs and was deciding whether to go ahead and pull it over her head and run out real quick to grab her coat.
Honestly, the warmest Rylee had been was during this morning’s trek from her office at WorldCares, where she’d parked her car, to the medical building. Though outside the ice was pinging, it was probably warmer than this icebox of a room.
Rylee was in a bad mood and grousing. The cold room was simply an easy reason to vent frustration. And if she ran out to get the coat at the same time the doctor popped in, she’d probably miss her opportunity to be seen and have to set a new appointment and go through this all again.
“Suck it up,” she chided herself. “Power through.” After all, Rylee had been through colder and for longer.
The determined conquered the day.
Turning to her phone, Rylee sank herself into a good doom scroll, immersing herself in a post from the Muddy K9 Charity Run she’d gone to with her dad and foster brother the day before.
Videos of the athletes and their dogs streaking by took her attention from a clock that seemed as frozen as the tip of her nose.
When the tap finally sounded at the door, Rylee had been in her shiver-clench so long that her “Come in” was a staccato ratatat she forced through chattering teeth.
“I’m Rose, Dr. Blanch’s nurse.” Rose wore a turtleneck and a thick fleece sweatshirt with the clinic’s logo. Her hands still looked stiff with cold.
“It’s ffff-rrr-eezing,” Rylee said, because there should be some conversation about a patient’s comfort. Unless, of course, they were trying to dissuade patients from coming in.
“The doctor’s running a bit behind. I’ll try to get you out of here fast. Can you tell me what’s going on for you today?”
Rylee reached for the spreadsheet she’d prepared and was lying beside her. On it, Rylee had listed all the data points that had come up in the last couple of years from previous medical appointments with an ever-growing list of doctors who shrugged and walked away.
Every time she got a new question, she added another category to the printout: her exercise regimen, nutrition pattern, years of blood work, her symptoms, their frequency, their impact on her day-to-day life, her family history of Multiple Sclerosis, the family members’ ages of onset and diagnosis, and their current level of disability.
Rose sat down with the papers and scanned them over. “Right now, you’re experiencing tingling?”
“Toes and fingers.”
Rose looked up. “And it feels like?”
“Like my hands and feet have started to go to sleep, and with some movement I could get the blood flow going again,” Rylee said.
Rose nodded, “But you can’t?”
“No.”
Rose turned the page. “Not a vegan? So not a B12 deficit.”
“I eat a high-protein diet because I lift heavy. The protein comes from animals, and I take sublingual B12 daily. The B12 labs on the third page, you can see it’s high normal range.”
Rose turned to that page. “These are past labs, and your A1C is normal, so you’re not experiencing diabetic neuropathy.” She glanced up. “Have you ever been diabetic?”
“I’ve always had stable glucose numbers. So no, this isn’t diabetic neuropathy.”
“Ever hit your head?”
“No, ma’am. I have been on battlefields as a medic, so I was around blast concussions. But when I was with the Navy, I had an MRI to check for damage, and I was okay.”
“How long ago was that MRI?”
“Twelve—no, thirteen years ago.” Rylee lifted her thigh to unstick from the paper table liner so she could shift into a new position.
“Up until the last doctor I tried, I was told these sensations were all in my head and that I should get a hobby that flexes my fingers. Have I considered taking up knitting? Apparently, if I’d move my fingers, it would make my toes stop tingling. ”
Rose held a blank face. “And the last one?”
“Told me that I probably have a pinched nerve, and I might consider chiropractic.”
“Have you considered that?” Rose asked.
“No. Not my thing to get crunched around.” Rylee lifted her hand and spread her fingers. “Each to their own. But I did go to a physiotherapist, and she did what she could for me.”
“Helpful?”
“She concluded that none of my nerves were pinched.” Rylee’s physio had worked hard, trying all the tricks from acupuncture to infrared, from stretches to exercises, to massage.
If it was in her care bag and could be dragged out and tried, it had been.
But Rylee got no relief, and the therapist was genuinely concerned when Rylee couldn’t move the needle. “She sent me to yet another doctor.”
“And who was that?” Rose asked.
“Here, today. My physio said I should try Dr. Blanch, as he was good at figuring out difficult cases. She called them zebras. That and my office is a block away, so if I were working with Dr. Blanch, it would be convenient.” Rylee adjusted her grip on the pink napkin top to make sure she wasn’t flashing Rose.
The paper had started to rip. “I don’t think this is a case of me being a zebra in a herd of horses, what with my family history of MS and all.
” Rylee looked directly into Rose’s eyes and said clearly, “I need to go through the diagnostic assessments for Multiple Sclerosis. I’d like to start that process. ”
Rose nodded. “This is very thorough and answers the questions I’d ask. You’ve been to a lot of doctors about this?”
“A lot. Yes.”
“And what have they done?” Rose asked as she flipped the papers back to the front page and dropped her arm, letting the papers dangle by her side.
“Until the last doctor, they offered me anxiety medications because they said that my breathing was too shallow, possibly too fast. But I think my breathing is fine.”
“Just sit comfortably. I’m going to count your breaths as I take your pulse.”
It was hard for Rylee to breathe normally with her body shivering.
“Eleven.” Rose put the pages on the exam table and pulled out a pad, writing that number down. “That’s athletic. You were breathing normally?”
“Page two,” Rylee said.
A glance at page two, and Rose nodded, “Yes, good job on your dedication to exercising.” She slid the pad and pen away and gathered the papers.
Rose lifted Rylee’s document. “I’m going to scan these into your file, and I’ll share this with Dr. Blanch. He should be in in a minute to see you.”
As Rylee said thank you, Rose stood, tight-lipped and worried. She gave Rylee a nod and left.
Alone again, with nothing but a poster of the muscular system and a painting of a duck to look at, Rylee was once again aware of just how cold that room was. She turned her phone over and looked at the time.
An hour late.
The nurse’s name was Rose. It was an unusual name.
It was Rylee’s middle name, Rylee Rose, because her mother liked poetry and letter sounds that repeated.
Rylee Rose Jones. Five letters, four letters, five letters made her mother happy with the symmetry and pattern.
And if her mother was happy, her father was happy, so he signed off on it.
Rylee was fine with it. It was a good enough name.
But the fact that her nurse was named Rose, too, had to be a good omen.
The delay and the inhospitable conditions were making her angry.
Wasn’t this what detectives did to people accused of a crime?
They put the defendant into an extra-cold room to heighten their survival instincts and make them want to lash out?
It was a tactic that included isolation, anxiety, and power imbalance.
All of that might mean the defendant had less control over their emotions and their tongue.
The same felt like it could apply here, but Rylee needed to keep a tight rein.
So Rylee spent the next few minutes trying to convince herself that this boded well.
She couldn’t account for the temperature of the room, but surely the delay in care meant that Dr. Blanch was thorough and listened carefully to his patients.
Once he got to Rylee, he’d weigh her experiences and symptoms, and she’d start moving through the process of getting a proper diagnosis.
A clear yes or no on MS was the most important.
She needed it physically so she could start the meds that would slow progression, and to allow her to apply for the various drug trials she’d been researching for her next steps.
Rylee also needed it for her psychological health.
The medical gaslighting was an exhausting mental load.
It was embarrassing.
It was demeaning.
Frustrating.
Yes, Rylee was frustrated.
There was a tap at the door, and after Rylee called out, Rose came into the room, handed Rylee back her spreadsheets, and moved to stand by the counter, blank-faced.
Well, that didn’t bode well.
Rylee turned to find a jowly man with reddish skin and orange-ish hair, dressed in a white lab coat with a stethoscope thrust into his pocket.