Centaurs in my throat

A review of having had a really painfully sore throat for six days, on a Friday, and—in the cursed window of “this is actually maybe semi-serious” and “regular medicine takes the weekend off and isn’t exactly gonna be hustling Monday morning either”—of trying to get a doctor on a virtual urgent care to help me out

The first person I saw on the virtual urgent care app—henceforth to be referred to as Dr. Zoom #1—had his camera turned off, or something weirder than that, like it was pointed at a wall or had something obscuring the camera: it was a mostly gray field but with some shadows along the edge, purples and grey-greens flecking with light.

I had sent pictures of the back of my throat, which mostly just looked like the back of a throat to me, albeit with some ugly looking welts on my uvula and maybe my tonsils? But who looks at your own tonsils? Who knows what a tonsil is supposed to look like? I fucking don’t. I just know that whole business hurts, and has for a week, and that’s too long.

Dr. Zoom #1 lets me speak about four sentences, and declares from the photos you’ve got tonsillitis and Are you allergic to amoxicillin. The latter is not a question (I am not) and within seconds—I’ll send your prescription to Wellspring, he says—we have consummated our blessed time together.

Oh! Ok! I’ve spent $30 and will spend a buck and change on some kind of penicillin product. And as Friday is wearing on, I hustle down to Wellspring, which tells me politely to fuck right off.

Wellspring is not my usual pharmacy. It was my pharmacy at some point in the distant past, though when I try to remember when, I’m picturing Covid precautions, real mid-2020 shit, back when someone standing too close to you was real “wtf you doing” stink-eye territory. That was the distant past, in my mind.

Why are they closed? No one answers their answering machine. So I go online, sick, on a phone, sitting in my car outside a closed pharmacy, sick and on a phone, trying to manage the zoom doctor service’s menus, to change to another pharmacy. That doesn’t work. I call their number, I talk to a person, they transfer me to their pharmacy department answering machine, which takes my sentences and spits me out, and I really feel like I’m never going to hear back (I don’t). I call again, spend ten minutes talking to a person who tells me that I need to leave a message on the answering machine, which I’ve already done. I’ve already done that, I say. You’ve done all you can do, she replies. It doesn’t seem like I have, I don’t quite say.

Back home, I go through madness again with the zoom doctor app trying to send a message to the doctor, or anyone, to change the prescription to a pharmacy that is open. Part of the problem that I’ve apparently signed up for this service using multiple emails and multiple usernames and multiple times—such that recovering my forgotten password is both complicated and confusing—and when I finally manage to log in, I find the app claiming that the prescription was sent to my regular pharmacy, which is in a supermarket. Wait, what? I call the pharmacy, tell them my birthday, they have no record of the prescription. I call again, they still don’t.

Nothing is happening. No one is calling me back. I call the supermarket pharmacy again—it’s been an hour—and as I tell them my birthday, they recognize my voice, no it’s still not here, but rather than being annoyed, they do check again, and let’s be charitable, and these are working people, but they have lost prescriptions before and I’ve had to be like hey could you check again and then they’re like oh yeah we totally do have it, actually. Anyway, they actually don’t have it. Definitely don’t have it. They cannot sell me less than two-dollars-worth of penicillin unless they get a message from zoom doctor #1 telling them to, and he has, as of yet, not done so.

Why does the app say it was sent to the supermarket pharmacy if it wasn’t? Well, the doctor did say Wellspring, so probably it’s just… that it was sent to Wellspring and the website words mean nothing.

OK. Well.

Throat is still awful. Fuck it, I’ll do another appointment. This time it’s $56? Why is– But ok, don’t ask. Until your medical care hits three digits, count yourself fortunate. This is America.

After another hour, Zoom Doctor #2 comes on, and it is a guy whose bald pinkish head looks like it has achieved its final and most powerful form. The app gives me his name, and when I google him later, I find that he has a website, a substack, a podcast series, a consulting business, posts pictures of scuba fish on facebook, and just, a lot of stuff. He did his residency when I was potty training, and I am not young enough for that to not make him a very active and vigorous retired guy. He was, and I can’t stress this enough, “Twice named to the Power 50 most influential business leaders in Spokane by Inland Business Catalyst Magazine.” Not exactly a lightweight.

This guy takes a surprising amount of time. He tells me his qualifications—nothing that I’ve mentioned, all just extremely relevant licensing and medical school and specializations stuff, and though he tells me a lot, actually, he tells it to me very crisply. I’m convinced that he’s a good doctor and thorough, but he also listens to what I say. He’s ready to end it there. Oh I can transfer your prescription, no problem, he says.

But since I’ve got you here, I say—since he does seem like a good doctor, and thorough—I decide I want my $56 worth. I get it: He squints dramatically at his screen so that he can tell me my photos are bullshit, that they show nothing, you can’t see anything. He gives me a succinct but still lavishly informative explanation of the three ways you can diagnose strep—the first, culturing, is a test they only do in medical school—no one does that, except in medical schools, he tells me again—the second is rapid but mostly accurate test that they do in person, and probably, really, I am realizing, I should have just gone to one of the local urgent cares in my network that would have done it. But he continues: the third is a set of centaur indicators that tell you that you mostly likely have it, enough to make throwing some antibiotics at it worthwhile. He walks me through the centaur indicators, while I try to figure out if he is saying “center” indicators, or something else like that (it turns out to be named for Dr. Centor, who developed it in 1981.)

(I think about how “centaurs in my throat” would be a good way to explain this to my kids, who no doubt gifted me with this bacteria, if they knew what centaurs were. I should explain to them what centaurs are.)

Anyway, my symptoms are bullshit, he decides, and I believe him: no fever, no white pustules, no joint pain—headache, yes, but who doesn’t have a headache? This is America. No coughing, which actually turns out to be a point in favor of strep. Something else I don’t have, but I’ve forgotten. It’s a wash. Centor test gives us numbers and no clarity.

And yet? Six days? He frowns, and he does it too dramatically for me to break in and say huh, actually maybe only 5 full days, come to think of it. But a virus would have cleared up by now, he explains. And after another moment of dramatic pondering, he asks: well, hey, do you want antibiotics? I do. I really do. At this point, I’m committed. I’ve been to a pharmacy, in person, and was turned away; you’re goddamn right I want antibiotics. So my man prescribes a different antibiotic than the one the other guy prescribed—and even cites a recent official sounding recent (CDC?) bulletin about some new bacterial infection in California that is resistant to amoxicillin, and look, at this point, I’m all in, a two-time IBCM Power 50 most influential business leaders in Spokane is reading some official-sounding bacterial strain updating mechanism and wants to give me the other special different antibiotic? Hell yeah.

I get a “Z-pack.” The supermarket pharmacy lady on the phone says “What’s your birthday, Aaron?” and I go in. They don’t have it yet, so I wander around the grocery store collecting the ingredients for soup, in my arms, and I suppose I could go and get a basket, or even a cart, but fuck it. Chicken and onions at home, so I need broccoli, carrots, noodles.

They text me, it’s ready. I get the antibiotics for $1.91. I take the antibiotics immediately. About two days later, I feel 40 percent better. This morning, I feel 60 percent better.