Bell's Palsy--which God forbid you ever wake up and look in the mirror and see you have one, or worse, see that your kid has one--is terrifying. Half the face is a face and the other half is slack, and the two halves don't add up to a face. That's fine for a Stephen King novel but not when you drive fifty miles out to the country to pick up your ten-year-old son at camp because his sister says "his face looks funny." I thought Lyme right away--the neighbors' kid had had it.
"Bell's Palsy is very common in children, and it's transient," the doctor said. "It'll be gone over time--weeks, a month or two at most. And the lab tests are negative."
"Doctor," I said, "I have read that Bell's Palsy should at least suggest specific bloodwork for Lyme."
"Unnecessary."
I think it was the doctor's tone that saved my son's future. It was a tone of serene tranquil contempt.
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Serene tranquil contempt can be very nice. "Doctor! Look at this! It's CANCER!" "Sorry. It's a bruise." That kind of serene tranquil contempt is fine, when your so-called cancer begins to turn yellow and green around the edges and then fades away just like, well, a bruise.
My son's Bell's Palsy did not fade away. By the sixth day the doctor's serene tranquil contempt seemed less like professional gruffness and more like bullshit.
"The lab work is negative," he said. "Let's just wait."
"I request," I said, "that my son be tested for Lyme."
"You don't tell the doctor what to do."
The last line was not uttered in serene tranquil contempt. It was a sharp assertion of professional authority. My kid was standing there with half his face drooping. Now I was completely, utterly terrified.
"Fine," I said. "I won't tell the doctor what to do. But I'm a lawyer. So don't you tell me what to do."
He ordered the test.
You can do this, too, without the credential. Like the use of a car horn, the options are wide. My option amounted to an obnoxious prolonged blast, the kind you give the oncoming headlights. Some other suggestions, in ascending order of obnoxiousness:
1. "Doctor, look, humor me. I want this test and I want it expedited. So I can sleep. Please? Yes, I'm being obnoxious." (If this works, excellent. It's results we're after, not a war.)
2. "Doctor, I am really, really concerned. Look, here's an article about Bell's Palsy." Hand it to him. He doesn't care what you think about medicine, but he'll look at it. Tell the doctor: "Look, all I'm saying is an ounce of prevention."
3. Or you can be as obnoxious as I was and say, "Fine, doctor. But if you're wrong, there are going to be lawyers telling me what to do. You know that saying 'An ounce of prevention?' "
When you're scared, you lean on the horn.
I have always wondered, in the fourteen years that have passed since then, what would have happened had I said "Okay, you're the doctor." Because the initial lab testing, at least as of then, was known to be insufficient as an initial diagnostic test for Lyme. It was the second set of tests, the set I demanded, the Western Blot, that revealed the culprit; and when the Western Blot came back, the doctor looked at the lab report and said: "Amazing."
The doctor didn't sound amazed that the test was positive. He sounded amazed that he could be wrong. I couldn't think of anything snappy to say, because my kid's face was still not a face. So we left.
A lawyerly word here. Did the doctor commit medical malpractice? No. Because there is no such thing as a medical malpractice case with a happy ending for the patient. Not to mention that Bell's Palsy does have about a hundred other causes, and that the symptom does regularly appear and vanish in a gazillion healthy kids, and there was no evidence of a tick bite, no bull's-eye rash, no other symptoms.
Still--with all due deference to the excellent and productive we-can-all-get-along view of public medical controversy--a nice long obnoxious screaming rude horn blast is generally better than a smashup.
*
"We don't fuck with Lyme in my office," the new doctor said. "We clobber the son of a bitch."
The new doctor flooded my son with antibiotics. There was a new blood test every week. "We got the son of a bitch early," the new doctor said. "Early early. Your son is going to be fine."
The Bell's Palsy faded. The lab work came back, eventually, normal. My son got his face back. Lyme never got him.
I watched the first doctor retire. He began to devote himself seriously to local philanthropic work. You couldn't go anywhere without seeing his name. He gave away money in barrels. His name went up on brass-and-mahogany plaques in buildings of note. Why not? He had served my town with distinction for two generations. He had been my wife's pediatrician when she was little. He remains an example of unusual and persistent devotion to his profession and to community service.
I have in weak moments imagined that he is doing penance for what might have happened to my boy. I doubt it, though. There isn't any book called "When Bad things Almost Happen to Good People But Don't."
Also From the 2011 Lyme Disease Awareness Series:
Welcome to Lyme Disease Awareness Month
The Mysterious Case of the Shape Shifting Spirochete
Researchers on Persistence In Lyme Disease