The following story is a fantasy.
*****
The first time Mrs C. entered my office, I was struck by her beauty. She was the kind of beauty that no amount of illness can hide. Though she had lost weight and looked very pale, she had a very pleasant face. Now I don't go around rating my patients for beauty, but neither can I shut of my brain. When a beautiful woman enters my consultation room I take note... and continue doing my job professionally.
I listened to her story with rising astonishment. She told me she had stomach cramps for two years now, and that more recently she had been losing weight. Unfortunately she had found no understanding with her family doctor, who had told her it was irritable bowel syndrome and nothing could be done about it... Only after she had pressed him he had done some laboratory tests which had shown she was also anaemic. Her family doctors referral letter had mentioned none of this, just the anaemia. It was clear that first consultation she was highly frustrated with doctors, and was not expecting much from me, a medical specialist still in training. I listened to her story, did a physical examination and ordered some extra bloodwork.
When she came back a few weeks later I had some bad news for her. The bloodwork had quickly confirmed my suspicions, she had Celiac disease, better known as gluten allergy. Do not let crazy foodies and fitgirls fool you, actual celiac disease is very different from not eating gluten because the latest magazines tell you you shouldn't. The inflammation disrupts the function of the gut, explaining her weight loss and anaemia. The treatment is as simple as it is horrible. No gluten, not ever, no matter how good that roasted garlic bread smells, eat one slice of it and you are back to square one. All this I told her and to my great surprise she thanked me, glad that someone had finally figured out what was wrong with her. She said she wanted to hug me then, but I told her I liked to keep some professional distance, a handshake would suffice.
She remained my patient for several months, in which she had to undergo some further tests, while learning to cope with a glutenfree diet. She gained eight kilos of weight in that time and her anaemia recovered. The last time she entered my office, she looked a different person. I hadn't seen her for over a month, and when I called her in I was astonished by her beauty. Her face had lost its gaunt hue and now her full lips and high cheekbones stood out even more. Winter had turned to late spring, so instead of a turtleneck she was wearing a rather low cut blouse, showing off quite some cleavage.
I was running late that day, as I called her in the secretary waved at me that she was leaving, trusting me to lock the doors when I left.
