Monthly Archives: June 2019

Field Report

I’ve been on the new job for more than three months now and it’s been a delight. I don’t regret walking away from the chaos into which my profession has descended. I don’t have to deal with ill-tempered administrators expecting the impossible. My visits aren’t rushed and there are no productivity targets.

And I have a lot of stories to tell.

Dead Men Walking
I’m astounded by how willing men are to put their lives and balls in jeopardy by lying like a cheap rug in front of their wives. I’ll ask the husband a question about health status he’ll say, “Of course, I’m fine!” She will roll her eyes, snort or say, “You didn’t tell him about this!

I’ll ask men, “Are you under any stress right now?” They will shoot furtive glances at their spouses, sitting a mere few feet away, and snicker. I’ll shake my head and mutter, “Don’t poke the bear,” while thinking you’re living on the edge, fool.

Another question on the list is: “Are you short of breath at night when you’re in bed?” An eighty-one year old guy chuckled and said, “It depends on what I’m doing.” His wife narrowed her eyes and said, “Don’t go there.” You want to sleep on the couch?

There’s a memory test near the end of the evaluation.  I give members three words to remember before asking them to draw a clock face and hands to indicate a random time. I then ask if they can recall any of the words.

One woman got two out of three. Her husband, two rooms over, and in a wheelchair, blurted out all three words.

She yelled, “You shut the f*ck up!”

I thought, she’s going to beat his ass as soon as I leave. It’s best if I’m not around when the cops find the body.

And That’s When the Fight Started
I evaluated an octogenarian Hispanic couple with the aid of a translating service I call on my cell phone. It’s not as efficient as an in-person interpreter; often one side doesn’t hear the questions or answers. I make sure I look at the person directly rather than telling the translator, “Would you ask him/her…?” It’s far more polite and lets them know I recognize them as individuals rather than anonymous subjects.

Her answers were short with few explanations. Her husband, however, responded to every question with a dissertation before getting to “yes” or “no.” It went well until the end when I foolishly asked, “¿Tiene preguntas?” – “Do you have any questions?”

She began a tirade in Spanish to which her husband responded just as vociferously. The interpreter waited a few minutes before translating the argument.

“She says her husband is always tired because he watches the television too much and then can’t sleep, and isn’t that bad for him? He wants to know what is wrong with watching TV because he enjoys it.’”

Their son, who’d been sitting at the table during the entire interview, just snickered.

I said, “I’m not getting involved in this; thanks for your help” and hung up. The couple and their son paused to bid me adieu before resuming their, uh, discussion.

No Good Deed Goes Unpunished
I saw a woman in her mid-70s one afternoon. I had time to see her two hours earlier, but she didn’t want me to because “I have to finish doing my nails.”  When I arrived at the appointed time, her husband greeted me when I arrived and graciously offered me a seat at their dining room table. A red-headed ball of fire who reminded me of Gladys Kravitz joined us a few minutes later, snapping at her husband, who appeared to be the perfect Abner. “Where’s my insurance card? It was here on the table! Go find it!”

She had a badly infected toe, purple and swollen. She’d also had both hips and knees replaced, running the risk of infecting the bone around the replacements. When I pointed it out, she said, “I don’t want to go on antibiotics because they give me diarrhea. And I don’t want to go to the hospital to get IV antibiotics. Can’t they do it here at home?”

“Well, it looks pretty bad to me. If you don’t get it treated, you’re likely need it amputated.”

She scowled at me.

Being a conscientious sort, I called her primary care physician and relayed my concerns. She said she would call Gladys and prescribe antibiotics for the infection.

The woman called me the next morning on my way to another evaluation. “This is Gladys Kravitz. Are you the doctor that snitched to my primary care doctor?”

“Yes, I did. Yer gonna lose that toe if you don’t listen to your doctor.”

“I told you I don’t want to take any antibiotics.”

Well, one can only go so far…

Curiosities
Halfway between Harlem Road and Ridgeland Avenue, on US 30, the Google Map lady says, “Welcome to Indiana.” A hundred yards or so farther down, she says, “Welcome to Illinois.”  Indiana is a good fifteen miles to the east as the crow flies. A wormhole, maybe?

A hypertensive, obese Pakistani man spent much of the evaluation extolling the virtues of natural medicine, telling me how things like turmeric and lime would cure my own hypertension and obesity.

Only the Good Die Young
She was an adorable 88-year-old with a charming smile and a voice like Georgia Engel. She was legally blind and used a walker. And, like the Little Old Lady From Pasadena, she could be a terror.

I met her with her daughter and one of two caregivers who always stayed with her. I introduced myself and the first thing out of her mouth was, “Are you going to give me my driver’s license back?”

Her daughter said, “We had to take it away because she’s now legally blind and it’s not safe for her to drive.”

“Well, no, I can’t give you your license back.”

“Then what good are you?”

I continued with the usual questions.

“Have you had a heart attack?”

“Not yet.”

“Have you had a stroke?”

“Not yet.”

“Have you had any kind of cancer?”

“Not yet.”

“You sound like you’re looking forward to it.”

Before I left, I said, “Well, you are doing pretty well for 88.”

Her caregiver replied, “She can still give you the finger,” which prompted her to flip us off with both hands.

Tea and Sympathy

It’s not all fun and games. Sometimes I act as bartender or father confessor, listening to sorrows, regrets and frustrations.

A man from Pakistan brought his extended family to the U.S., along with their bitter familial feud. When I asked if he had any regrets during the depression evaluation, he said sadly, “I’ve begged my family to forgive me for bringing them here, but they refuse. Some of them won’t talk to me.”

A woman’s worsening arthritis left her unable to walk more than a few feet without agonizing pain. When her adorable, diminutive Shih-Tzu wanted a potty break, I let her out (and had to coax her back in because she wanted to play). We continued the evaluation, but she started to cry.

“Look at me! I can barely move. I used to go out all the time and now I can’t. I’m in so much pain all the time and there isn’t much they can do.”

A man only a few years older than me had lost his wife one month earlier after a short but horrible illness. He sat next to me on the couch, his late wife’s two Shih-Tzu puppies by his side, wagging their tails as they looked me over. He looked like a biker, big and burly, but he was completely lost without her.

“I have to get the house ready to sell, but I don’t have the energy.” His voice trailed off and he looked as if he could cry.

Early in my career I learned I couldn’t fix all the ills of my patients. Often, just listening without judgement or reproach is sufficient therapy.