Making Rounds and Oscar (2010) by David Dosa Read Free Book Online
Authors: David Dosa
eventually broke the silence. "Is it Alzheimer's, Doctor?" he asked. Suddenly he was the captain of a rudderless ship on an uncharted ocean. He was flying without instruments, driving without a map.
"I'd like to order a few more tests, Mr. Rubenstein, but Alzheimer's is the most common form of dementia and the memory tests I've performed thus far are consistent with that diagnosis."
Frank nodded grimly. Since they had no other questions, I began to tell them about Alzheimer's disease and how it affects brain cells. I told them the disease would ultimately result in further memory loss and perhaps even behavior changes. I tried to console them by saying that there are a few medications that might delay her symptoms and that her deterioration will be gradual at best. I informed them that she should exercise regularly, something that has recently been shown to improve memory. I concluded by telling them that in all likelihood, she might one day die with dementia rather than of it.
Small consolation to someone who has just been told her life will never be the same. Their lives.
The discussion left both husband and wife visibly shaken. A minute passed and I finally broke the spell, asking them if they had any further questions. They shook their heads. I left the room and walked toward my office.
"Doctor!"
Frank had followed me down the hall to ask the one question that everyone wants to know.
"How long does she have?"
"Truthfully, Mr. Rubenstein, I really don't know."
"But Doctor, surely you have some idea of how long she has."
Pressed on the issue, I offered a guess.
"She has relatively early dementia currently but based on where her memory is today, I suspect that she has perhaps three to five years before she loses the ability to care for herself."
My response was met with a look of nonbelief, followed quickly by anger. It was as if I was the one who had brought her the disease rather than the diagnosis.
All he needed was a gun to shoot the messenger.
As I said, sometimes I hate my job.
CHAPTER FIVE
"One cat just leads to another."
ERNEST HEMINGWAY
A LARGE PORTRAIT OF HENRY STEERE HANGS OVER THE piano in the lobby. It's a cozy setting, what with the sunlight streaming through in midafternoon. But that wasn't what I thought the first time I heard the piano playing. When I had wandered into the lobby on my first visit to Steere House, piano music filled the space with a Chopin prelude, but there was no one else in the room. I had looked over expecting to see one of the more able residents or a family member seated before the keys practicing. Instead, there were only Billy and Munchie, the two resident lobby cats, staring back at me from the comfort of an otherwise unoccupied piano bench. The oddness of the scene, two cats seated at a piano bench while music filled the air, was overwhelming--until I realized it was a player piano.
Today I was stealing a few minutes of downtime before rounds. I had settled myself into one of the lobby's comfy chairs and was enjoying the music. I guess I was reflecting, too, on the need to soften the reality of a nursing home--the last home most of our patients will know. At Steere House, perhaps we've achieved the same effect with a family of cats, an atrium of glass, and the sounds of classical music played by the best pianist you never saw.
As if on cue, one of the lobby cats rubbed against my legs. It was Munchie. He's an unusual-looking fellow: grayish-black with spatters of chestnut and brown, like an expressionist painting gone wrong. He meowed loudly, calling out for affection. Cautiously, I reached over and stroked him behind the ears. That flipped the purring switch and he continued to bang against my legs like a bumper car.
"You're not so bad," I said. "At least you don't attack me, like some cats I could mention."
Munchie looked up at me and then curled up over my feet, fully obscuring them from view. As he settled in for a nap, a more ordinary-looking
"I'd like to order a few more tests, Mr. Rubenstein, but Alzheimer's is the most common form of dementia and the memory tests I've performed thus far are consistent with that diagnosis."
Frank nodded grimly. Since they had no other questions, I began to tell them about Alzheimer's disease and how it affects brain cells. I told them the disease would ultimately result in further memory loss and perhaps even behavior changes. I tried to console them by saying that there are a few medications that might delay her symptoms and that her deterioration will be gradual at best. I informed them that she should exercise regularly, something that has recently been shown to improve memory. I concluded by telling them that in all likelihood, she might one day die with dementia rather than of it.
Small consolation to someone who has just been told her life will never be the same. Their lives.
The discussion left both husband and wife visibly shaken. A minute passed and I finally broke the spell, asking them if they had any further questions. They shook their heads. I left the room and walked toward my office.
"Doctor!"
Frank had followed me down the hall to ask the one question that everyone wants to know.
"How long does she have?"
"Truthfully, Mr. Rubenstein, I really don't know."
"But Doctor, surely you have some idea of how long she has."
Pressed on the issue, I offered a guess.
"She has relatively early dementia currently but based on where her memory is today, I suspect that she has perhaps three to five years before she loses the ability to care for herself."
My response was met with a look of nonbelief, followed quickly by anger. It was as if I was the one who had brought her the disease rather than the diagnosis.
All he needed was a gun to shoot the messenger.
As I said, sometimes I hate my job.
CHAPTER FIVE
"One cat just leads to another."
ERNEST HEMINGWAY
A LARGE PORTRAIT OF HENRY STEERE HANGS OVER THE piano in the lobby. It's a cozy setting, what with the sunlight streaming through in midafternoon. But that wasn't what I thought the first time I heard the piano playing. When I had wandered into the lobby on my first visit to Steere House, piano music filled the space with a Chopin prelude, but there was no one else in the room. I had looked over expecting to see one of the more able residents or a family member seated before the keys practicing. Instead, there were only Billy and Munchie, the two resident lobby cats, staring back at me from the comfort of an otherwise unoccupied piano bench. The oddness of the scene, two cats seated at a piano bench while music filled the air, was overwhelming--until I realized it was a player piano.
Today I was stealing a few minutes of downtime before rounds. I had settled myself into one of the lobby's comfy chairs and was enjoying the music. I guess I was reflecting, too, on the need to soften the reality of a nursing home--the last home most of our patients will know. At Steere House, perhaps we've achieved the same effect with a family of cats, an atrium of glass, and the sounds of classical music played by the best pianist you never saw.
As if on cue, one of the lobby cats rubbed against my legs. It was Munchie. He's an unusual-looking fellow: grayish-black with spatters of chestnut and brown, like an expressionist painting gone wrong. He meowed loudly, calling out for affection. Cautiously, I reached over and stroked him behind the ears. That flipped the purring switch and he continued to bang against my legs like a bumper car.
"You're not so bad," I said. "At least you don't attack me, like some cats I could mention."
Munchie looked up at me and then curled up over my feet, fully obscuring them from view. As he settled in for a nap, a more ordinary-looking