Doctors are scientists who work in an uncertain world. We use statistics, odds, and probability to diagnose and treat. Good or bad, we make the best-informed decisions we can.

“I’m going to order an MRI.” I typed more notes in her file.

“Can you give me something for the pain?” she asked. “I’ve heard OxyContin is good for back pain.”

I kept my face neutral. The opioid crisis had made it difficult for doctors to know where the line was, when to prescribe pain medicine and when not to. It was a doctor’s job to help people, to assuage their pain, and yet I’d watched other doctors’ patients succumb to addiction. I knew about addiction firsthand, from my brother. I refused to let my patients become another statistic.

“I’ll write a prescription for naproxen to help the pain.” I smiled gently at Alice. “Once we get the MRI results, we’ll know better how to treat it. In the meantime, ice it, and stay off your feet for the next few days, okay?”

I handed Alice a leaflet with advice on how to treat back pain, gave her arm a compassionate squeeze, and left to see my next patient.

AFTER MY last patient of the day had left, I went to find Julia. She was clearing up one of the exam rooms after seeing a patient. Tendrils of dark hair were falling out of her ponytail. Julia was conventionally pretty, with sea-glass eyes and a slight overbite that somehow made her look even more adorable. She smiled faintly, and I noticed her wrist was bandaged, her movements slow, a little delicate.

“You all right?” I nodded at her wrist.

“Oh, carpal tunnel syndrome. Lucky me.” She laughed wryly. Julia was lively and cheery, a nurse practitioner who somehow did more work than all the doctors combined.

I told her about Alice Jones, and she scowled, her freckled nose crinkling. “The husband was here last week. Said he’d sprained his wrist.”

“He wasn’t wearing a wrist wrap.”

“I think Dr. Watson saw him. She might’ve prescribed some OxyContin, although check his chart to be sure. Maybe he was back for more? I seem to remember he was pretty aggressive. She was glad to see the back of him, I know that.”

I’d come across my fair share of angry men in the ER during my residency at Harborview in Seattle. I could still remember stitching open wounds with shaking hands, dodging drunken fists, standing near the exit to make sure I had a quick escape route.