Mullberry Whine

poured out before bed

All Systems Go

“Alright Mr. Jones, just a few more prying questions before I ask permission to examine you.  We call it the ‘review of systems’ – it’s a set of questions about your health, head to toe, where we make sure we haven’t missed or forgotten anything.”

The peaked gentleman, his blanket, sheet, and arthritic hands folded neatly at his waist, nods obligingly and leans forward.

“Any fevers or shaking chills?”

He shakes his head.

“Any night sweats where you’re soaking the sheets?  Any unintentional weight loss?  Have you had any new or increasing headaches?  Have you noted a change in your vision?  How about changed hearing?  Ringing in your ears?  Nose bleeds?  Sores or white spots in your mouth or on your tongue?  Trouble swallowing or speaking?  Any rashes on your skin?  New or evolving spots on your skin?   Chest pain, pressure, or palpitations – feeling that your heart is racing or pausing abnormally?  Are you short of breath?  Do you feel short of breath when lying down, or do you wake at night feeling short of breath?  Do you wake up feeling that you are choking or gasping?  Have you been coughing?  What do you cough up?  Is there blood in your sputum?  Any abdominal pain?  How about nausea or vomiting?  Diarrhea or constipation?  Is there blood in your stool?  Do you have pain with urination?  Do you feel a sense of urgency before urinating or feel like you are urinating frequently?  Ever not make it to the bathroom in time?  Do you feel you aren’t completely empty after you’ve done urinating?  Do you feel your stream is weak or dribbling?  Any change in the quality of your urine?  Any blood?  Have you noticed easy bruising or bleeding?  Do you feel that you are thirsty all the time?  Do you feel that you are always hot?  Do you feel intolerant of cold?  Do you notice any tremors in your hands?  Abnormally clammy or dry skin?  Have you noticed any one sided weakness?  How about general weakness?  Any light-headedness or vertigo?  Feelings of instability?  Any falls?  Any loss of consciousness?  Do you experience frequent numbness, tingling, or burning anywhere?  New or worsening boney or joint aches or pains?  Muscle pain?”

To all of these questions he quietly shakes his head and smiles wanly, or thinks a moment, then answers, “No, none of that, thank goodness,” or “Thank heavens, no!”

“Well, it sounds like all is in good order,” I say, patting his thin arm and believing not a word.  “Thank you for answering my questions.  I’ve just a few more to see how you feel things are going.”

“OK, fire away.”

“How is your appetite?”

“Same as always, good for three squares,” he pats his scaphoid abdomen.

“How about your sleep?”

“Well, OK, I guess.”

“Tell me about that.”

“Well, I’ve always been a nighttime thinker.  Not a worrier, mind you – just a thinker.  I haven’t slept more than 3 hours at a time for 50 years on account of my deep nocturnal thoughts.  But I don’t want to try any drugs or any therapy or anything – don’t believe in that nonsense.”

“Fair enough, sir.  But if you do want to address that issue, we are here for you, and we have some very effective remedies to help you get some shut-eye.  You just let us know.  Now, how about your energy?”

“Oh, that’s alright.  Same as always.”  He flexes his diminutive bicep.  “I’m a toughie, I am.”

“I don’t doubt it!  And how do you think your mood is?”

“My mood?”

“Yes – how you feel about your life from day to day.”

For the first time in our interview the blank pleasantness he exudes falls away.  He stares hard at the floor between us.

“I don’t know how to answer that…”

I let my silence urge him on.

Finally, he turns his misty eyes toward me.

“I just need to connect with people sometimes, you know…  I just want to tell people how I really feel…”

“How is that Mr. Jones?”

“Like I am….like I can’t…like it’s just…” he sputters a moment, then looks at me pleadingly.

“Take your time,” I nod and touch his wrinkled, withered hand, rising to pull the curtain, shutting out the hustle of the hospital hall.

He sighs and wipes away a stubborn tear.

“Ms. Mullberry,” he says finally.  “Can you do me a favor?”

“What’s that, Mr. Jones?”

“Ask me that review of systems list again, please…  This time I’ll tell you truth.”

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12 comments on “All Systems Go

  1. Kate
    September 17, 2012

    Your posts are always so touching.

    • mullberrywhine
      September 17, 2012

      I credit the strength of the experiences I have opportunity to write about – always touching in some way…

  2. kindredspirit23
    September 17, 2012

    Wonderful! I understand completely. You touched a nerve and he was willing.

    • mullberrywhine
      September 17, 2012

      Sometimes just asking someone how they think things are going from day to day is the key… And, of course, sometimes they just smile sweetly and say, “Oh, just fine!”

  3. isandos
    September 17, 2012

    Great story. It’s always so rewarding to break through to a patient with whom you KNOW everything’s not okay. Props to you for sticking with him!

  4. on thehomefrontandbeyond
    September 17, 2012

    this gave me chills for some reason

  5. Trypanophobia
    September 18, 2012

    Oh my god. This is oh-so-very believable and sad. Thank goodness the world is going to have doctors like you 🙂

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House Rules

Creative Commons License
Nothing under the table.
***
The views expressed on "Mullberry Whine" are NOT intended to diagnose or treat disease.
***
The med-ed related stories described here are based on real events. Details have been changed in accordance with HIPAA de-identification guidelines to protect confidentiality.
***
Mullberry Whine can be enjoyed daily; there is no unsafe quantity. Real wine, though, should be enjoyed in moderation. At-Risk Drinking for males under 65 is defined as >14 alcoholic beverages per week or >4/day, with >7 drinks a week or >3/day being the cut-off for females under 65 and for anyone, male or female, who has graced this planet for 65 years for more. Drink Mullberry Whine like there are no consequences. But drink alcohol responsibly. Your friends, your family, your health-care provider, and your liver - heck, ALL of the organs in your body - will thank you.
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