7. The Blackout

‘Jax, where the hell did you put my scrubs? I’m going to be late.’

I usually did the laundry, but Jax was still being extra nice to me so he decided to do the laundry that week. I’d let him, but I was already regretting it.

‘How would I know, Lisa?’

‘Because you washed it.’ I took his morning omelet plate out of the table. ‘Go find it.’

He sighed and went to look for it. And I just ate a little bite of the omelet, so I wasn’t even that mean. Stop judging.

Despite the delay, I managed to get to the hospital in time by subway. I was in outpatient care that week. I used to hate it when I was in medical school, but I have to say I was actually enjoying it. It was calmer, but still interesting if you looked at it the right way.

Robert Harris was the first that day. A 35-year-old male with knee pain. He entered the office in his work uniform, it seemed like he did some kind of maintenance work.

‘Good morning, Mr. Harris. I’m Lisa Diaz. How can I help you today?’

He seemed a little uncomfortable.

‘My knee is killing me, Dr. Diaz.’

‘When did it start?’

‘I’m not sure, it hurts sometimes, on and off. I usually take some painkillers but this time is worse for some reason.’

‘Always the same knee?’

‘Not really. Sometimes the knee, shoulder, I don’t know. But I do a lot of heavy work, so I guess that’s why.’

‘But did you suffer any trauma in particular to the knee this time? Falling or something like that?’ He denied it.

I thought maybe he was right. He could just be hurting from labor, but he seemed a little young for that. I asked if he’d been to the woods, thinking of Lyme, but he said he’d never left the city.

‘Let me take a look, Mr. Harris.’

I wasn’t sure about his knee. It wasn’t warm, but it did look a little swollen, although it was hard to tell since he was a little overweight. 

I decided to order him an x-ray. He’d probably just hit his knee somewhere and didn’t remember it. But I also ordered a Chlamydia Gonorrhea PCR in the urine and a blood test, just to rule out gonorrhea and gout.

Anyway, I explained to him the tests I was ordering but also said that I thought trauma was more likely since he did such heavy work. I told him I would see him again after the test results were ready in the afternoon.

Before I left, I reached out to shake his hand but he looked embarrassed.

‘I’m sorry doctor. I work in the subway so my hands are always a little dirty, It’s hard to clean it off.’

‘I don’t mind, Mr. Harris!’ I smiled trying to make him more comfortable and shook his hand anyway.

A few hours later, the lights of the hospital went out. Can you believe that? A complete blackout. Apparently, the generator would take two hours to start working, which was insane. The hospital desperately depended on energy.

Thank God it was during the day, so it wasn’t completely dark, but it still made everything difficult. Peter went looking for me and told me Lucy had asked for both of us to go check on the internal medicine ward patients, just to make sure they were fine after the blackout.

We went to each room, checked the patients’ vitals, and talked to them to calm them down. At least they didn’t need the power that much, but the ICU was just crazy. That’s why she asked us to check on them, because all the attendings were called to the ICU.

All the patients were fine, so we went to lunch.

‘So, are you liking outpatient care, Lisa?’

‘It’s actually not as bad as I thought.’ I said while still chewing my food. I hadn’t realized how hungry I was until then. ‘What about you?’

‘Well, I always loved it.’ Peter said grinning. ‘No surprises there.’

‘I guess not.’ We both laughed. He was such a good boy.

‘And how crazy is this blackout? The hospital needs to fix this problem asap.’ I said.

‘You’re right.’ He chewed his food loudly. ‘But hey, at least we had time for lunch.’

‘Peter Allen, always such a glass-half-full optimistic.’ I teased him.

It took 3 long hours to fix it. But thankfully all the patients were okay after the lights came back on. I went back to my outpatients.

When I was on the second or third, a nurse I didn’t know knocked on the door and asked If she could talk to me for a moment. I excused myself and went outside.

‘I’m sorry to bother you, Dr. Diaz. But you ordered a urine test for one of your patients, right? Robert Harris.’

‘No worries! And yes, I did. Is the result out yet?’

‘Well, not exactly.’ She seemed worried. ‘The test was delayed because of the blackout.’

‘Oh’ I was a little disappointed ‘That’s okay, it’s nothing urgent anyway.’

‘But that’s not the problem, Dr. Diaz. The lab called and said that when they went to test Mr. Harris’ urine sample, it had turned black.’

At first, I was just confused. I thanked her for the information and told her I would see Mr. Harris after I finished the current patient. 

I only figured it out when I was saying goodbye to that patient I’d left waiting and reached out to shake his hand. Damn, isn’t medicine a beautiful thing.

‘Your hands are not dirty, Mr. Harris!’ I greeted him with excitement.

‘I’m sorry, I don’t understand.’ He looked confused.

‘Give me your hands, Mr. Harris.’ I sat across him.

He extended both his hands for me. They were like before, with bluish-black spots on them.

‘These don’t come off because they are in your skin. I believe you have Alkaptonuria. Do you know what that is?’ He shook his head no. ‘It is a genetic deficiency of an enzyme that makes this pigment accumulate in various places of your body. And the most common places are the hands, the cartilage of the ears, and the cartilage of the bones, which explains your recurrent joint pain.’ He looked confused.

‘But how do you know I have that?’

‘I didn’t. In fact, I only know it because of the blackout. This pigment also accumulates in urine, and it turns black when it stays in the atmosphere for a while. Your urine test was delayed and it turned black in the lab.’

He was startled by all of that. I answered all his questions about the disease and in the end, when we were saying goodbye, he thanked me for everything.

On the way home in the subway, I thought about what he said last.

‘At least I don’t have to be embarrassed by my hands anymore.’


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AR: autosomal recessive; typo: ochronosis.


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