The Other Woman

The Other Woman

It was several years ago and I was doing a fellowship in Infectious Diseases. I was on the consult service and got a call on a new consult. This was on a young woman who used intravenous drugs. She had apparently used unsterilized needles to inject herself with heroin. In the process she had developed an infection in her blood which had involved the heart. The medical term was bacterial endocarditis. We had been consulted for antibiotic management.

She was a young girl, in her early twenties. In appearance, she was very slim, and almost wasted. She had very poor dentition which is often a sign of crack cocaine use. Her heart had a loud blowing systolic murmur, a classic sign of endocarditis. Her heart Echocardiogram had also confirmed a vegetation on a heart valve and her blood cultures were positive, confirming her diagnosis.


I could not get much history from her. She was sedated as she had been withdrawing from drugs. I looked up from examining her and I suddenly noticed an older man sitting quietly in a corner of the room. I had missed seeing him earlier. He was a dark complexioned Asian man, very well dressed, probably in his fifties. He was wearing a Fedora hat. He saw that I had seen him and asked me how she was doing. I told him that she will need intravenous antibiotics for a few weeks and should recover.


I stepped out of the room and saw the patient’s nurse. I took her aside and asked her, who is that man in the room with her? Oh that is her boyfriend she said. He has been visiting her every day.


Two weeks later, I was in the Infectious Disease clinic, and a Pakistani immigrant woman was brought in for a follow up. She was a tragic case. She was brought in on a stretcher. She was in her late forties. About two years previously, she had developed neck pain and was found to have an abscess from tuberculosis in her neck. In the process of draining that abscess she became paralyzed from her neck down. The Infectious Disease clinic was treating her tuberculosis, but she remained paralyzed, essentially a quadriplegic.


I had been born in Pakistan and tried to speak to her in Urdu, her mother tongue. She was well educated and had gone to college in Pakistan. She had three teenage children and a husband that lived at home with her.


She was pleased to talk to me in Urdu and introduced me to her husband who had accompanied her. As I was being introduced to her husband, I was startled to see the same man that I had seen with the young drug addict. He recognized me too, but we kept our conversation focused on the care of his wife. She had completed her course of treatment for Tuberculosis, but her paralysis remained. There was nothing more that the Infectious Disease clinic could do.


I felt sad at the turn this lady’s life had taken. She was still relatively young, but effectively bed bound.


A few months later, this lady died. I do not know what happened to the young drug addict or the husband. I pray that my quadriplegic patient is resting in peace.

A Man in a Fedora Hat