This could be fiction, or it could be future history. Ultimately, that choice is up to us.
Dr. Grace Wu was exhausted. She’d been at her Sunset Park office since eight in the morning, and it was now approaching nine at night. Most of the day’s patients had been new ones, and it always took longer to get their history and a sense of their situations. On one hand, it was reassuring to see that none of them had anything serious. On the other, there were regular patients who needed more urgent attention, and Maria Serena hadn’t been able to schedule them immediately.
Charlie, who was on dialysis, would need blood work, and waiting for the results would make any delay in treatment even longer. Then there was Ray, who was past eighty, too proud to admit that he had arthritis and only came in after he’d dropped something and either cut or burned himself. Knowing Ray, he probably wouldn’t have gone to the pharmacy for some antibiotic ointment. Maybe the herb store on 86th Street, if he was really motivated. Dr. Wu worried about him, as she did about a lot of her patients.
“Maria Serena, you still here?” she called out into the waiting room, now finally empty.
Maria Serena Marin had her coat on, her purse slung over her shoulder, her face drawn and tense. It had been a long day for her too. “5000, Grace,” she said.
Since the office was empty, both women had taken off their masks, hoping to ease the headaches that always came from lack of oxygen. “Anybody call?” Dr. Wu asked.
“Just people who keep asking for you to make a diagnosis over the phone,” Maria Serena replied.
“Tell ‘em we practice real medicine here, we’re not Walmart,” Dr. Wu sneered.
“I do. You know these yuppies. They’re all entitled,” Maria Serena yawned. “Oh yeah, the Health Department called.”
“What do they want?”
“They’re going to come by on Thursday.”
“Good luck with that. We have patients all day and tomorrow too.”
“They said it’s some kind of pandemic thing.”
“Well, they’re going to have to wait. I’m not making patients stand around for those idiots.”
“OK, gotcha,” said Maria Serena. “See you tomorrow.”
Dr. Wu was up by six the next morning. Foggy-eyed, she made herself a mug of green tea, sat down and picked up her phone. She texted an older colleague, a fellow G.P. from the neighborhood who had just retired a few months ago. She’d picked up some of her people since then.
“Hey Dr Z I’m swamped with new patients. Any interest in joining my practice for the time being? I’m dead serious.”
Soraya Zenyatta, better known as Dr. Z, called back just as Dr. Wu was walking out the door. “What are you seeing? People with the virus?”
“No, just people with colds. They all think they have the virus and they’re freaking out,” Dr. Wu replied. “I had a woman who was so scared yesterday that I put her on valium. That way she won’t be bugging me on the phone all week.”
Dr. Z was interested. The two quickly worked out a tentative plan. Dr. Wu would open and see patients without a break til four, then Dr. Z would work from four to eleven. That way they would be able to handle all the requests for appointments.
Dr. Wu was ambivalent about the sudden surge in patients. The potentially dire consequences for people who needed immediate treatment were troubling – then again, there was always the emergency room. But who wanted to go to the emergency room? That’s where everybody caught the virus the last time around. And then those people, who’d come in without the virus, were put on vents, and most of them died.
On the other hand, Dr. Wu’s income was soaring. She’d made more money in the past month than she had in the previous six. If only she could get some sleep! This was like her residency all over again! Having Dr. Z onboard would help immensely.
Dr. Wu’s first patient was a newbie. Agnes was a tense, haggard woman from the neighborhood with a smoker’s cough and a runny nose. Dr. Wu quickly sized up the situation: another anxious person who never would have thought to see a doctor had there not been such media hysteria about the virus. That’s all that was ever discussed on tv, 24/7, these days
“You have a cold,” Dr. Wu smiled reassuringly. “Drink plenty of fluids, and juice, and get as much rest as you can.”
“I want to be tested for the virus,” Agnes insisted.
Before the weather had cooled off, that’s what hundreds, maybe thousands of callers had asked for. Word had gotten out that everyone who went to the state test sites was testing positive, and that would set off a clusterfuck with the Trace and Track Corps demanding access to phones, and Facebook, and Instagram, and emails, right down to the minutiae of a person’s daily activity. Nobody who could afford to get a test from their doctor would think for a second of letting the state do it.
“We don’t test for the virus here,” Dr. Wu responded mechanically. She’d been through this hundreds of times. “There is no test for the virus that can determine for certain whether or not a person has it, or has had it. You don’t have a temperature, you’re not having trouble breathing, and those are the two main symptoms. You do have a cold. That will go away by itself. It will go away faster if you get some rest,” she reassured the woman with a pat on the arm.
“But what if I do have the virus? And then I get sick and I die. That’s malpractice,” Agnes sniffed.
Dr. Wu did a doubletake. This was the first time in years that a patient had used that word. She fought the urge to tell this obviously clueless victim of media propaganda to go to hell. She hesitated. “It’s malpractice to make a diagnosis based on a test that can’t provide one.”
With that, Dr. Wu picked up the phone extension. Maria Serena didn’t pick up, but Dr. Wu pretended she did. “OK, send him in,” she said to the dead line. She turned to Agnes. “OK, time to go, I have another patient coming in.”
Agnes left in a huff. The next patient, and the next, and the next, all had colds. Something was definitely going around, but it wasn’t the virus. After them, the next guy in line had something going on intestinally: she gave him a referral for a GI and a colonoscopy.
Sonia, the woman after him, was a wreck. And she did have a slightly elevated temperature, and a cough. Dr. Wu hastened to tell her that it was probably the flu, but the woman was trembling, undoubtedly more from fear than actual illness.
“Tell you what,” said Dr. Wu. She hadn’t seen a patient who’d presented anything remotely like the virus in months, and she hadn’t prescribed anything for it. Ethically speaking, putting this patient on a two-week regime wouldn’t deplete any stockpile of supplies.
“I don’t think you have the virus,” Dr. Wu said, calm and low, “But just to be safe, I’m putting you on an antibiotic. And I’m giving you this.” She scribbled on a prescription pad and handed her the slip of paper. “If anyone asks you, you’ve been diagnosed with arthritis.”
“Arthritis? I don’t have arthritis, I’m too young to have arthritis,” Sonia said anxiously.
Dr. Wu kept her voice down. “What I’m giving you is an old malaria drug from the 1950s, in a very low dose. It’s also used for arthritis, to keep the inflammation down. Take one pill every day with breakfast for two weeks. And you need to stop by the vitamin store, or the drugstore, on your way to fill it. Get a bottle of zinc, twenty milligrams, and take one of those with it, every day. The antibiotic is just to make sure you don’t get pneumonia. Now I’m sending you to the pharmacy that I always use for this prescription, it’s on 53rd Street in midtown. I don’t know what your copay is but even if it’s high this won’t be more than eighty, a hundred bucks. Like I said, you probably don’t have the virus, but what I’ve just given you is the protocol that hospitals around the world use if you actually have it. And don’t forget the zinc!” Dr. Wu smiled.
“But why arthritis? And why can’t I just go to Duane Reade?” the patient persisted.
Dr. Wu lied. “I’ll tell you why. It’s because I’m trying to save you drama, like the people at the Duane Reade thinking you have the virus, and refusing to let you in, to pick it up, that kind of thing, you know how people are these days, right? This is the pharmacy I always use for this kind of prescription, they’re very fast and they’re good people to work with.”
Sonia nodded her head in agreement.
Dr. Wu let out a silent sigh of relief. The patient probably didn’t have the virus. Five out of six people were immune or resistant, anyway, Dr. Wu reminded herself. Most of the people who got it were past eighty, and this woman was half that age. The people at the pharmacy in midtown knew the drill. The health department had banned the protocol that every other state, every other country around the world, would always use to knock out the virus. This was political. There was talk of the governor having invested in an unproven new drug that the Federal virus czar was conducting a dynamic study on, which kept going on and on, and adding more people, with little indication that it would work. And it cost a thousand dollars a pill.
And the state had bought thousands of doses.
Meanwhile, the old malaria drug was still legal as treatment for arthritis. That way, in the unlikely scenario that any issue ever arose, Dr. Wu could cover herself.
Sonia called her husband on the way out. “I’m going to Duane Reade and then to the vitamin store,” she told him. She didn’t feel like shlepping all the way to midtown, not the way she was feeling. And a cab was too expensive.
There was a long line to get into Duane Reade, and then another line for the pharmacy, and all the chairs that used to be there had disappeared. She was thinking that maybe she just should have gotten on the train and taken it to midtown, as the doctor had instructed her, when the young guy behind the counter finally called her over.
She handed over the prescription. He studied it. His face grew taut. “We can’t dispense this,” he told her. “It’s against the law.” Holding the slip, he took his phone out of his pocket and typed Dr. Wu’s name and her information into a text. Then he handed the slip back. “This drug is illegal in this state now. You’ll have to go to Pennsylvania or Vermont for it.”
This time it was Sonia’s turn to lie. She called Dr. Wu’s office and got Maria Serena on the phone. She explained that she’d been to the pharmacy in midtown and that the pharmacist there had told her that the drug was illegal.
Maria Serena buzzed Dr. Wu.
Dr. Wu, who was in the middle of yet another patient with a cold, was surprised to hear Maria Serena buzzing her. This had better be good, she thought. “What it is?” she asked brusquely.
Maria Serena relayed what the woman had told her. Dr. Wu panicked momentarily. “I’ll call them. Or, tell you what, you call them. See if you can get Sam, the pharmacist on the phone and explain the situation. They’ve filled this same prescription for me before, and he knows me.”
Maria Serena called Sonia back first and told her to stick around, that she was going to sort everything out with the pharmacy, not knowing that the woman hadn’t even gotten on the train yet. Then she called the midtown pharmacy, a tiny ground-floor space squeezed in between two new Eurotrash hotels. Sam the pharmacist was mystified. No, he hadn’t told anyone anything of the sort, he insisted, nor had anyone at the counter done so either. Obviously the woman was lying. Would they fill the prescription? Of course they would, but nobody had asked them to that day.
Maria Serena was interrupted by a couple of first-timers with insurance forms, and a couple of callers urgently asking for appointments. No, there were no appointments available in the next three weeks with the doctor, but her associate might be in. Could they check back tomorrow?
After half an hour, it suddenly occurred to her that she hadn’t called Sonia back. This time the call went straight to voicemail. Maria Serena explained that she’d sorted out things with the pharmacy, who would be glad to fill the prescription, and to call her back if there was a problem.
Without checking her phone, Sonia dragged herself up the subway steps, down the block and into the pharmacy. She noticed how the guy at the counter gave her a weird look when he saw the prescription, but he didn’t say anything. In five minutes, she had the bottle of pills in her purse. On the train home, she fell asleep. Waking up disoriented, just in time for her stop, she forgot all about the vitamin store.
Dr. Wu woke up at six the next morning, just as exhausted. Over her green tea, she was overjoyed to find that Dr. Z had confirmed that she would be joining the practice starting the following week. They’d reached a compromise: Dr. Z would work second shift on Mondays, Wednesdays and Fridays, and maybe Saturdays if needed. That would lighten the load considerably. Dr. Wu resolved to have Maria Serena try to juggle the schedule, to get some of the people that she suspected had nothing more serious than a cold to take evening appointments, so that the patients with more serious ailments could get in during the day.
When Dr. Wu arrived at her office, there was a blue van with the windows blacked out sitting directly out front. There were two large men inside. Dr. Wu walked up the stairs and was about to unlock the door when she heard steps approaching. Turning around, she saw the two men, dressed in what looked like police riot gear, coming up behind her.
The larger of the two had a blonde fauxhawk and tatoos on his wrists. ““Grace Wu?” he demanded, loudly.
“Can I help you?” Dr. Wu replied, jarred from her early-morning fog.
“Are you Grace Wu?” the man demanded.
“I am Dr. Wu, can I help you?” she replied. The other man passed the guy with the fauxhawk and stood directly in front of her. With the railing on the stairs behind her, and the guy with the fauxhawk to her left, Dr. Wu was boxed in. She couldn’t move.
“Where’s your mask?” the man in the fauxhawk leered, even though neither of the two men were wearing one.
Oh shit, Dr. Wu thought. “It fell off on the way here.” She paused. “I’m a doctor. We have boxes and boxes of them inside.”
“We’re from health department enforcement, we have information that you are prescribing illegal controlled substances,” the guy with the fauxhawk insisted, rotely. This was a drill, Dr. Wu understood immediately. He’d done this before. “We need to see your records.”
Dr. Wu’s face scrunched up. “Where’s your subpoena?” she demanded.
“We don’t need a subpoena. Ever since the virus, new rules. You gonna let us in, or are we gonna have to break down the door?”
Dr. Wu was stunned. “Doctor-patient confidentiality. You’re going to need a court order. And besides, I hardly ever prescribe controlled substances. They’re dangerous and very addictive.”
This time it was the smaller man’s turn to speak. “This isn’t a narcotic we’re talking about. It’s the drug the governor banned. You obviously know all about it,” he said calmly, motioning to the door. “Are we going to have to break it down?”
“I’m calling my lawyer,” Dr. Wu asserted, reaching into her purse for her phone.
The man in the fauxhawk grabbed her purse and threw it behind him. Dr. Wu’s phone skidded on the concrete, into the street. “You’re under arrest, mask violation,” he snarled, gripping her arm and twisting it behind her. Dr. Wu screamed in pain.
“Hands behind your back!” the fauxhawk guy hollered.
“Let go of my arm, you bastard!” Dr. Wu screamed. “You broke my arm!”
Maria Serena came running around the corner. “Grace!” she screamed.
“Get this on video!” Dr. Wu hollered. “And get my phone!” The man in the fauxhawk pulled her other arm behind her back as she began to sob. The smaller man squeezed red plastic cuffs around her wrists, drawing blood.
to be continued