Sunday, September 10, 2017

Work History

I always find myself asking a new patient what they do or, for the elderly, what they did for work.  All this stuff about heart caths and gallstones and knee scopes and the gout acting up is numbing and disconnecting. Abstract collections of fact.  Case studies in a stack of medical journals.  Where am I?  What is this place?  Why are we in this room together?  Why are we sharing this space?

If you aren't a doctor you wouldn't know exactly what I mean.

The contrived forced intimacy.  One on one, the one way sharing of embarrassing secrets and frailties. Enough of the unmentionables.  Let's discuss something else.  What kind of work did you do when you were younger?  As if knowing Stan ran a hair salon or Sue was a third grade reading teacher would somehow bridge the gap of absurdity that brought us together here in this small room.  Remind me I'm not alone in here, brightly lit, all the gauze and tape, antiseptic steel. Something to interrupt the piercing gaze, to start again to feel.

The old woman snoozed during the initial interview.  A daughter answered all the pertinent questions.  The colitis.  Bedridden.  Recurrent urinary infections.  Confined.  Early dementia. But what did she used to do?  And the old woman heretofore ignored, sprung to life, as if plugged in, visage brightened.  I used to teach Sunday school.  You know my granddaughter says I have squishy skin.  She likes to pinch the skin on my arms between her fingers like this and she says I have squishy skin and I tell everyone I am an old woman with squishy skin.

And just like that her smile faded.  Her eyes went dull and she turned away toward another blank wall.  That was it.  The lady with "decreased skin turgor".  I put my hand on her forearm.  I didn't pinch, just a light gathering of loosening elastic flesh.  I could see what her granddaughter meant.


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