May 27, 2004
Gunkectomy

Dr. Stillwell doesn't remember me.

"This is the first time I'm seeing you, correct?" he asks, breezing into the examination room where I've been waiting for the past twenty minutes. He looks at his clipboard, then peers at me over the top of his glasses.  "Mrs.  ...  er  ...   Rafter?"

"Actually," I reply, "this is the second time you've seen me.  And you can call me Secra."

He squints at the clipboard again.  "Really?" he asks, frowning a little. "I've seen you before?  I don't remember."  He rifles quickly through my printed medical history, looking for some documentation of that first appointment. 

"It was sometime in the spring of '03, I think," I tell him.  "We discussed the bone growth on my foot." You looked at my bunion for 2.2 seconds, announced that you've 'seen worse,' and told me all I needed to do was wear more comfortable shoes.  

"You were wearing cowboy boots that day," I add.

[At this, we both look at his feet.  The cowboy boots are gone: today he is wearing a pair of shiny black patent leather loafers, accented with fake gold coins. I had a pair exactly like them in fifth grade.]

"Well," he laughs. "That sounds about right."  And he plops down in a chair next to the examination table, still combing through the stack of papers affixed to the clipboard.  A moment later he manages to locate that first appointment, recorded somewhere on my chart  --  "It was February '03, actually," he says  -- and with that, the mystery is solved.   But it's OK.  I honestly didn't expect him to remember me after  one brief appointment, more than a year ago.  Yes, he's my assigned primary care physician  ...  but he must see a bazillion and a half patients a week, here at the Kaiser Permanente Drive-Thru.  [Plus I had an entirely different group of physicians for The Big Lumpy Thing In My Breast:  Dr. Stillwell wasn't involved at all in that bit of medical drama.]  I don't care whether he remembers me or not, anyway.  I'm just thrilled to pieces that I managed to get an appointment with a living, breathing medical professional the very same day I called the advice nurse.  I'm glad that he wasn't stuck on the eighteenth hole, or called in to perform emergency surgery, or on his way to France for a second honeymoon.  Ordinarily the scheduling wheels at Kaiser move much more slowly than this.  [See: my next annual pap smear, scheduled for 11/7/08.]

"So what seems to be the problem today?" he asks.

I explain to him that my ears have been "congested" for several weeks now  --  "It's like walking around under water," I say, "except that all the water is INSIDE my head"   -- and that lately the condition seems to be getting worse instead of better.  The past two nights in a row I've woken up at 1 a.m. in searing pain.  Tylenol, heating pads, decongestants, whimpering pathetically into a lumpy pillow  ...  nothing seems to help.  "I'm not sleeping at all this week, and I can't hear a thing," I tell him.  "It's starting to really screw me up at work." 

He nods sympathetically. "I can imagine," he says. "Not being able to hear is probably a real problem when you're a  ...  a  ... "  He glances helplessly at the clipboard.

"Administrative assistant," I reply.

He snaps into a fresh pair of rubber gloves and digs around in my ears for a couple of minutes, using a variety of shiny metal gadgets   --  first the right ear, then the left  --  poking, scraping, prodding, examining, murmuring to himself.   "Well," he says finally. "You've certainly got a lot of gunk in there."  [I cringe inwardly at this.  'Gunk' sounds so ...  so  ...  inelegant.   So nasty.  Couldn't he have referred to it as 'ear debris,'  maybe?  Or 'wax deposits'?  Or 'dainty little Secra molecules'?  Anything would be an improvement over 'gunk.']  He hands me a small metal pan, filled with water, and instructs me to hold it just beneath my right ear. Then he picks up what looks like the world's most expensive [and sinister] water pic. "Let's see if we can blast some of that gunk out of there," he says with a determined grimace.  And he plunges the water pic deep into my ear canal and flips the switch.

Four minutes later  ...  I can hear again.  Hallelujah.

When the procedure is over  --  when both ears have been blasted clean of all offending gunkage, and water is dribbling freely out of my ears and down the front of my blouse  --  Dr. Stillwell goes back and inspects the interior of my right ear with his special ear-inspecting-doohickey, just to make sure he made a clean sweep of things.   "Hey,"  he says suddenly.  "There seems to be a little otitis media here."  He sounds surprised  ...  as though he expected this to be a routine gunkectomy, without any unexpected complications.  He comes around and looks at the left ear, and again he seems surprised.  "You've got infection on both sides," he says. "A pretty nasty infection, actually."  He picks the metal pan up and pokes a gloved finger at the pieces of gunk, still floating in the water. "See?" he says, holding the pan under my nose and pointing out one particularly large chunk of gunk. "This isn't ordinary ear wax," he says.   I nod politely.  Truth be told, I don't actually want to be looking at a panful of ear gunk right now.

Dr. Stillwell, on the other hand, seems positively entranced by the little gunk particles.

"I guess this explains the pain?" I venture.   The maddening itch?  The redness?   The pink crusty stuff on my pillow this morning?  An ordinary build-up of ear gunk wouldn't have me weeping in the middle of the night like a teething infant, would it?  No, he says, it probably wouldn't.  "This is more like swimmer's ear," he says. "You haven't been swimming in contaminated water lately, have you?" I assure him that I haven't been swimming in any sort of water  ...  contaminated or otherwise.  I haven't been sick. I haven't had trouble with hay fever or allergies.  I gave up cleaning my ears with a rusty paper clip ages ago.  I have no idea how my ears could have gotten infected. 

Neither, apparently, does my doctor.

"Well," he says with a shrug, "sometimes things like this just happen."  He scribbles me a handful of prescriptions  -- ear drops, amoxicillin, Sudafed, a mild painkiller   --  and he gives me some basic instructions for the next few days. [Drops three times a day.  Antibiotics, same.  Tylenol if I need it, the prescription pain meds if something stronger is required.  No Q-Tips.  No paper clips.  No screwdrivers or knitting needles or shish kebob skewers: nothing smaller than my elbow, in fact, is to enter my ear canal for the next little while.]   I stand up and automatically reach out to shake his hand, but at the last second I realize that he's still wearing rubber gloves.  So I give him a smile, instead.

" Thanks very much, Doctor," I say.  "I appreciate your help."

"No problem," he replies. "Take care, Mrs.  ... er ... "

"Rafter," I say, sparing him another glance at the cheat sheet.  I don't care if my doctor doesn't remember my name from fifteen months ago  ...  or from fifteen minutes ago.  All I care about is that for the first time in eighteen days, my ears don't feel like they're filled with fresh wet concrete  ...  and  I can  HEAR again.  The rest of it is just background noise. 

And with that, I grab my purse and my prescription, and I head for the door.

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