Closing up Shop

They say that as we age, time accelerates.  Those endless waits for summer vacations, Christmas and our birthdays that we experienced at age six, become a mere blink of an eye at age sixty.  And if you’re approaching sixty, you will remember, like I do, those old Kodak commercials:  “Turn around, turn around, turn around and they’re gone.”  Indeed they are.

 

A few weeks ago I visited a good friend in Arizona.  We were talking about her horse, a beautiful and rare Fell pony that she bought as a two year old stud colt, mahogany bay and full of promise.  She has had very little time to train or ride him, and now gelded, he lives on her small ranch, solitary and unworked.  I asked her, “What are you going to do with Scooby?  He’s six and a half now, and he’s being wasted.  Surely there are people who would love to have him as a riding or driving pony!”  She protested, “There is NO way he could be six years old already!”  I replied, “Oh yes, he most certainly is—I remember driving with my daughter from California to Texas four years ago when she started medical school.  We stopped in to see your new horse. You had just gotten him—he was two and a half. You know she is graduating in two months.”  She was completely taken aback.  How is it possible that four years have gone by this quickly?

 

Four years ago we came to Texas and looked at condominiums to buy.  Texas is very supportive of its young doctors in training—if you become a homeowner, after one year you qualify to become a state resident, and the cost of attending medical school drops by two thirds.  Texas of course, has that Texan way of thinking—if you live here for a few years, and grow to know and love the state, you won’t ever want to leave.  In many cases, it’s true, and those of us who eventually do leave feel pangs of regret and forever when asked, we say, “I’m from Texas.”  Four years ago, we looked at my parents condominium—empty and unused after they retired and left for the mountains of Aspen, Colorado.  The maintenance costs were too high, and we settled on a nice one bedroom within walking distance from the Texas Medical Center, the Museum District and the live oak shaded avenues around Rice University.  My daughter has loved living here, in this light filled place with her cat perched on the eighth floor windowsill.

 

My parents’ place is now “under agreement” and I spent the day Thursday sorting through their possessions that remain there.  Today my daughter and I will do the same for her place, and this afternoon we meet with a realtor.  Four years—still a near eternity for her, with the rigors of medical school being what they are.  For me, a mere blink of an eye.

Deep in the Heart of Texas

One of the things I have learned since starting this blog last September is how many doctors enjoy telling their stories, and how many of them do it very well.  Dr. Kevin Pho is an internal medicine physician in New Hampshire who started a website where he brings together many voices of medicine—doctors, patients, educators and policy makers.  The website is www.kevinmd.com and I have spent many short lunch breaks at my desk, reading and laughing, or crying, or just plain recognizing kindred spirits as their stories fill my computer screen. The following piece, by Dr. Pamela Wible, appeared yesterday and took me right back to medical school in Texas.  I am “reblogging” it here, with Dr. Wible’s permission.  All you Texans out there—here’s a yellow rose for you!

Learning about human relationships and the art of medical practice

PAMELA WIBLE, MD | EDUCATION | JANUARY 31, 2013

 

An excerpt from Pet Goats and Pap Smears.

After two decades of formal education, today I’m finally set loose with real patients. It’the actual moment I’ve been waiting for my entire life.

We’re each assigned to a family doc for the month. I scroll down the list of third-year medical students, place my right index finger beside my name, slide it across the page, then read aloud: E. Sinks McLarty, Jr., M.D., III.

The next morning I find his office—a small nondescript building with his name on the side—and enter the waiting room, which features 1970s-style wood paneling, faded and covered with the grime of decades of cigarette smoke. Centrally located is a large oil portrait of E. Sinks McLarty, Sr., M.D., who opened the place nearly 100 years ago. I pass rows of empty chairs to the front desk, where I meet three bouncy women—all relatives of Dr. McLarty. I introduce myself to the friendly, frenzied group of chatty chart finders, then the garrulous gang scurries me down a narrow, smoke-filled hallway where I meet Dr. McLarty’s nurse, affectionately nicknamed “Olive Oyl.”

A friendly, slender, snappy-tongued woman with a gravelly voice, Olive Oyl chain-smokes at her desk. Her deep red lipstick and nail polish are the color of freshly clotted blood. She escorts me into a dimly lit room where I’m not at all sure I’m safe. There, on the couch, I meet Dr. McLarty—a seventy-year-old cowboy eating Metamucil wafers while puffing on a pipe. He wears Wrangler corduroys and sports a crew cut with some gray hairs shooting through. With his thick Texas twang, he slurs his words together around southern slangisms and medical anecdotes.

With pen, paper, and stethoscope, I follow Dr. McLarty around to see what I can glean from him. I’m immediately struck by his speech with patients. He calls all the men “pahdna” and all the women “shuga.” Isn’t that sexual harassment?

Dr. McLarty has no tolerance for big-government rules. When a patient needs a triplicate form signed, he snaps, “Well, now, shuga, that’s a bunch of horseshit!” or “I don’t give a ram dam or a rat’s butt!” While cursing, he signs the forms, gives one to the patient, and throws the other two across the room in a wad. “Hell, I’ll make toilet paper out of it one day,” he rambles as he tramps out of the room.

Dr. McLarty makes even the common cold an event to remember. “Okay, now, pahdna, let’s look in that there snoot. Ah, a little redness, nothing to say grace over. Let’s listen to your ticker while I gotcha here.” Slamming down the chart, he exclaims, “You’ve prob’ly got some of that damn crud we’ve seen going around!”

In the next room, an elderly woman complains of joint pain. His diagnosis: “You’ve got arthritis! Well, hell, you can see that. No need to pay for that, shuga. Now hold that cane in your left hand and tell Byron to give ya a damn golf ball to carry around in the right.” He didn’t cure her arthritis, but she looked like an avid golfer when she left.

After seeing a few patients in the morning, Dr. McLarty closes down for a two-hour lunch. We all squeeze into his office on the couch to watch soap operas. During a romantic interracial scene, they shake their heads in unison. “Oh, no! We don’t believe in that!”

So I offer the clan some of my chocolate soy ice cream and one gal gasps, “Oh, no! My husband wouldn’t like that!” Dr. McLarty puts down his Metamucil wafer and grabs a spoonful. “That’s pretty darn good!”

After lunch we’re getting ready to see a man named “Sunshine.” Before entering the exam room, Dr. McLarty pulls me aside and says, “This family’s been shot in the damn butt with bad luck!”

“What’s going on?” I ask.

“He got cancer. I’ve known a week, but gonna break it to him now.”

“Why didn’t you tell him last week?” I ask.

“If he lived by himself, I’d a told ’im right away this is how the cow ate the cabbage, but his wife, Lordy, ya couldn’t scrape her off the wall last night,” he rants as he trudges down the hall.

I gathered that Sunshine’s wife was extremely anxious.

We enter the room. Doc pats the old fellow on the shoulder and says, “Sunshine, now I ain’t gonna pull any punches by tellin’ ya we got a drug.” After a few cryptic sentences, he asks, “Ya get what I’m sayin’?”

Sunshine replies, “Yep! Lights out.”

That was the entire office visit.

Most of Doc McLarty’s patients are old white guys who have aged right alongside him. But this afternoon, we jump into Doc’s old pickup to see a young gal in the hospital. On exam, he notices her breast implants and asks, “Hey now, shuga, how long ya had these damn things blown up that way?” She answers politely and the interview continues without a hitch.

We only saw one kid that month. As the boy raced around the exam room, Dr. McLarty quickly warned, “Hey now, pahdna, get back up there on that there table. We don’t want ya to bust your gazoo!”

I’ll always savor my month with E. Sinks McLarty, Jr., M.D., III. I didn’t learn much about diagnosing or treating disease, but I learned a lot about human relationships and the art of medical practice.

I sure miss him.

So, after fifteen years, I track him down to thank him.

He answers on the first ring.

With my heart pounding, I ask, “Is this really Dr. McLarty?”

“Yep, this is Doctor McLarty. Who the hell is this?” he shouts.

“I’m a medical student you mentored long ago, and I just want to say thank you.”

“Well, thank you, sweetie, but I got cancer of the bladder and just had therapy today, and I’m bleedin’ like hell!” Before I can express my sympathy, he quickly blurts out, “What comes around goes around. Thanks for calling on me, but I gotta go pee again!”

He hangs up on me.

That’s it.

I never even tell him my name—not sure he would have remembered me—but I do get to thank him before lights out.

Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Pet Goats and Pap Smears.