Diagnosis of the Heart – Chapter 3
Priya
The tremor had returned with a vengeance overnight, as if her hand knew exactly what day it was. Priya stood in her office bathroom, fingers pressed flat against the cool porcelain sink, willing the trembling to stop before her appointment with Dr. Davis.
“Not today,” she whispered, staring at her reflection. She’d deliberately scheduled this meeting at the end of her shift, dressed in her most professional attire rather than scrubs, determined to present herself as a colleague rather than a patient. She couldn’t afford to appear vulnerable in front of a researcher looking for test subjects.
Priya checked her reflection once more, adjusting the sleeve that hid her trembling hand. Her mother’s voice echoed in her memory: “The moment they see weakness, Priya, that’s the moment they stop seeing you.” It had been her mother’s mantra during hospital visits, her stubborn dignity even as rheumatoid arthritis twisted her joints. Priya had inherited that pride, for better or worse.
A knock at the door pulled her attention back to the present. She took a steadying breath, tucked her right hand into her pocket, and opened the door with her left.
Maya stood in the hallway, her expression a careful mix of casual and concerned. “Just checking if you’re still on for the pediatric staff meeting at four.”
“That’s two hours away.”
“I know.” Maya’s eyes dropped to Priya’s hidden hand. “I also know you have that consult with Dr. Davis in fifteen minutes.”
“It’s not a consult,” Priya corrected, keeping her voice low as a nurse passed in the hallway. “It’s a professional meeting.”
“Right.” Maya folded her arms. “A professional meeting that happened to get scheduled after I slipped a referral form under the locker room door.”
Priya’s jaw tightened. “I’m only going to get him off my back. And yours.”
“If that helps you show up, I’ll take it.” Maya’s professional mask slipped, revealing the friend beneath. “I’m worried about you, Priya. We all are.”
Something in Maya’s tone, the gentle concern, the absence of her usual teasing, made Priya’s throat tighten. It was harder to maintain denial when someone who knew you so well refused to play along. For a dangerous moment, Priya felt her carefully constructed walls threatening to crumble.
“A tremor could be a dozen different things,” Priya countered, instinctively falling into doctor-mode. “Stress, caffeine, medication side effects.”
“Or something neurological,” Maya said quietly. “Which is why you’re seeing Dr. Davis today.”
“I’m not seeing him. I’m meeting with him. Professional courtesy.”
Maya’s gaze was steady. “Call it whatever you need to. Just go.” She checked her watch. “I’ll cover your patients until you’re back.”
“It won’t take long,” Priya insisted, though she had no idea if that was true.
“Take as long as you need.” Maya squeezed her arm gently. “And Priya? Whatever he tells you, you’re not alone in this.”
The simple statement nearly undid her composure. Priya nodded, not trusting herself to speak, and headed toward the research wing.
The half-finished area was a maze of plastic sheeting and construction materials. She found her way to a makeshift reception area where a young woman with bright blue glasses looked up from a laptop.
“Dr. Raman? Dr. Davis is expecting you in Room 2. Second door on the right.”
Priya followed the directions, noting how the examination room stood in stark contrast to the construction zone outside, fully equipped, immaculately clean, with that distinct smell of fresh paint and disinfectant. A glimpse of the future research center amid the current chaos.
Dr. Evan Davis stood at a counter, reviewing something on a tablet. He turned at her entrance, and Priya felt an unexpected jolt of awareness. His hospital ID photos hadn’t captured the intensity in his hazel eyes or the focused energy he radiated.
“Dr. Raman.” He extended his hand. “I’m Evan Davis. Thank you for coming.”
Priya hesitated before offering her left hand instead of her right. “I prefer Priya,” she said, meeting his gaze directly, a small assertion of equality. “And just to be clear, I’m here as a professional courtesy to a colleague, not as a patient.”
His eyes, an interesting hazel that shifted between green and gold in the office light, held hers for a beat longer than necessary. “Of course. Please, sit down.”
She chose a chair rather than the examination table, another small rebellion. “I understand you’re recruiting for your study.”
“I am.” He leaned against the counter, clipboard in hand. “Patients with early neurological symptoms that might indicate MS but don’t yet meet diagnostic criteria.”
“And Maya thinks I fit that profile.”
“Does she?” His expression revealed nothing. “What do you think?”
The directness of the question caught her off guard. “I think my friend worries too much.”
“But you came anyway.”
“As I said, professional courtesy.”
Davis nodded. “Would you mind if I asked you some questions about your symptoms? Professionally speaking, of course.”
Priya recognized the subtle challenge in his tone. “Go ahead.”
“When did you first notice the tremor?”
“About four months ago. Intermittent. Right hand only.”
“Worse with stress or fatigue?”
“Yes.”
“Any visual disturbances?”
She hesitated. “Occasional blurring. Brief episodes.”
“And balance issues?”
Priya stiffened. “Who said I have balance issues?”
“You did. Just now, by asking that question.” A hint of a smile touched his lips. “Your reaction confirms it more than a direct answer would have.”
She felt a flash of irritation at being so easily read. “I’ve had a few moments of unsteadiness. Nothing significant.”
Davis made a note. “Any numbness or tingling in your extremities?”
“Sometimes in my right hand. After the tremor.”
“Family history of neurological disorders?”
“No.”
“Autoimmune conditions?”
“My mother had rheumatoid arthritis.”
He looked up. “Severe?”
“Debilitating by the end.” The admission cost her, each word a surrender of the careful distance she’d maintained.
Davis nodded, making another note. “Do you mind if I examine you?”
She’d been expecting this, had prepared herself for it, but still felt a flicker of resistance. The fluorescent lights suddenly seemed too bright, the office too small. This was the moment where theory became reality, where her symptoms became something that existed outside her own perception, confirmed by another physician’s assessment.
“If you think it’s necessary,” she said, her voice steadier than she felt.
“I do.” He washed his hands at the small sink, his movements efficient and practiced. “Can you move to the examination table?”
Priya complied, sitting on the edge of the padded surface. Davis approached with a penlight.
“Follow my finger with your eyes, please,” he said, moving his index finger slowly from left to right. Priya complied, recognizing the standard test for eye movement abnormalities.
He continued through the basic neurological exam, testing her reflexes, strength, coordination. Priya knew what each test was designed to reveal, which somehow made it worse. When he asked her to touch her nose, then his finger, then her nose again, a test for cerebellar function, she felt her right hand falter slightly on the return journey.
She hated being on this side of the examination. Hated the role reversal that transformed her from respected physician to specimen under glass. Each test stripped away another layer of her professional identity, replacing it with something she’d spent her entire career avoiding, vulnerability. Dependency. Need.
“Any dizziness with position changes?” Davis asked as he tested her reflexes.
“No.” The rubber hammer tapped just below her knee, and her leg jerked appropriately.
“Headaches?”
“Occasionally.”
“Characterize them.”
“Dull. Behind the eyes. Worse with fluorescent lights.”
He nodded, making mental notes. His hands were warm as he tested the strength in her arms, asking her to push against his resistance. The clinical touch still managed to be both impersonal and intimate, a contradiction that left her uncomfortably aware of him as both doctor and man.
“Stand, please,” he said. “Walk to the door and back.”
Priya slid off the table, conscious of his scrutiny as she walked the short distance. She’d practiced this, making sure her gait remained even. Today was a good day, no wavering.
“Now heel to toe, as if walking a straight line.”
This was harder. The narrow base required more precise coordination. Halfway across the room, she felt a slight wobble, her right foot landing at an angle.
“That’s enough,” Davis said. “You can sit back down.”
Priya returned to the examination table, tension coiling in her stomach. Davis made a few notes on his tablet, his expression unreadable.
“There’s a subtle unsteadiness in your movements,” he noted, his voice neutral. “And you seem to have some difficulty sensing exactly where your limbs are in space without looking at them.”
The clinical observation hit with surprising force. Hearing her symptoms described so precisely made them more real, harder to dismiss.
“Could be nothing serious, a benign tremor that many people live with. Could be a reaction to medication. Or it could be something more concerning, like early Parkinson’s or multiple sclerosis.” He said the last possibilities without emphasis, but Priya heard them like thunderclaps.
“You can’t make that determination based on a ten-minute exam,” she said, medical training asserting itself defensively.
“I’m not making a determination. I’m outlining possibilities.” His gaze was direct, unflinching. “Which is why I’m recommending a full workup.”
“What kind of workup?”
“Brain and spine MRI with and without contrast. Lumbar puncture for cerebrospinal fluid analysis. Blood work, including the neurofilament light chain assay that’s central to my research protocol.” He set down his tablet. “And twenty-four hours in our monitoring suite to establish baseline cognitive and motor function.”
“Twenty-four hours?” Priya shook her head. “That’s impossible. I have patients, responsibilities.”
“The protocol requires—”
“I understand what your protocol requires,” she interrupted. “But my protocol involves caring for sick children. I can’t just disappear for a day.”
Davis studied her for a moment. “You’re concerned about people knowing.”
It wasn’t a question. Priya looked away, uncomfortable with his perception.
“My medical status is private.”
“Of course, but avoiding diagnosis won’t make the symptoms disappear.”
“I’m not avoiding diagnosis,” she said sharply. “I’m here, aren’t I? I’m simply stating that I have professional obligations that don’t allow for overnight monitoring right now.”
Construction noise from the hallway punctuated her statement, the whine of a drill, followed by hammering. Davis glanced at the door.
“Let’s continue this discussion somewhere quieter.”
He led her out of the exam room and down a corridor where the construction seemed less active. They stopped near a large window overlooking the hospital grounds, partially secluded from the main walkway.
“I understand your concerns about privacy,” Davis said, his voice lower. “And I respect your commitment to your patients. But I need to be clear about something.”
Priya crossed her arms, waiting.
“The symptoms you’re experiencing, the tremor, the coordination issues, the visual disturbances, they’re not going to improve without intervention. They’re likely to worsen.” His gaze was direct, unflinching. “As a physician, you know this.”
The truth of his words hit home. She did know. Had known for months but refused to acknowledge it.
“I can modify the protocol,” he continued. “The monitoring can be done in segments—evenings, early mornings—to accommodate your schedule. But I can’t compromise on the comprehensive assessment. It’s necessary both for your care and for the integrity of the study.”
Priya felt a surge of conflicting emotions, gratitude for his flexibility, resentment at being forced to confront her situation, and something else, a response to the intensity of his focus that had nothing to do with medicine.
“I’ll agree to the testing,” she said finally. “But I maintain my clinical duties for now. And I want the results directly, not filtered through hospital channels.”
“Agreed.” He nodded. “I’ll have Matthew prepare the consent forms and testing schedule.”
As if summoned by his name, Matthew Vance appeared at the end of the corridor, waving enthusiastically when he spotted them.
“Dr. Raman! Just the person I was looking for.” He hurried toward them, a folder tucked under his arm. “Got a minute to talk about the gala?”
Priya blinked at the abrupt change of subject. “The hospital fundraiser?”
“Yes! The committee meeting just ended, and we need someone to introduce the silent auction portion.” Matthew’s energy was irrepressible. “Since the pediatric department is getting thirty percent of the proceeds this year, we thought you’d be perfect.”
“I don’t—”
“It’s just a brief introduction,” Matthew continued, pulling a sheet from his folder. “Two minutes, tops. The event’s next Friday. We’re expecting record attendance with Dr. Davis’s research bringing in the biotech crowd.”
Priya glanced at Dr. Davis, who had stepped back slightly, his expression neutral once more.
“I should get back to my patients,” she said. “We can discuss the gala later.”
“Actually, the committee’s meeting in the cafeteria right now to finalize the program.” Matthew looked hopeful. “Could you spare fifteen minutes? Maya sent me to find you, she said you’d be finishing up here.”
Of course Maya had. Priya suppressed a sigh. “Fine. Fifteen minutes.”
“Great!” Matthew beamed. “Dr. Davis, you’re welcome to join us. The board is particularly interested in your thoughts on the research presentation.”
“Another time,” Davis replied. “I need to finalize Dr. Raman’s testing schedule.”
Matthew nodded, then led Priya toward the cafeteria, chattering about auction items and table arrangements. She glanced back once to find Dr. Davis watching them, his expression thoughtful.
The cafeteria was crowded with lunch traffic, but the gala committee had claimed a corner table, surrounded by poster boards displaying event layouts and decorations. Maya waved them over, relief evident on her face.
“There you are,” she said. “How did the consultation go?”
“Fine,” Priya replied, not wanting to discuss it. “Matthew says you need me for the silent auction introduction?”
Maya nodded, clearly recognizing the deflection but allowing it. “Yes. We’re highlighting the new pediatric monitoring equipment your department needs. Having you introduce that segment personalizes the appeal.”
“I’m not much for public speaking.”
“It’s just a brief introduction,” Maya assured her. “Two minutes, then you can enjoy your champagne while the rich people bid against each other.”
Priya smiled despite herself. “When you put it that way…”
The committee discussion flowed around her, debates about centerpieces, music selection, the precise wording of the program. Priya contributed when necessary, but her mind kept returning to the consultation with Dr. Davis. The way he’d looked at her during the examination, clinical yet somehow intimate. The certainty in his voice when he’d named her symptoms.
Her phone vibrated in her pocket. She pulled it out to find a calendar notification: MRI APPOINTMENT: Friday, 8:00 PM, Cascade Bay Medical Center Research Wing. Friday. The night of the gala. The same event where she was now scheduled to speak.
“Everything okay?” Maya asked, noticing her expression.
“Just a scheduling conflict,” Priya said, pocketing the phone. “Nothing I can’t handle.”
But as the meeting continued, the weight of the notification weighed on her. She couldn’t be in two places at once. Either she would miss the critical imaging that might explain her symptoms, or she would fail to appear at an event where her department’s funding, and her public professional face, depended on her presence.
The choice felt symbolic of everything she now faced. Doctor or patient. Caregiver or recipient of care. The identity she’d built versus the reality she could no longer ignore.
Priya excused herself from the meeting, claiming patients waiting. As she walked through the corridor toward the pediatric wing, her phone vibrated again, another notification, this one a text from an unknown number: Consent forms ready for signature. Blood work scheduled for tomorrow morning. – E. Davis
She stopped walking, staring at the message. Each test, each appointment, each form pulled her deeper into a reality she’d been fighting to avoid. She could cancel it all, of course. Walk away. But the tremor in her hand, the occasional blurred vision, the moments of discoordination, they wouldn’t disappear because she refused to name them.
Priya pressed her back against the wall, momentarily overcome. The hospital continued its rhythms around her, patients being wheeled to tests, nurses checking medications, doctors reviewing charts. The normal flow she’d been part of for years, now viewing it from this strange new perspective.
She took a step forward, and her right leg buckled without warning, as if the connection between brain and limb had suddenly severed.
The floor seemed to rise up to meet her, the impact sending a shock through her palms as she caught herself. For a moment, she stayed there, the white floor tiles swimming in her vision.
Twenty years of training and discipline, erased in a single graceless moment. The shame burned hotter than any physical pain.
“Dr. Raman.”
She looked up to find Dr. Davis standing a few feet away, a folder in his hand. He must have been coming to find her with the consent forms. Of all the people to witness her fall, it had to be him.
“I’m fine,” she said automatically, struggling to rise. Her right leg still felt disconnected, unreliable.
He knelt beside her, his presence solid and steady. “Priya,” he said softly, just her name, nothing more. Not offering help yet, somehow understanding that reaching for her now would only deepen the humiliation.
“I lost my balance. It happens to everyone.” The lie sounded hollow even to her own ears.
“Not like this.” His voice was gentle but firm. “This is a neurological event, not a stumble.”
She managed to get to her knees, then paused, uncertain if her legs would support her. Dr. Davis remained kneeling beside her, close but not touching, giving her space to decide how much assistance to accept.
“Let me help you up,” he said finally, offering his hand.
Priya stared at it for a long moment. Taking his hand meant acknowledging she needed help, crossing a line she’d spent months avoiding.
She took his hand.
His grip was strong, steady as he helped her to her feet. He maintained contact until he was certain she was stable, then stepped back, giving her space to collect herself.
“I think you should sit down,” he said, his voice gentle but firm. “We need to talk about what happens next.”
The clinical detachment was gone from his eyes, replaced by something worse, compassion. In that moment, Priya knew she had crossed an invisible line. She was no longer just a colleague with a minor issue.
She was a patient.
And the expression on Dr. Evan Davis’s face told her with devastating clarity that whatever was happening to her body wasn’t something she could ignore away.
You have been reading Diagnosis of the Heart...
The first rule of medicine is *do no harm*. Dr. Priya Raman sleeping with her brilliant, arrogant new neurologist probably counts.
Dr. Evan Davis is everything she shouldn’t want. Her colleague. Her doctor. The one man who holds her future in his capable hands.
He’s also devastatingly attractive, infuriatingly perceptive, and the only person who sees past the confident facade she shows the world.
When a medical crisis forces them into close quarters, professional boundaries become impossible to maintain. Every stolen glance burns. Every accidental touch ignites something they both know they should resist.
He wants to save her. She wants to save her career. Neither of them expected to fall this hard.
The hospital has rules about doctor-patient relationships. But some attractions are too powerful to deny.
