Among the residents and histotechs, there was a whispered nickname for Dr. Irene Haas: the Condyloma Queen. It was never spoken in her presence. She was famous for spotting even the subtlest HPV-related changes on Pap smears, and her tirades during cytology sign-out were legendary. If you missed a koilocyte, you paid for it in humiliation. The irony wasn’t lost on James when, later that week, someone else claimed the same title—loudly, and with pride.

James wheeled the cart back to the cytology department, still rattled by his encounter with the Pearl Harbor veteran. Three flats of slides sat stacked on his desk, awaiting his return. The FNA had taken longer than expected; there would be no time for lunch and barely enough to review the Pap smears before his 1 PM sign-out with his attending. Fishing through his backpack, he came up with a granola bar, then headed to the end of the hall for the coffee pot — its contents brewed six hours earlier and bitter as tar. Refueled, he settled at his microscope.

The Pap smear had revolutionized the early detection of cervical cancer, a public health success story rivaling the eradication of smallpox. Now James was part of that chain of prevention. Each morning he received about forty Pap smears, pre-screened by cytotechnologists. Their careful dots of ink marked suspicious cells, silent testimony to the hours they’d spent scanning each smear. His task was to confirm or amend their impressions. Tedious work, yes — but James stayed focused. Every abnormal cell was a map, a breadcrumb trail to cancer. He was determined to follow it, however long or arduous.

After half an hour, he’d worked through a third of his stack. On one slide, he instantly recognized the cytologic hallmarks of HPV infection.

“Condyloma. Venereal wart,” he murmured, checking the box on his worksheet and setting the case aside.

The overhead speaker interrupted.

“Dr. Deetan…line one!”

“This is Dr. Deetan.”

“Are you the pathology resident looking at my case?”

James straightened. “I’m sorry — who is this?”

“This is Dr. Louise Treacher. I told the cytotechs I wanted the Pap results on Madison, STAT. She’s sitting in my office and I need the report. The computer system’s down, so I decided to call.”

James shuffled his paperwork. “Yes, Dr. Treacher — I have it here. Donna Madison, 34 years old, correct?”

“That’s her! Does she have the wart?”

“I’m afraid so. I’ll still confirm with my attending, but it looks like a classic condyloma.”

“I knew it! Honestly, I can’t believe how many of my patients have condyloma. It’s an epidemic! I’m the Condyloma Queen!”

James blinked. “…Yes, ma’am. I’ll call if there are any changes after sign-out.”

“Well, aren’t you polite. What’s your name again?”

“James Deetan.”

“Is that Chinese?”

“Yes, ma’am. Chinese-Filipino.”

“My nurse is Chinese — Shirley Kwok. Maybe you know her?”

“I’m afraid not.”

“Well, very nice talking with you, James.”

James hung up, shaking his head. “Nice talking with you, Condyloma Queen,” he muttered. Two queens, one whispered, one proclaimed. Either way, the computer system was still down.

He dialed IT.

“Information Systems. Jake speaking.”

“Hi, this is Dr. Deetan in Pathology. Any update on when our system will be back online?”

“Who is this?”

“Dr. James Deetan. First-year resident.”

“Oh right — I remember setting up your login. Good to meet you, Doctor. The system should be up in about fifteen minutes. One of my coworkers accessed the wrong file; I traced the error and corrected it.”

“Thank you, Jake. Nice to meet someone so efficient. Sorry, what was your last name again?”

“Thompson. Jake Thompson.”

“Appreciate your help, Jake. Hope to meet you in person sometime.”

“You can count on it.”

James refreshed his screen — the system blinked back to life. Relief washed over him, but the reprieve didn’t last.

“Thought I forgot about you?”

He turned. “Wilma!”

The chief histotech set a small stack of surgical slides on his desk. “Here are the companion slides for your cytology cases. And I couldn’t help noticing you drinking that stale, scorched coffee.” From her bag she produced a thermos and styrofoam cup. “Try this.”

She poured. The aroma was richer, sweeter than anything he’d ever tasted. James took a sip — smooth, nutty, almost chocolatey.

Wilma grinned. “You like it?”

“It’s incredible. What is this? Hazelnut?”

“That, Dr. Deetan, is a New Orleans specialty — chicory coffee. Back home there’s a famous café, Café du Monde. I brew their recipe every morning. Told you I’d take care of you.”

James laughed. “You did. Thank you. Wish I’d had this instead of that granola bar.”

“Well, maybe a piece of pecan pie will find its way to your desk later.”

“Ooh, the famous Rousseau pecan pie? It can find its way here anytime.”

“If you come to New Orleans, I’ll take you to Café du Monde — coffee and their famous beignets. Ever had one?”

“No, but it sounds wonderful. Is it a pastry?”

“Better. It’s—”

“Oh, sorry to intrude. Didn’t know you were here, Wilma.”

Deanna.

James quickly set the cup down.

“Dr. Berkowitz,” Wilma said smoothly. “I was just leaving. Dropping off slides for Dr. Deetan.”

Deanna’s eyes flicked to the thermos, then to James. “That doesn’t smell like regular coffee. Hazelnut?”

“Deanna,” James stammered, “Wilma brought me some of her New Orleans chicory coffee. It’s fantastic. You should try it.”

“Maybe I should,” Deanna said coolly. “If I were ever offered a cup.” She shot Wilma a sidelong glance.

“I’ll get you one,” Wilma offered quickly.

“It’s all right,” Deanna replied. She studied James’ refreshed screen. “Just checking to see if the system’s back up. Seems everything is… back to the way it should be.”

Next Chapter: Chapter 17-Blood Brothers