Maggie felt the cold diaphragm of the stethoscope make contact with her feverishly warm skin, eliciting a small shiver.

“I know,” Tim said apologetically. “I’m sorry it’s cold. When you’re ready, take another deep breath in and out for me, with your mouth open.” Maggie breathed in deeply, then exhaled with a shudder. She resented the fact that she couldn’t keep at least some of her anxiety to herself, but the way she was shuddering it was virtually impossible. When someone is listening to your insides, there’s really nowhere to hide. “Okay, again,” Tim said quietly as he moved methodically across her back. “… and … once more,” he said. “Good. Okay.”

Maggie felt his other hand on her shoulder as he gently moved the stethoscope over to her lateral lung fields, eliciting another shiver, this one causing her nipples to harden in response. She closed her eyes to try and stay calm. Tim hung the stethoscope from his neck and began to percuss along her back, then extended the bottom of the exam table and further lowered the head.

“Can you lie back for me please?” Maggie wrapped the gown securely around her and then shifted into a supine position on the exam table.

“I want you to breathe nice and easy,” Tim said as he gently repositioned Maggie’s hands along her sides so that he would be able to open her gown easily once he was ready. Their eyes met as Tim plugged in his stethoscope. “I’m going to listen to your heart now,” he said, shifting the diaphragm underneath the left side, careful not to displace the gown more than necessary to auscultate at the aortic and pulmonic points.

Maggie nodded, and was certain that her heart would beat out of her chest, so prominent were the beats she felt thumping against her rib cage. She imagined her heart as a captive bird, trying fitfully, futilely, to free itself from her rib cage.

When he was finished with his heart auscultation, Tim took a quick listen to Maggie’s abdomen for the presence of bowel sounds, and then briefly palpated to make sure she wasn’t having pain anywhere else of significance.

“You can go ahead and sit up,” he said, offering her a hand.

Do you know what’s going on?” Maggie asked wearily.

“Yeah, I think I do,” Tim said with a sigh, sinking onto the stool at the counter. “It’s looking like shingles. It matches all of your symptoms,” he added, raising a finger for each symptom: fever, flu-like symptoms, fatigue, confusion, rash.”

Maggie looked bewildered. “But isn’t shingles something that older people get?” she asked. “And doesn’t it make you itch like the chickenpox?”

“Typically, yes,” Tim replied. “If by ‘older’ you mean over 60. But there’s actually been an uptick in incidences among a younger class of patients in recent years. It’s not the norm, but it can happen.

As for the itching, I’m sorry to say yours probably just hasn’t started yet. Your rash is going to get worse and more sensitive as the virus runs its course, and it will very likely start to itch,” Tim said regretfully. “But the good news is that your body is more likely to respond well to the antivirals if you start them at the first signs of a rash. So it’s good you came in when you did. I’m going to send a prescription for acyclovir to your pharmacy and I want you to start taking it as soon as you pick it up, okay?”

“Okay,” Maggie said, feeling suddenly very tired and very hungry – a dangerous mix for those who were unfortunate enough to find themselves in her presence.

Tim spoke as he entered the prescription info into the computer for the pharmacy. “Motrin or Ibuprofen for fever reduction and any body aches or pains, tepid wet compresses and calamine for the itching, should it get bad.” When Maggie didn’t respond right away, Tim looked up and found her in another brain fog. “Don’t worry, I’m writing all of this down for you,” he added. “Any questions?”

Maggie’s head didn’t move but her tired eyes shifted in his direction. “Yes actually. What brought you up here?”

Tim laughed briefly, and finished up his documentation on the computer before closing it up and turning to face her, the exam clearly finished.

“Work mostly, but I was ready for a change too,” he said simply. “I completed my residency at Duke University Medical Center almost two years ago and was ready to move out of NC. That, and my roots are in the Northeast so I always intended to get back this way eventually." After a beat, and to his credit, he said, “I’d love to catch up for a few minutes, but I’m going to step out and let you get dressed first, okay?”

Maggie was grateful for the suggestion, and eager to get her clothes back on. “Thanks, I’m down with that plan,” she said appreciatively. Tim excused himself and stepped out. When Maggie was dressed again, she opened the door and stepped out into the hallway.