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Title of Journal: J GEN INTERN MED

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Abbravation: Journal of General Internal Medicine

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Springer-Verlag

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DOI

10.1016/0030-4018(92)90002-9

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1525-1497

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Failing

Authors: Tracey Delaplain
Publish Date: 2011/01/05
Volume: 26, Issue: 7, Pages: 819-819
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Abstract

I’m sitting in a doctor’s waiting room My daughter gives me a handful of pills every day so I suppose it would not be unusual to visit one of my doctors every few months I have a doctor for my failing heart my degenerating eyes my deaf ears and I guess this doctor takes care of the rest My daughter thumbs through a magazine I am envious having not been able to read for three years Maybe I’ll crawl out of this chair and find my own magazine to look at Or not Why do they put chairs like this in a doctor’s office They are impossible to get up from and I’m not going to ask for help “Do I know that person on the TV” I ask “Mom I’m trying to read” she barks I try to imagine the speaker’s face without black holes I tilt my head until I can focus on different parts of her face and then try to put all the pieces together in my head to form a whole She’s a little clearer than a Picasso painting but not much I ponder the image—if I could just smooth out the lines of that face I think I could remember her name The TV volume is low so hearing her voice is impossible and I can’t read her lips So I sitMy name is called by a voice I’ve heard but cannot place “Why don’t nurses wear name badges anymore” I blurt but she’s not looking at me She directs all questions to my daughter Doctors and nurses used to speak to me not about me I can’t hear their questions so they have to repeat themselves that annoys them The nurse leaves the room with my daughter “I want to talk to the doctor first today” my daughter says over her shoulder I know that tone in her voice She’s mad at me againI remember yesterday vividly I told her that someone had taken my red blouse In the darkness of my bedroom my clothes are all the same graybrown color I don’t recognize them when they’re moved from their usual places Imagine your closet Now imagine looking at it through a very dirty window pane with the center completely obscured by gray paint Try to imagine your closet on the other side of that window As far as I was concerned the blouse was gone so I assumed that someone took it out of the closet Apparently that makes me paranoid “Not being able to find your clothes might make anyone paranoid” I snapped “Leave my stuff the heck alone” So we fought about the red blouse She scolded me like a naughty child and I threw a tantrum pulling clothes from my closetI run through all the other mistakes I made this week Dropped my pills and couldn’t find the tiny round one Poured salad dressing on my mashed potatoes In all fairness lettuce and potatoes look the same through that dirty window pane Lost my hearing aid—again Stepped on my glasses—again Dumped my purse out on the ground in frustration trying to find the abovementioned lost items You can’t really call that a tantrum can youThe nurse returns alone “I need to…blah blah blah OK” she mumbles to her clipboard “OK” I say without any idea what she’s asking of me Using the available clues I guess she wants to take blood or a blood pressure I roll up my sleeve but she looks at me and does not take my offered arm Guess I guessed wrong “I need to ask you some questions” she shouts “I want you to remember these three objects—a red ball a blue skate and a green apple” Red ball blue skate and green apple Wait—what did she ask me just now “You don’t know your name” she asks again “Of course I know my name” I snap She waits I wait—then I say it She checks a box I concentrate intensely afraid to ask her to repeat her questions How can I remember the three objects when I have to concentrate so hard to hear the next question The objects have flown the coop One flew over the cuckoos’ nest I think humoring myself Why doesn’t she ask me about my grandkids I keep up to date on things I care about I don’t care who’s running the country What color was that ball I know she’s going to ask me I miss another question What was the second object I’m smart enough to know that I have dismally failed my mental status examThe nurse leaves and returns with the doctor and my daughter What were those damn objects she asked me to remember I know for sure that this can’t be good ganging up on me I concentrate on the doctor’s voice though he is talking not to me but about me “Blah blah blah…medication” What medication “Risk of sudden death…blah blah…worth it to control behavior…blah blah blah” What WHATHow about a pill that makes lettuce green and potatoes white again How about cleaning the damn window pane so people’s faces new and old aren’t stored as Picasso paintings How about I get back everything that life on earth has taken away from me at 90 in full color and technosound How about I see hear and walk unassisted again Even if I knew I’d still not give a hoot about who’s running the country From this point on my prayer is for sudden death leaving my failed body and the cuckoos nest behind


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Other Papers In This Journal:

  1. Comparison of Hospital Costs and Length of Stay for Community Internists, Hospitalists, and Academicians
  2. Health Literacy, Cognitive Abilities, and Mortality Among Elderly Persons
  3. Capsule Commentary on Olchanski et al., Abdominal Aortic Aneurysm Screening: How Many Life Years Lost from Underuse of the Medicare Screening Benefit?
  4. Trends in Primary Care Clinician Perceptions of a New Electronic Health Record
  5. Moving Forward in GME Reform: A 4 + 1 Model of Resident Ambulatory Training
  6. Does Motivation Matter? Analysis of a Randomized Trial of Proactive Outreach to VA Smokers
  7. A Symbol of Our Profession: White Coat Ceremony Address to the Class of 2014
  8. Patient Expectations as Predictors of Outcome In Patients with Acute Low Back Pain
  9. Effects of a Video on Organ Donation Consent Among Primary Care Patients: A Randomized Controlled Trial
  10. “Could this Be Something Serious?”
  11. Building a Career as a Delivery Science Researcher in a Changing Health Care Landscape
  12. Comorbidities, Treatment and Survival
  13. Predictors of Mortality in Patients with Stable COPD
  14. Reflective Practice and Stress: Helpful, Harmful or Uninfluential in Critical Thinking
  15. Pre-Exposure Prophylaxis: A Narrative Review of Provider Behavior and Interventions to Increase PrEP Implementation in Primary Care
  16. Interventions to Improve Outcomes for Minority Adults with Asthma: A Systematic Review
  17. Awareness of Hepatitis C Diagnosis is Associated with Less Alcohol Use Among Persons Co-Infected with HIV
  18. Using Evidence to Inform Policy: Developing a Policy-Relevant Research Agenda for the Patient-Centered Medical Home
  19. Providing Patients Web-based Data to Inform Physician Choice: If You Build It, Will They Come?
  20. Extended Evaluation of a Longitudinal Medical School Evidence-Based Medicine Curriculum
  21. The Relationship Between Multimorbidity and Patients’ Ratings of Communication
  22. Symptom Burden, Depression, and Spiritual Well-Being: A Comparison of Heart Failure and Advanced Cancer Patients
  23. Improving Medication Adherence: Keep Your Eyes on the Prize
  24. Improving Quality of US Health Care Hinges on Improving Language Services
  25. Retroperitoneal Hemorrhage from Kidney Angiomyolipoma
  26. Massachusetts Health Disparities: Key Lessons for the Nation
  27. Using Decision Tree Models to Depict Primary Care Physicians CRC Screening Decision Heuristics
  28. Collaboration and Authorship of High-Impact Randomized Clinical Trials
  29. Cyanotic Congenital Heart Disease (CCHD) with Symptomatic Erythrocytosis
  30. Capsule Commentary on Al-Khatib et al., Future Research Prioritization: Implantable Cardioverter Defibrillator Therapy in Older Patients
  31. Duty Hour Reform in a Shifting Medical Landscape
  32. “Learning by Doing”—Resident Perspectives on Developing Competency in High-Quality Discharge Care
  33. Patient Perceptions of Electronic Medical Record Use by Faculty and Resident Physicians: A Mixed Methods Study
  34. Patient Care Outside of Office Visits
  35. Cefdinir-Induced Hepatotoxicity: Potential Hazards of Inappropriate Antibiotic Use
  36. A Successful Multifaceted Trial to Improve Hypertension Control in Primary Care: Why Did it Work?
  37. Predictors of Primary Care Management of Depression in the Veterans Affairs Healthcare System
  38. Concurrent Sweet’s Syndrome and Erythema Nodosum
  39. Do Health Educator Telephone Calls Reduce At-risk Drinking Among Older Adults in Primary Care?
  40. Do Health Educator Telephone Calls Reduce At-risk Drinking Among Older Adults in Primary Care?
  41. Structuring Payment to Medical Homes After the Affordable Care Act
  42. Longitudinal Patterns in Survival, Comorbidity, Healthcare Utilization and Quality of Care among Older Women Following Breast Cancer Diagnosis
  43. Mysterious Abdominal Pain
  44. Quantification of Authors’ Contributions and Eligibility for Authorship: Randomized Study in a General Medical Journal
  45. Tailoring Outreach Efforts to Increase Primary Care Use Among Homeless Veterans: Results of a Randomized Controlled Trial
  46. Capsule Commentary on Rana et al., Diabetes and Prior Coronary Heart Disease Are Not Necessarily Risk Equivalent for Future Coronary Heart Disease Events
  47. Anorexia Nervosa: Russell’s Sign with Concurrent Tetany
  48. The Effects of Guided Care on the Perceived Quality of Health Care for Multi-morbid Older Persons: 18-Month Outcomes from a Cluster-Randomized Controlled Trial
  49. Massive Paraesophageal Hernia Mimicking Pulmonary Embolus
  50. Reducing Health Disparities or Improving Minority Health? The End Determines the Means
  51. Medication Adherence After Myocardial Infarction: A Long Way Left To Go
  52. Brief Training of Student Clinicians in Shared Decision Making: A Single-Blind Randomized Controlled Trial
  53. From HMOs to ACOs: The Quest for the Holy Grail in U.S. Health Policy
  54. A Heart-Breaking Case of Fever and Rash
  55. The Need for Higher Standards in Correctional Healthcare to Improve Public Health
  56. Assessing the Quality of Clinical Teachers
  57. Secondary Symptomatic Parvovirus B19 Infection in a Healthy Adult
  58. Conducting High-Value Secondary Dataset Analysis: An Introductory Guide and Resources
  59. Clinical Image: Clubbed with a Reminder to Test for HIV
  60. Disability and Decline in Physical Function Associated with Hospital Use at End of Life
  61. Are Physician Estimates of Asthma Severity Less Accurate in Black than in White Patients?
  62. Training Residents to Employ Self-efficacy-enhancing Interviewing Techniques: Randomized Controlled Trial of a Standardized Patient Intervention
  63. Recognition of Depression in Older Medical Inpatients
  64. Understanding the Costs of Patient-Centered Medical Homes
  65. Choosing Wisely: Prevalence and Correlates of Low-Value Health Care Services in the United States
  66. Patients’ Satisfaction with and Preference for Telehealth Visits
  67. Capsule Commentary on Grant, et al., Exercise as a Vital Sign: A Quasi-Experimental Analysis of a Health System Intervention to Collect Patient-Reported Exercise Levels
  68. Toward Safe Hospital Discharge: A Transitions in Care Curriculum for Medical Students
  69. Perspectives of Non-Hispanic Black and Latino Patients in Boston’s Urban Community Health Centers on their Experiences with Diabetes and Hypertension
  70. Professional Language Interpretation and Inpatient Length of Stay and Readmission Rates
  71. Overcoming Poor Attendance to First Scheduled Colonoscopy: A Randomized Trial of Peer Coach or Brochure Support
  72. A Computerized Aid to Support Smoking Cessation Treatment for Hospital Patients
  73. VA and Medicare Utilization Among Dually Enrolled Veterans with Type 2 Diabetes: A Latent Class Analysis
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  75. Electronic Health Record-Based Patient Identification and Individualized Mailed Outreach for Primary Cardiovascular Disease Prevention: A Cluster Randomized Trial
  76. Having a Say: Agency and End-of-Life Decision-making in The Chaneysville Incident
  77. Evaluation of the Effectiveness of Making Weight Watchers Available to Tennessee Medicaid (TennCare) Recipients

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