Love Is Just a Four-Letter Word

Excerpted from
Bedside Manners: One Doctor's Reflections on the Oddly Intimate Encounters Between Patient and Healer
By David Watts, M.D.

The wards of the General Hospital were large barns, patients lined up along the walls like cows in their stalls. Flimsy off-white curtains on rings conferred semipermeable privacy. The gaps, the absent rings, made it all relative.

Then, of course, sounds and smells knew no boundaries, bed to bed, stall to stall. They who were there shared one common experience. I saw a black-and-white photo once of the "old clays." Old, old days at the General Hospital. There were no curtains then, but rather an all-pervasive light in the room and radiators lined up in the center aisle of the floor like involuntary radio transmitters in what must certainly have been a room overwhitened and overheated.

We rounded at eight o'clock. Every morning. Old patients got updates. New ones got complete clinical histories, presented by the intern on call during the previous night. I was the neophyte, the medical student who could not be expected to know much and whose blithered, half-opened eyes blinked from stall to stall, having already learned to expect the same old faces, old bodies, still there it seemed, past death.

That morning I saw in the distance, a distance usually approximating infinity between bed one and bed twelve, a young Latin woman whose drop-dead beauty was visible even from afar. Her presence made it difficult for me to concentrate on the updates of the old crones, wondering what disease she would have, and why such a spectacular jewel might be lying in our hospital.

Standing finally at the foot of her bed, the intern recited her history: third admission. All of them for gonorrhea septicemia.

I noticed the IV running. A piggyback infusion bag marked PCN dripped methodically.

Why septicemia? the resident asked.

She disseminates, the intern said. She spreads it everywhere in her body.

Why does she? asked the resident. The pelvis has a spectacular defense mechanism, evolved over centuries of survivalism. A girl just never knows what she'll come across in this world.

The resident paused for the expected sniggering, then went on, The pelvis protects against most anything.

Not pelvis, the intern said. Pharnyx.

It took a couple of beats to catch what was just said. Not pelvis.

I grew up in the South with its conservative behaviors, lived in a "Christian" family, and all that - the girls I knew wouldn't let me touch them, much less give me a blow job.

The intern went on. She has some kind of localized susceptibility to this organism. The lymphatic system of her throat is selectively deficient. It allows the gonococcal organism, and only that organism, to slip past and gain access to the bloodstream. She doesn't disseminate from any other source or with any other infection.

But why three times?

She's monogamous. Same boyfriend each infection. The boyfriend refuses to get treated.

I felt like I was caught up in a freewheeling fiction.

The intern continued. She has the Snow White syndrome, he said.

Part of the job of the intern is to one-up everybody with facts or diagnostic pearls that no one else knows. It's a little game that keeps everyone on his toes. We suspected he'd made this one up.

Only in this case the poison apple was the boyfriend.

The resident was unimpressed. Seasoned. Less inclined to be moved by romantic eponyms. Why does she stay with him? he asked.

Or why does she keep going down on him? said the intern.

In that moment we became acutely aware of her, as if the questions we asked turned us that way. Everyone knew she had heard our discussion. Others in nearby beds, if they were conscious, would also have heard. Privacy was difficult, but could have been created by more discretion in what we said. There was something more to this extravagance of information at her expense. To be sure, most of the patients didn't care or wouldn't remember five minutes later. But we all knew she was different. Maybe we were just crude. Maybe we hoped this unflinching frankness, bringing her story out into the objective light of a medical teaching exercise, might give her a new perspective.

I was busy being in shock. First to be spellbound by her beauty and then stunned by the knowledge, entirely new to me, that a beautiful woman, knowing the consequences, would give herself so completely. It gave me goose bumps.

Ask her, the intern said.

We did.

She said nothing. Just turned her head to the pillow.

The resident stared at her with hard, knowing eyes. Love is just a four-letter word, he said, and moved on.

All day I watched her out of the corner of my eye. Her willingness, her vulnerability, made her beauty all the more striking. It was too much to bear.

Truth is, I could fall for her in a moment. She was the kind of woman who "needed protection." Someone who would keep her from harm. But I was a student, white coat and all that. Professional. We were in different worlds.

I went to her bedside. I said, You could die from this, you know.

Her round eyes misted. But she said nothing.

He should get treated. My words had no impact. Or arrested, I added with unexpected gusto.