the book he was reading. Then he regaled me with stories of his recent volunteer work with a local nonprofit and his plans to travel to Florida for the winter. When my exam was finished I sat down with him. Even though I was running a little behind, I wanted to let him go on for a few more minutes before I moved toward the door, the indication that our time was over. He took my gesture with good grace and apologized for taking up more of my time than he intended to.
“Mr. Earl,” I said, waving off his apology, “I hope I am as healthy as you are when I get to be your age.” I knew I wouldn’t be—I already had more health problems in my thirties than he had—but I said it anyway.
He smiled. “I’m a lucky man, Dr. Dosa. The trick is eight hours of sleep, a healthy diet, and lots of lovin’!”
Who can argue with that?
Donna Richards, my office manager, confronted me as soon as I stepped into the hallway. She was looking at her watch and seemed a little frazzled.
“Are you done yet?” she asked.
I nodded.
“You have a new patient in room 3 who is getting restless. Her husband has already been out to ask where the doctor is. I’ve played interference, but you’ve got to speed it up.”
I told her I was doing the best I could. Of all people, Donna should know how hard it is to appropriately care for older patients and give them the time they deserve. Her own mother was a patient in our clinic.
I grabbed the next chart and took a moment to look over some paperwork from another local doctor before I knocked on the door. The well-dressed couple I found did not look pleased. The man held up his watch and tapped it several times with his finger.
“You know, Dr. Dosa, our appointment was for 2:15 pm. You are twenty minutes late.”
“Mr. and Mrs. Rubenstein, I’m so sorry to keep you. Please accept my apology.”
Going to the doctor is not like getting your shoes shined and, unfortunately, there are times when other patients need my attention for longer than I anticipated. But I’ve learned over the years that explanations only make things worse. Simple apologies work better. Not in this case, though.
Frank Rubenstein was insulted, not on his behalf, I soon realized, but on his wife’s. He was a gentleman of the old school, and rather old world, at that. I recognized his Eastern European accent as being not so distant from that of my own parents, and I thought I recognized the attitude too.
Concern takes many forms, I’ve come to learn as a doctor, and it’s easier to recognize when it comes as a purr than a growl. Frank was like a papa lion protecting his lioness from predators, real or imagined. I posed no threat to his wife—I was simply there in front of them at the wrong time. What was really stalking her came from within.
Ruth Rubenstein, who was sitting across from him, seemed mildly embarrassed.
“Oh, Doctor, I’m so sorry for my husband’s brutish behavior. I’m sure you have lots of other patients to attend to. Frank just doesn’t like coming to the doctor’s office.”
She flashed me a disarming smile and then turned quickly to glare at her husband. He got the message; they’d been together long enough. As Ruth stared down her husband, I took a moment to look her over. She was neatly dressed in a long skirt and white blouse. She was strikingly attractive with blue-green eyes that radiated warmth. Her long silver hair was arresting, pulled back behind her ears with what looked to be an expensive pearl hairpin. Her skin still had a youthful vigor, and my first thought was that this woman still had it together.
I offered her my hand. She grasped it firmly and I was overpowered by her perfume.
My heart sank.
I moved in closer and confirmed my initial suspicion. Beneath the scent of her cologne I recognized the unmistakable musty odor of urine, a sign of incontinence.
I introduced myself again and asked how I could help them. Mr. Rubenstein launched into an explanation.
“Doctor, as you’ve probably figured, neither of us particularly want to be here, but I’m concerned about my wife’s health.”
He looked down at the floor, collecting his thoughts.
“I’m concerned…” His voice trailed off as if he was searching for a delicate way of telling me about his wife’s problem.
“Go on,” I said, nodding.