It sometimes irritates me to recall how often I’ve asked doctors for the convenience of meeting by telephone, each time being told “no.” Now, the world is off its axis and suddenly everyone in the medical community is all about the telephone.

I’d sent The Great Scott an email about a few updates and one question about a potential drug trial. I’d read an article the evening prior about a potential promising new treatment from Multiple Sclerosis News Today (could I have ever imagined the world was so full of publications like this five years ago? The answer is hell no.) It was about Ursolic acid, a compound found in some herbs and in the peels of certain fruits, and how it promoted nerve cell repair and restored the myelin sheath in a mouse model. I pounced all over it, because of course I did, recalling that last conversation TGS and I had about keeping our collective eyes open for potential trials focused on progressive disease and repairing existing damage. One doesn’t forget a conversation like that when one has a spinal cord made of Lorraine swiss. My email said:

—– Message —–
From: Maribeth Nigro
Sent:4/14/2020 2:46 PM EDT
To: T Scott
Subject: Non-Urgent Medical Question

Hi Dr. Scott,
I hope you are well and staying safe and healthy.
I wanted to send you this article to get this topic on your radar (in the event it’s not already) as you and I have discussed in the past keeping our eyes open for possible clinical trials related to progressive MS. This one caught my attention and I wanted to see if you had thoughts.

I am also assuming that I should continue to delay my round 2 of Lemtrada until this virus situation is under control I am also waiting for my mobility to improve even more post-surgery for my baclofen pump. I was in-patient at West Penn rehabilitation for a month and have been continuing that recovery with home care therapy. I’m making great progress but strength building is slow but steady. I’m hoping to be ready to be out and about more as soon as this virus situation is lifted. But I’m also trying to be patient.

Please let me know what you think of the article attached or if you think we should schedule a telephone appointment to check in before you leave for the summer. I’m pretty flexible as I am on leave from work until my rehabilitation is complete.
thanks,
Beth

My reference to his summer schedule was about my experience of meeting with him that one time just as he returned from his summer sojourn, I’m assuming to a beach of some sort, because I remember him walking into the stark white exam room wearing a pale blue oxford shirt under his standard clinical white jacket. He brought to mind images of madras plaid shorts and TGS with a sweating Seabreeze cocktail in one hand and a medical journal in the other like some kind of middle-aged medical Malibu Ken. I didn’t want to let too much time pass before making a decision about the whole Lemtrada Round 2 thing. TGS is like that bartender you used to hook up with occasionally. You never like to let too much time pass between the next meeting lest you lose your position in the queue. TGS’s queue is even more exclusive, though.

It was minutes after I hit send on my email that my phone was ringing.

Now, very rarely do I answer a number that I don’t recognize but the timing was so strange, I was breaking my own rule before I even realized it and as soon as I’d done it, I realized that there was at least a 70/30 chance this would be some random cold call forwarded by my work phone and I regretted it, almost hung up, honestly. I mean, I’m still getting sales calls even while the world falls apart, even while I’m in my own cocoon of so-called healing on medical leave from work. No, Daniel, I don’t have time to talk about your staff placement services at the moment, you see I’m over here spending my time trying to learn how to traverse steps, could you be any more like a cannibal if you tried? Stop calling me.

“Hi Maribeth, this is Lisa from Dr. Scott’s office,” a familiar voice said on the other end. “Dr. Scott wanted me to set up a telephone appointment with you so you two could catch up. We’re offering telephone or video visits, your choice.”

I chose telephone mainly because I find Facetime distracting. I’m too busy trying to make sure I have a good angle on my own face to focus on the other person and what they’re saying. I’m nothing if not honest, reader, and this is the painful truth. I hate FaceTime. A lot. At the agreed upon time, I got the call from TGS’s intake staff who then transferred me to the man himself.

“Hello Maribeth!” The Great Scott was way more exuberant via telephone than I was prepared for. “Tell me, is this your number (reads off number) because I’m going to call you right back so we can FaceTime. That will be ok with you, right?”

I never had a chance to respond before my cell was ringing with the dreaded FaceTime call. “Ok pick that up now, ok Maribeth? That’s me calling you.” Well, duh. As the window opened, the man himself was seated in his office adjusting his white coat around yet another pale blue oxford shirt but no tie in sight. TGS always wears a tie.

“Well there you are, Maribeth, isn’t this fun?”

Wait. Who are you and what have you done with Dr. Thomas Scott?

“It’s great to see you, Maribeth. You’ve been up to quite a bit I see from your email.”

I’d yet to have gotten a word in. He was smiling so big his eyes got very tiny like little brown pin pricks. I was completely thrown off.

ME: Well, yeah, it’s good to be seen. How are you?

TGS: (chuckling) Well, I’m here in my office and I haven’t been stricken by Covid yet so things are going well. Are you staying healthy?

ME: Yes, I mean, as healthy as possible. I did spend a month in the hospital after pump surgery and that kind of sucked but the rehab thing was what I needed so I made the best of it.

TGS: You got out of there in the nick of time, I see, before the virus was so prevalent. That’s a good thing. Are you keeping up with your recovery at home?

ME: Well, yes I am mostly because I have therapists coming to the house every day of the week almost. I have Thursdays off. And the weekends of course but things haven’t been happening fast enough for me…

TGS: (…cutting me off) Well, if I remember right patience is not your best skill. Recovery of strength and stamina takes a good long time. How is that pump treating you?

ME: I mean, quite frankly, it was life changing. The meds I no longer have to take! The lack of constant pain and threat of spasms. I mean, I’m sleeping so much better. And I’m definitely getting stronger, it’s just the damn steps in front of my house that haunt me but I hope to get there. I mean, I can’t stay in the house forever.

TGS: That’s good to hear. I don’t always get that answer. It’s pretty much a 1 in 4 chance that this pump is effective for people.

ME: Well, I’m kind of glad you didn’t tell me that before I had the surgery. Geez. I don’t think I did a great job of explaining to you how badly my intense spasticity was negatively affecting my life. It wasn’t good, Dr. Scott. Not good at all.

TGS: I’m happy it’s working for you then. Keep at the rehab. It will take time but you’ll get there if you stick with it. Now put the phone up to your face so I can see your eyes.

And on it went. We did the usual neuro-testing hijinks like touch your nose touch your fingers look right look left look up look down.

TGS: Can you lift your feet off of the floor one at a time? Show me.

ME: Well, that’s not working so well right now but I can do it sometimes. I’m not really in a good position for trying to…

TGS: (…cutting me off again) Well, I. guess I did kind of spring this whole video thing on you. That’s ok. But you look good Maribeth. You seem to be in good spirits, I like to see that. Keep working at the therapy. You can do it.

ME: Hold on just a minute…I have a question about that mouse study I sent you. The one about the ursolic acid? I feel like I’m getting the bum’s rush here. We said we’d keep our eyes open for potential clinical trials that might be good for me. That one looked pretty exciting.

TGS: Well, here’s the thing, Maribeth. You’re not a mouse, sadly. When these things are at the mouse stage there’s going to be 6ish years before trials get to humans. Unfortunately, that’s probably too long considering your age. You’re likely to start learning to manage around your symptoms better before we got to a trial for this one. But it was good to share.

ME: Again with the reminding me of my age. I mean, really. Well that sucks. (At this point TGS has pointed his iPad or phone in the wrong direction and now all I can see are the wrinkles on his forehead and the white ceiling tiles above his head). I can’t see your face, Dr. Scott. You’re pointed as the ceiling.

TGS: Oh. Right. How did that happen? (All of the sudden I’m recalling when I tried to teach my mom to use FaceTime). Well, no matter Maribeth. We’ll keep looking, don’t get discouraged. You’re doing great.

ME: Wait! Lord you’re rushing me. I have one more thing…Lemtrada round 2! I’m assuming it would be dumb to obliterate my immune system at this juncture. To be honest, I’m not inclined to do the second round at all. I’m guessing that by the time this virus madness is past us, I may have finally built up some strength. I’m disinclined to knock myself out again at that point. If you recall, after Round 1 was when shit started to go downhill even faster.

TGS: Well, that could have been your reaction to the drug or it could have been your MS merely progressing. We won’t ever know. But you’re right. Let’s discuss this when I see you again at the end of the summer. See how you’re we’re feeling about it then, sound good?

Looks like I’ll be having a date with medical Malibu Ken in August after all.