I told her what had happened and, in doing so, triggered another bout of panicky tears. Rhonda kindly, if impatiently, handed me a box of Kleenex. Then she proceeded to fish out from a filing cabinet no less than eight different questionnaires, each of which she now seems determined to methodically complete in its entirety.
“No. This is my first needle stick,” I answer, twisting the damp Kleenex around my fingers.
“Do you have any risk factors for HIV or hepatitis C?” Rhonda asks.
“No.”
“Have you ever been tested for either?”
“No.”
“Are you currently sexually active?”
“Nope.”
“When was the last time you were sexually active without barrier protection?”
“Um . . . never.”
“As in you’ve never had unprotected intercourse?”
“As in . . . I’ve never had intercourse.”
Rhonda pauses, her pen hovering above the paper.
“It’s cultural,” I add quickly. “I’m Indian. Premarital sex is frowned upon. Like, a lot. You’ve seen Bend It Like Beckham, right?”
“That’s . . . fine,” Rhonda says, scratching one raised eyebrow.
I sigh inwardly. Whatever, Rhonda.
She asks me for my medical history (None, except a mild case of asthma), list of allergies (None, except cats), and social history (Do I smoke? No. Drink? No. Do I use illicit drugs? Obviously not.). Then she asks me to put my arm on her desk, ties a tourniquet around my biceps, and draws four vials of blood.
As she tapes a wad of gauze over my skin, she says, “You’ll need to come in for another blood test in six weeks and again in three months.” She hands me a slip of paper. “And this is for the antiviral tablets. Pick them up at the pharmacy next door. You’ll take them three times a day for the next six weeks.”
I look at the prescription. “Lamivudine? A nucleoside reverse transcriptase inhibitor?” I say, aghast.
Rhonda stares at me. “That’s the protocol.”
“But the potential side effects of this are nausea, diarrhea, abdominal pain, headaches, pancreatitis, and liver failure.”
She regards me skeptically. “If you say so.”
“Isn’t there anything else I could take instead?” I plead. “I’m an intern. I can’t afford to have headaches and go into liver failure. I have patients to round on. I have a lot to do.”
“That’s the protocol.” She enunciates each word in a way that indicates that she has fulfilled the duties laid out in her job description and, therefore, our interaction must come to an immediate close.
I turn toward the door. “You don’t think didanosine or even efavirenz would be a better—”
Rhonda puts her phone to her ear. “Have a nice day, Doctor!”
* * *
* * *
I’m sitting at one of a cluster of long tables near a picture window. A curt little sign in a metal stand nearby reads: Reserved for PGH Doctors and Staff. It’s early, a half-moon still visible in the dawn sky, and the only other patron in the cafeteria dining room is an elderly man connected to an oxygen tank that he carries in a cloth duffel bag. He shuffles in my direction, notices the sign, then shuffles away. A plastic tray appears across the table from me, and a slender young man with round glasses says, “Hi. Stuart Ness, Harvard Med.” He begins to vigorously dissect a grapefruit.
“Yes, I remember. We met at orientation.” Where you introduced yourself as Stuart Ness from Harvard Med. Twice.
“Being on call is great!” he enthuses without prompting. “I admitted eleven patients, started fourteen IV lines, and still had time to watch a movie. I’m not even tired. I think I’ll go for a run when our shift is over.”
I wonder if it’s possible that I’m so fatigued I’m hallucinating this entire interaction with this gratingly peppy Harry Potter look-alike. “That’s dynamite,” I say.
“I’m so psyched to finally be here. I can’t wait to meet Dr. Portnoy. The man, the legend, am I right?”
“Yup.”
“And the Dr. V. Did you hear that we get to work with him? Like, actually round with him and everything?” His eyes gleam. “So awesome!”
“It’s pretty awesome.” I manage a thin smile.
“What was your name again?”
“Norah Kapadia.”
“Hey, any relation to Dr. Kapadia, the head of Pediatrics at UPenn? The one that came up with the Kapadia criteria for Kawasaki disease? I mean, I don’t know how common a last name of Kapadia is, but—”
I blow a puff of air through my pursed lips. I’ve lost track of how many times I’ve answered this question over the years, but it always comes from someone eager to show off that they’re well-versed in rare pediatric disorders. “That’s my father.”
“No way! Is he still practicing?”
“He passed away.” I tuck a strand of hair behind my ear.
Stuart shifts in his seat. “Oh, wow. I’m really sorry.”
I nod tersely and shrug. “It’s fine. It was a long time ago.”
“His paper on the diagnosis of Kawasaki is epic. It’s practically biblical.”
I smile at the compliment.
Having finished dismembering his grapefruit, Stuart starts in on an enormous bowl of oatmeal. “He must have been an amazing doctor.”
“That’s what I’ve heard.” And I’m sure he never spent a night on call crying in a supply closet. I stare at my plate and silently count exactly twenty-three little sugarcoated doughnut crumbs.
Stuart clears his throat. His tone is forcefully bright. “So, how was your night?”
“I got a needle stick.”
His eyes widen in a way so cartoonish I almost expect a honking sound to accompany his stunned facial expression. “Seriously? Yikes. Did the patient have any . . . you know . . . communicable diseases?”
“HIV.”
“Oh, boy. Well, the rate of HIV infection from a needle stick is like one in one hundred thousand. I wouldn’t even worry about it. Now, hep C, that’s the scary one. That’s more like one in forty.”
I jab my index finger at the crumbs. “He had hepatitis C, too.”
He takes this in. “Wow. You were that kid in elementary school that ran with scissors, right?”