Brainstorm. Sheldon J.D. Cohen
You get a computer. I know from my kids. And you can make the appointment? Sounds kinda suspicious to me, Eve.”
“Now now, Gail, let’s not jump to conclusions. You let me handle it. When do want the appointment?”
“George has a day off on Thursday.”
“I’ll call you later and give you your time.”
“What if he’s busy? This is such short notice?”
“I’m sure he’ll do me the favor. Trust me, Gail.”
“What’s the doctor’s name?” asked Gail.
“Crowell, Dr. Burt Crowell.”
Eve was as good as her word, and when George arrived at the office in the doctor’s building of Covenant hospital, the receptionist handed him a four-page medical history form to fill out. He minimized his problem, jotting down stomach pain on a question labeled chief complaint.
After about twenty minutes, George met the doctor. He shook his hand. At about five feet and ten inches, the doctor was impressive. A former baseball player in college, it was clear that he was making every effort to maintain the same musculature he had in his playing days. His white coat could not mask the circumference of his upper arms. His hair was brown as were his eyes. He had a cleft in the center of his chin. There was a warm smile on his face.
George had avoided doctors all his adult life, but he was impressed with the demeanor of this man.
“It’s nice to meet you, Mr. Gilmer. How can I help?”
“I’ve got stomach pains, and my wife nagged me until I would see you.”
A typical story, Burt thought. Women come in on their own. A man’s wife usually drags him in. Burt checked the medical history form while keeping a watchful eye on his new patient who was sitting at the edge of the examining table abutting the windowed back wall. He noted his patient fidgeting with his hands, his eyes darting all around the room. Burt sat down on a stool in front of a desk and side chair adjacent to a built in sink. He had seen similar behavior from other male patients.
“Where’s the pain located?” Burt asked taking a medical history, which he viewed as the most important part of the medical evaluation.
“Here.” George pointed below his breastbone.
“Is the pain persistent, or does it come and go?”
“It comes and goes.”
“Does it stay in the middle of your stomach, or can you feel it other places in your abdomen or in your back?”
“Stays right there,” George said, pointing to the same location
“Can you describe the pain? Does it feel sharp like a knife, or a burning, dull, gnawing, or achy kind of pain?”
George thought for a moment before he said, “Mostly dull and gnawing, but sometimes burning.”
“Is there anything that makes the pain go away?”
“Yeah, I take these antacids,” he said as he took them out of his pocket to show the doctor.
Burt looked at them and nodded his head. “On a scale of one to ten with one the least and ten the most you could possibly stand what number would you assign to the pain?”
“Mostly four or five, but one time it felt like an eight.”
“Does it ever wake you up in the middle of the night?”
“A couple of times.”
“Have you had any nausea or vomiting?”
“Um…what did you say?”
Burt took note of his patient’s inattentiveness and repeated the question.
“I vomited a couple of times.”
George was squirming. His answers were getting short and abrupt, so Burt chose to scrutinize the history form again for any other pertinent information and said, “That’s about all the questions I have now, Mr. Gilmer. Strip down to your shorts and I’ll be back in a minute.”
Surveying the room again, George saw three diplomas on the wall and a picture of a man seated at the bedside of a sick child. The picture, titled The House Call prompted a “Hmm,” from George. He smirked. A framed collection of antique fishing lures hung next to the picture. He was still scanning the room when he realized that the doctor’s minute was stretching into two, then four, then six. He struck his left palm with his right fist. He was struggling to suppress the desire to leave when Burt returned and observed his patient’s agitation. “Sorry, but I got a call from the emergency room. I had to be sure everything was okay.”
George stared with unchanged expression.
Burt performed a complete physical examination and then told George to get dressed. “When you’re ready, just open the door and I’ll come right back.” George got back in his clothes and this time Burt kept his word.
“What do you think?” asked George.
“Your physical examination didn’t give me any real clues, and that’s the good news.”
“How about my stomach. What do you think is wrong?”
“My first guess would be an ulcer.”
The wife was right as usual, thought George.
Burt continued. “There are other possibilities such as an inflamed stomach, a hiatus hernia, an inflamed esophagus, inflamed gall bladder and other upper abdominal problems. But, my money lies with the ulcer. We need imaging studies to be certain, and we need blood tests to rule-out some other rare possibilities that can cause you to have these kind of symptoms.”
“What about my stomach pain? What can I take for that?”
“Here’s a prescription. It will cut down the acid that your stomach makes and help with the pain. Take it morning and evening, twelve hours apart. You could also take the antacids if you need them. This paper I’ll give you tells you what you shouldn’t eat until we find out what’s causing your problem. Take this order slip to the outpatient department and schedule the blood and urine tests and imaging studies. You’ll get instructions. In the meantime, don’t drink any alcohol, don’t miss any meals, don’t take any aspirin and don’t miss any doses of the medicine.” Burt wrote the instructions out on his letterhead.
George felt calmer. If medicine could fix the ulcer, he thought, who needs all these tests? He extended his hand to Burt. “Thanks, doctor.”
“Make an appointment to see me after the tests are complete. It was good meeting you, Mr. Gilmer.”
George took the prescription to the pharmacy but didn’t schedule the tests, electing to see how things went. After a twenty-minute delay at the pharmacy where he paced back and forth while waiting, he realized that since he developed this problem he’d been losing his cool a lot. Maybe that’s why I’m getting an ulcer, he thought. He received his prescription and returned home.
“Well, how’d it go?” asked Gail.
“Good, he’s a nice guy. He gave me some medicine.”
“What did he tell you?”
“He said I’m as healthy as a race horse.”
“So you need medicine to make you even healthier, right?”
“Correct. Man, I’m sure lucky to have a smart wife like you.”
“And you know how to change the subject. Cut the bull, and tell me what the doctor said.”
“He said I wasn’t getting enough.”
“Enough what?”
“I’ll show you,” he said as he grabbed Gail and wrestled her down on the couch.
“You’ve