Eight: Southern Hospitality

I had lofty expectations for Emory.

I thought a medical school and research hospital must surely be the kind of place where collaboration and innovation were commonplace. I imagined doctors and professors in the cafeteria having coffee and discussing their days. One doctor would say, “I had this unusual case yesterday. The patient was bit by a tick and now he has forgotten how to walk,” and another doctor would say, “Wait a minute, I read about a case like that in Zimbabwe in 2011. We may have Patient Zero! Get him back in here. I will list you as co-author on the article I will write for Neurology Today.”

My experience was only a little like that.

The first neurologist I saw was an attractive middle-aged Columbian woman who spoke the King’s in the manner of someone who learned the language classically rather than through Rosetta Stone. She spent an hour with me going through The Book, asking questions about this test or that. She and the Redhead discussed anomalies and their pertinence to a diagnosis.  

She spent a lot of time looking at the Electromyography (EMG) test results. She checked my reflexes with a small rubber hammer and an instrument that looked like a tuning fork and stuck me with a needle at various points on my feet and hands.

“Do you feel this? This? How about now?”

She looked thoughtful for a moment. “You have ‘glove and boot’ neuropathy. It is not the classic manifestation of carpal or tarsal tunnel. The nerves are not conducting above the typical compression points. This EMG report and diagnosis is not altogether accurate.”

We went down the “cause” list as I had done with all the others. No diabetes, alcoholism, heavy metals, pesticide exposure or family history of autoimmune disease?

I asked if it could be Lyme Disease, since all my symptoms originated after hospitalization.

“Neurological Lyme Disease is very rare in Georgia.”

I let it go.

I asked if I was going to get worse.

“It is difficult to say. I am going to refer you to one of my colleagues who specializes in neuro-muscular medicine. She will want to repeat your EMG and run some additional blood tests to make a diagnosis.”

We returned two weeks later.

This doctor was a young Ecuadorian. She brought along another young resident doctor, and we spent well over an hour rehashing my history.

She asked some questions that none of the other doctors had.

“Do you have dry mouth?”

Yes.

“Digestive issues?”

Yes.

“Do you perspire normally?”

No, I meant to mention that. I have always been a heavy sweater, but now I never break a sweat, even during a hard workout at the gym or being outside.

She and the resident exchanged glances.

“Interesting.”

We ran down the list of causes of neuropathy again.

She sighed. “Sir, you need to understand that 20-30% of all cases of peripheral neuropathy are idiopathic. Do you know what this word means?”

I said I was fairly sure that it meant the doctor either was not clever or caring enough to figure out a diagnosis. That was why I was at Emory, and why I was so happy that she was my doctor.

I think she smiled behind that Covid mask. At least her eyes smiled.

“I am going to run some extremely specific blood tests, including a genetic profile that may reveal a few rare mutations that can cause symptoms like yours. We will repeat the EMG test when you come back to see if there has been any progression in damage to the nerve function.”

She walked us to the front and told the receptionist to make me an appointment in two weeks. She patted my shoulder and winked. “See you again soon.”

I was hopeful. She was the one. We would only have to wait two more weeks to finally get the answer.

I did not realize that it would be the longest two weeks of the two-year ordeal.