Allison cocked her left eyebrow and fixed Scruggs with her stare.
“Just kidding,” he said quickly.
Allison considered giving him a lecture on sexism before concluding it would be wasted on a patient who’d begun by asking if he’d get to see a “real” doctor—presumably male. She raised the shirt over Scruggs’s chest and gently lifted the ring piercing his left nipple. Scruggs yelped. She probed the inflamed, scabbed skin. Reddening. Ulceration. Necrosis of the dermis. “You might have come in when it first got infected,” she admonished. “Take it out.”
Scruggs maneuvered the ring from his nipple. Pus and blood oozed from the puncture holes. Allison spread a paper towel on a box on a counter next to the examination table. Scruggs placed the ring on it.
Allison cleaned the wound and examined the inflamed area with a magnifying glass. She judged it to be eight centimeters, about twice the size of a fifty-cent piece.
On any given day, her clinic—a yellow converted Victorian home three blocks from the river—saw a catalogue of the ills that had befallen mankind within a twenty-mile radius of Winston, West Virginia. Snake bites, cut feet, broken arms and ear infections, assorted injuries to workers at the plant, predictable diseases of the aged and dying. When someone in the area needed medical attention, they showed up at the Winston Medical Clinic. Allison enjoyed the variety. Every day was a new problem, a new challenge. And despite having to deal with occasional boors like Ricky Scruggs, every day provided a chance to help people who were hurting and who appreciated her help. It made her feel competent, useful—needed.
“How long have you had this piercing?”
“Couple days.”
“You did it yourself?”
“Wasn’t hard.”
Allison cleaned and dressed the wound, scribbled a prescription for flucloxacillin and gave Scruggs half a dozen small tubes of mupirocin, the generic form of Bactroban.
“Take the pills twice a day and use the ointment until the samples are gone. If it doesn’t clear up in a week, call me.” She decided what she’d write in the case notes in the patient file. Infection—surely caused by a do-it-yourself job with an unsanitary instrument.
Scruggs pulled on his shirt. “What about the ring?” he asked.
“Leave the ring out while you heal. The hole will close but if you feel you must, the piercing can be redone. This time, use a licensed professional.”
Scruggs put the nipple ring in his pocket and left without a thank you.
Allison sighed. If Scruggs was like a frustrating number of patients, particularly males, he would ignore her orders. The nipple ring would be reinserted as soon as the infection abated.
Her last appointment of the day was with Katie Gibbs.
“My God!” she exclaimed when Katie walked into the examination room. “You’ve become a clone of your mother!” Allison forgave herself for the reaction. It really was like looking at a ghost.
With the exception of what Allison called her “lost years,” Sharon Gibbs had been Allison’s closest friend from grade school until her death, sharing secrets, ambitions and causes. Winston had no Race for the Cure until Allison and Sharon started one. The irony was lost on neither of them when Sharon developed breast cancer. When the end was near, Allison had been there to provide palliative care—and afterwards worked with Josh to create a hospice county program in Sharon’s honor.
“Hi, Allie.” Katie blushed.
Allison couldn’t believe how quickly the girl had grown—at least eight inches in the last year. She was definitely at the awkward stage—still a child in many ways but quickly becoming a woman, as evidenced by the baby fat turning to curves.
“What’s happenin’ with the Kate-ster?” Allison gave her a fist bump.
“My left leg hurts. Dad wanted me to get it checked out.” She took a folded piece of paper from her pocket. “Also, I need you to sign this health permission form for soccer camp.”
Allison took the form. “Camp Kanawha. I met my first boyfriend there because I had the perfect strategy for Sadie Hawkins Day.”
“I know. Run fast.” They laughed.
Allison measured Katie’s height and weight. “All good,” she pronounced. Katie sat on the examination table. Allison pulled a stool close.
Allison understood the principal diagnostic tool for any primary care physician wasn’t a lab test or a machine but asking the right questions in such a way as to produce useful, honest answers. So as she examined Katie’s eyes, nose, ears and throat, Allison pumped the teenager for information.
“How’d the soccer team do?”
“Decent. Fourteen and four.”
“School’s good?”
“It’s nice being the highest grade in middle school. I can’t believe how young the fifth graders are.”
“Already on the way to being old and gray,” Allison chuckled. “Like me.”
“No way! You’re a cougar. Half the boys in my class have a crush on you.”
“Cougar, huh?” Allison smiled.
“Definitely.”
“How are the grades?”
“All A’s.”
“How’s your dad?”
“Okay, I guess. He misses Mom a lot.”
“How about you?”
“I miss her. Lots of times I wish I could talk to her. I talk to Dad but it’s not the same and it’s awkward with some stuff.”
“Like boys?”
“Yeah and other, you know, girl things. Sometimes boys can be so dorky.”
Alison laughed. “You have a boyfriend?” It wasn’t a social question. Having a boyfriend meant a whole array of potential health issues a physician needed to watch out for, from pregnancy to abuse.
Katie eyed her seriously. Allison saw in the girl a wariness—and weariness—beyond her years, a wisdom born of sorrow. Losing a parent at such a formative age, she knew, did things to a kid. Death was the great betrayer. Childhood’s end. Trust always became an issue.
Allison wanted to enfold this girl, this lovely daughter of her deceased friend, in her arms and shield her from life’s many hurts and assure her that everything would be okay. But that in itself would be a betrayal of sorts and a lie. No one could protect anyone else from anything. Allison was positive of that. In the end, she knew, each of us runs life’s gauntlet alone.
“This is just between us girls,” Allison added quickly.
“I have friends that are boys.”
Allison smiled. Despite the coy answer, she was getting more from Katie than she did from most teens, especially boys who generally responded to her inquiries with grunts. She plunged ahead.
“Has your father had the ‘birds and bees’ talk with you yet?”
“No. He tried but . . .” She crossed her arms over her chest and said, “Anyway, we learned that in school.” Allison knew she had pushed things about as far as she could. But there was one more question she needed to ask.
“What about sex . . . ?”
Katie flushed tomato red. “What? Me? Of course not!”
“I’m glad to hear that. That’s a good decision for your health and for many other reasons. But if you are ever considering it, you