Chapter Ten Vanya
The rest of the week goes by quickly as I assess patients under my care.
I met with a seventy-year-old teacher recovering from a stroke. We worked on improving mobility and created an occupational therapy plan.
A young executive came in with chronic lower back pain that had not been solved by an epidural steroid injection. I recommended further diagnostic imaging and a few simple core strengthening exercises.
Every other meeting involved some version of knee pain or knee surgery recovery. Unfortunately, the knee is a fickle joint that keeps the clinic busy.
“Do you have lunch plans, Vanya?” Sabrina asks after helping me navigate one of the patient portals that I’m unfamiliar with. Each medical institution has its own software with a steep learning curve.
“No plans. Thought I’d grab something at the vending machine and review some files.”
I check my phone to find it’s past one in the afternoon. On cue, my stomach grumbles.
“Can I interest you in a Clover Leaf lunch? It’s one of the food trucks I organize since there aren’t a lot of restaurants in this industrial park. They’ve got healthy salads and rice bowls. Protein shakes, too.”
“That’s surprising. The only food trucks I’ve ever seen serve sweets or fried foods.”
“There are definitely lots of those. Why? Are you in the mood for fried foods? Because I can always be persuaded.”
Sabrina is widely adored in the office, and I can see why. She’s relentlessly efficient yet easy to be around.
“I’m more of a sweet tooth, but a healthy lunch sounds better than a bag of chips,” I admit.
We head to the side of the building where there are picnic tables with umbrellas. The food truck is lime green with painted flowers, grunge rock music wafting out of the opening where a woman is handing out salads to a couple of guys.
“Hey, Sabrina! Hey, Dr. Vanya,” they say cheerfully. I feel a familiar dread when I don’t remember their names.
“Pete and Oli are physical therapists,” Sabrina whispers in my direction, lips barely moving. “Wanna sit with them?”
Since lunch usually demands small talk, my first reaction is to say no. However, one of them—I think it’s Pete—states, “Can I run something by you, doc? It’s about a patient.”
“Sure!” I pipe up immediately. I’ll take a medical consultation over casual conversation any day.
We bring our salads and sit across from them.
“What did you want to talk about?” I jump right into it.
After swallowing his bite, Pete starts, “I’ve been working with a patient for four months or so. Eric Deichert, thirty-one, former football player, and fit as can be. He’s been experiencing chronic calf pain. The X-rays showed no abnormalities. We’ve had regular physical therapy sessions focusing on mobility, strengthening, and stretching exercises. He’s also on anti-inflammatories. They help a bit, but the pain never completely leaves.”
“What kind of pain? Dull and spreading discomfort, or sharp?” I ask.
“At its worst, he describes it as stabbing pain. It worsens after exercise, but unlike typical muscle strains, it doesn’t go away with rest. He also reports occasional tingling or numbness, but nothing definitive shows up in routine tests.”
“Has he had imaging done? Maybe an ultrasound while he’s moving to identify impingement during motion?”
“Ultrasound showed nothing conclusive.”
“If he was my patient, I’d order an MRI with arthrogram. The contrast dye highlights joint structures, making it easier to identify tears and other abnormalities. It can also catch a combination of issues, like if he has old tears along with cartilage damage.”
“If I leave his file at your desk, would you be willing to order the MRI?”
“With a prelim consult, yeah, sure.”
“Let the woman eat her lunch,” Oli says to his companion. Pete reddens.
“It’s fine,” I state, taking a bite of my salad.
“How are you liking Columbus?” Oli asks.
“It’s only been a week, so I haven’t seen much.”
“If you aren’t busy this weekend, a bunch of us meet at Riley’s on Saturday night to catch the hockey game.”
“It’s an Irish bar,” Sabrina adds.
“Maybe next time,” I state.
Sabrina directs the conversation to something else and I’m grateful for the break from small talk and false promises of “next time.” I have no intention of going to bars—or parties or outings or whatever—with coworkers.
The men leave to meet their upcoming appointments while Sabrina and I finish up.
“Thanks for helping Pete.”
I’m taken aback, because there’s nothing special about my advice at all. “Kyle could have done the same thing, had he been informed,” I say.
“Kyle is great, but he’s a bit conservative with tests,” Sabrina mutters before drawing her lips to a tight line.
“What do you mean?”
“He’s all about consistent care but isn’t on top of the recent testing protocols,” she discloses hesitantly. “It works for most patients, but for ex-athletes like Eric…” Sabrina trails off. For the first time since I met this sociable woman, she appears guarded. “Anyway, since we’re on the subject of athletes, I made a change to your afternoon schedule.”
I shrug nonchalantly, happy to concede my appointments to Sabrina’s discretion. I’ve been at the mercy of her scheduling, and she has neither overbooked nor left me out of the loop.
“It’s Jeremy,” she says timidly. “Jeremy Lopez.”
I do a shitty job of hiding my surprise and annoyance. Sabrina inhales deeply before launching into an explanation.
“He warned me that you might not want to see him. And if that’s still the case, I’ll cancel it right now. But I saw an opportunity in your schedule that matched with his training, so I put him in, knowing how much he benefited from the one time you saw him. He said he made a shitty first impression but wasn’t clear about what. Do you want to talk about it?”
“No,” I say curtly. In fact, I would like to erase it from memory.
Since he dropped me off at home last week, I’ve softened to the idea of starting over. Besides, he’s my neighbor with whom I am required—as per neighborhood protocols—to share a wave when we find ourselves outside and across the street. Shutting him out at work would make things awkward. Propriety and the demands of research make it impossible to completely avoid Jeremy.
“I can honestly and confidently say that Jeremy wouldn’t hurt a fly. But if he was unprofessional in any way…”
“It’s fine. I’ll see him,” I interrupt.
“Great! Thank you, whew. I was worried you’d be upset at me.”
“Not at all.” It’s true. Sabrina was looking out for her friend and doing her job. I don’t blame her. I’m not annoyed at her at all.
I’m annoyed at myself because I cannot, in fact, wait to see him.