My last clinic patient of the day was a frail, elderly man. I initially found him to be ornery. He had the air of someone who was chronically irritated. He was also incredibly hard of hearing. Due to the awkward set up of the exam room and computer, his wheelchair was positioned in such a way that we sat side-by-side. His wife sat sleeping in her chair, her red lipstick applied perfectly and pearls gleaming under the fluorescent light. Their caregiver stood in between them.
I asked him a few times before he heard me how he was feeling. Then with a disgruntled expression on his face, he said he had a back problem and couldn’t turn to me. His caregiver and I clamored over the computer and gurney to wheel him around so we could sit face-to-face.
We stared at each other.
He was quite frail and very well-dressed. He was someone who had been very successful professionally. His hairless head hovered between hunched shoulders. Eyeglasses sat atop his nose. Clear hearing aids were housed in each ear. He seemed a very serious man.
“You’re a lady doctor,” he said.
“Yes, I am. Surprise!” I quipped, my attempt at a polite answer to his assumption. “How are you feeling? What would you like to discuss today?”
He paused and looked down. Then he looked back at me and said quietly, “Well, my wee-wee system isn’t working.”
“OK. What do you mean by that?” hoping my question would open a floodgate of descriptions of urine color and stream strength.
He didn’t answer. I knew I was going to have to prod a little more. I asked him many questions about his urine and his urinary habits. My next question elicited more of an answer and true insight into what was bothering this man: “Tell me about your bowel habits.”
He sighed deeply. “I’m having trouble. I haven’t gone in a week. I think that is the mess I’m in and it’s causing problems with everything.” His forehead was wrinkled, eyes intense.
I told him not to worry, that I had some stuff that could help him. For the first time in twenty minutes, his face softened, his eyes twinkled, and his mouth turned upwards in a half-smile.
“Oh, good! You’re saying I’m full of crap?” He eyed me cautiously, testing my humor.
“Well, yes probably. It sounds like you need to poop!” He finally laughed, and I joined him. He looked relieved. Well, emotionally relieved, at least.
He didn’t want an enema. We created a plan together. I told him he could call me if the plan didn’t work.
When I stood up to leave, I saw him try to kick one quivering leg off the foot stand of his wheelchair. His caregiver and I looked at him. “What are you doing,” she asked.
“I’m trying to stand up and greet the nice doctor,” he insisted.
I assured him he could greet me from his wheelchair. I held out my hand, which he grabbed and shook with both hands.
As I left the room, I heard him say “Thank you for listening to me.”
By no means do I consider my job to be glamorous. But I do realize the impact I can have on one individual person. And that’s what keeps me going back for more.
Uzma Khan is a hospitalist and can be reached on Facebook.
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