The pediatrician employed by the school to come in and care for us in the infirmary saw me briefly that day, and wrote on my chart, “See outpatient report. Has herpetic lesions. Will start Zovirax.” He underlined the prescribed medication three times.
It would be more than twenty-five years before I learned what he’d written that cold afternoon.
The pediatrician did not talk to me about herpes simplex virus, those “herpetic lesions” he meant to treat with Zovirax. Had he done so, I’d have been floored. Herpes was an STD, and STDs were acquired through sex, and I had not had sex.
He did not tell me and he did not tell my parents and he did not tell my doctors. Not then and not ever. And that “outpatient report” he referred to from the ENT in Concord was never shown to me or to anyone who cared for me, and it is now lost to time—or, as documents would come to suggest, to more pointed interventions.
Reading his shorthand more than twenty-five years later, though, I can hear the nib of his pen. I’m there on the bed beside him, inpatient at Armour Infirmary, attempting to sip ginger ale. I don’t remember, but I can imagine. I’d have been articulate and compliant, but not forthcoming. I’d have been quite thin, with lank hair and not a lick of makeup. I was likely agitating to get back to class. He’d have had me open my mouth to say Ah, just because, and I can see him clicking the penlight and putting it back in his jacket pocket. Just like he was then, I’m looking for something I’m not going to be able to find. He was a pediatrician, after all. His job was to care for children. Certainly he could not have meant to lie to me. Is it possible that by writing herpetic he meant only to describe the appearance of the lesions, which he, without appropriate tools, could not even see? If so, who described them to him? How did they decide to give me Zovirax, and why did he underline this indication alone?
And what did it say on that outpatient report?
Information faxed much later to my pediatrician at home indicates that I was started on a range of medications: the Zovirax, yes, but also antibiotics, and throat lozenges and cough drops—everything you’d use if you didn’t know what a patient had and meant to cover all bases.
Except that it seems that they knew. The ENT in Concord. The school’s physician. And at some point soon, via some process of privileged intrusion that would never be explained to me, the administration would know.
Now. Here is a fifteen-year-old girl swallowing blood. The suspicion is that she has a sexually transmitted disease so deep in her throat it cannot be seen during a normal exam. You hold this suspicion strongly enough to make this note in her chart and indicate that she will begin the proper treatment for it. Her bafflement, coupled with the disease’s ferocious presentation, strongly suggests that she has just contracted it. Her body has never seen this virus before and is mounting a mighty response. Because she lives on campus—and, like all of her peers, is not allowed to leave without written consent from the vice rector—you can be reasonably sure that she contracted it from another student (or, I suppose, from a faculty member or an administrator). Therefore, there are at least two students at this school with a painful, infectious, incurable, and highly contagious disease. And here before you is a girl, a thousand miles from home, who cannot eat. You are, legally and ethically, in loco parentis of them all.
And you say nothing?
Hiccups, head colds, herpes, ho-hum?
Maybe, said my physician years later, it was just that the sores were so deep. Herpes is very unlikely to present that way—that is, in the hypopharyngeal space and nowhere else. To introduce the virus only there would have required an aggressive act, and maybe that was unimaginable? You’d be surprised what a clinician can miss.
To which I’d reply: You’d be surprised what a kid can find it unimaginable to say.
By this time my pediatrician, psychiatrist, and an ENT at home in Chicago were discussing whether the Prozac might be making me sick. They couldn’t think what on earth was wrong with me. There was no record of it in the literature, said Dr. Miller, reached by phone, but the drug was so new that they supposed it might be possible, and neither the ENT in Concord nor the pediatrician at St. Paul’s had given them anything to go on. Also included in the differential were lupus and erythema multiform, a rash related to certain immune disorders. Blood work was ordered. It was decided that I would stop Prozac, just in case, and to the antibiotics and antivirals they added Vicodin for the pain.
Not quite a week later, the records tell me, I went with my mother to see an ENT in Chicago. I have no recollection of this visit at all. My parents were so worried that they flew me home, but I don’t remember this—not the airplanes, not the night in my own bed, not the doctor’s questions. Certainly not my mother looking at me and my needing to hide what was there. I’d have been terrified. I was terrified. I went to the doctor dutifully because I knew I was already being punished mightily. God was taking care of business. No reason to make things worse by breaking my mother’s heart.
By that time I had been on the Zovirax for several days, and the initial outbreak was finally subsiding. The ENT I saw in Chicago noted that the hypopharyngeal lesions were healing. He offered no diagnosis. I was instructed to continue the course of medications and follow up with a physician in New Hampshire if things got bad again.
“Thank you for referring this interesting
