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Seven years ago for almost a month I was in Chicago. I was fortunate enough to have been granted a stint in two of the top Geriatrics and Behavioral Health hospitals in the midwest, if not most of the US.  After corresponding through e-mail, the CEO of the hospital network arranged for a much longer one-on-one mentoring for me with the director of the neuroscience institute.

On our first meeting, I was instantly smitten and bowled over by the lovely Italian doctor. I remembered having previously seen her in Dementia conventions before in various venues as well as having been just behind her on the queue on my way to visit Topkapi Palace in Istanbul. She never remembered me of course but I did have vivid recollection of her because at the time of the tour, while everyone else was wearing loafers and flats and shirts and jeans,  she  stood out in very vogue hot off the fashion pages three inch pumps, tweed Chanel suit and an emerald green scarf that complimented her flawless skin.

She was fashionable then and she was just as fashionable when I saw her again. She had arrived at the institute a few minutes ahead of me and called me to her office. She was a very kind lady who offered me a book (a compendium of neuropsychological tests that may be used for evaluating dementia). ‘Read this’ she told me. ‘I need to call my son.’ The son earlier had been injured from a minor skiing accident. She ended her call with  ‘Ciao, ciao carissimo. Mama loves you!’

Italian mothers! You just have to love them.

After the perfunctory introductions, my background, my interests among other things, her secretary gave her a list of patients she was to see that day. She pored over the sheet wiping her furrowed forehead.

‘Eeeeva, why are they doing this to me?’  She complained.

‘I beg your pardon, Doctor?’ I asked, befuddled.

‘They gave me twenty patients today! These HMO’s!’

I gave her a quizzical look. ‘ Let’s get started!’ She rose from her chair, grabbed her Prada Madras doctor’s bag and went out into the examining room, her very in season Prada snake skin stilettos clip-clopping on the narrow aisle.

The first patient  that day happened to be that of an eighty year old  lady who had been assessed by the case manager/social worker to be well enough to be sent home after her stint in the nursing home. After having examined the old lady, the doctor asked me to come sit in the family conference.

The meeting room, as it was in most big hospitals was huge. It had a long beech conference table that must have been meant for twenty four people lined with the cushiest of ergonomic chairs.

That there were only four of us made the room much bigger and much more hollow and even sad. Because while Doctor Tina and I sat in the middle,  either of the two other parties – the brother sat on one end of the table and the other sister, her head bent as she was knitting, sat on the other end.

For a brother and sister who had not seen each other in six months, they seemed so polarized. Later on I learned too that they had not spoken to each other even much longer than that.

You see, the daughter lived in California. The son lived in Florida. The mother lived in Chicago.

The meeting was to determine who will oversee their frail old mother.

The daughter didn’t want to – she had young children and she lives in ‘ Freakin’ C-A-L-I-F-O-R-N-I-A’, she yelled.

The son didn’t want to – he was in between jobs and neck deep in debt and he’s in staying in a ‘dump in Florida!’ he grumbled.

The two would exchange heated words between them and because of their distance had to shout, yell and scream.

‘Stop that knitting you b–tch.’

‘All you do is drink’

‘Yeah, and who has been bailing you out all this time’

There was a volley of verbal exchange between the two Doctor Tina and I were like spectators in a tennis match, our heads turning right and left, right and left.

In spite of the Doctor mediating, interrupting their embarrasing discourse, the two would not let up. All we could do was stare and listen to their cussing and cursing and muckraking and hanging out their dirty linen before us.

The Doctor had had enough of the fighting  of these two middle aged adults she stood up and told them to call her when they were ready to talk with her as the 11 o’clock appointment had arrived. She asked me to follow her and as soon as we closed the door behind us, she sidled up to me and said  ‘ These two need to see a shrink!’

This doctor minced no words.


DISCLAIMER: The identities of the subjects in the vignettes and other stories on this blog are intended to be ‘anonymous’ to protect the patient and their families and keep the doctor-patient confidentiality or fiduciary relationship. The personas cited here are not meant to be blind items or fodder for gossip. My lips are zipped in that department. Some of their identities and circumstances have been altered but the nuances of their medical condition are fact and not hidden behind veiled medical-clinical fiction. Think Oliver Sack’s ‘The Man Who Mistook His Wife For A Hat’. Okay, it’s like comparing Roederer Cristal rose wine with vin d’ table but  I know you see the drift.