Chapter 3: A Shocking Suggestion

She explained, "It hurt for a couple days at the start, but now it’s just... there. Feels like I’ve got a piece of gum stuck or something. I can’t get it out of my head."

I paused, prescription pad ready, but honestly, I was stumped. ER docs are supposed to have answers for everything, but sometimes you just get blindsided. This kind of canker sore was unusual: large, painless, and persistent. Not your average mouth ulcer. My brain spun through the differential. Big, painless, lingering sores? Not your standard issue. I thought back to those Red Bull-fueled all-nighters in med school, mouth raw from stress and vending machine snacks. This was different. With no solid evidence and knowing this wasn’t my specialty, I figured she needed a dentist or oral medicine specialist tomorrow for a real workup. "Look, this is a little outside my wheelhouse. If you can swing it, see a dentist or oral medicine doc tomorrow. They’ll know exactly what to look for."

Suddenly, Alex blurted out, "This looks a lot like the mouth ulcer that HIV patient had before." For a second, the only sound was the vending machine dropping a soda can. Then the patient’s face went white. My pulse spiked. In the space of a breath, I saw lawsuits, social media blow-ups, the chief’s disappointed face. I swallowed hard, forcing my voice steady. HIV—how could you just throw that out there in front of the patient and her friend? But I couldn’t tear into Alex in front of them, so I tried to smooth things over: "It’s not necessarily HIV. There are lots of causes for mouth sores—fungal infections, viral infections, autoimmune diseases, and so on."

I shot Alex a look, then turned back to the girls, making my voice as calm as I could. "Mouth sores can come from all kinds of things. Sometimes it’s a virus, sometimes autoimmune, sometimes just a weird fluke. Let’s not jump to conclusions."

But the damage was done. I could see the anxiety climbing up their faces, the roommate’s mouth tightening into a thin line. The patient’s face changed instantly, and she shot back, a little sharply, "How could it possibly be HIV?" Her voice trembled, caught between anger and fear. The kind of look that says, "You just flipped my world upside down."

Her roommate squared her shoulders, suddenly fierce. Her cheeks flushed, and she leaned forward, voice tight. "You can’t just throw stuff like that out there. That’s not fair." She clutched her phone so tight her knuckles went pale. I couldn’t blame them. In an era where rumors go viral in minutes, a doctor’s words can feel like a verdict. I made a mental note to pull Alex aside later and talk about the power of words in a crisis—especially when you’re the one in the white coat.

As I watched them leave, I couldn’t shake the feeling I’d missed something important—and that whatever it was, it would be back before Monday.