By Raymond Chandler (adapted to Careweb).
HPI: The name’s Marlowe. I’m an MD. I’m not just a clinician, I also do a great deal of research – particularly in the apartments of tall blondes. I was neat, clean, shaved and sober and I didn’t care who knew it. It was about 4 o’clock in the evening, mid February, with the sun not shining and a look of hard wet snow in the clearness of the trees. I belonged here like a pearl onion on a banana split. I was moon-lighting cause I was broke; I’d been shaking two nickels together for a month, trying to get them to mate. What I needed was a drink…a vacation… a home in the country. What I had was a white coat, a notepad, and a stethoscope; I put them on and entered the exam room.
Ms. Vivian Regan was a 28 year old dame who came to my office with a story that her stomach hurt… but a woman will lie about anything, just to stay in practice. She gave me a smile I could feel in my white coat pocket. I sat down on the edge of a stool, and looked at Ms Regan. She was worth a stare. She was trouble.
Physical exam: General: A tall, thin blond…a blond that would make a bishop kick a hole in a stain-glassed window. She smelled the way the Taj Mahal looks by moonlight.
HEENT: Her eyes were as dark and empty as the spaces between stars. She gave me a look which ought to have stuck at least four inches out of my chest.
CV: She had a systolic murmur that was as inconspicuous as a tarantula on a slice of angel food cake.
Extremities: I didn’t mind that she showed me her legs. I told her they’re very swell legs and it’s a pleasure to make their acquaintance; she said she didn’t like my manners, I told her I didn’t mind if she liked my manners. They’re pretty bad. I grieve over them during the long winter nights. This seemed like a nice hospital to have bad habits in.
Skin: The kind you could light a match on. It was as cold as the ashes of love.
Neuro: Her reflexes jerked away like a startled fawn might, if I had a startled fawn and it jerked away. She was tense, had something to hide…but then again, who doesn’t? When I asked her to close her eyes tight, she lowered her lashes until they almost cuddled her cheeks and slowly raised them again, like a theater curtain. I was to get to know that trick. That was supposed to make me roll over on my back with all four paws in the air.
Assessment/Plan: She asked me what I thought was wrong; I was honest as you can expect a doc to be in a world where it’s going out of style. I told her she talked too damn much, and too damn much of it was about her.