An Ounce of Cure
by Alan Edward Nourse
The doctor's office was shiny and modern. Behind the desk
the doctor smiled down at James Wheatley through thick
glasses. "Now, then! What seems to be the trouble?"
Wheatley had been palpitating for five days straight at the
prospect of coming here. "I know it's silly," he said. "But I've
been having a pain in my toe."
"Indeed!" said the doctor. "Well, now! How long have you
had this pain, my man?"
"About six months now, I'd say. Just now and then, you
know. It's never really been bad. Until last week. You see—"
"I see," said the doctor. "Getting worse all the time, you
Wheatley wiggled the painful toe reflectively. "Well—you
might say that. You see, when I first—"
"How old did you say you were, Mr. Wheatley?"
"Fifty-five!" The doctor leafed through the medical record
on his desk. "But this is incredible. You haven't had a checkup
in almost ten years!"
"I guess I haven't," said Wheatley, apologetically. "I'd been
feeling pretty well until—"
"Feeling well!" The doctor stared in horror. "But my dear
fellow, no checkup since January 1963! We aren't in the Middle
Ages, you know. This is 1972."
"Well, of course—"
"Of course you may be feeling well enough, but that doesn't
mean everything is just the way it should be. And now, you
see, you're having pains in your toes!"
"One toe," said Wheatley. "The little one on the right. It
seemed to me—"
"One toe today, perhaps," said the doctor heavily. "But tomorrow—"
He heaved a sigh. "How about your breathing
lately? Been growing short of breath when you hurry upstairs?"
"Well—I have been bothered a little."
"I thought so! Heart pound when you run for the subway?
Feel tired all day? Pains in your calves when you walk fast?"
"Uh—yes, occasionally, I—" Wheatley looked worried and
rubbed his toe on the chair leg.
"You know that fifty-five is a dangerous age," said the doctor
gravely. "Do you have a cough? Heartburn after dinner?
Prop up on pillows at night? Just as I thought! And no checkup
for ten years!" He sighed again.
"I suppose I should have seen to it," Wheatley admitted.
"But you see, it's just that my toe—"
"My dear fellow! Your toe is part of you. It doesn't just
exist down there all by itself. If your toe hurts, there must be
Wheatley looked more worried than ever. "There must? I
thought—perhaps you could just give me a little something—"
"To stop the pain?" The doctor looked shocked. "Well, of
course I could do that, but that's not getting at the root of the
trouble, is it? That's just treating symptoms. Medieval quackery.
Medicine has advanced a long way since your last checkup,
my friend. And even treatment has its dangers. Did you know
that more people died last year of aspirin poisoning than of
Wheatley wiped his forehead. "I—dear me! I never realized—"
"We have to think about those things," said the doctor.
"Now, the problem here is to find out why you have the pain
in your toe. It could be inflammatory. Maybe a tumor. Perhaps
it could be, uh, functional ... or maybe vascular!"
"Perhaps you could take my blood pressure, or something,"
"Well, of course I could. But that isn't really my field, you
know. It wouldn't really mean anything, if I did it. But there's
nothing to worry about. We have a fine Hypertensive man at
the Diagnostic Clinic." The doctor checked the appointment
book on his desk. "Now, if we could see you there next Monday
morning at nine—"
"Very interesting X rays," said the young doctor with the
red hair. "Very interesting. See this shadow in the duodenal
cap? See the prolonged emptying time? And I've never seen
such beautiful pylorospasm!"
"This is my toe?" asked Wheatley, edging toward the doctors.
It seemed he had been waiting for a very long time.
"Toe! Oh, no," said the red-headed doctor. "No, that's the
Orthopedic Radiologist's job. I'm a Gastro-Intestinal man,
myself. Upper. Dr. Schultz here is Lower." The red-headed
doctor turned back to his consultation with Dr. Schultz. Mr.
Wheatley rubbed his toe and waited.
Presently another doctor came by. He looked very grave as
he sat down beside Wheatley. "Tell me, Mr. Wheatley, have
you had an orthodiagram recently?"
"I—don't think so."
The doctor looked even graver, and walked away, muttering
to himself. In a few moments he came back with two more
doctors. "—no question in my mind that it's cardiomegaly,"
he was saying, "but Haddonfield should know. He's the best
Left Ventricle man in the city. Excellent paper in the AMA
Journal last July: 'The Inadequacies of Modern Orthodiagramatic
Techniques in Demonstrating Minimal Left Ventricular
Hypertrophy.' A brilliant study, simply brilliant! Now
this patient—" He glanced toward Wheatley, and his voice
dropped to a mumble.
Presently two of the men nodded, and one walked over to
Wheatley, cautiously, as though afraid he might suddenly vanish.
"Now, there's nothing to be worried about, Mr. Wheatley,"
he said. "We're going to have you fixed up in just no time at
all. Just a few more studies. Now, if you could see me in Valve
Clinic tomorrow afternoon at three—"
Wheatley nodded. "Nothing serious, I hope?"
"Serious? Oh, no! Dear me, you mustn't worry. Everything
is going to be all right," the doctor said.
"Well—I—that is, my toe is still bothering me some. It's
not nearly as bad, but I wondered if maybe you—"
Dawn broke on the doctor's face. "Give you something for
it? Well now, we aren't Therapeutic men, you understand.
Always best to let the expert handle the problem in his own
field." He paused, stroking his chin for a moment. "Tell you
what we'll do. Dr. Epstein is one of the finest Therapeutic men
in the city. He could take care of you in a jiffy. We'll see if we
can't arrange an appointment with him after you've seen me
Mr. Wheatley was late to Mitral Valve Clinic the next day
because he had gone to Aortic Valve Clinic by mistake, but
finally he found the right waiting room. A few hours later he
was being thumped, photographed, and listened to. Substances
were popped into his right arm, and withdrawn from his left
arm as he marveled at the brilliance of modern medical techniques.
Before they were finished he had been seen by both
the Mitral men and the Aortic men, as well as the Great
Arteries man and the Peripheral Capillary Bed man.
The Therapeutic man happened to be in Atlantic City at a
convention and the Rheumatologist was on vacation, so Wheatley
was sent to Functional Clinic instead. "Always have to
rule out these things," the doctors agreed. "Wouldn't do much
good to give you medicine if your trouble isn't organic, now,
would it?" The Psychoneuroticist studied his sex life, while the
Psychosociologist examined his social milieu. Then they conferred
for a long time.
Three days later he was waiting in the hallway downstairs
again. Heads met in a huddle; words and phrases slipped out
from time to time as the discussion grew heated.
"—no doubt in my mind that it's a—"
"But we can't ignore the endocrine implications, doctor—"
"You're perfectly right there, of course. Bittenbender at
the University might be able to answer the question. No better
Pituitary Osmoreceptorologist in the city—"
"—a Tubular Function man should look at those kidneys
first. He's fifty-five, you know."
"—has anyone studied his filtration fraction?"
"—might be a peripheral vascular spasticity factor—"
After a while James Wheatley rose from the bench and
slipped out the door, limping slightly as he went.
The room was small and dusky, with heavy Turkish drapes
obscuring the dark hallway beyond. A suggestion of incense
hung in the air.
In due course a gaunt, swarthy man in mustache and turban
appeared through the curtains and bowed solemnly. "You
come with a problem?" he asked, in a slight accent.
"As a matter of fact, yes," James Wheatley said hesitantly.
"You see, I've been having a pain in my right little toe...."