Free The Real Doctor Will See You Shortly by Matt McCarthy

for improv.
    â€œOkay, next on here is kidney disease.”
    He shook his head. “No one has ever mentioned that I have kidney disease.”
    That seemed impossible. If the previous physician had put it in the note, why wouldn’t he tell Sam about it? Or was there something about Sam I was missing—he wasn’t responding to me in the way I had seen patients respond to primary care doctors at Harvard. Perhaps I needed to switch tactics—to change gears entirely—but how? In time I’d learn to ask wide-ranging questions—
is that growth on your face new? Is your diarrhea frothy?
—but for now, sitting in front of Sam, I was stumped.
    A voice from outside the door announced, “Your two P.M. is here. One-thirty is still waiting.”
    My pulse quickened. “Okay, let’s hustle through these conditions.”
    â€œHustle away.”
    After twenty more minutes of stilted interrogation that produced little useful information, I stood up. Sam was clearly more confused now than when he’d arrived. “I’ll be right back. Just need to discuss your case with someone. I’ll be just—”
    â€œAren’t you going to examine me?”
    I looked down at the stethoscope that was resting comfortably on my desk. “Yes, of course.”
    The idea, undoubtedly, was that I would eventually find my way, stumbling upon a bedside manner through trial and error. But how long would that take? In orientation, the expectation of primary care clinic had been clearly laid out: residents would concoct a plan of action for each patient and the PIC would critique that plan, ensuring that the patient received quality care as we learned. I had supervision, but it was in another room, a room that at the moment seemed very far away. Every patient was trouble, the comatose ones who needed to be kept alive, the seeming healthy ones who might be dying, all of them my responsibility. Getting the adrenaline going was the only thing that momentarily relieved the pressure, but in the low-key setting of the clinic, my anxiety expanded to fill the room. And I suspected Sam could tell.
    â€œTake a deep breath,” I said, pressing my stethoscope against Sam’s back. “And again.” I took a few deep breaths, too, hoping it would calm my nerves.
    As I searched in vain to find Sam’s thyroid gland, which was supposed to feel like a bow tie, I missed Baio’s silent hand gently pointing me in the right direction.

10
    A few minutes later, as Sam waited, I walked down the hall to an office labeled PIC. Inside the room, a fifty-something man with a page-boy haircut was reading the latest issue of
The Journal of the American Medical Association.
    â€œHello,” I said softly, “I’m one of the new interns.”
    He put down the journal and looked up at me, beaming. “Welcome!” he said. “Please take a seat.” The PIC, whose name was Moranis, was wearing khakis and a blue Ralph Lauren button-down with a red tie, the unofficial uniform of an academic physician.
    â€œI want to apologize for running late. My first patient is a bit complicated.”
    Moranis shook his head. “Never begin any presentation with an apology. It’s your first day in primary care,” he said, quickly blinking his sea-green eyes, “and they’re all complicated.”
    I took out my notebook. “Where should I begin?”
    â€œYou tell me. I’m just here for guidance.”
    I gazed down at the sun-faded notebook—a tempest of composition—and felt unsteady. “Well, I made a problem list.”
    â€œGood way to start. What’s at the top of the list?” It was clear he’d been coaching young physicians for years, and I felt a bit more at ease. But that might’ve been just because I was no longer dealing face-to-face with a patient.
    â€œTop of the list is high blood pressure,” I said. “His blood pressure