𝕎𝕙𝕦𝕞𝕡spiration🦎

Poor guy, your heart sympathizes. Lets see what we can do.

You breathe outwards before rapping on the door, barely hesitating before pushing inwards.

"Hi!" you greet enthusiastically, sparing the (hulking) man hardly more than a glance before you reach for the hand sanitizer dispenser, "Mr. Riley, is it?"

He clears his throat, "Yes."

His voice is much quieter than you'd expected, soft and muffled, like he hated the sound of it. You resist quirking a brow, turning around to study him while you rub the sanitizer in. He's...

God, he's big.

The stupid, rickety patient chair makes him look like a giant, bulging biceps heaped atop the arm rests like solid steel resting on bamboo scaffolding. If he stood, he'd probably hit his head on the doorway, but sitting there, his shoulders are hunched, his head hung low, the perfect picture of abject reticence. A black facial mask covers his jaw, matching the black baseball cap shielding his head.

Mysterious, your brain interjects.

Clinically self-concious, your (rather blunt) professional self deduces.

Inwardly, you think it's rather impressive, how such a large man manages to shrink himself down into something near invisible, but you keep that observation to yourself. You extend your hand in his direction when you introduce yourself.

"So what brings you in today?" you bounce onto your rolly-chair, scooting closer to the man, eager to hear his story.

He tsks.

"Read my chart, didn't you?" he scoffs, voice twinged with disdain...or is it amusement?

It takes a special type of person to walk the fine line between those two, your inner-world says, hardly offended.

"Yes, but I'd like to hear it in your own words. Better to let words speak rather than typing mistakes," you laugh.

"Hm," he acknowledges.

For a few seconds, you wait for a reply. However, after the awkwardness grows to a palpable level and nothing but the rusty hinges on your wheely-stool remain, it becomes apparent he isn't going to give one. Still, you don't make to interrupt the process.

His chest rises on an inhale, and slowly, his head lifts, just enough for you to see blue irises peek out from the shadow of the brim of his hat. When he finally meets your eye, vision settling across your face, the once stoic set of his brows loosens, pupils expanding to capture the light as best they can. He seems stuck there for a second, drinking you in from your forehead to the tip of your nose, until you cock your head in curiosity. The exhale is punched right out of him, and he hurriedly ducks his head, repositioning the brim of his hat.

Suddenly, he doesn't look so tough.

No, he just looks...shy, eyes darting around the room as if he'd rather stare anywhere else but at you.

He's quite cute, the chronically single part of you chimes in.

AMA Code 9.1.1, your white coat whispers.

Internally, you shake the thought off your back. Focus. This man is looking for your help.

Again, his voice is soft -- so contrastingly soft -- when he speaks.

"I've got scars," he blurts, obviously discomforted and too afraid to hold eye contact.

"Okay," you respond.

Another beat of silence. You hope that it conveys your assent to his control of the conversation.

"And..." he stutters, "And I want them gone."

"Okay," you nod, wheeling backwards to grab a pair of gloves, "And do you mind if I take a look at them? To see what treatments might be best?"

Again, he doesn't answer. You only look on patiently as you situate your gloves. He's not wearing a heart monitor on his fingertip, but if he were, you imagined it'd be racing right about now. He looks towards the closed door, Adam's apple bobbing with a harsh swallow.

"You gonna bring anyone else in? To look?" he mutters.

"It's just a quick exam, doesn't require any tools or assistance," you promise, "But if you'd be more comfortable with another person in the room with us -- or with another physician entirely -- we can certainly make that happen. It's your choice."

"No. It's not that."

He stares at the door for a few more seconds. His hands wring in his lap, and for the second time today, he manages to look you in the eye.

"Just...make it quick. Okay?" he says aloud, commanding.

Don't want anyone else to see, his fidgeting frame conveys.

"Of course," you say, standing from your chair. He reaches for the cap atop his head, shoulders taut, before he unhooks the mask from his ear. You can see it almost immediately despite the way he keeps his vision locked resolutely on the floor. Beneath buzzed blonde hair, you see the beginning of red raised lines, trailing down his neck and beneath the collar of his shirt. They're long, fluid, and reaching, starkly mottled with color against his pale white skin. When he finally raises his face, you can see that his right eye is drooping at the corner, obscured by a small waxy section of fused skin on his outer eyelid. The eye doesn't look damaged, though.

The scar extends down the entire right side of his face, and the skin is textured there, raised with bright red in every spot that the liquid touched. It recedes into the surface of his skin in some parts -- the flatter portions of his face -- where pools of the substance had time to eat away at his cells a bit longer. The skin is wrinkled and stretched in those parts, including the bit by his eye.

In medical school, you'd studied case photos before. It was quite a distinctive burn pattern due to the way liquid runoff caused scars in the shape of the running droplets themselves, diffused across the surface by gravity, spreading the agony by nature's hand.

You cannot begin to imagine how painful it must have been. Your heart aches imagining how it occurred.

Slowly, you raise your hand to touch the edges of the the marks, assessing their texture.

"How did the injury happen?" you ask between careful fingertip taps, taking mental measurements of the length and size of each mark.

"It's in my chart. They teach you how to read in medical school?" he huffs...almost pouting.

You giggle.

"It is in your chart -- which I can read, by the way. But I want to hear your perspective on it."

He tsks again, "Does that even matter?"

"It's the thing that matters most," you reply -- and rather seriously, too. You emphasize the sentence with a pointed glance at his face, before you return to your task.

The scars are winding, branching things, diffused across his cheek, forehead, nose, and neck, like interconnected constellations across the night sky.

Despite how much pain you know is embedded in them, you can't help but think that, in a way, they're beautiful. Like many of the scars you saw each day, they're part of the people you help. A part that, in many cases, is just as much a facet of them as their hair color or clothing choices. That, and like many other things, something that wasn't so easily removed or erased.

As always, you keep that opinion to yourself. You can't tell whether the idea stemmed from your own clinical interest in them as a specialist. Or maybe the smaller, softer side of you couldn't help but marvel at the way Mother Nature always stitched herself back together in the end, leaving her touch as a reminder that, once the blood had dried and the dust had settled, you would always be made whole again. Someday. Sometime.

Of course, maybe you'd just published too many papers on the topic not to find them interesting by now. Staring out at conference crowds ranting about it for hours tended to do that to a person.

But hey, at least you weren't, like, a podiatrist or something. Somehow, you doubt your friends would find you as cool as you are if you ranted about big toes with the same enthusiasm as you did talking about the mechanism of Lichtenberg figures.

"Acid. There. That good enough for you?"

"Yeah," you curve your head to track the scars through his hairline. He perks up at the feeling your hands brushing through his hair, "And how long ago were these marks made? They seem well-healed given the circumstances of the injury."

He takes a breath in, "I'd say it's been...almost two decades, minus a few years."

"Huh," you raise your brows when you step back, pulling your gloves off.

He latches onto that little sound for some reason.

"What?" his cracked, crooked lips curve into a smirk for the first time since he walked into your office, "You think m'old, doc?"

"What makes you say that, Mr. Riley?" you laugh, "I thought it was pretty nonchalant on my part...they teach us that in school, y'know."

Why are you making jokes with him?

Why are you making jokes with him?

Seriously, this is what happens when you don't have a boyfriend for five years straight. Yeah, maybe you needed to get through medical school, and yeah, maybe you're too busy for a relationship. But then, every time a man so much as looks in your direction your heart starts to lurch.

That, and this is what your last preceptor would call 'ethical bullshit that will bite you in the ass if you let it fester long enough.'

Offput by the combination of those thoughts, you busy yourself with typing your observations into his chart. But of course, that doesn't negate the form of him sitting in the edge of your vision.

(That, or his warm, rumbling laugh. Or his awkward half-smile. Or the way that, when you leant closer to him, his cologne wafted over you in waves.)

Yeah, you should revisit your ethics textbook.

Or maybe you should buy another vibrator.

(Maybe you should do both.)

"Never thought I'd live to see the day a lab-coat developed a sense o' humor," he huffs, still smiling, before he reaches out to grab ahold of your name tag. The reel of the tag snaps back into place with a teasing noise, "How long you been wearing that thing anyway, huh? A year? Maybe two? Or do they enroll into medical school straight out of daycare these days?"

"Hey!" you swat at his hand before it can pluck at your name tag again, and suddenly, he's anything but shy, "You sayin' I have a babyface?"

"Uh-huh," he chuckles, "Doesn't match the white coat, love. Hate to break it to you."

"Pot calling the kettle black."

At that, he balks. His confidence falters, and for a second, the syllables get caught in his mouth.

"What? You think I came outta the womb lookin' like this?"

He gestures to the myriad of scars across his face, disdain evident in his expression.

"What?" you plop back down on your rolly-stool, "No. Just sayin', if you're trying to get a discount on the botox, it's gonna take more convincing than that. You look pretty good for your age."

That last bring yanks a laugh out of his stiff frame.

"'For my age?' What am I, seventy-five?"

"Well, seeing as how my professors never taught me to read a chart, it's a possibility, I guess..."

"Fuck off," he huffs, laughing.

"Aww, c'mon, don't say that just yet," you rock back and forth on your stool, "We're just getting to the fun part."

"The fun part?" he mutters.

"Yeah," you swivel back towards the computer, clacking away once more, "The anti-smoking lecture I'm professionally obligated to give you. From your chart. Which I can read."

"Save it."

"You want lung cancer?"

"Save it."

"Then stop smoking."

"Done."

You giggle, shaking your head.

"What?" he snickers.

"Y'know, I can see the Marlboro package sticking out of your pocket, right?"

Behind you, he straightens up in his chair to glance down at his belt, below which is the red and white façade of that familiar package. He licks his lips.

"What, a man can't change his mind, love?"

Love. God, you nearly melt at the stupid little quip.

"Not sayin' that, it's just..." you cross your arms, giving him a long hard look, "You don't look like the type to go back on your own convictions."

"You callin' me stubborn?"

"Not at all," you roll your eyes, "You sure you're not projecting?"

At that, he's got no good response. He merely lets his smile widen, just enough to let his teeth show through, and for that alone, you figure you can forgive yourself for your own professional transgressions.

"Well, smoking aside..." you sigh, forcing yourself back to business. You hate the way Simon's smile falls at the sudden transition, "You're in good shape for treatment. We can discuss the intricacies in further appointments, but there are several options depending on your own preferences. For the contracture scars around the eyelid, that'd most likely require surgical correction, but if you're aiming for less invasive options, laser treatments and topical medications would work as well."

"Whichever works the fastest," he speaks, voice deepening into something serious. He looks back down at the floor. It strikes something within you, and you brace yourself to act as the bearer of bad news.

"Mr. Riley--"

"Simon," he interjects, "Call me Simon."

You nod.

"Simon," You scoot your stool closer, "Before we get any deeper into exploring your options, I just want to make sure that you have reasonable expectations for your treatment."

He balks, hands wringing again, "''Reasonable expectations?'"

"Yes," you inhale lowly, "Given the extent of your injuries, and given the nature of your other inujuries as well...It's unlikely that the appearance of your scars can be completely negated. They can be reduced, yes, but they can't be removed. Not in the sense that you may be thinking, at least."

"Why not?" he asks -- no, demands. It's wrought with emotion, verging on anger. You don't recoil, however, you only continue onwards.

"Well...when you sustain a burn, it doesn't just affect the surface or the appearance of your skin. Altogether, what you might call...'the architecture' of your skin has changed. Scar tissue isn't normal skin, and aside from that, the blood vessels and hair follicles may have been damaged, too. With chemical burns like yours, the thickness of the burns is difficult to counter. Chemical burns can be deep, speaking relatively, and even with treatment, it's often not possible--"

"Why not?" he demands again loudly, and this time, his voice strains around the exclamation. He leans forward in his seat, and you're pinned beneath his harsh glare.

Instead of launching into another explanation, you let him sit in the silence, in the anger and emotions. The longer you look onwards, empathy hardly wavering on your face, the faster his belligerent expression falls into something...deeply hurt.

His anger falls away, whether it be from remorse for shouting at you or grief for his own situation, he ducks down to bury his face in his hands. A far cry from the man you'd just been joking with.

For minutes, you sit in silence. Simon, repetitively running his hands over his face -- over those raised red scars he despised. And you, looking on, unable to promise anything more than you could give.

"Simon," you eventually speak, quieting your tone, "Why'd you come in today? I mean, after almost twenty years living with these scars...why now? What changed?"

You hear him sniffle beneath the cover of his hands.

God, is he crying?

If it were possible, your heart breaks even further. Slowly, you wheel backwards to grab a box of tissues out of the supply cabinet.

"Does it even matter?" his voice is muffled from the hands he hides behind, warbled with tears. He's determined not to let you see them. (Not to let himself have them).

"Yes, Simon," you pull a tissue from the box, holding it out in his direction, "It matters. I could give you a whole spiel about the health science behind resilience and purpose in recovery, but I'm not saying this because of the research. I'm saying this because I'm your doctor and I care about you."

For a few more seconds, he cries silently into his hands, sucking in every hitching breath, like maybe if he tried hard enough, you'd never notice the tearstains on his collar. It takes awhile, but eventually, he reaches out shakily to take the tissue.

You don't recoil, not even when he lifts his head, and exposes his swollen, reddened eyes. His words are shaky when he finally opens his mouth.

"My nephew..." he manages, nearly choking, "He's -- he turns three years old in a few weeks."

"Yeah?" You pull another tissue, "He's what makes you want to get rid of the scars?"

He nods his head, and for a split-second, that look of sadness on his face deepens into an aching look of sheer anguish.

"He's a sensitive lad, gets -- gets nightmares real easy," he looks down at his boots, "Last time I went over, he burst right into tears, and -- and my brother said he woke up cryin' for damn near the whole weekend."

A sob escapes his mouth before he can stop it. He swallows it and clears his throat.

"He's so scared of me he won't come near. Won't let me hold him. Won't let me talk to him," he shakes his head as more tears burst forth, "He's terrified of me. His own uncle. Because I look like this." He gestures towards the smattering of scars across his face, tissue clutched in his balled up fist, "Because this is who I am."

"Simon, that's..." you reach forward to grab his fist, squeezing it between your warm hands.

"My brother says he'll grow out of it, that -- that it's not a big deal, but..." you hand him another tissue, "I know it's not easy for them. And -- and sometimes I wonder...if maybe they'd be better off if I stopped going to see them altogether."

Immediately, you shake your head, scooting your stool closer emphatically, "That's -- that's not the answer, Simon. I promise."

"Yeah?" he looks up at you, watery eyes unsteady, "Then what is? Because -- if you can't get rid of them, then what's even the point of trying?"

That strikes a chord within you. Seeing him there, looking to you for help, for comfort, for answers...Your preceptor told you not to get close to your patients, but after this...How could she expect you to put up walls?

You reach for the box of tissues, and lift one towards his face. He can't help but flinch backwards when you raise it words his injured cheek, but when you hold steady in the face of his reproach, he squeezes your hand in silent consent.

You dab around the corner of his injured eye, studying the contracture marks beneath your tissue. His fingers twine with yours, nervous and worked up, but you don't rush.

Already, it's hard to imagine his face different than what is already is, but if it's as important as he believes...

"Simon, I can't promise you more than what science has to give," you whisper, "But if there's anything I've learned in the past few years, it's that nature is more surprising than we give it credit for."

"What do you mean?"

"I mean..." you swipe across his jaw, where several tears hang, "Research might say one thing, but the results of treatment might surprise you. What you think is a small difference might be what changes everything. How your family thinks about your appearance...how your nephew thinks about your appearance..."

You squeeze his hand.

"How you think about yourself."

His brows draw tight when you say that.

"That's why it's worth trying. Because if that's what you think is best for yourself, then all of us should listen."

You let your eyes wash over his face, wash over his harsh cheekbones, sharp jaw, blonde hair, and white-red skin. The color looks like supernovas against his complexion, like something tended to, healed, and stitched back together with love in every thread.

"You think so?"

"I think so," you nod, "And I promise I'll do anything to help you get there."

He spends a few more seconds studying the conviction in your eyes, studying the way your hand fits against his own, but eventually, he manages a deep breath, and he gives a small but sure nod.

"Okay," you nod back, tapping your figures against his hand, before you turn your stool and grab a piece of paper from the supply cabinet. You don't waste a minute before starting to write.

"Here," you rip a section of the paper off, "It's my personal number."

"What for?" he suddenly straightens up, something...unreadable and confused overcoming his face.

"I'm booked out for months -- gotta love the efficiency of the healthcare system," you complain sardonically, "If I left you with Julie, she'd do her best to find you a place, but this is important, and I don't want you falling between the cracks."

You stand from your stool, "Whenever you get a chance, call me. I'll fit you in after hours, come up with a plan that's better than just 'wait and see.'"

At that, something akin to hope flickers in his eyes. He looks down at the small scrap of paper and the loopy handwriting thereon, before he gathers himself and finally stands.

For a split second, you're blinded by how tall he is. God, you nearly have to crane your neck just to maintain eye contact.

"Okay," he nods, tucking the baseball cap back over his head, "I will."

"Then..." you smile, sticking out your hand, "I look forward to it, Simon."

He looks down at the offered hand, at your starched white coat, and the irresistible glimmer in your eye.

He didn't know it then, but in the future, he'd come to realize that moment was just the beginning of it all. What followed was deeper than he could've thought. Deeper than seven layers of scar tissue. Deeper than a scalpel could cut. Deeper than he'd dared to let himself imagine.

Now, he knows its significance. But back then, it was only ten little numbers, written in sparkly pen ink, with the letters 'M.D.' left in signature.

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