March 18, 2019
Syracuse, New York
I sat down at the computer to slog through the emails that had been piling up, but was distracted by the chilblain on my middle finger. It was one of many chilblains that had appeared in recent months. My rheumatologist was concerned; they were supposed to be controlled by the antimalarial I take for autoimmune issues. But I’d refused to start another drug, an off-label blood pressure med that maybe would help. My doctor clearly thought I was being silly. I was going back today.
I actually arrived to my appointment five minutes early despite having to brush snow off my car before leaving. The wind still felt bitter, but the sky was bright and blue. After arriving, I checked in with one of the less gruff receptionists. Her glitter nail polish was half-chipped off. After confirming my address, providing my insurance card, and paying my copay, I sat down in the main waiting room. When I first sat down, there was a show about sword-fighting in Toledo, Spain on TV and, judging from the closed captions, it had something to do with the Knights Templar. Before long, it switched to health programming – how to get your kids to exercise, how to tell the difference between glaucoma and cataracts. For whatever reason, the volume for this programming, unlike the sword show, was switched on.
The nurse called me back and we went through the normal openers – getting weighed, checking blood pressure, confirming the drugs I take and that I still don’t smoke. My nurse is always friendly and chatty. She has an 8-year-old, too, and we commiserated about the indignity of having to use a pill organizer, something that definitely ought not to be for moms with 8-year-olds.
When she left the room, I stared at the digital picture frame that rotates through a series of PSAs about diseases treated by rheumatologists. These digital posters always fill me with dread, and maybe because of that, I fixate on them. For the first time in years, the one I hated the most was out of rotation – it was about sjogren’s syndrome and featured a cartoonish image of a head fully hinged open at the mouth, which someone apparently thought depicted the terrible dry mouth the condition can create. Instead, slide after slide reminded me about the benefits of exercise for basically all conditions – fibromyalgia, lupus, arthritis, something called ankylosing spondylitis. There were two slides each with five facts about gout. Many slides, including one of the gout ones, featured a red bull’s eye where those with the condition are likely to feel pain.
In another slide, I was reminded that 90 percent of lupus patients are women. I had not forgotten. I looked resentfully at the clip-arty woman’s face with the badly colored in “characteristic butterfly rash.” The other slide about lupus suggested ways to prevent a flare, but oddly showed a man with a boy on his shoulders standing in a sunny field. I wondered why they chose a man given the previously noted statistics, and also why he was in a sunny field with no shade in sight given that sun exposure seems like the only documented factor science says is associated with flares.
My appointment was pleasant. I didn’t get chastised for refusing the medicine that might help prevent the chilblains. I was relieved. After that part of the appointment, I checked out at the front desk, and headed to “the blue chairs,” which is how they refer to the phlebotomy waiting area. When I sat down, there were six older women ahead of me. One asked me about my shearling-lined boots, which I bought after refusing the new meds the last time. The nurse practitioner had said that since I wasn’t going to take the meds I at least needed to invest in better shoes. Who can argue with a prescription for expensive shoes? Anyway, we chatted about feet and the importance of good shoes as we waited. The other women all listened and nodded. A new woman arrived to the area, sparking a conversation about the chairs themselves. At several different points during my wait, people checked in to determine or confirm the order in which people arrived to the blue chairs, making sure no one will get skipped over when the phlebotomist barks, “Next!”
When it was my turn, I was excited to see what “National Days” were marked on the whiteboard for today. It’s the thing I most look forward to about going to phlebotomy. It turned out today was Juvenile Arthritis Awareness Day, Awkward Moment Day, and Sloppy Joe Day. I was amused. I said to the man preparing to draw my blood, “Isn’t it great that it’s National Awkward Moment Day?!” He gave a half-hearted, awkward chuckle and said nothing else to me. Just to make the experience more awkward, he screwed up the first attempt at drawing my blood and had to throw away the needle and start again. As he was jiggling the first needle and mashing on my vein, the shoe woman from the blue chairs was leaving. She told me to enjoy the sunshine. I was trying really hard not to pass out, but I think I managed a smile.
After my rheumatology appointments, I always go to the carwash. In the carwash line, some old guy in a Buick SUV failed to respect the proper order of the line, cutting in front of the car who should have gone next. It’s not particularly unusual carwash behavior, but after the carefully observed phlebotomy line etiquette, his fronting filled me with rage. It was short-lived, though. Something about the tunnel of colored lights with the falling bubbles that envelop the car creates the feeling of a psychedelic cleansing ritual – as though I am being cleansed along with the car. I decided to go ahead and have the interior done while I was there. As I was moving some stuff into the trunk, I realized that there were a million of those clown-style balloons back there from some kid party that had not happened recently. I wondered what the car behind me thought of the great balloon purge. No one made small talk in the carwash waiting room. We all just looked at our phones.
I went home after the carwash and heated up some lunch. I worked until my husband and daughter came home. Then I began the Monday night mad rush of getting dinner on the table so we would have enough time to eat and get my daughter to her music lesson on time. When we sat down to dinner, I told them about all the National Days we could be observing today. My daughter said matter-of-factly that she already knew it was National Sloppy Joe Day. Incredulous, I asked her how she could have possibly known that it was National Sloppy Joe Day. She said that it was because sloppy joes were her best friend’s favorite.