I was determined, too, to reap the most value from the appointment in terms of duration, though I am aware that this is probably mostly an effort at proving some point (though I'm not sure which point) after coming to the realisation at the conclusion of the last seven-minute visit that the doctor's fee amounted to more per minute of his time than I earn per hour. Further more, after two appointments of similar duration (the first resulting in a bill inexplicably double that of the subsequent visit) I feel no better off for the expense.
When the doctor met me in the waiting room, his pleasure at seeing me seemed genuine - the smile accompanying his handshake not so broad as to imply exaggeration, nor lasting so long as to suggest it were forced. That said, I would also probably appear happy if I stood to earn over $25 per minute for someone's company. Once inside his office, the first several minutes of that costly time were occupied by the doctor battling his seemingly dubious grasp of computer technology to open files which he would read for the first time in my presence. One might expect this kind of preparatory work to have been completed prior to a client's arrival. This is at least the expectation in industries in which I have worked, and even my experience with some other neurologists.
Once he eventually managed to display the documents on his screen, he stammered through key points, all of which I was already aware. On some of the points I probed the neurologist for further detail and insight which he was unable to provide, citing having not studied the test results in detail. I asked if I might be provided with a copy, but this proved a perplexing request, as it had in the hospital. Apparently I am the first patient to have ever made such a request. After several more minutes of back-and-forth conversation during which the provision of detailed answers was mostly postponed, my medication dosage was bumped up. It was suggested that a follow-up appointment be scheduled to review the change in dosage for two weeks' time. I refused. I suspected that I may be in Manila by that time, but I also disliked the minimal timeframe to allow for change. The alternative suggestion was to make an appointment for when I expected to return. I begrudgingly agreed, and the doctor started to close all the files on his computer about me.
I detected the session drawing to a close, and felt dissatisfied with the minimal information I'd been given, and also with the brevity of the appointment. It had been ten minutes, and I wanted at least a couple more. The doctor asked pointedly if there was anything else I needed, so I told him that there was.
'I'd like you to draw a conclusion,' I told him. 'Or don't.'
The neurologist nodded, folded his hands in his lap. He sighed. 'SUDEC,' he said. 'There is a condition called SUDEC.'
I tried to hide my smile. It seemed if I wanted an opinion, it needed to be forced. I relaxed in my chair.
The doctor explained that the acronym stood for Sudden and Unexplained Death from Epileptic Convulsion, or words to that effect anyway. This was dramatic, though not as scary as perhaps it should be. Maybe it was difficult to take the diagnosis seriously due to not actually feeling that sick. It was good to hear something new for a change, though. I asked if this conclusion was related to the newly discovered fact of my slow heart rate during seizures. He said that it was, and also due to my suggestion of their frequency (although 'events' subsequent to that recorded in the hospital were dismissed as being unable to verify due to not having witnesses.) He speculated that the SUDEC conclusion was probably something that the hospital doctor had considered when ordering the PET scan. I asked why he thought so, and he said that, since the doctors were considering my imminent death, they had to consider resolutions, and that if one of those was surgery, they would obviously need tomographic images of my brain to ploy their course.
I couldn't help but laugh a little. My imminent death and brain surgery, used in the one sentence. I don't really fear death, particularly lately, and found that having it the subject of a serious discussion was not at all as daunting as I thought it might be. The concept of brain surgery is much more concerning. My mother has mentioned it seriously a few times, suggesting it could be the cause of my problems, but I am especially reluctant to consider it. Death is one thing, but the thought of failed - or even successful - brain surgery changing my personality in some way is of concern.
Perhaps I shouldn't take the speculation too seriously. It was, after all, merely a speculation, and one which came about only after I put pressure on. However, it was nice to leave with something to think about for a change, and in the end, I did make a follow up appointment for a few months into the future. I allowed myself time to cancel, though, if I reconsider.