My regular doc I see annually is old school and old country. Until a few years ago, he operated a solo private practice as an internist, although to survive in the U.S. healthcare dystopia, he’s now been swallowed up by a larger health network, as has almost every other physician and medical practice.
But he still manages to run his practice as if he’s from another era. When I was first referred to my doc about twenty years ago, I was immediately taken by him, not because of any medical brilliance I recognized, but because he reminded me a lot of my mother’s brother, Uncle Leonard: a short, bald, amiable Italian guy. I later learned my doc was from Italy and speaks Italian (I do not, but half of my blood is Italian, thanks for my mom).
He still works as a solo practitioner. He has no nurse or assistant backing him up or performing the basics such as recording temperature, weight, and blood pressure. He does have a receptionist, and behind her is a space with shelves and shelves packed with folders containing paper patient files. Not once have I seen a computer in my doctor’s hands. He never takes notes on a tablet or laptop. He writes on paper. He flips through pages to refer to previous visits with me. When I go in for my annual physical, we talk a lot. He listens closely to anything I have to say.
Along with the usual physical examination, he gives me a short-term memory screening, which can be stressful because I don’t want to screw it up.
For the test, he usually gives me four words, tells me to repeat them to myself, commit them to memory, and then he’ll ask me to repeat them in five minutes.
Then he says, “Let’s try five words today.”
Hold on, doc, who said anything about raising the bar?
But okay, bring it on. I’m up for the challenge. Maybe. Last time I did one of these tests, I couldn’t remember one of the words, but I’m competitive by nature and determined to prove myself.
He starts giving me my words: pencil, bridge—I interrupt him. I say, “Doc, you use bridge every year.”
“Do I?”
He thinks for a moment, then says, as if pulling the other words out of the air: “Pencil, bridge, orange, shoe, scissors.”
My technique is to create a visual stack of these nouns. I picture a pencil holding up a bridge with an orange on top getting kicked by a shoe that’s being cut by a scissors. Sometimes this works.
We move on to other things: reflexes, balance, etc. What vaccines I’ve had and might want. We talk about what a rotten sleeper I am. I’m mostly distracted because I’ve been repeating the words to myself and visualizing my stack.
“Do you think it’s been five minutes?” he asks.
I feel like it’s been an hour. I say, “Yeah, I think so.”
He asks for the words; I repeat them back in order, no problem.
I ask him if he comes up with the words spontaneously(other than his go-to word bridge). He admits he does. Then I ask: “If you just think up the words spur of the moment, how do you remember them after five minutes?”
He chuckles a bit and says, “I figured you would.”
Hmmn. Bit of a cryptic answer. If he doesn’t remember them, how will he know if I do? Yet I’m sure he understands exactly what he’s doing.
I’ll miss my doc when he retires. He says he has a couple of years left, that he’s winding down his practice, working less, and not taking on new patients. I’ll have to find a new doc, one who likely types a lot into a laptop. I’ll lose not only a great physician with old-school habits, but the last reminder of my Uncle Leonard, gone now for years.
