White Coat Syndrome

 I get off the bus and walk down the hill toward the hospital entrance. The last time I did this it was six months ago, and the days were cold and short. It’s only midmorning and it’s already uncomfortably warm out. An enormous woman in a mobility device is blocking the front doors. A woman with a walker asks if she can move a bit so she can get in. “I ain’t movin’ for nobody!” the woman bellows. The other woman squeezes behind her and I do the same. 

The x-ray machine and metal detector are wrapped in caution tape. A volunteer is stationed by the counter, directing people to the line. Clusters of guys in tactical gear stand here and there. I check in with a woman I don’t recognize and she directs me to the Tower Elevator. To get there I walk down a hallway lined with brightly colored paintings of various Portland landmarks, passing a café with a sign that says it’s closed until further notice. 

After a few wrong turns I find myself in the Endocrinology East/Weight Loss Clinic. I know that many type 2 diabetics struggle with their weight but it still feels weird that they combine the two.. 

I check in and give the guy my new insurance card. Our rates jumped so high that the museum changed providers. I’m a little nervous because this is the first time I’ve used the new card, but it all goes fine and my copay turns out to be the same as before.

I take a seat and look around. The room is long and narrow, and everything is tan. One wall is covered with a wallpaper photo of Crown Point Vista in autumn. Next to an empty glass case stands a tropical plant with leaves like outspread hands. An open door reveals a closet filled with brightly colored blouses marked XL, 2X, 3X, 4X, and finally 5X. There are three other people waiting and none of them look like they’re here to lose weight. An older, deeply tanned woman cackles at a video on her phone, then looks deeply serious, then cackles again. I feel like I’m in a David Lynch movie.

I only have to sit for a few minutes before they call my name. On the other side of the door is an astonishingly long corridor lined with identical doors. The aide leads me to a tiny examination room and takes my blood pressure and pulls some blood to check my glucose levels. My blood pressure is high and I tell her it’s probably because I’m so nervous. “Probably white coat syndrome,” she says, and I’m reminded of the first time I heard that term, down in wound care. I know it’s referring to doctors in general but I can’t help but think of people saying “The men in white coats will come for you,” meaning of course that you’re being taken to a mental hospital. 

She leaves and another woman arrives immediately. I’m not used to being helped so quickly. Her name is Barbara and I feel immediately at ease with her. She asks me if I’m here for a specific issue and I tell her that I really just need help managing things and that I’m also struggling with chronic foot ulcers that open up the moment they’ve healed. When Dr. Taggert released me, I developed a blister a week later, and despite my babying it, it soon blossomed into a full-blown ulcer. I couldn’t bear to go back to the clinic, and for the past six months I’ve been struggling to get up the nerve to call them. In the meantime I pretended everything was fine, even though I was constantly gnawed on by fear. 

She downloads the information from my glucose reader and talks to me about the results and some options for bringing my sugars down. She asks if I would be interested in an insulin pump and I say yes but that all my past doctors had been reluctant to help me get one. She says she will connect me to their nutrition education who will talk to me about the options for getting a pump, as well as go over some dietary suggestions with me. Barbara asks me a lot of questions and then she leaves and returns a minute later with Dr. Jackson. 

He pretty much repeats all the points Barbara made, and tells me I should make an appointment with wound care. I thank him and leave. Wound Care is only two floors down and right around the corner, but it's not accessible from here, so I have to go all the way down to the first floor and weave my way through the complex, past the shuttered café, past the irritatingly cheery paintings, past the people mover, its driver looking like he’s falling asleep, past groups of security guards hurrying to respond to a Code Gray, until I find the Green Elevators. 

I realize my heart is pounding as I get off on the fourth floor. There is now a key pad on the door to the Wound Care department, with a  sign that reads, “Press the blue button to enter.” I press the blue button and the door swings open. Everyone turns to look to see who’s there.

“Holy crap,” says Gladys. “Did you stop by to say hi?”

“I wish. I need to make an appointment,” I say, flooded with shame. 

“Sure thing, Bella is… I don’t know where Bella is. She’ll be back. What’s going on?”

“I missed you all so much I gave myself another ulcer. How are you?”

“Big life changes,” she says. “Dumped the boy Looking for a new place to live..” She looks tired, and older than 26. 

The glass has been taken down from the front counter. An Oscar figurine is standing beside the bell. Standing next to Gladys is… oh god, what’s her name?  I can’t think of it. Shelley is also back there with a woman I’ve never seen before. She glances at me and turns away, flipping her ponytail contemptuously.

“Well well well, look what the cat dragged in!” CK jumps out from around the corner, holds up her hand for a high five. “Come on, don’t leave me hanging.”

“Aren’t you supposed to be on strike?” I say, overcoming my legendary dislike of high-fives to pat her little palm.

“Please, not again,” she says, pulling down her mask. I ask how Cathy is. 

“I accidentally locked her outside overnight the other night. I had too much wine. I feel so terrible. I’m such a bad mother.”

“But hey, at least you won an Oscar?” I say, pointing. 

“One of our patients brought that in yesterday,” she said. “He left it blank so we can put our names on it. Mine will be biggest, of course.”

Dr. Thompson appears. “Well hello there!” she says. “How are you doing?”

“Really good!” I say. “I mean, except for the foot.” She stares at me. 

“Your eyes look good at least,” she says at last. I forgot that the last time I saw her, I hadn’t had my second cataract operation yet. That feels like years ago. “Well, talk to Bella, we’ll fit you in no problem. Where is Bella?” Gladys shrugs. 

“I’m here,” says Bella. Gladys introduces us and I say we met already, while they were on strike. Bella pulls up the schedule and says they can see me Monday, but I tell her I need a few weeks to give notice at work. She fits me in a few weeks from now and Dr. Thompson says she’ll see me then. I say I hope so, and I do; I don’t feel up to dealing with the well-intentioned screeching of Dr. Taggert. 

I want to stay and catch up with everyone. I miss them all so much, miss people lavishing care on me, miss the banter. I feel so changed, though I’m not sure how exactly, or why. The past six months have been fairly uneventful, aside from our precious democracy’s rapid transformation into a fascist oligarchy. But I feel like a different person than the one who walked out of here six months ago. I feel like I’m an actor playing that role, a drunken hack, moving woodenly and flubbing my lines. Most days I feel like I’m unraveling, breaking apart piece by piece, waiting for the men in the white coats to come sweep up the crumbs. 

I head back down the elevator and leave by the side entrance, which still has not been closed up like they keep threatening. I cross the parking lot where the baby goats were, where my friends used to pick me up and drop me off for my hyperbaric treatments, and cross the street, where a guy with a leaf blower blasts a cloud of dust into my face and tells me to look where I’m going, though to be honest I really don’t want to.