Saturday, September 23, 2000:
Inevitability Index: 18.
Wins at Local Arcade: Me - 4. Mallratman (a live opponent) 0.
Ashamed to Admit: I kind of like the new Bon Jovi song.
Preferred Attorney: Dr.
Eama.
COUNSEL
I knew it was a trap.
The grandson was sitting there, armored in an expensive dark suit decorated with a blaringly red power tie. He sat nearly hidden between his 90-year old grandmother's bed railing and the divider curtain. He was young, looked my age even, so he was probably younger.
Despite the narrow confines, his thin body still managed a classic GQ cover pose in his oversized suit. Legs crossed. Elbow on knee. Chin on palm, with cufflinks visible.
I pegged him for a businessman or a lawyer. Either way, I've dealt with his type before and something in me sank.
I said hello to the suited grandson and asked his frazzled and often belligerent mother across the bed,
"So how is she (our 90-year old patient) doing today?"
"Aren't you supposed to be telling US that?" the 90-year old's daughter retorted defensively. Yes, this was definitely a trap.
"Well, I meant, has she been talking to you today?" I clarified for the comprehension-impaired.
"So why is her hemoglobin still dropping?" the grandson interjected. Even though he was sitting down, he still managed to get his nose in the air higher than the rest of us.
I run into people like him once a month it seems. Sometimes it was an overbearing CEO or someone with "high-ranking friends" or even another "doctor" in the family, which often turns out to be either:1) an ophthalmologist or psychiatrist,
2) someone with a Ph.D. ... like in sociology,
3) or a medical student from The World's Finest Medical School Or At Least Better Than Yours.
I explained her multiple medical conditions to them: the gastrointestinal bleed, the pneumonia, the stroke, the diarrhea, the heart failure, the infected ulcers. For 90 years old though, she looked a lot better than some of the 60 year olds I've taken care of.
The suited grandson stood up, paced as if in a courtroom or board meeting, and drilled me on irrelevant lab values he must have overheard from the nurse. Normally, this is fine, but I could tell he was enjoying playing the predator in this information chase a little too much and this annoyed me greatly. His tone suggested disdain not only for me but for the 90-year old grandmother he was supposedly defending, as well.
I made sure not to run for the chart or turn my back on him. This wasn't a concerned family member with appropriate questions, this was a power play, a pissing contest under inappropriate circumstances.
I could tell he didn't understand half the things he was asking. But he did like asking them to see if I knew the answers.
Eventually he reached the end of Question List, Page Six, and then cocked his air-blown head to one side as if to capture his best angle for a camera, and asked with a weaslely grin,
"If she was your mother, what would YOU do?"
I could tell he reveled in such a table-turning question, as if to put me on the spot as "patient" instead of "doctor." The thing is, I hear that same question twice a week. I pretended to be surprised, and said,
"Hmm. Tough question ...."
"I'm a lawyer. I'm good at asking tough questions," he swelled with pride.
I'm a doctor, I thought in reply, I know what you look like dead.
I gave the question some real thought, and explained that I would do exactly what I was doing now.
He discussed it with his mom on the other side of the room, almost whining that Grandma was 90 years old anyhow and what did she expect. He was being surprisingly reasonable. The Young Lawyer sounded impatient and a little bratty when talking to his mother. He sounded a lot like I do when I talk to my mother.
"I agree. Good answer, by the way," the young lawyer said to me as if I'd escaped his carefully laid trap.
"Thanks. Coming from you that means a lot," I answered ambiguously.
"Well, it should," he finished.
The day before the 90-year old's discharge back to the nursing home, we organized a family meeting.
Present were the older daughter, two uncles, and the Young Lawyer (the grandson) in full suit attire. It was then that I saw him for what he was. The youngest son trying to gain respect and attention from family members who had dismissed his brashness long ago. He looked quite small in that large suit.
We discussed the future of our 90-year old patient, their mom. She was better now, but she would get sick again, I assured them. Each time she would lose something of herself.For a 90-year old, medicine isn't about immortality. It's about extended tortured mortality.
Finally, they seemed to understand this. Indeed, they had already seen this.
"Just take me home now," the 90-year old spoke for the first time that day.
"We appreciate you telling us this," the daughter said with a change-of-heart, "Do you have an office?"
"No. I only take care of people in the hospital," I answered.
"Well, if you ever need a lawyer, give my son a call then," she meant that in a good way I'm sure.
The Young Lawyer averted his glance apologetically and replied,
"Hopefully, he'll never need my services."
"Hopefully, you'll never need mine," I smiled in reconciliation.
Clearly, our youth had made us both overly optimistic.
One week later, the 90-year old grandma was re-admitted for a raging blood infection, probably from her bladder. (I was betting on pneumonia myself.) After family counsel, the Young Lawyer chose morphine over antibiotics for his dying grandmother. She died the next day.
He had no further questions.
OLD DOGS
NURSE 1: "Oh shit! Have to call security!"
ME: "You lost someone?"
NURSE 1: "Yeah, my 95 year old patient!"
ME: "You can't trust anyone over 90 anymore."
NURSE 2: "Wait! We found him, in one of the female beds."
NURSE 1: "That's probably exactly what he needs."
Dr. DEEPSCOPE (Anonymous Imperial Insider):
"We like Dr. ---, he has a healthy fear of authority."
AMY (watching Olympics): "This isn't fair. The Americans are all taller than the Koreans. Is that my relative?"
ME: "Did someone measure the height of that net? It looks 5 cm off."
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