After The Honeymoon

16. The Crux

Madiha

The Infectious Diseases (ID) fellow's workroom was where I spent almost 80% of my waking hours these day. After Omar's apartment in Chicago, and my apartment in St Louis, this mid-sized room with a view of the concrete parking garage, books strewn all over the place, several workstations and lots and lots of coffee mugs, was my third home. 

This is where I learnt about common presentations of uncommon infections, and uncommon presentations of the common ones. Where I ate, drank and day-dreamt of my life post-fellowship when I would finally be living with my husband again. I am not going to lie - this was also the room when I sometimes took a quick nap, exhausted from a day of running around the hospital. 

It was also a room where I along with my co-first year fellows, Simon and Chelsea, were making what we hoped were lifelong friendships. There was no one else who understood the grueling mental training that I was going through this year, other than the two people who sat on either side of my desk. 

We were besties in the trenches and that meant we shared a lot more of our personal lives with each other than most people would with their colleagues. That is why they were almost as nervous as I was today - the day that I would finally be meeting my in-laws in-person. 

"Have you double checked your flight? Make sure you leave on time," Simon told me, his voice tense as if he was the one meeting his in-laws. He was a White man, married to an Egyptian-American woman. Let's just say that much of my family drama reverberated with him. 

Before I could reply, Chelsea added, "And did you go to that gourmet foods shop and get those special nuts that I told you about? I swear my dad's side of the family loves that stuff."

Chelsea identified as African-American, because her mother was from Nigeria. But her father was Indian-American, so she had some experience with desi families and their tastes. She had been adamant that the way to impress my in-laws was through their gustatory senses. 

"Yes, to both of your questions! I think I am all set now. My flight is on time, I have already checked-in online, and my suitcase is packed and in my car. I just have to make sure that I leave here at exactly 4 pm so I can get to the airport on time."

Chelsea looked at Simon and smiled at me. "We'll make sure you leave at 3:45."

"You guys are awesome..." I couldn't help beaming at them. 

Simon was going to cover the weekend, so I asked him to give me an update on one specific patient who was very sick with fevers and severe flu-like symptoms, but his flu test as well as other viral tests were negative. 

"Mr Toni, lives on a farm and hunts in the woods nearly every day. The list of possible infections he could have is like a mile long," he chuckled. It was true, when we ID docs heard the words farm, animal contact, wildlife or woods, our brains go into overdrive with all the possible uncommon infections a patient could have. 

"Ok, whoever gets the diagnosis right, gets treated to lunch by the others!" Chelsea piped up. "I bet its Tularemia - he hunts and eats rabbits. It makes sense that he would have a picked up a bacteria that infects that animal species."

"You're on," Simon replied enthusiastically. "But I think he has some tick-borne disease. He goes into woods every day without applying any insect repellant."

Not to be left behind, I chuckled and gave in to our friendly competition, "I'm in too, but you're both wrong. I think he has Q-fever from bacteria he might have caught while helping the cows on his farm give birth."

Obviously, we were treating him for everything on our differential. It would still be a few days before all of his test results came back. For now, we simply tried to keep the patient alive to the best of our intellectual capability.