Grocery shopping and advising for free
To soon get a biopsy
On a trip to the store,
For a chile or four,
It’s the way that I like it to be
The morning starts OK, but I bog down explaining to people the bandage on my forehead and my upcoming career move. Before things get hectic a drug rep suggests that I say that I am graduating rather than retiring. I like the turn of phrase.
I learn that I’m going to lose 316 patients when the John Morrell meat-packing plant closes. A fixture in Sioux City for more than a century, that packing house employed successive waves of immigrants, slaughtering pigs and packing the meat. I attracted a lot of the workers who came from Mexico, Guatemala, Honduras and El Salvador because I speak Spanish. I suspect a gross underestimate of the number of patients I’ll lose.
One more reason that my move comes at the right time.
Lulled into thinking I’m running ahead, suddenly I find myself three patients behind. I finish my 10:30 patient at 11:06, jump into the car, and arrive late for my appointment with the plastic surgeon to get my stitches removed.
I drive aggressively, rushing. I lose the pleasure of watching the snow banks melting.
My incision is healing well. The stitches slide out easily, and I look at the efficiency of Dr. Formosa’s office between her two exam rooms. I eye the dimensions and make a mental note.
Getting back to the office takes thirty seconds longer than getting away but I perceive a much more leisurely drive.
A patient with a lot of stress, a history of bipolar illness, and tobacco addiction comes to discuss an abnormal chest CAT scan. The patient, understandably, worries about the implications of the report and the possibility of cancer. We decide that Chantix would be a bad idea, despite the desirability of smoking cessation, because of the patient’s ease of slipping into psychosis. I go to my second choice for tobacco addiction, the clonidine patch. We then discuss roommate stress.
Occasionally it happens that I get a clear picture of a situation without having actual knowledge. I shut my eyes and I describe the roommate’s character. I make twelve points and I hit eleven of them correctly.
I am not a psychic, and I don’t believe in psychics. In retrospect I can give an analysis of what lead me to come to the correct conclusions. I call it holistic data retrieval, a term I borrowed from Time Considered As A Helix of Semi-Precious Stones, a science fiction story from the ‘60’s. Given the correct student, I can teach the techniques. It’s fun to use, it gives credibility, but it creeps people out. HDR made an appearance in one of my novels.
I receive with approval the announcement that the roommate’s days in the apartment are numbered.
A Hispanic mother brings her two children in for well child checks; in both cases I diagnosed pregnancy and attended the delivery. They know me so well that we play our way through the exam. When the core of the visit finishes, I tell the family that I am leaving for a year. The bitter mixes with the sweet. I have so much enjoyed the integrated process of seeing couples become families, watching the children grow up, while relationships and groups mature. I get to see the whole thing from a front row seat for the best reality drama in the world.
My explanation in Spanish rolls at the same speed my explanation in English did four years ago.
I get out of clinic early, and at five I stride into the gym. I sweat for an hour, stride out and drive home.
One of our friends had a surgery and till he can stay by himself he’s staying with us. We make a run to my favorite Mexican grocery store, Plaza Latina.
I know five of the nine people present in the store when I walk in. I pick out some poblano chiles and avocados. My friends and acquaintances make comments on my forehead wound, and I talk about my ‘graduation’.
A person whom I don’t know points to a 6 millimeter purplish lesion on her face. It’s been present for less than a year, she says, and it’s growing. I touch it and tell her she really needs a biopsy.
As we walk out my friend observes that few doctors would give a definitive recommendation without making the patient schedule a visit. I shrug. It’s part of who I am in the community.
It’s one of the reasons that, even if I want to travel, I want to come home here.