The young man sits quietly on the exam table with the legs of his trousers rolled up, exposing his bare feet. He dips his head in a barely perceptible bow when I enter the room. I glance at his toes; silently, they reflect the reason for today’s visit.
“How long have they been like this?” I ask, stooping down for a better look.
“One week, maybe a little longer. I thought they might get better on their own, but they got a bit worse.”
The nails of both great toes are completely blackened by underlying pools of extravasated blood. “Do they hurt?”
“A little bit,” he tells me. “I can sleep okay, but they bother me when I try to play basketball.”
I rise to my feet, regaining my footing. “We can drill a small hole through each nail to drain out the blood. You’ll feel much better when the pressure is relieved. It won’t hurt—the nail itself has no feeling, like your hair.”
“Okay,” he says.
I disappear and return shortly with a tray of medical supplies: gauze, alcohol wipes, Band-Aids, an absorbent towel. I prepare the field, clean the surface of one nail and begin to drill, twisting the tiny point of a number 11 blade into the thickened keratin. “Let me know if this bothers you,” I say.
“I’m fine,” he says.
I make conversation as I continue my work. “Where are you from?”
“China,” he tells me.
“Ah! What part?”
“Southern China,” he says. “This is my second year in the states.”
“How do you like it here?”
“I’m glad to have the opportunity to study abroad in the U.S.” he says. “The only thing I’m not accustomed to is the snow. I had never seen snow before coming to America.”
“You’re certainly getting a baptism by fire this winter,” I say, then qualify my remarks—“we’ve gotten record snows this year.”
I continue to twist the point of the blade down through the nail. “What do you plan to do after you graduate from prep school?” I ask him.
“Oh, go to college, definitely.”
“What do you want to study?”
“Probably math or science. I like the arts and music as well, but I think I would like to concentrate my studies in one of the sciences.”
“Your English is very good,” I tell him.
“Thank you. My father started to teach me English when I was two. He spent several years abroad with a company in Australia. He learned English there. I started taking formal studies in English when I turned four. Now it’s no problem for me—I get along fine.”
A bubble of dark red blood erupts onto the nail surface. I exert gentle pressure to help it along. “How does it feel now?” I ask him.
“Better,” he says.
I apply a Band-Aid and turn my attention to the other foot.
“Do you have brothers or sisters?”
“No. In China the government says you can have only one child, unless you agree to pay a lot of money for the privilege of having another one.”
I think of China’s President Hu Jintao’s visit this week to Washington. There were several days of talks on a host of issues ranging from relations with North Korea to economic problems to the recognition of the need for greater human rights in China.
So far the exchange on the diplomatic level has been cordial and mutually beneficial—but not nearly as beneficial as the myriad exchanges that my afternoon patient has been having with his schoolmates over the past two years.
“There, all done,” I say, applying the final Band-Aid. “Soak your feet in warm water several times a day over the weekend. The small holes will gradually grow out with the nail. Just keep your toenails trimmed and things should work out fine.”
He looks down at his feet. “When can I play basketball again?”
“Whenever you feel up to it,” I tell him.
Were he born in America, I wager he would have had a Chinese Tiger mother.