Mullberry Whine

poured out before bed

Rotten

denial

L’Absinthe, Edgar Degas, 1876…

“Oh, I’ve been doing just the same, just the same, quite well, no complaints.”

“That’s good.  Anything you’d like to discuss with Dr. Gray today?”

The slight man’s face is blank as he stares past me at nothing in particular before he shakes his head and gives a faint smile.

“Not that I can say, no ma’am.”

A drop of saliva falls silently from his stiff lower lip onto his freshly pressed slacks.  The fine tremor in his hand disappears as he reaches up to wipe his mouth.

I scroll through Dr. Gray’s last note from a routine visit over two years ago and find no issues, no clinical reminders, no findings on physical exam.  I continue to make small talk, running through a truncated review of systems – negative, of course – as I search the chart.  I finally find an entry with the information I’m looking for, an old intake note from a decade prior.

Family History: No cardiovascular disease known.  Breast cancer – mother, diagnosed at 72, deceased 74.  Type 2 Diabetes, Hypothyroid – sister, alive at 41.  Prostate Cancer – father diagnosed at 57.  Parkinson’s disease – father diagnosed at 68, deceased 73, brother diagnosed at 61 yo.

“Mr. Smith, have you noticed a tremor in your hands?”

Mr. Smith looks at me, his face stiff, his eyes hard.

“My hands don’t tremor.”

“When you sit still with your hands in you lap, I noticed you have a slight tremor.”

Mr. Smith looks away, folds his arms across his chest and hugs himself close.

“I don’t have a tremor.”

“I also noticed that sometimes when you speak, your lips have a hard time keeping control of your saliva.  Have you noticed that?”

His face remains void, eyes averted.

“No, I have not.”

Although his expression is not revealing, his inflection is; he has, indeed, noticed.  He does, indeed, understand the symptoms and their potential cause.  But, having little recourse and limited time, I move on to the physical exam.

When he cannot easily initiate those movements necessary to rise from the chair and walk to the exam table, Mr. Smith seethes, “Gol darn arthritis.”  When he has trouble with specific portions of the neurological exam, he says simply, dismissively “It’s hell to get old.”  When I mark large bruises on his knees, arms, and back, he quietly, but forcefully denies falls.  And whenever his arms are at rest, they exhibit a fine, characteristic tremor, in between those times he must dab his lower lip, frozen like the rest of his face in a blank, masked expression.

In the physician work room, Dr. Gray nods slowly as I present my findings, sighs when I suggest that Mr. Smith has likely developed the same disease his father and brother before him suffered, agrees that Mr. Smith is most certainly well aware of that fact.

“Let’s go see him,” Dr. Gray punches the alcohol gel dispenser on the wall and pauses.  “Parkinson’s is a rotten disease…  Denial is even more rotten.”

He takes a deep breath as he prepares to knock on the exam room door.

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6 comments on “Rotten

  1. on thehomefrontandbeyond
    January 29, 2013

    stupid disease

  2. kindredspirit23
    January 29, 2013

    Denial can be more damning than the disease. Better, I think, to just face it and keep praying.
    Scott

    • mullberrywhine
      January 30, 2013

      I agree – it’s always better to face it. It just doesn’t always feel that way…

  3. ahyesplans
    January 30, 2013

    Oh wow. As a daughter with multiple sclerosis in the family, I’ve seen a variation of denial like this and it’s truly heartbreaking.

    • mullberrywhine
      January 30, 2013

      I’m so sorry MS has touched your life and that of your family. I’m similarly sorry about this brand of denial…it makes things tougher both on the the deny-ee and her/his support system.

      Sigh.

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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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