Turn 65 of 226
Out of curiosity, go to the doctor a physical. I am perfectly healthy. My vitals, organs and bloodwork return as perfect. My resting heart rate is 35 bpm
The clinic is on Fourth Street, the kind of place that takes walk-ins and does not ask questions about insurance until after the visit. Lena walks in barefoot and naked and the receptionist does not say anything about either. The receptionist is a woman in her fifties who has seen everything and everything includes a seven-five woman carrying three hundred and eighty-five pounds of fat and muscle who fills the waiting room chair to its structural limit and then some. Lena sits in the chair and the chair creaks and she fills out the intake form with a pen that is small in her hand. Reason for visit: physical. The form does not have a field for what she is.
The nurse is professional and the professionalism is a mask that slips twice — once when she takes Lena's height and the measuring device on the wall does not extend high enough and she has to use a tape measure instead, and once when she takes the blood pressure cuff and realizes the standard cuff will not fit around Lena's arm and she has to find the thigh cuff. The blood pressure is one-ten over sixty-eight. The nurse looks at the number and looks at Lena and does not say what she is thinking. The heart rate reading makes her stop. She takes it again. She takes it a third time with a different device. 'Thirty-five,' she says, and the number is not a question.
The doctor is a man named Patel and Dr. Patel is thorough. He orders the full panel — bloodwork, metabolic panel, liver function, kidney function, lipid profile, thyroid panel, fasting glucose. He listens to her heart and his stethoscope moves across her chest in careful arcs and the arcs find nothing wrong. He palpates her abdomen and the abdomen is dense — the layer of fat over the abdominal wall and the muscle beneath it and the density is unusual but the unusual is not abnormal. He checks her reflexes and the reflexes are sharp. He checks her joints and the joints are stable. He looks in her ears and her throat and her eyes and everything he sees is correct.
The bloodwork comes back in three days. Lena walks back to the clinic and Dr. Patel sits across from her in his office and the office is small and the small is the office's problem. He has the results on his screen and he looks at them and he looks at Lena and the looking is confusion because the results do not match what he sees. 'Your liver function is perfect,' he says. 'Kidney function is perfect. Your metabolic panel is — there is nothing here that I would flag. Your fasting glucose is eighty-two. Your lipid panel is excellent. Your thyroid is normal.' He pauses. 'Your resting heart rate is thirty-five beats per minute. That is the resting heart rate of an elite endurance athlete. Your blood pressure is textbook.' He sets down the printout. 'I am looking at someone who appears to be in — there is no other word for it — perfect health.'
The confusion is in the space between what he sees and what the numbers say. What he sees is a woman who has not bathed in weeks, whose teeth are yellow, whose body hair is full, whose skin is weathered and tanned and calloused, who weighs three hundred and eighty-five pounds, who is naked and barefoot in his office. What the numbers say is that nothing is wrong. Nothing is deteriorating. Nothing is failing. The body is not breaking down under its own weight or its own neglect. The body is thriving. Dr. Patel does not say the word 'impossible.' He says: 'I cannot explain the disconnect between your presentation and your labs. I would recommend follow-up in six months.' He does not say what he is thinking, which is that the follow-up will show the same thing because the same thing is what the body does now. Lena takes the printout and walks home and the walk is thirty-two blocks and the walking is nothing and the body is warm and the warmth says yes and the printout is data and the data says the wish knows what it is doing better than any doctor.