The intern said, “Hi,” as he entered the room.
The patient replied, “Greetings and salutations, young acolyte of the temple of Aesculapius, heir to the aphorisms of Hippocrates, disciple of Osler, and now an Iatros in training under the auspices of this storied institute of the highest curative education. I surmise this with certitude, evidenced by your pristine and immaculate alabaster raiment, bedecked with the suitable accouterments and paraphernalia, embellished with your identification. I furthermore presume that your arrival presages what is colloquially known as the history and physical. If so, let us proceed without divagation.
“Perchance we may initiate this interrogation and investigation with my wretched jeremiad, without obfuscation or circumlocution. I suggest this is undertaken optimally with my chief complaint, that being my primary raison d’être in this medicinal pas de deux. I desire not to make a pretentious gasconade, but I am generally robust, vigorous, and filled with joie de vivre. But recently I am finding myself hyperpyretic and tussive and am inquisitive regarding the causation of symptomology.
“I was enjoying my usual state of supreme well-being, attending an exquisite and sublime operatic performance; it was ‘La Bohème.’ I began to experience a tickle in my trachea, followed by a sternutatory triumvirate and a cough like the bark of a cacophonic canine. I was forced to absquatulate, my mind rife with consideration of the fierce irony that I was absenting myself from a performance which includes, in the final act, the demise of Mimi from consumption. I looked for the telltale erubescence in my handkerchief; it was free, unlike the hands of Lady Macbeth, from sanguineous stains. Of course a horrid and Brugellian fate flashed across my occipital cortex. Was this phthisis, inhaled anthrax, or perhaps even pneumonoultramicroscopicsilicovolcanokoniosis? I am certainly no hypochondriac, just a somewhat above-average apoptotic human, and all I could fervently aspire to was that this was just a transient occurrence and not the presaging event of my eventual demise.
“Over the subsequent solar orbits, I experienced alternating and excruciating episodes of shuddering ague and defervescence. My tussive episodes increased in frequency, though still I was without rubiginous expectoration. I was filled with vexation and consternation. My caput ached mightily, less migrainous and more arrhythmically pounding. The muscles of my decimated corpus cramped and twinged with every movement. I felt fatigued, as if I had just completed a Herculean task, but I had mucked no Augean stable. Without a cacoethical consideration, I entered this place of healing for a divination. I am not prevaricating when I assert that I felt ready to shake off my mortal coil.
“As to the momentous medical and surgical events in my past, I am happy to delineate these tragic occurrences. My procreation was accomplished with minimal difficulties, and the puerperal period was uneventful. As a youth, in my exuberance, I pirouetted off a trampoline, fracturing my upper extremity, the osteal components of my appendage in a state of extreme discontinuity. In my pubescent years, I developed an inflammation of my appendix requiring advanced surgical intervention. The surgeon stated my vestigial remnant had grown to Brobdingnagian proportions and was on the veritable verge of rupture prior to operative decompression. I also had frictional resurfacing of my epidermis due to its post-acne astrobleme-like surface combined with solar-induced coriaceous texture. Otherwise I have been a model of extreme salubriousness.
“The medical soundness of my remarkable progenitors is of obvious interest to you, my interviewer. Needless to say, I am not of adoptive origin. I am the scion of a phenomenal and stupendously hardy and flourishing set of kinfolks. On my paternal side there was merely a glimmering of the French disease, with the inexplicable tendency towards dipsomania, and crapulence. My grandmother on my maternal side succumbed to plumbism, and her husband was both an entomophagist and omophagist who died of an obscure parasitic infestation, perhaps diphyllobothriasis. My uncle was a renowned blatherskite and my glabrous aunt a trichotillomaniac who perished from the deglutition of extraordinary and generally inedible objects such as paint chips and tonsorial afterthoughts; her demise was secondary to a gargantuan bezoar.
“As to my social milieu, I am surprisingly unbetrothed, though a bon vivant character. I have been, in my time, a cantillating colporteur, a serpent venom extractor, a poultry gender identifier, and a bibliophilic librarian. I am currently working in the asbestos remediation industry. I ingest a modicum of ethanol-related products and abstain from the consumption of tobacco products, aside from the occasional panatela and the sporadic cheroot.
“My, as per the apt nomenclature, review of systems is rife with incredible and astounding items, such as my monorchidism post-equine misadventure, to my audible bruxism and borborygmi. I live in constant consternation and expectation of exsanguination from my impressive scybalic feces and callithumpian cardiac arrhythmias.
“So, fledgling practitioner of the healing art, can you allay my unfounded concerns, prior to my becoming an ecdysiast for your examinatory manipulations, and suggest a eucatastrophic explanation for my symptomatology?”
“Flu,” the intern replied and exited the room.