“So, your pain level, on a scale of one to ten, is?”
This is a hard question to answer.
“Six or seven, I guess. Most days. It depends.”
He nods.
“And the fatigue—does it interfere with your daily life?”
An easier question.
“Yes.”
“And this started . . .”
“Well, the pain part started three months ago.”
I could tell him exactly when. June 28, 1990, 3:27 P.M. I could tell him exactly how it started, how I felt it in my fingers first—not like the kind of fatigue that comes naturally after practicing piano for three hours, but actual pain, aches in all the bones of my fingers—then my wrists, then my arms. How it slowly moved to encompass my whole body, like I was being swallowed, hands first, by a snake. How it hasn’t stopped hurting ever since.
What I can’t tell him is why.
He nods again, leans back in his chair, holding the details of my life in his hands. The file should be thicker, I think. But then again, I haven’t been allowed to read it; maybe it says everything it needs to.
“Cognitive issues? Fuzzy thinking, problems coming up with the right words, that sort of thing? Memory problems?”
“Yes,” I say. “Like I’m thinking underwater. If that makes any sense.” Words swim away from me all the time. I am heavy with gravity.
“You’re a music student?”
A deceptively easy question. But this way lies the trap.
“Yes. Piano.”
“Ah, New England Conservatory?” He smiles.
“No, the Boston Conservatory.” He frowns. Perhaps he doubts me. More likely he’s never heard of it. “New England Conservatory is our deadly rival.”
I’m joking, but his eyebrows raise.
“Quite a high-pressure field, classical music. Competitive?”
This is the trick question, even though he has cleverly disguised it as something else.
Already I feel the anxiety rising. Already I want to head him off at the pass, tell him not to assume that I’m sick because I’m stressed or under pressure, not to assume I’m the kind of person who complains about pain, who simply gets tired, who lets being tired ruin her life, who wastes doctors’ time with petty complaints about being tired and in pain when really she could just work harder. But I can’t say any of that, because then I’ll not only confirm to him that I am stressed and under pressure, I’ll confirm to him that I am high-strung and neurotic, and then I’ll be sick because I’m just a sick person, and he’ll give me the same “You’re a teenager, you’re a musician, you’re just a girl, just try to relax” conversation I’ve had with a million other doctors and shoo me out the door, and I’ll still be in pain—in so much pain—and still I won’t know why, and still we will dance around the unspoken question I know he really wants to ask, the question I ask myself all the time, the question everyone dances around but never actually comes out and says, which is: Are you crazy?
But he surprises me by not bothering to wait for an answer.
“Do you have friends at school?” he asks.
This is a suspicious question. If I say yes, that will mean I am normal. If I tell the truth and say not really, I will not be normal, even though at the conservatory it is normal to not really have friends, because we are all too busy practicing, and because we are all in competition with one another. If I am normal, that factors into the diagnostic equation, becomes a question mark, in fact: How could a normal person be sick with such mysterious symptoms? If I am not normal, that itself becomes a symptom. Perhaps even a cause.
“Yes,” I say. “I have friends.”
I’m not technically lying.
“Do you have a boyfriend?”
This is the most difficult question. I don’t even know how to begin to answer it. How would he answer it, if he were here?
“Kind of?”
My right shin throbs, my left arm, too, in concert. My hands ache, but not the practicing kind of ache: The pain ache. I feel it in the top of my left wrist, just beneath my right thumb, the knuckles of both hands. I’m so tired.
He smiles. “It’s not a trick question. Either you have a boyfriend or you don’t.”
His friendliness about it makes me feel for a moment as though we are not doctor and patient, but just amicable strangers making the kind of small talk you have to make at parties or holiday dinners when you are old enough to be out in the world but not yet old enough to be taken seriously.
“Are you sexually active?” he asks.
A humiliating question. This isn’t small talk, I remind myself, no matter how much it feels like I’m sitting in somebody’s grandfather’s study. These are doctorly questions. I have to be vigilant.
“No.”
This is the truth. But he doesn’t even look up at me, just jots something down in my file.
“Well, then that answers my previous question: No boyfriend,” he says. “Have you ever been in the past?”
“Excuse me?” I ask.
“Sexually active.”
“Oh.” The most humiliating question. “No.”
He closes my file folder, lays it on the desk. Taps his pen a few times as he looks around the room. My bones ache. I hope I’ll be able to sleep on the bus ride back. Finally he looks at me.
“Well. I have a few recommendations to make. For one thing, I’d like to have some further blood work done.” He looks through the file for just a moment. “I’ll give your doctor a call and go over my thoughts with her, and then we can get you scheduled for another blood draw. It’s just a hunch, but I think I might have an inkling about what’s going on with you. The blood panel will let us know if I’m on the right track.”
“You mean.” My mouth is dry suddenly, and the words
