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The
Martha's Vineyard Times is a weekly publication.
January
13 - January 19, 2005 Edition
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North Road The last patient January 13, 2005 By Russell Hoxsie, M.D. “Is this the doctor?” “Yup, just finishing. What's up?” “I'm new in town; would you be my doctor? My prescriptions, they've run out. Asthma's bad, need my medicines.” “Why not come in now?” I said. “We'll see what you need.” He said he'd be right there. The phone stayed quiet only a moment, long enough for me to finish looking through the day's lab reports and send them to the out basket. “Hello, Eleanor.” Eleanor was a long-time patient with a list of complaints. “I have several questions,” she said. “At five-fifteen on Friday, Eleanor?” “Well, I just had to know the results of those tests in Boston last month. You know, the ones you wanted me to have with Dr. Brown, no, Bronsted, oh, I can't remember. You know who I mean.” “Dr. Block,” I supplied. “No, I don't think I've seen them. Can't remember now with all these slips and letters. Wait, I'll look in the next room. . . . Nope, not there. I'll get out your record.” God, I thought, this is a never-ending job, Friday too. The girls are gone. Smart girls. They knew I'd have them working if they stayed past five. “All right, here it is, Eleanor, but nothing about the tests. You'll have to call Block's office Monday. He's left by now and my girls are gone. I've got to leave; someone's at the door. All right, I know you're worried. You always worry. Find out from Block.” A young man rushed in breathless as I hung up the phone. “You made it fast.” “I'm just down the street,” he said. “I need your name and address, phone, all that, then we'll see what's up. I waited until he filled out a short office form, and we went down the hall to the examining room. “For three days your asthma's been worse? And when did it start? Age five? Long time. And medicine you take? Inhaler, pills, cough medicine?” From the first phone call, I'd had a signal, couldn't say for sure. “Cough medicine, that's what I came for. Helps me to sleep.” He's a strong one, tall, dark, Italian from the name, heavy arms and chest. Nose bent to the side, fight probably. And a large dark mole at the nostril. Ruins his face. Mustache is a brush, needs a trim, but he's right out of the shower by the looks of his damp hair. Handsome but flawed. A tough one. “Let's see what I can see. Breathing OK, temp's 98.6, pulse 64, throat red, tonsils crowding in the middle some. Glands swollen in the neck. Chest now, that's it, breathe deep, in and out. Nice and clear. Wheeze did you last night? Funny, lungs are clear as a bell now. No hay fever, no cough.” “Cough keeps me awake at night, Doc.” I listened carefully again. No wheeze. Good full air exchange. No asthma this minute. “It hurts down below when I cough,” He seemed to tense when I told him how clear he sounded. Belly was soft; he looked too well. “Stand up and drop your pants. Does it hurt now? Cough hard and tell me. Pain to it? No hernia for sure. Good, dress up while I write a few notes in your chart.” We walked back up the hall and I took an empty prescription pad from my desk. I watched him off to the side. The office was darkened, lonely. “Here for a year,” he said. “String cable TV, work hard and hate the winter, traveled in 30 states, lived in all of them, always like to come back here – New Englander at heart.” Something was fishy, this brawny Italian guy talking about New England winters. He looks a drinker to me but carries it well. No flab or stomach. Funny asthma. “You smoke? Nope? Drugs? Nope? Straight as an arrow.” “Well, you know, I've tried them all, but I'm clean now. No more of that stuff. I keep in shape.” By now at my desk I had his scripts. “Your inhaler to use every four hours, two puffs — you know how. And these sample pills, one every six hours. If they agree with your stomach, fill the script. The cold capsules you take if you have a cough.” He fingered them all with more care than I'm used to seeing. “What's this?” he asked. The nebulizer? “Oh yeah, I know. And these? I don't think they're good for me. I've had them before.” “These are new. Try them. They'll loosen your cough and asthma.” “Where's the cough syrup? That's what I came for, I've had Hycodan before.” “That's codeine. You don't need codeine.” “Why? You won't give me codeine?” “I can't give you codeine, can't do it.” “Well, I've used Oxycodone.” “It's the same. I can't give you codeine. It's a narcotic.” “But it helps me sleep. One bottle lasts a year. It's what I came for.” “I can't give you codeine.” Something had changed. There was a tension now to his muscles and he stood up, first on one foot, then he walked to the window. Then over close to my desk, looking down at the drawer where I'd replaced the prescription pad. Nostrils flared. Gone was the ready smile and light banter. Was I imagining? I listened to hear if there was anyone next door, the janitor or the nurse returning for something forgotten. I wondered if I could squeeze by him and reach the door before he could. He started to leave — decided I meant what I said, I guessed. I caught up to him at the door. “That'll be twenty-five dollars,” I said. A surprised look twisted his face. “How much, twenty-five, you say? I need to go out to my car to get my checkbook. Give me a minute.” His eyes shifted and for a moment they met mine. Just a particle of smile breached his lips and prompted the same from mine. |
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