"I know it's hard to give up the sweets, Mr. Pyle. I've had your wife's cherry crumble, and it is to die for... but not
literally
. So, let's try and keep it to just one small treat a day, okay? And you already know what I'm going to say about vegetables and whole grains, don't you?"
"Yes, doctor," he nodded with the lack of enthusiasm that comes from having heard it all before.
"And if I was a middle-aged White man, you might actually listen to me," I thought silently to myself. Out loud I added "Remember to keep that leg up as much as you can and change the dressing every twelve hours. I'll see you again in a couple of weeks."
"Thank you doctor, I will," he replied, but he avoided looking me in the eye when he said it.
"It's nice to see you again, Mrs. Pyle. Keep an eye on this troublemaker for me." I joked to his wife as I held open the door between the exam room and the empty waiting room.
"Oh, don't you worry, Doctor Sarkar," she said with a smile that didn't quite reach her eyes, "I will."
She won't though.
For all their good intentions, the Pyles just can't bring themselves to change the bad habits of a lifetime. Not on my say-so anyway. Her diabetes is almost as advanced as his, but the only thing that brought them into the clinic today was the weeping ulcer that had developed on his foot. And that's only because he let it get so bad that he couldn't hide it from her any more.
He's going to lose that foot by the end of the year. I hope I'm not the one who has to do it, but I probably will be. I'm the only doctor in a good two-hundred mile radius of this town, and I just know he's going to wait until the very last minute.
"Why did I ever take this job?" I asked myself again, like I do every time I fail to get through to a patient.
Because by the time I finished my residency, my student loans were overwhelming. Because I was going to be in debt for decades. Because I jumped at the opportunity when the state's recruiter offered to pay off my loans in full. All it took was a five-year commitment to work in an underserved, rural county tucked away in the heart of nowhere.
I knew it would be a big adjustment from my life back east. My now-ex fiancé tried to talk me out of it. He tried very hard, and when I refused to listen, he refused to follow me because there's no work for him out here.
That was a little over ten months ago. It's hard to blame him now. In hindsight, we both refused to give up our own dreams for the other person. Unfortunately, we both said some things that neither of us can take back. So that's over.
"Are we clear for lunch, Sandy?" I asked the nurse receptionist behind the desk when the front door had closed behind the Pyles.
"We're clear, Pasha. Next appointment's not until one," she confirmed.
Other than a few sheriff's deputies with paramedic training, Sandy and I are the only health care in the county, so our appointment calendar is typically full. Sandy always blacks out time in the middle of the day though. It gives us a chance to clear any early back-ups, or to have a break if the morning runs smoothly.
I went back to my desk and typed up a few quick, depressing notes on Mr. Pyle's left foot.
After that, I slipped off my cute kitten-heel pumps under the desk, closed my eyes, took a deep breath, and tried to compartmentalize my worry and frustration. There would be more patients to see, and I couldn't let the emotional toll show. I only wished I had some outlet for it, but there were precious few opportunities around here.
Originally I harbored Hallmark-movie dreams of the perfect small town with quaint, seasonal festivals and quirky little shops and cafés. I imagined the perfect meet-cute with a ruggedly handsome new guy who would sweep me off my feet. In those movies, the small towns are always vibrant and full of active, diverse, and interesting young people with rich social lives.
Then I got here and found the "town" is only a few dozen loosely clustered buildings along a two lane stretch of highway. The asphalt is cracked and patched, none of the street lights work, and half the buildings are either boarded up or falling down. The natural resources that brought people here for a century were used up decades ago. All that's left is a county full of played-out mines, clear-cut timber, and fallow farmland.
I have to drive forty minutes to the nearest grocery and feed store. It has an automotive aisle that is usually better stocked than its fresh produce section. It's really no wonder that the Pyles can't improve their diet.
With the paperwork and my reverie out of the way, I slipped my shoes back on and took my phone to the big, back room of our repurposed storefront clinic that serves as a store room, break room, and meeting room all in one.
"What have I got today?" I wondered aloud as I opened the refrigerator door. Inside I found my homemade
dal palak
with basmati rice, just as I knew I would. Thank god for Amazon. Sandy had already started in on the plate of cold fried chicken and potato salad she had brought from home, along with a package of Oreos and a bottle of Diet Pepsi.
"What was that?" she asked, looking back from our lunch-slash-conference table.
"Oh, nothing. Just talking to myself."
"What have you got today?" she asked, as she did every day, when I took my steaming lunch from the microwave.
"It's um, lentil and spinach soup with rice. Would you like to try some?"
"Oh, no. I'm sure it's much too spicy for me," she declined. "Smells good, though."
I always offer, but she's never adventurous enough to take me up on it.
Sandy has become my unlikely best friend out here. She's been married for over thirty years and has four kids who have all grown up and moved away. We don't have much in common besides work, but that's more than I have with anyone else. She invited me to her church the day I arrived. I was raised Hindu, so I declined. But she persisted.
After a few weeks, I finally realized that church is really the only form of social interaction around here, other than high school sports, and so I took her up on it. The high school is over an hour away. At least going to church gets me out of the house on Sundays and Wednesdays.
"Be careful not to drip any on your pretty blouse," Sandy added when I draped my lab coat over the back of my chair and tucked my skirt under my legs as I sat down.
Back when I was a little girl growing up in central New Jersey, my mother used to brush my hair and dress me in saris and tell me that we're only as pretty as we feel. Back then, I didn't want to feel pretty, I wanted to feel smart. I wanted to win the spelling bee and get straight A's and be valedictorian in a high school with a graduating class larger than the population of this whole town.
I don't feel so smart any more. I feel naive. I feel like I got suckered by the recruiter. I feel trapped, a stranger in a strange land, with no one I can really relate to or lean on. Now, feeling pretty is about all I have left, for all the good it does me.
