I reach to check her blood pressure and listen to her chest because she says she is unwell.
It’s Monday; I start on time. That is only because I came in early to review the weekend reports and see the unscheduled patients who waited out the weekend to line up at the clinic door. As a rule, I try fiercely to maintain my appointments, but the patient on blood thinners who shows up in my office with a nose running red will always trump the booked ingrown toenail. On this particular morning, the phone rings and interrupts my first patient encounter. The nursing home informs me that a ninety-year-old man with dementia has slipped in some water; a hip might be broken. I send him off to emergency, a crisis with a clear solution.
I’m back to monitor Mrs. Zucker’s blood pressure.
I’ve already removed a nasty black mole, tucked in a quick allergy shot, and discussed a lumpy gallbladder with a bloated fireman before I open the door to Melissa, who has booked an appointment for Henry’s well baby visit.
New baby, new mom.
Even though I have four children, I keenly remember being a first-time mom and reluctantly recognize I was probably like Melissa, obsessively wanting to get everything right. God above had given me this squalling bundle, and I had no concrete understanding of how often it would puke, how erratically it would sleep, or how exhausted I would be.
I had so many questions as I started on the parenthood journey. Like most new moms, I, too, asked questions of my family doctor, although I’d also resource my mother, my mother-in-law, and the other moms in playgroups or the church nursery.
The new Melissa moms of today have the added blessing (and burden) of the Internet and Dr. Google. They come into the office armed with smartphones and AV material, brandishing pictures of their baby’s rashes, scratches, or poop. There are audio recordings of coughs and crying. On this particular Monday, Melissa pulls out a two-by-two feet spreadsheet documenting all the pooping, sleeping, crying, nursing and smiling from the last seven days. She also hands me yesterday’s diaper in a Ziploc bag. I gently fold the sheet and slide it back to her; I toss the diaper, remembering that Henry arrived after several heart-crushing failures with fertility treatments.
“You’re a good mom,” I tell Melissa.
We look at Henry together. He’s plump, attentive, and has the best gummy grin in the world. “He’s perfect,” I tell her. “My grandmother would call him delicious.”
“Patients are like Christmas presents,” I tell the resident doctors working with me in my office. They are competent physicians in their final year of practical training, and they can be an intimidating lot although I am sure they don’t mean to be. Fresh with knowledge of current medical guidelines, they infuse enthusiasm and inquiry into a busy day. I reflect on what pearls of wisdom I might have to offer them, and on this day, I offer them the Christmas present analogy.
“Some you won’t have expected, and some you might be a little fonder of.” The latter would be Aileen.
I walk down the hall to collect Aileen from the waiting room, as I do to get my all my patients. I tell them it is because I’m trying to get my ten thousand steps, but in reality, I am on a covert mission to see how they sit in their chairs. Are they in pain? Do they look ill? How well do they rise from their seats? Aileen is by herself, and her scorched auburn hair is sprouting white roots. She is wrapped in an oversized grey flannel coat and has no stockings. It is November, and something is wrong. She lumbers down the hall with what I think is arthritic ache. Only later do I learn that it is the weight of her soul.
I have looked after Aileen for twenty-five of her eighty-seven years. Her chosen hair colour is red, consistent with her Irish heritage. My husband was born in Ireland, and to Aileen, this makes me almost kin. Most visits, she shares stories of her youth or reminisces about the care she had given to her dying husband. We’ve laughed over the luck of the Irish but never neglected the murmur in her heart or the pitting fluid around her ankles. On this Monday visit, she enters my office and sits down quietly.
“Aileen, you’re not yourself.” Silence. I repeat my concern.
“Aileen, what’s wrong?”
“Ah, it’s my daughter.”
“How old is your daughter?”
“Can you tell me what’s wrong? Is she ill?”
“No, no, not ill. She’s left her husband, and she has nothing. She’s moved in with me.”
Old baby, old mom.
A widow of thirty years, Aileen lives in nearby subsidized housing. She has no car. Meal planning is limited. Moments pass, and I don’t know what to say. I want to take away Aileen’s worry about the future, her finances, and the burden of her daughter.
“Dr. Sampson, it’s like this. When your kids are young, they are a handful. When they are older, they are a heartful. It never goes away.”
I do not have an easy response because there isn’t one. I reach to check her blood pressure and listen to her chest because she says she is unwell.
I think I will do a house call next week.
Text: Gwen Sampson
Illustration: Tim Wat