May 1, 2010
by Robert E. Horseman, DDS
When I pay one of my infrequent visits to my primary care guy, I make certain to get my $10 co-payment’s worth by saving up symptoms until I’m sure I have enough to command his attention for at least 10 minutes. These are carefully recorded on a list I bring with me.
My left knee has begun to hurt. My knees, unlike some of my other body parts, had not communicated with me for more than eight decades. I compared the ailing knee with its mate. Although they are both the same age and appear to be dimpled twins, the complainant had taken on a life of its own, either refusing to bend comfortably or threatening to flex both ways without advance warning.
After six weeks of ignoring it, I finally managed to accumulate a qualifying number of unrelated complaints, including a twinge in my right shoulder and two suspicious spots on my right forearm at least 4 microns in width. In addition, an annoying extra trip to the bathroom around 4:30a.m. convinced me that at least one or two of these symptoms confirm the presence of a fatal disease requiring surgical intervention immediately.
My instinctive distrust of general anesthesia was intensified by the probability of the operating surgeon assigned to save my life being revealed as a head case on the verge of going postal from stress and fatigue. “You need to make an appointment,” I told myself. I did — the following spring.
An overhead wide-angle shot of a surgical amphitheater overflowing with students and resident doctors form clearly in my mind. Gathered from as far away as Moosebreath Manitoba, the assemblage leans forward in hushed reverence to witness my surgeon’s legendary expertise. I had just become aware of two morgue attendants standing expectantly in the background beside their gurney when I hear a female voice announce, “Robert, you may come in now.”
I try to respond in kind by attempting to read her name tag pinned to her blouse just south of her left clavicle, but realize that staring any longer to make out the words would not be in my best interests. Laying aside the article I had been reading in Woman’s Day on how to cope with those pesky postpartum stretch marks, I trail after the paisley-topped assistant into the inner sanctum. Young enough to be my granddaughter, she is preternaturally cheerful as she confides that we will pause for a moment to weigh me.
At the end of the hall is the scale, impossible to circumvent. The drill is always the same and her buoyancy is ill-suited for the occasion.
“Hop on,” she trills cheerfully. Every time I have ever mounted one of these doctor scales it is obvious the patient before me could not have weighed more than 110 pounds. There follows a deliberate, prolonged humiliation during which the weights are slowly advanced along their tracks almost to the end before balance is achieved.
“My shoes weigh at least five pounds each, you know,” I always offer, feeling this should be taken into account as a truer indication of my poundage. I could be wearing a full-length raccoon coat, pockets loaded with enough lead weights to anchor the QE2 and the results would be carefully recorded in my chart. Technically, one should be weighed in the buff. If nothing else, the procedure would add interest to an otherwise dull day at the office.
If an inaccuracy of this magnitude is tolerated, the requisite recording of my vitals that follows is subject to plus or minus 35 percent errors and are meaningless except to satisfy blank places on the chart.
It seems under-the-tongue thermometers are an anachronism. A hand-held electronic probe is inserted three inches into my ear, beeps once and immediately withdrawn. I assume this is a rejection because of the wax buildup, but Paisley dutifully notes the 98.6 on my chart and takes my blood pressure.
Blood pressure taken in an examination room automatically initiates the white coat syndrome and elevates itself to near fatal limits. I also believe if I hold my breath, close my eyes and roll my eyeballs upward in their sockets, then focus on arbitrary numbers like 120 and 75, I can achieve any reading I please commensurate with my age. Or better yet, some kid about 25 who has matured in every way except for calling everybody “Dude!” and wearing a baseball cap incorrectly.
Paisley smiles benignly at me. Were the room to be suddenly bathed in ultraviolet light, a little “thought bubble” would appear over her head containing the words “What a porker!” In any event, Paisley is satisfied with my BP, thinking, not bad for a geezer with one foot in.
She departs to fetch the doctor, taking my 2-inch thick folder with her lest I sneak a peak at my own records that I couldn’t read anyway, written as they are in Physicianese!
Modern medicine has streamlined the whole medical appointment experience to the point where the doctor is the last person encountered. When I was younger, the next step would be the entrance of the doctor, an older man radiating compassion and wisdom, sort of like my grandfather, only richer.
In time, (this is Doctor Time, different from Patient Time) the doctor breezes in. A substantial part of my wardrobe is older than he. He gets right to the point, the meter is running. “What’s the matter with your knee?”
“It hurts when I do this,” I explain, flexing my left leg gingerly.
“Then don’t do that.” His eyes grow pensive. “How long?”
“Six weeks.” He palpates the joint in a doctorly manner. “A stretched ligament or tendon,” he says, conserving unnecessary words as if texting me. “Nothing to worry about. Take a while to disappear. Couple of Advil or Aleve are OK.”
“But, I…” It is too late. Obviously, administering extreme unction to my knee is premature and the problem is too intricate and inconsequential to warrant recapitulating.
“You need a flu shot and a pneumonia shot,” he states. “Take this form to the lab. See you in two weeks.”
He’s out the door and I am left sitting on the crinkly paper-covered table, as my list of assorted ailments flutters to the floor. Left knee, CHECK.
What a nice man! Not once did he mention the fact that at my age it would be unrealistic to expect anything less than yard-long grocery list of physical woes. Maybe I’ll come back next fall after a summer of reckless hedonism. I should have a list to reckon with by then. OH
Reprinted with permission, CDA Journal, March 2010.
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