Tuesday, December 1, 2009

"Take Two Aspirin and Slit your Wrists in the Morning."

When people think of New York, they envision bright lights and dark alley ways. They think of a teaming Metropolis where anything can be obtained or experienced if you have the money and the desire for it.

New York is where Jerry Orbach (His work is his monument.) played Billy Flynn on Broadway and Lenny Briscoe on 'Law & Order'. It is, and was, the capital of commerce and art; of fashion, food and great music. Busy and exciting, it's made even spicier by a hint of danger and intrigue. It's the 'Big Apple. It's the city that never, ever sleeps.

I come from no such place. "My' Town, New York slept straight through the 1930's and into the 1970's, yawning and shifting position only slightly during it's long nap. It was a place where dirt roads were common and sidewalks (when there were any) were made of wood. It was a town and a time where a nine year old child could walk into the local druggist and buy a pack of cigarettes for her mother, without a blink from either side of the counter. (And it wasn't always a lie.) It was a town that even the railroad had abandoned, yet we still all lived on the wrong side of the tracks.

If 'My' Town possessed a doctor, we children didn't know of it. When we were ill; when our cousins, aunts, uncles and probably our dogs were ill, we were put into a car and driven to Ossining. (Which is home to another monument occasionally featured on 'Law & Order'; Sing-Sing Prison.)

We were taken to one Dr. Gilbert, a quiet and genteel physician of the old school - A man who resembled 'Judge Hardy' in appearance, dress and manner. We visited him in his office which was located in his own home, a sedate brick affair tucked quietly into a well-heeled residential cul-de-sac. His waiting room looked as though it had been decorated by Jane Austen, with paintings of rosy-cheeked children smiling out from gilded frames hung on creamy walls. The carpeting was thick, (in an Oriental style, if I correctly recall) and the settees were in heavy brocade.

The good doctor, and I say that in all sincerity, had his office to one side of a long, darkened hallway, at the very end of which was the door that led to the house proper. We never saw behind that door, and I was somehow wildly curious about 'Mrs.' Gilbert and her brood of little 'Gilberts'. (Who had to have been in their thirties by then, considering Doctor Gilbert's advanced age.)

In his brightly lit office, we received our polio shots, had deeply embedded splinters removed and stood stock-still on his tall, metal scale while he measured us and told us how much we'd grown since our last visit. He was a full-service doctor, providing care from before infancy to beyond old age for generations of our family. In fact, we later discovered that he had acted as de facto marriage counselor for our parents. He kept us all well.

That was an age ago. I still live in 'My' Town, but time has visited us, and while we retain a measure of 'Podunk'ness, we are now just another bedroom community to Gotham that lies forty miles southeast.

And nobody has just one doctor anymore. Between us, my husband and I have Dr. FeelGoodEnough, a psychiatrist and all-around good fellow who tends to my bouts of melancholia and shares my interest in travel, botany and photography. We have Dr. Mailbagger, a bright young thing (under fifty) who syringes out my husband's ears and manages his asthma symptoms. And we have Dr. Longshadow, who bills himself as an internist and phlebotomist. It is Dr. Longshadow who has inspired this essay.

Dr. Orin Longshadow received his medical education from a prestigious European university at about the same time that 'My' Town was hitting the snooze button for the last time. I know little about his personal life and would like to keep it that way. On first impression, you would notice that he is a man who looks you squarely in the the elbow, the shoe, or at the wall behind you. A veritable oracle, he deduces your illness, diagnosis AND your course of treatment before you've walked through the office door. Admirably, he disregards any wild opinions from his patients. (He once advised me to have my gallbladder removed because my liver enzymes were elevated. Since I was visiting him to be treated for an acute case of Lyme Disease and had been running a temperature approaching 103 degrees, I protested that my liver enzymes had every good reason to be elevated without any assistance from my gallbladder. Fourteen years hence, my gallbladder remains well-behaved at home and my liver enzymes are perfectly within normal range, thank you very much, Dr. Longshadow.)

It's my own fault, I suppose. He's given me ample reason for finding a different (read, 'better') physician. About a decade and a half ago, I fell into a particularly dark, blue funk. And having no one else to turn to, I made an appointment with him. I sat on the examination table, weeping and unable to explain why, while he stood as far away as that hot and tiny room would allow, his back up against the door and his hand straying for the knob. I was sent away with a prescription for Zoloft (2 refills), Ativan, (no refills. This is New York.) and the admonition that if I took it into my head to commit suicide, I should first dispose of the bottles so that no one would know he had prescribed them for me. He offered me no follow-up visit and no referral to a psych therapist. His only piece of advice was that nurses (I am a nurse.) were very likely to become addicted to drugs.

Because of that visit, and because of his subsequent hunger for my gallbladder, I avoided Dr. Longshadow for many, many years. Good fortune has given me reasonably good health and I felt that my procrastination in finding a actual doctor was forgiveable. Indeed, on the eve of my 55th birthday, I remain hale and hearty, free of any physical complaint except those attendant to my age and genetic heritage.

I was recently casting about for a job. I found one quickly enough and was only mildly distressed to be told that I must supply my new employer with the results of a recent physical exam.

I did call other doctors, but they, following proper standards of care, told me that as a new patient I would have to be thoroughly tested, examined, scanned and sniffed before they would do anything like a basic work physical. In addition, since I was not ill, and since my visit would necessarily be a long one, these truly busy doctors couldn't offer me an appointment for a month or more. So, it was, "Hello, Dr. Longshadow."

I called and made my appointment for the following week. I told the office manager that I needed a pre-employment physical. I was very clear about that. Very clear.

When I arrived, I was shown into the same (possibly the only) arid and air-less matchbox of an exam room where I had defended my gallbladder so many years before. And after twenty five minutes of contemplating the wrinkled butcher's paper that covered the exam table I was re-introduced to the durable Dr. Longshadow.

Studiously avoiding my gaze, he asked me why I was there. I had assumed that the folder he held open in front of him was my chart, but apparently it was his daily horoscope or perhaps a recipe for 'Chicken Marengo', because there certainly wasn't anything written on it that told him who I was or what I needed.

I explained that I was getting a new job and needed a pre-employment physical. He took my blood pressure. Then he asked me if my new employer had given me a form for him to fill out. They hadn't. I said so.

"They should have given you a form.", he said, obviously annoyed.

"Well, they didn't, and your office didn't tell me to bring one when I called to make the appointment."

He turned his back to me and began to write. (Remember, at this point, he has only taken my blood pressure.) When he turned back he was holding a prescription slip in his hand. I took it and read it.

It said; "She can work at LPN position."

He would have brooked no protestation, even if I hadn't been too astounded to offer it. One co-payment later and I was out the door.

The supervisor at my new job must have a good sense of humor. When I handed her the 4"x4" results of my physical exam, I put on my most abashed face and told her that Dr. Longshadow had perfected the position of GP to a minimalist art. I said that his motto was, "This far and no futher." Without a form, that is. Her laugh was genuine. She told me that she would find a form for Dr. Longshadow, since what he had given me was.....ridiculous.

I left her building with form in hand, and by traveling quickly enough to make the scientists at CERN glow green with envy, I reached Dr. Longshadow's office just before they closed. (This was the Tuesday before Thanksgiving.)

The doctor was not in. (More on that in a moment.) But the office manager told me to come back the day after Thanksgiving to pick up the completed form. "Not before 9:00am!", she added as a parting shot.

I went directly home and found a message on my answering machine. It seemed that the doctor (who was not in) wanted me to make an appointment for Monday in order to complete my physical. This was very annoying to me, but surprisingly conscientious of him. The trouble was that I was supposed to start work on that same Monday. Since his office was now closed and would not re-open for another two days, I had no choice but to call my supervisor and beg her to let me start the next Monday. She said, bless her, that it wasn't a problem.

So, I went to have my physical completed today. I had already filled in all that I should fill in, and some of what he should have filled in. I didn't expect much, and what I got was even less.

After a 45 minute wait spent happily listening to Stephen Fry reading short stories on my Crackberry, I was permitted into the oubliette. He appeared with the form, signed it, stamped it and handed it to me without ever getting close enough even to take my blood pressure. Another co-payment later and I was out the door.

Looking back, I can't say that I feel aggravated or chagrined about any of it. Today is my birthday. (It took me longer to write this than I thought it would.) Happy Birthday, I have my physical! And while Dr. Longshadow may never have gotten my gallbladder, he certainly has my bile.

- Maggie

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