Gillian Shirreffs

The appointment

Laura’s name was called at nine forty. 

People often had difficulty with it. Her surname had a surprising number of double consonants and the vowels often seemed, to strangers, to be in the wrong order. The nurse therefore did what those in authority had been doing consistently for almost five decades, he rearranged the letters into an order he deemed more sensible and bellowed his version of it across the waiting room.

Laura stood regardless. She was quite sure none of the assembled actually had the butchered alternate of her name. 

No one else moved anything but their eyes.  

She imagined their thoughts as she walked, deliberately, to the door that led to the corridor that led to the next waiting room. The anteroom for her particular clinic. Neurology. 

It was normal to watch without looking in a place like this. Seasoned occupants were accomplished in the art of reading their companions whilst carefully avoiding eye contact. A young woman in the front row had yet to perfect the skill. Laura acknowledged her with a smile and silently wished the redhead a chair in a clinic that treated matters of minor inconvenience, if such a one existed. She hoped it might.

Her thoughts returned to the task at hand. This time she would ask Dr Kelsey straight out and she would do it before the usual dance: the testing of reflexes; the walking up and down; heel toe, heel toe; the request to follow the point of a pen with her eyes; the answering of questions about symptoms and how they had changed since her last appointment.

A year earlier when Laura had skirted the subject, Dr Kelsey removed a chart from the top drawer of her desk. She smoothed it onto the space between them. Its title, to the best of Laura’s memory, which had a talent for treachery, was Disease Progression in Multiple Sclerosis. 

Dr Kelsey began with the bottom axis. Age. Her finger skimmed over the space indicating Laura’s twenties, her thirties; it slowed over Laura’s forties and stopped just shy of the number fifty. It was clear from the trajectory of the line that cut its way through the middle of the graph that aging was not to be encouraged. Dr Kelsey had nodded to indicate the appointment was at an end. 

Conduct such as this might suggest a lack of care on Dr Kelsey’s part. Her behaviour was, in fact, an attempt at kindness. Laura was quite sure of this. And the avoidance of a difficult conversation, the breaking of bad news­, was, after all, a wholly human inclination.

What did the label matter anyway?

Relapsing Remitting.

Secondary Progressive.

The bucket into which one now fell.

Laura asked herself these questions as she began to study a new collection of patients; the graph had been brought to life in front of her eyes, with one exception. A young man whose disease progression far outstripped his years. Laura reminded herself that he might well have a different neurological condition. Although something about him told Laura he did not. Twenty-six years in, she felt she had something of a knack for these things.

Her eyes fixed on the decaying stack of lifestyle magazines that had been on the melamine topped table in the corner for as long as she could remember. People rarely took advantage of them. This was a place for thoughts, Laura thought. On the odd occasion a patient would bring a loved one through to the anteroom, the interloper invariably attempted inane, whispered conversation and then, when it was poorly received, would stalk over to the corner, reach for the top copy of the pile, return to the seat next to their person and affect the look of someone absorbed in the act of reading.

At ten past ten the nurse rolled Laura’s surname uneasily in his mouth once more. Less certain, this time. Laura ascribed his lack of confidence to the more intimate space. 

She did not expect to find a second person in Dr Kelsey’s room. The young man cluttered up the place. 

Dr Kelsey stood up. She explained she had the beginnings of carpal tunnel and that Ben, the student doctor currently assigned to her, had agreed to scribe. Laura was then invited to sit on the treatment table for the neurological examination: the tapping and pricking of limbs. 

Ben’s presence had thrown Laura. She realised this as she walked heel, toe, heel, toe. 

This was a move she normally did well. Thankfully, today was no exception. Regular Pilates had helped her balance. Laura always felt these tests were pass/fail and she was anxious to excel. The lesions in her brain and spine did not always allow this. Regardless, when she thought of them, her lesions, it was as mischievous rather than malevolent. She sometimes joked about them chomping on her grey matter, but she would feel strangely disloyal even as she did. 

Dr Kelsey was asking her about cognitive deficit when Laura remembered the question, but it would have been rude to interrupt. She would ask at the end. 

Ben tap, tapped away on a laptop that sat on a fat stand with wheels. Laura thought of R2D2. Or was it C3PO? She settled on R2D2.

And the dysphagia? Dr Kelsey was asking.

My swallowing. Laura said, not meaning to make Dr Kelsey feel uncomfortable.

Sorry. Yes. Has it got any worse?

I choke more than I’d like. Mainly at night. It wakes me up.

More often than before?

Not really. I suppose.

Did I not refer you to speech therapy?

The question appeared to be more directed at Ben. 

Laura watched him as he seemed to scroll backwards through her notes. 

He looked up at Dr Kelsey and shook his head.

We’ll do that then. There might be some exercises they could suggest.

Laura was not convinced but found herself saying thank you. 

Back in the corridor, she remembered her question. 

Gillian Shirreffs is in the third year of a doctorate at Glasgow University in which she is exploring the relationship between object and illness. She has an MLitt (with distinction) in creative writing. Her short fiction has appeared in Issue 2 of thi wurd and Tales From a Cancelled Country.