Thursday, December 31, 2009

Whose headache is this?

Oy, Barbara B. is requesting more narcs. An on-line check confirms my fears--four different docs doling benzos and Percs.

In office, she’s misery embodied, waifish voice barely heard, partner stroking her arm.  Part drama, part pain, no knowing what’s what.

Five phone calls, the last one to Barb.  I’m no longer the problem, but what’s the solution?

Tuesday, December 29, 2009

A curry-ous case

Green curry, rice, and a doughnut for lunch. (Eat as I say, not as I chew!)

I’m good to go for my first p.m. visit, then a carb-laden cloud rolls over my brain.  Chin heads to chest, I struggle with eyelids.  My patient drones on about issues, but suddenly stops, eyeing me with alarm.

“Are you okay?

Monday, December 28, 2009

A window to her soul

Overweight, and diabetic, she shut me down with mono-syllables.

“Watching your diet?”



“No.”  This punctuated with a lift of the lip.

“Anything special for Christmas?”

“Why yes.” She shifted, eyes widened.  “I decorate my apartment, especially the window.”

She e-mailed a pic of the window dressing. Shimmering, bejeweled, it sparkled like her eyes at the end of our visit.

Saturday, December 26, 2009

Time to pass it on!

Lillian works full-time in food prep, fingers and toes in arthritic twists.  Her face pale and drawn, feet afire with gout.

“You need a cane,” I urge. And so much more...

She gives an ‘as-if’ sort of shrug.

“Hold on a sec,” I advise.  Return post-haste with my mom’s walnut cane. Here, I conclude, is one worthy heir.

Tuesday, December 22, 2009

Reflux redux

Carol complained of acid reflux.  On the exam table that day, her abdomen rose like a nine month pregnancy...but she wasn’t.

“Am I in trouble doc?” she asked when she saw my face fall.

The gynecologist delivered a twenty pound ovarian tumor.  As promised to Carol, I scrubbed in and watched.

The path report was, thank heavens, benign!

Sunday, December 13, 2009

Thanks...I guess

My old patient had on a good-looking jaunty wig and a leopard-print top.  She smiled at me and said I was cute. 

Nice perhaps, looking good for my age, but cute?

I thanked her but questioned the adjective.

“No honey,” she enthused.  “You are cute.  You and your pony tail and your little purple nose.”

Say what?

Thursday, December 10, 2009

Can I be saved?

A first year teacher, lots of exposure, frequent colds.  This one was bad--severe sore throat, painful cough, no voice at all.

I knew the answer, but looked him over for the hands-on touch.

Son (I didn’t really call him that), you’ve got a helluva virus.”

He grabbed a pen and pad, looked up anxiously,  “Could you spell that?”

Wednesday, December 9, 2009

The kid and I in 30-some years?

Bea still drives; she’s 91.  Son Gabe’s a sprout of 72.  He seemed down, so she brought him by for a morning visit.

“Doctor,” she began after both sat down, “He doesn’t do anything, he just mopes in the house!  He should get out and be with his friends.”

“Mo’om” he wailed, stretching two syllables from one.

Monday, December 7, 2009

An unstructured life

I’d asked Linda in to discuss her bone density.  The usual stuff--enough bone to get through her life but no more must be lost.  Calcium, D, exercise, drugs...

Wait!  We’ve got tears, lots of them.  What’s going on?  This can’t be just bone!

Lost job, lost love, no bones about it.  What’s the drug for lost hope?

Sunday, December 6, 2009

Pet therapy

Carol warned me last minute; she’d scheduled this appointment to ‘fess up to hubby a large credit card debt. 

Yikes!  Have I lost my mind? He’s Hell’s Angel scary, she’s frightened and thin.

By sheer luck, my dog was the fourth in the exam room that day.  Five scrawny pounds, a lap technician working her charms.

Saturday, December 5, 2009

A couple of problems

Mr. C. came for his physical, his wife in tow.  As I took his history, she sat quietly, lips pressed firmly in a downward line.

"So how do you spend your days?" I asked.

He pondered the question, smiling slightly as he considered his answer.

"He doesn't do a goddamn thing," came a thin, angry voice from behind.

Thursday, December 3, 2009

Who you calling old?

Carolyn was a psychiatrist at a time when women weren’t and state hospitals were full.  At 90, to my surprise, she opted for a new heart valve.

A year later, she flew to Paris; after two, she fell in love with a man at the home.  She died today at 94, two daughters at her side. 

Saturday, November 28, 2009

Last words

Helen’s voice was soft on the phone, the words disjointed, unclear. When she quit talking altogether, I yelled to the front desk, Call 911 to her home!  Dogs barked frantically as help broke through her door.

Later that day, I spoke with her husband, reassuring him that she had faded out quietly, without fear, without pain.

Wednesday, November 25, 2009

She's come undone

Kim was a math teacher until arthritis and toxic drugs got her number.  She arrived one day by cab, dirty, vomit-splattered, too weak and dehydrated to come inside.

I saw her at the curbside and sent her straight to the ER.

“She’s a math teacher,” I told the ER doc twice.  “This could be you or me.”

Tuesday, November 24, 2009

Not really done for yet

“Done with defibrillators!” he declared in spring.

No shock when his heart quivered in November and dropped him to the floor.

A younger Ed clowned and smiled through his memorial slide show. In the final slide, yesterday’s Ed held his tiny grandson like a treasure in his lap, a comma not a period to his life’s story.

Monday, November 23, 2009

A lump in my throat as well

I struggled to keep my expression neutral as I stared at her breast in disbelief.  Peau d’orange the picturesque name, the red skin tense, dimpled by cancer.

“Let’s get a surgical consult,” I said, my voice light. “Today.”

Ten years later, she brought me a bottle of fine red wine to toast the joy of her survival.

Sunday, November 22, 2009

Where's her village?

Marion, an ex-bank officer, still wears matching outfits--velour sweats instead of suits.  Eighty-plus, childless and prone to confusion, she cries over lost independence.

Her visiting nurse calls often with updates: “Forgets food and medications", "oxygen off", "legs swollen”.

A Midwestern brother visits.  He doesn’t phone, he leaves no plan.  Marion muddles on, missing meds and meals.

Saturday, November 21, 2009

Lest we forget

“Where did you go to college?” I asked my new patient as I glanced through the records she’d brought.

“Kent State.”

Looking up, my heart rate accelerated as I put down my pen.  She was just my age.  “Were you there when...?”

“My roommate died in my arms that day.”

New tears for innocence and a life long lost.

Friday, November 20, 2009

For the birds...

She lumbered large to the exam room each visit, clutching penciled notes scrawled on tiny pages. I sighed to see her on the schedule, wondering anew if fibromyalgia really exists.

“So,” I said interrupting her litany, “Anything new in your life?”

“Why yes,” she said, “My cockatiel’s eggs have hatched, four babies!”

Our heads touched over pictures.

And I don't much like you either!

The surgeon exclaimed “I’m like you, let me die in the saddle!.  But I can fix this with a wide excision and bone grafts from your skull!”

Could he not see my husband’s face, pale and grimaced beneath the skin cancer on the bridge of his nose, body language screaming “I’m not like you at all.”

I've heard worse...

“I am so sorry to have to meet you under these circumstances.” The oncologist’s intro had been kind, the words that followed blunt: “undifferentiated carcinoma” “six months without treatment.”

Later, the waiter’s face was crestfallen.  “I’m afraid I have very bad news, we’re out of pate foie gras today.” We laughed so hard that we cried.

Why you haven't changed a bit!

My friend got up slowly from the waiting room chair, much transformed from six months ago.  Just my age, too skinny, her left knee puffed above her matchstick leg. As she settled in the exam room, I saw her hands were permanently flexed with arthritis.

"How are you?" I asked. 

"Just fine," she answered, "And you?"

Seeing I to eye

My heart sank.  An old patient on the schedule, Ms. Big Hair with Big Demands.

“Long time, no see,” I said, “How are things?” 

Lost job, big move, schizophrenic son, now menopause, insult on injury.  We talked, we laughed.  She’d found a sense of humor, and I my compassion.  Two moms with hot flashes and sons.

A touching story

He was doing a little dance on his feet like the college quarterback he probably once was. Then the doctor tackled a stool and sat with his hand on my husband’s knee, explaining the course of radiation therapy.

My husband’s folded arms and hunched shoulders screamed “Don’t touch me!”, unheard gestures in a cold, white room.