“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler






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Golden Oldie

My last patient of the day yesterday was an add-on belonging to some other doctor in the group. I heard him singing at the top of his lungs in the exam room next door; the patient I was seeing at the time looked at me and rolled her eyes. "I think we've got an Alzheimer's patient in here," I said dryly.

The note on his chart read "hand laceration." I stepped into the room to be greeted by the unmistakable aroma of Unwashed Elderly Male.

"Hi, sweetheart!" my patient greeted me. He was a cheerful looking old guy, with what was indeed a nasty-looking laceration across the heel of his hand. At least the margins were clean and it was relatively superficial.

"How'd you do this?" I asked.

"Well, honey, I had a tooth pulled yesterday and at 2:30 in the morning I went to the bathroom to rinse my mouth out. Whadda ya know, I forgot to put the lid back on the mouthwash and dropped the whole goddamn bottle on the floor. Next thing you know, I was on the floor." He turned the story into an epic. "I knew it was bad but I didn't want to go to the emergency room, so I just put some tape on it."

I looked closely at the wound and decided it was something I could suture. I don't do more than three suturing jobs a year (internists almost never use their hands), but I enjoy doing it when I can.

"Is it gonna hurt?"

"I'll be honest with you, the first part will hurt. I have to put some numbing medicine in there so I can sew it up and take my time."

"You do whatever you want, sweetheart. What do I call you?"

"Just call me Alice." I was starting to like this guy: 86 years old and as sharp as a tack.

"You don't mind if I sing, do you, Alice? It takes my mind off my troubles."

"Go ahead." He howled a bit as I injected the lidocaine, and broke into "Shanghai Lil" and then "Shuffle off to Buffalo" as I proceeded around the wound margins. As I broke out the suture material, we started to chat.

"So you're retired. What did you do for a living?"

"I ran a newsstand on Wilshire for 42 years," he said proudly.

"See any movie stars?" I asked, curious to see what kind of local history he could give me.

"Hah! Did I see movie stars! I saw Jeannette MacDonald! I saw Charlie Chaplin, Paulette Goddard..." The guy was a walking time capsule! He might be a tad eccentric, but there was nothing wrong with his memory. "I worked near the Four Star Theater. They had Lost Horizon playing there for a long time."

"Ah, yes," I said, stretching my memory. "Ronald Colman."

"And Margo, Edward Everett Horton..." he proceeded to give me the entire cast list. I was impressed.

As I finished up, Newsstand Guy began to be concerned about what he'd be able to do with his right hand for the next few days.

"Keep it dry," I advised him. "Do you have anybody around who can help you?"

"No. I never married. My sister and I were close, but she's been dead for twenty years." His cheerful demeanor slipped for a moment.

"Well, look, if you have any trouble this week, you can call Dr. X [his primary care doc]. Or call me."

"Okay, Alice! Thanks a lot, sweetheart!"

"You're welcome!" And for once, I meant it.

posted by Dr. Alice at #