The Next Patient

Dr. Wilkins picked up the next patient chart with a sigh.   It had been a long day.   According to his schedule, this was a new patient evaluation. He opened the chart not knowing what to expect.

“The information the parents gave us said that it’s another case of funny face,” the nurse said.

Dr. Wilkins closed the folder without reading any further.   “I hate those,” he said. “Is it bad? The chart says it’s a ten-year-old boy. They can be pretty inventive at that age.”

“I’ve seen worse,” the nurse said. “Well, not in real life. But on the internet I saw a picture once that I think wasn’t touched up or anything…” The doctor raised an eyebrow. “Um, yes, it’s bad,” the nurse said.

“Well, it won’t get any better if we just sit here,” Dr. Wilkins said. “Let me get my otoscope.”

“His ears aren’t the problem,” the nurse said.   “You’ll see.”

They walked down the hall and the nurse knocked on the exam room door. “Come in,” a voice said. A small boy in a hospital gown sat on the table. His concerned parents were sitting in the visitor chairs. All three looked up at him hopefully.

The doctor’s heart felt like it dropped a little.   This one was pretty bad. He managed a smile. “So, Billy is it? Billy Jones?” The boy nodded. “   I’m Dr. Wilkins. Are these your parents?” Billy nodded again. “Why don’t you tell me how this happened?”

Billy nodded again and looked down. “Tell the doctor what happened, Billy,” Mr. Jones said.   “That way he can help you get better.”

“I told you not to make faces like that, Billy. What if your face is stuck like this forever?”   Mrs. Jones scowled and wiped at her eyes with her sleeve.

Billy looked up at the doctor again and looked down.   “I was making faces,” he said.   His words were slurred and lisped.   Dr. Wilkins had practice with understanding patients talking around tongue depressors and such, so it wasn’t difficult for him to understand Billy.

He took out his otoscope. “I’m going to check your ears now, Billy.” He turned on the little light and held the instrument out for Billy to look at. Billy nodded. Dr. Wilkins started to check Billy’s ears. No obstructions. “Why don’t you tell me how you managed to make this particular face?” he asked.

Billy sighed. “I stuck pencils in my nose,” he said.

Dr. Wilkins waited a moment. “Tell the doctor the rest, Billy,” Mr. Jones said.

Billy looked down. Dr. Wilkins held up the end of his stethoscope. “I’ll check your heart and lungs next, all right?” he asked. Billy looked up again and nodded.

The doctor put the eartips in and warmed the cold metal chest-piece in his hand. Then he started to listen to Billy’s chest. “ I drew a mustache with pen,” Billy said.

“You’re doing a good job, Billy,” the doctor said.   “What happened next?” He moved so that he could listen to Billy’s back.

“I spiked up my hair and pulled the ends of my eyes down and the edges of my mouth up. Then I tried to touch my tongue to my nose,” Billy said in a rush. It took a moment or two for Dr. Wilkins to process everything.

“Very good, Billy. Is that everything?” Dr. Wilkins asked. Billy nodded. “And when you let go, your face had frozen like that?”   Billy nodded again.   “All right. Well done. Now, breathe, and I’ll check your lungs.” Billy breathed deeply several times as Dr. Wilkins listened to his lungs.   He started to relax.

Unfortunately, his face was still frozen in the terrible face he’d made. It was a rare condition, but sadly all too real. He made a few notes in his chart and looked over at the parents.

As soon as she’d caught his eye, Mrs. Jones straightened up. “Can it be fixed, doctor?” she asked. Every eye in the room was focused on him.

“I hope so. We will try a series of medications to relax his facial muscles. It has a good success rate and is the least invasive option. It can take up to three months to see any results.” Dr. Wilkins paused.

“Three months?” Billy said. He sounded dismayed.

“Yes,” Dr. Wilkins said. “Or less. It depends.”

“And if that doesn’t work?” Mr. Jones asked.

“I’d have to refer you to a plastic surgeon who would evaluate his case and decide where to go from there. Fortunately, that’s rarely necessary.” Dr. Wilkins smiled. The parents managed small smiles in response.

“I can’t believe this really happened,” Billy said.

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