#gives me very painful heart palpitations to the point i feel i'm going to die

[feluka]

i should've gone for a science degree.

[ccallahann]

Differential diagnosis | SELF PARA

I kinda used to be free — I kinda used to be bold — I'm kinda missing me — I'm kinda missing my soul.

It was always like this. He closed his eyes against the lights, to drive away the sight of hope that the sun still set like any other day stuck in a prison. The library was always quiet, but new arrivals always brought an influx of action in the dingiest parts of the hospital. Slouched on the bumped out window seat with boots drawing dirt on the pristine panes of glass, Casey hadn’t a care in the world, disregarding the plethora of mental issues still painting him as a monster. Wasn’t the last part of grieving acceptance? Ah, whatever.

“But I’ve had this chest pain.” Her voice sounded worried, too loud in Casey’s ears even if she tried to whisper it to whoever was listening to the list of symptoms. Involuntarily his head tilted to the source of the noise, blue eyes still closed but turned towards them. It wasn’t his conversation, but it was morbid curiosity. If allowed, the flashbacks to his residency would come back in full swing, the years he’d spent listening to people complain about sniffles and joint pain. Sheer willpower kept the reminiscing at bay, as it always did, and the blonde strained to hear the conversation further. Some murmurs later he almost gave up on the eavesdropping, when she continued, still despair in her voice; “Around here, but like deeper.” He could almost chortle at that, but he cracked one eye open to see if he could glimpse what she meant. Blinking away the blurry vision he could see the two friends sitting by one table like good little new patients. Her hand hovered over her left side, over the chest. A clear reason to call a nurse to check it out. It would’ve been his first instinct if he wasn’t stubborn. It wasn’t his area of expertise, cardiology and all that. Big wow if he’d failed that class, or ever taken it. Did he? A frown appeared on his face. The memories of med school were blurry, everything before America had got like that. She was leaning forward with evident intention, that much was clear. She shifted, but never backwards. Side to side, pulling her legs up so she sat on her tiptoes. It wasn’t an alarming thing, Casey himself sat like that when he was anxious, but he was assuming, not connecting. “No, you don’t get it, I don’t want to tell the nurses! They’ll say I’m just imagining things because I’m stressed!” Her voice rose, and a coughing fit rang through the library. All the while she held her chest, a sign of painful spasms, maybe. From her chest to her neck, a radiating pain then. Now invested, he focused on the new patient. Maybe this was the thrill he’d needed, getting out the repressed doctor from his brain. “They’ll just give me something for this damn fever and tell to sleep it off.” Between coughs, she was barely audible. It sounded like just a cold, but he’d seen more than enough of those. Was it wishful thinking he would make some breakthrough by listening to complaints in a library? Something to remind him he wasn’t a failure, that losing one patient wasn’t his fault. It took more willpower to stop that train of thought, the brief stress enough to make the Aussie ball his fist, consider breaking another window, maybe a finger to distract from the spiral of self hate gathering on the horizon. “I can’t just sleep it off, it hurts to lie down, and I can barely breathe! I can’t even sleep at night, and I’m so tired.” Pain, a cough, fever, shortness of breath, alleviated by sitting or leaning forward, fatigue. It didn’t narrow it down much. There were hundreds, if not thousands, of diagnoses for those flu-like symptoms. She was getting hysterical; the tears were almost audible in her tone, so Casey let out a sigh and pushed himself up and off his seat. The patients silenced when he approached, pretending to focus on their books about... Botany. Cute. Leisurely lounging by the table took only about five seconds before he reached his hand out, confusing the young girls even more. “I ain’t here to ask you for a bloody dance, gimme your arm, would ya?” There were more eloquent ways to ask for a pulse, and the stress of having a big, rugged thug ask for your arm wasn’t a way to keep the pulse steady, but it was all he knew now. She was hesitant, obviously, the question of why on her lips before her friend interjected. “Just do it, Maya. Or does that hurt too?” Ouch, not good friends then. That assessment had been wrong. Her wrist was delicate, adorned with a telltale green wristband that promised Casey some more days in solitary if the guards ate their piss-soaked cereal that morning. Her skin was clammy, sticky from the apparent fever she was sporting. Eyes on the clock, her pulse kept racing

like she’d just witnessed her crush confess to her. It could be from his sudden appearance, but he could add it as a symptom, just for the extra challenge. As soon as his fingers left her pulse point, she yanked her hand back and curled in on herself. A shy one, which was unfortunate. “So, you always got your heartbeat up like that, or are you scared?” Pointed question, he assumed, but she shook her head. “N-No, I’m not scared. It’s been doing that a lot.” So, heart palpitations. Casey nodded and crouched down by the large wooden table, throwing his arms over it for support. Squinting into nothingness, the silence prevailed for a while longer before she peeped up again. When had his eyes closed? The insomnia had really taken a toll, apparently, but he slowly cracked his eyes open anyway. “Um,” she began, unsure, eyes darting around the room, “Are you a, uh, doctor?” She barely had time to finish the sentence before Casey snorted, dismissive, maybe rude. She looked taken aback, apologetic almost, like a deer caught in headlights. If he’d get a penny for every time he caused that reaction, he’d have... Many pennies. At least six. “Nah, jus’ a guy who reads too much WebMD.” A half-truth is better than a lie, isn’t that what Sophia had said? All those hours scouring through that very site, as a young hopeful med student hoping to make a mark on the world. What a mark that was. “Then why— ” “Right, you got swollen legs lately? Stomach?” The questioning didn’t head in a direction he could call comfortable; Medical questioning was easier, more routine, something calming about the puzzle it presented even if some called him too dumb to play with a stick. She’d nodded at some point, and Casey dipped his head under the table to check the situation himself. Skin-tight jeans weren’t the best for that, but the compression might be what kept her standing. “Who are y—“ “Should have the nurses check you for pericarditis.” “Wha—“ “Might be a nasty infection ‘round your heart, yeah? Or you want the professional sounding spiel? An inflammation of the pericardium, membrane around your heart’s swollen, extra fluid in the space between the pericardial layers, blah blah blah, yada yada yada.” Slamming his hands against the tabletop makes both the girls jump, even in their bewilderment. The patient in question gingerly places her hand over her heart, anxiety clear on her face. Right, he wasn’t supposed to scare the other patients anymore. Maybe he was making up for the violence in his past by collecting himself, softening a rough, aggressive voice into something kind and caring, something he knew how to do but never wanted to. No reason for them to get attached. “If I'm right, it’s treatable, you ain’t gonna die. Just a few meds and you’ll be runnin’ around reading about... Coneflowers. That’s tight. Go see a nurse.” Leaving them with a confused stare in their eyes was all he could do as he stretched his arms up and left their side. His shoulder popped twice before his thoughts settled in lunch, a welcomed distraction from the growing feeling of pride, a twisted sensation he was quick to kill off with another deadly sin of glutton. “I’m going to see a nurse.” Her relieved voice carried into the hallway, and Casey distantly wondered if he could get the cook to smuggle him some Tim Tams.