Two Potential Diagnoses

“Be honest now, when did you first notice this as an issue?”

Rethais grunted, trying to remember, so he could give an honest answer. The pain had become noticeable and annoying only a couple of days ago, but there had been some vague pain for a while. As for the visible bruising? He was not sure at all.

“The pain or the bruise?”

“Tell me about both, preferably.”

Doctor Kaldi seemed impatient today. Normally she was quite laid back, but she currently had a lot on her plate, what with all her new clients. The Vice General here was one of them, a patient she had inherited from her old boss General Kaldoran, who had… disappeared a while back. Not a problem, Rethais Rethianos was definitely a good patient. The problem was that Kaldi normally specialised in geriatrics. Older patients. Not someone as healthy as Rethais was.

“The pain got noticeable after the 6th of the month. Up until then, I had… slight twinges in the same area, but I assumed it was stress. I only really noticed the bruising when the pain got worse on the 10th.”

“Uh-uh.”

Rethais eyed the medic standing in front of him.

“You seem to not believe me.”

“You only noticed the absolutely massive black sore on your neck three days ago?”

Rethais tutted, not appreciating this medic’s attitude. “I noticed it on the 10th. I thought it was a bruise. It was about the size of a large coin at first. This morning, it was a lot larger, so I came to visit a medic.”

Kaldi took a deep breath and closed her eyes. She really didn’t believe what the Vice General was telling her. After all, most older Rethavok would lie about vague pains. They saw it as a sign of weakness, of their increasing age. Why would Rethais here be any different?

“General, the spot on your neck is cold. There is a lack of proper blood flow into the area. This could be pretty serious.”

“Which is why I came to see you!” Rethais snapped. “I am not a fool! I know when things are out of control. And this little bruise had been just that, a little bruise for a couple of days, until it felt awful and cold this morning! Do you know what it is or not?”

“Alright, easy now…” Kaldi sighed. “Did not think you would be genuinely honest with me. The mark on your neck could be a variety of things. It may just be an infected insect bite, considering how quickly you have said it has expanded. Aside from the coldness of the affected area, it matches all the symptoms. Luckily, after cutting away the infected skin, we should be able to cover it and treat it with antibiotics…”

“I assume you are about to say “but” here…” Rethais grumbled.

Kaldi nodded. “You would be correct. The other diagnosis is that it could be a very aggressive skin cancer. One that is in a very worrying position. But from just sight and touch, I cannot be certain in any way. I will need to take a sample and have it sent to a dermatologist and a composition lab to be able to tell you with certainty. Will you allow me to take a sample?”

“Of course!” Rethais exclaimed. “Please do take a sample! We need to know what this is so it can be removed!”

Glad that her patient was cooperating, Kaldi reached into a nearby drawer and pulled out a small test tube and a scalpel. She washed both in disinfectant, before turning to Rethais.

“Please lean to one side.”

“Oh…” Rethais hesitated, before doing as he was told. “I… thought you would just… use a needle or something…”

“You should close your eyes. It helps. You will feel a quick pinch!” Kaldi explained as she approached Rethais from behind.

“Alright…” Rethais did as he was told, closing his eyes tightly.

“Nothing fancy or anything, I will be as gentle and quick as possible.” Kaldi kept on talking for what seemed like a long time. As she continued talking though, Rethais began to get suspicious. He opened his eyes briefly, then realised that everything had… already been done. Somehow, without him noticing, Kaldi had taken the sample and already sealed it inside the test tube with a thick, rubber stopper.

“Is that…”

“That is it!” Kaldi smiled, writing some notes on a sheet of paper. “The testing will take between 24 and 48 hours. Here is a prescription for now, for the pain, just some simple painkillers. I recommend however that you restrict your eating to smaller amounts though, in case we need to perform some kind of surgery.”

“Oh…” Rethais fell silent, then got up off his seat. “Alright… Thank you very much, doctor.”

“No worries. Try and take the next few days off, if you can!” Kaldi suggested. “It is most likely just an infected bite, but better safe than sorry…”

Rethais sighed as he left the room. “I will try, but no promises on that…”