19. Dr. Mark Sinclair: My Pediatric Orthopedist

The day had finally come to meet Dr. Mark Sinclair. How did it go? Well, it isn’t easy to explain, because somewhere within the past nineteen years my mind has lost sight of this particular day. In a way, it sits there in my mind as a faded memory always does; it wants to be forgotten. The details are a bit hazy, but as I recall, this is how it transpired:

Nemours Pediatric Clinic had recently opened its doors in downtown Orlando and it was gorgeous. It had all the modern technology a parent could only hope for, and it truly made it the ideal place to see any pediatric specialist. It was like the clinic of dreams in my mind. I had never seen anything like it. As soon as you walked in through the automatic doors you were greeted by a friendly woman showing you where to sign in and where to pay for your visit. Each step had a different counter, a different smiling face there to greet us, and it kept the registrations and payments flowing. Once we registered and paid for the visit, we were directed to the orthopedic waiting room, which was on the first floor on the right-hand side past the pharmacy. The lighting in the room had this permanent yellowish tint. It wasn’t like most clinics or hospitals whose blinding white light makes you feel one step closer to death. No, Nemours Clinic was different. Their lighting was yellowish and made everything look yellow, even the skin of my mama’s face; it’s usually a permanent brown color. Not at Nemours though—there, she too was yellowish from the lighting. We entered the waiting room and my mama sat down in the middle chair of the first row of seats alongside the back wall while I went up to the counter to write my name down. I dropped the pen on the clipboard and found a spot next to my mama. The waiting from was filled with all kinds of toys. Most kids in the waiting room appeared to have simply broken a bone or something. All except this three- or four-year-old who sat next to me whose legs were fully bound. It reminded me of how Forrest Gump’s legs were bound in the movie. As I watched her wobble along holding onto her mom, I felt sad for her. She was so young to have to live with braces on her legs. As I stared at her and her deformity, I wondered how everyone saw me. Was I like this little girl who people felt bad for? Or did I simply blend in? Before long, my name was called and my gaze was pulled away from the girl. I immediately focused on crossing the waiting room and entering an unknown world behind the door. Why is it always so intimidating when they call my name into the doctor’s office? It’s like the suspense of what is actually going to greet me on the other side always eats at me with anxiety. I don’t know what I expect to happen, because generally it always looks the same: The nurse takes your vitals, asks why you are there, and discusses your symptoms, and you hand over all your medical records. In this case it was just a few X-rays that I had from my previous visit with the geriatric orthopedic. When that’s all said and done, you always get the same exact cookie-cutter response: “The doctor will be with you in just a moment.” It always has me wondering why they ask all those questions to begin with. It’s not like they are going to do anything about it. Besides, the doctor prances in a few minutes later and asks the same questions, and that’s precisely what happened.

“Good morning, ladies,” the doctor said as he strode into the room. He was young. The kind of young you wouldn’t expect for an orthopaedic surgeon. His thick red hair and freckled face made him look like just another geeky, nerdy kid. His eyes were warm and innocent as if they still hadn’t been tainted by the years of practice like all the other doctors I’d seen and met.

He extended his hand to me and and then to my mama and introduced himself. “My name is Dr. Mark Sinclair.”

“I’m going to do a neurological exam and then we can discuss your medical history and finally we’ll take a look at your X-rays,” he said.

He turned, facing my back and said, “I need you to bend forward and touch your toes.”

He rubbed his hands along my curve and took a look at the position of my shoulders and my hips.

“Now bend to the left…and to the right.

“Okay, seems like you still have a good amount of flexibility. This is great to see.

“Can you walk forward on your tippy toes?” he said. So I stiffly rose up, extended my arms for balance, and walked forward.

“Now walk back on your heels for me.” So I wobbled my way to him using my heels and praying that I wouldn’t fall face forward.

“Okay. Perfect. Can you sit on the exam table for me?”

I nodded as I jumped on the exam table with my feet dangling over the edge of the bed.

“I’m going to measure your reflexes. This won’t hurt, I promise.”

He took out his reflex hammer and hit my left knee until it bounced up all by itself and he did the same with my right knee, although it didn’t have as much bounce as my left. He moved on to my ankles and then my elbows, but said nothing.

My mom just sat there with a concerned look on her face. I could tell she was hoping that I would pass the weird test without any issues.

He turned around and grabbed his clipboard to write down his findings. The good news was that I still had a lot of flexibility; my hips were aligned and so were my shoulders.

“Thank you, Ms. Velez, you can relax now.” I jumped off the table and went and stood next to my mama.

“How about we discuss your medical history,” he said. As I spoke about my chiropractic visit with Dr. Gray, what the geriatric orthopaedic doctor had said, and my symptoms, he just sat there taking notes—pain, discomfort, numbness and tingling. Check.

I interrupted the medical history conversation to ask, “Do you think if I wear a brace it will help?”

“I’m afraid that your condition has already progressed far beyond the ability to wear a brace. What we need to focus on now is surgical options for you,” he said with a slight hesitation.

“But let’s take a look at these X-rays,” he continued as he put them up on the projecting screen.

He stood up and took his protractor out of his pocket and began to measure the angles of my curve.

He stood back to really look at the X-ray. I looked at my mama and she too was transfixed on the image. The severity of the curvature was too much to deny and they were both amazed by it.

He finally interrupted the silence by saying, “Look, what we have here is a very complicated case. It looks like the way your curves are formed and their locations makes it extremely difficult for us to perform surgery. I would recommend only fusing you halfway. This will still give you the ability to grow if you still have some growing to do. The risk though, is that you can get worse if we do not fuse you all the way.” He explained it all to me as if I was an adult making my own decisions. He said it as if I knew exactly what he was talking about. And even though I could follow his explanation, it was hard to envision myself making these kinds of decision for myself.

My face flushed and I just stood there in shock. I shifted my weight from my right leg to my left leg, hoping that if I fidgeted enough I would think of something to say, but nothing good came out.

“Um, okay,” was all I managed to blurt out.

“I understand this is a big decision, and we also have to find a way to get you covered for the surgery. Do you have another adult that can come with you to these appointments so you don’t have to do all the translating? Besides, it might help your mom and you come up with a good decision for your future. Let’s schedule you an appointment for a month from now so that we can monitor the progression of your curve. I will discuss your case with my colleagues and we will work together to come up with the best option for you.”

“Okay. That makes sense,” I said.

“In the meantime, please call the office if any major issues come up or if you are able to find a financial solution sooner. This way we can go ahead and schedule this surgery as soon as possible.”

I nodded and watched him walk out the room.

I nearly broke down right there. It was incredibly suffocating how powerless I felt. There was nothing I could do. I had no idea how we were ever going to pay for this surgery. I was convinced that this condition was going to be the end of me, and I had no way of fixing the situation.

My mama put her hand on my shoulder, realizing the degree of this soul-crushing moment, and led me out of the clinic.

My mama looked at me and with complete confidence said, “No the preoccupies nana, que no te vamos a dejar asi. Vamos a encontrar una solution.” Don’t worry nana, we are not going to leave you this way. We are going to find a solution.

It’s okay. It’s okay. It’s okay.

I endlessly repeated to myself.

It was my chant. My way of numbing my feelings. My way of convincing myself that it was actually going to be okay. As I walked out of the office all I could see were my feet: one foot at a time. I stared at them as they moved me forward. I focused on them as I kept on chanting to myself that it would be okay. With each okay, I hoped to convince myself that it would actually be alright. With each step I took, I moved farther and farther away from Nemours Clinic. With each step, I caught my breath and it was a relief. I looked up and I could see my mama’s car parked in the distance. I turned around and it was like the clinic began to fade away, and as it faded in the distance, in my memory, it took with it my reality. My fear of my impending surgery. My concern for whether or not I would be able to get the surgery. My concern for my lack of health insurance. As the building faded, it took with it that day and all that came with it.

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