She nods.
I flash my penlight and find the telltale yellowish-white exudate and fiery redness of terrible strep. “You can close up. That looks pretty rough, Opal.”
She nods once, then clings to the woman who says, “We keep doing antibiotics, but strep keeps coming back. Had her tonsils removed, and it’s still here. I don’t know what to do next.”
“Opal, can I palpate your lymph nodes?”
The girl frowns in confusion.
“Can I feel along your jawline to check for swelling?”
She extends her neck out to me in silent permission, so I check her. Swollen all to hell. I continue the exam and find her temperature is 103.6 tympanic. The right ear is borderline.
“Any response to the antibiotics? Any whatsoever?”
The woman nods. “It usually seems like she’s recovering, and for a few weeks, she’ll be herself again. But then it comes back faster each time. I don’t know what I’m doing wrong.”
Mom. Definitely the mom. That kind of guilt almost only ever creeps onto moms.
I try for a sympathetic smile, but it’s like wearing the wrong size shirt, so I give up. “I’m sure you’re not doing anything wrong. What’s your name?”
“I’m Lena. Her mom.”
“Good to meet you, Lena. I’m Dr. Spinelli. You can call me Dario—I’m not formal.” I shrug. “Most cases of chronic strep are due to proximity to a carrier. Could be a classmate or a neighbor. Anyone she commonly has contact with. But it can also be as simple as an antibiotic-resistant strain or an infection that has set up shop somewhere other than the throat or tonsils. If it’s in the sinuses, for instance, she can seem healed for a little while, then get reinfected with a couple of sneezes.”
“Oh.” She looks confused now. “So, I’m not doing something wrong?”
No, you’re perfect. “You’re not?—”
“So, I can’t fix it, can I?”
Shit. I can hear the depression spiral in her voice. “It’s not like that, Lena. It can also be chronic stress, poor nutrition, or incompletion of the antibiotic course… There are tons of things you can do. You’re not helpless here.”
She takes a breath, and her top stretches across her full breasts. It’s impossible not to notice—she’s built by curves that distract.“That’s good to know. But I don’t know what else I can do. Trying prescription after prescription gets very expensive.”
Hence why she’s in the free clinic. Azithromycin script. The macrolide is the right call given the recurrence. “Be right back.”
The supply closet houses plenty of samples. It’s amazing anyone can find a damn thing in this alphabetical-order-optional drawer, but I manage after a minute or four. I put together enough for a five-day course and return to the pair. “Enough to start tonight, skip the pharmacy delay, get a therapeutic level established. She must take all of them?—”
“She will, I promise.”
“In the meantime, get to the pharmacy with this.” I pass her the script. “Hopefully, they’ll get that to you in time so there’s no lag between the samples and their bottle.”
Those warm brown eyes shine up at me, and I have the strangest sense that I’m happily sinking into the floor. “Thank you, doctor. Thank you so much.”
Something scrapes in my chest. Her gratitude, I think. Not sure I like this feeling.
Then she follows it up with, “None of the other doctors here listen like you do. Did the clinic change ownership before they hired you or something?”
“Not to my knowledge.” Need a cover story. “My practice is private. I come here on a volunteer basis, a few times a month.” Mostly true. “I want you to have a direct line to me.” I write my number on the back of the prescription. “Call me if things go sideways. Day or night. Not the clinic. If they’re jerking you around, there’s no point in calling them when I can help.”
But she hesitates at that. “A private practice is out of my budget, but thank you for the offer.”
That won’t do. “Free of charge. As I said, I volunteer here. So, the patients I see from here get my volunteer rate.”
I can’t figure out why she stopped breathing. But before I can ask, she throws her arms around me. “Oh my god, seriously?”
Every sense in my brain lights up. She smells incredible. Like a meadow full of early spring flowers. The press of her against me is its own hell—I must maintain decorum, but here she is, all warm and soft and mind-blowing. I want to run my fingers through her hair, then pull it back tight until she gives in to whatever I want?—
