Monday, March 2, 2009


Raymond and Eloise
~A Lesson of Love~

Today is February 14th, Valentines Day. I awoke early, unable to stay away from my writing…for I have a Valentines Day story to tell.
A true love story that quietly unraveled before my eyes.
Eloise appeared even smaller in stature than the last time I saw her. This was difficult to imagine for I have never met a tinier lady. She weighed 85 lbs and was well under 5 foot tall. Her advanced osteoporosis caused a posture to be stooped forward and stiff in her movements. This is the posture that is so common in the elderly but now physicians attempt to prevent. Her walk was more swift than expected and mostly steady. Despite this, I still found myself walking close to her in case she stumbled and offering a hand to help her on and off the exam table. She dressed neatly in older but well cared for slacks with a matching pastel sweater that had been worn many times before but still appeared new. Her hair was clean silver, short and well groomed. She later told me that she made herself get out to the hair dresser regularly.
Eloise had been coming to my office now for about 4 years. Today was different than all the previous times.
Today, Eloise was alone.
For the past 4 years, they presented to my office together…Raymond and Eloise. I list his name first for this was how one would see them.

Raymond was a large man even in his advanced age. He was well over 6’ 4” and carried himself even taller. He wore a barrel chest and carried strong, square shoulders that were relaxed like old mountains. His build was stocky with a slight relaxed belly but not considered overweight by any standard. His arms were longer than expected until you noticed the length of his legs. Then you realized that this was just Raymond. He had thick hands with long meaty fingers that made yours feel inadequately small when you shook his hand. He possessed a man’s grip reaffirming his size.
Echoing his physical attributes was his baritone voice. He was loud and assuming. When Raymond spoke, you couldn’t help but listen for it was impossible to talk over him. Everything about Raymond was that way….not to be ignored.
Early on, during our initial office visits, I received the impression that he was feeling me out. He would study me as I entered the exam room as a father would a suitor calling on his only daughter. He monitored the way I held myself and studied my movements looking for any sign of insecurity.
He would, of course, dominate the interview with questions that deserved answers and then sit tall and await my response. He asked many questions. Sometimes the questions were very direct requiring direct answers while other times he would lead me into a conversation just to listen to what substance “The Doctor” possessed. No matter how he was doing it…he was looking to see if I possessed the qualities that he expected from his new doctor. I must have passed.
I would meet with Raymond and Eloise every few months and help them as they navigated through old age. Oftentimes they would present for check ups to monitor their blood pressure, heart rate. Weight, etc. It never ceases to amaze me the therapeutic effects of having your vitals checked by the nurse and hearing from the doctor that everything looks to be going along as expected. These visits are indeed…a strong medicine.
Sometimes Raymond and Eloise would come in between their scheduled office visits with various questions or ailments that were plaguing them. Thankfully the questions weren’t too difficult and the ailments not so serious…just valid concerns that arise from a slowly failing body. I counseled on hurt knees, rashes, backs that were stiff and the never ending insurance questions that my wife, Sandi, was capable of answering in more detail than myself. We adjusted “non-generic” medication to “generic” to allow a shared retirement pension to stretch just a little bit further. The generic meds were always less expensive by an oftentimes significant amount. We tweaked Raymond’s blood pressure medication, mostly under his guidance instead of mine, to where he was only taking one sixth of a the smallest milligram tablet available twice a day. This amount was difficult to imagine but he assured me that his measures were accurate. He stated that he was overly sensitive to all medication and anymore would make him dizzy. Every appointment, every treatment was a compromise…a compromise between my recommendations and his willingness to listen to them…or not to.
Please do not get me wrong. It wasn’t that I didn’t try. Early on I would become frustrated with Raymond’s visits and insist that he heed my advise for after all…I was his doctor. He would give me the floor, allow me to give him my spiel of why I think that he should do this and shouldn’t do that. He then would acknowledge that he knew that I was the doctor and that he certainly was not. He then would, in a polite, very “matter of fact” manner, would educate me on what he was willing to do and what he wasn’t willing to do. He certainly was a challenge. It would have been much easier to just dismiss him as a cantankerous old man who was stubborn and set in his ways…but to do this I realized that he would leave and not follow up with any other physician. What good would that do for him? At least he was coming in and listening to me though be it only sometimes. It wasn’t until much later that we found common ground that we could together stand upon.
But common ground we found. All in all, his blood pressure was controlled and his aches and pains responded adequately to the fragments of medications that he would allow me to supply him. Despite the fact that he challenged me in about everyway possible, I truly began enjoying his visits and found myself especially respectful even with his desire to supersede my advice and direct his own care. After all…I could see myself being the same way. Maybe he knew that of me and that’s why I “passed”.
Raymond disliked testing and hospitals more than he disliked medications. It was here that was another area we would find ourselves butting heads. He often complained of chest pain and difficulty breathing with physical activity on more than one occasion. This is what upset me the most for I knew that symptoms such as these denoted serious heart problems until proven otherwise. That’s just what he wouldn’t let me do…prove them otherwise.
On every visit after he mentioned these symptoms I would question him and his willingness to allow me to run some tests and if positive send him for treatment. I offered many different levels of attention from going to the ER enabling us to receive diagnosis and treatment almost immediately to working this up as an outpatient by getting some bloodwork, stress test, etc. full knowing that if I could get him to set foot in an emergency room, he would be admitted secondary to his complaints and immediate attention, treatment provided.
I know now that he trusted and respected me, for after months of pleading with him, he finally gave in…at least in part. Raymond agreed to see a cardiologist. He met with a respected local cardiologist and listened to what he had to say. I don’t know what the exact interaction was like that took place in the cardiologist’s office but could imagine that Raymond wasn‘t at all impressed. Sure he was polite and respectful but sure he wasn’t going to do much of what the cardiologist had to say. Bloodwork and an EKG was agreed upon but the Stress Test was definitely out of the question. I even met with Raymond and reviewed and concurred with the doctor’s recommendations. In perfect Raymond fashion, he respectfully declined a further work-up despite the knowledge of further heart damage and even death.
Over the next few years our office visits continued. Physician continued to navigate patient through the aging process. Like a path of fallen leaves, old age continued to reveal to them a direction they were destined to follow but with often uncertain footing.
It is here the story takes an expected and tragic twist.
Like many mornings, I arrived at my office and was greeted by our staff with an update of what labs and tests are back for my approval as well as who was seen in the emergency room and who of them were admitted. The news of Raymond’s heart attack was part of this morning’s report.
Apparently they were in Columbus at his daughters, and he became lightheaded with increasing shortness of breath. These symptoms must have been worse than previous or his daughters were better “doctors” than myself for they transferred him to the local emergency room where he was admitted.
The only other details that were given to me that day was that it was here that Raymond died.
Eloise appeared even smaller in stature than the last time I saw her. This was difficult to imagine for I have never met a tinier lady. She weighed 85 lbs and was well under 5 foot tall. Her advanced osteoporosis caused a posture to be stooped forward and stiff in her movements. This is the posture that is so common in the elderly but now physicians attempt to prevent. Her walk was more swift than expected and mostly steady. Despite this, I still found myself walking close to her in case she stumbled and offering a hand to help her on and off the exam table. She dressed neatly in older but well cared for slacks with a matching pastel sweater that had been worn many times before but still appeared new. Her hair was clean silver, short and well groomed. She later told me that she made herself get out to the hair dresser regularly.
Eloise had been coming to my office now for about 4 years. Today was different than all the previous times.
Today, Eloise was alone.
An excerpt from "The Journey Learned" copyright 2009
To be continued...soon.

8 comments:

jrmom said...

Now I know how you so patiently put up with me. Raymond has paved the way. Poor Eloise...God Love her! Thank you for a beautiful story.

Dr M said...

The second part is on its way in a few days...I just wanted to try something a little different.

Suzs said...

As Your Patient
I Have also had to be Pushed , Begged, and had my Hand Held to Receive Medical Tests!!
Thanks !
Keep up the Good Work !!

Bless Eloise

As For you giving us. Half of the Story !
It's The Fisherman in you coming out !!
SET THE HOOK AND REEL US IN !!!!

Darlene (SCS:akronstamperdpk) said...

Beautifully written as always Dr. M.! God Bless Eloise ... she must be so lonely ... thank God she has your guiding hand to help her through the remainder of her years.

I have to agree with Suzs ... the hook is set ... can't wait for "the rest of the story!"

Suzs said...

Your Readers are Growing Restless.
There could be a Mutiny !!!
Please send the Rest of the Story !
The Wait is Unbearable!!

Novalis said...

Be sure that the word is beeing spread, even out here where so many people can't even read...
Truth might be shared in many diferent ways.
Out here - do to my lack of spanish - it somtimes takes more than words for a simple conversation.
Your writings so, are full of strength giving one the opportunity to find a way of sharing more than just a "story".
To share moments of life with each other - in truth.

Martin

godsgal said...

We're ready for the rest of the story!

Mainak said...

Very touching indeed! Waiting for the rest...

Dr. Mainak