My father’s stroke: 1

 

Sticking it to yourself

Sticking it to yourself

Eight days have passed since my father stroked out in a south Jersey parking lot. I am just beginning to piece together how he — and some of his doctors — contributed to this latest of his health crises.

This afternoon as my father was sitting down to eat dinner, he realized that he had run out of his Novolog insulin. He wasn’t concerned. He said he had some other insulin stored in a cardboard box with a bunch of medications he used for treating gout, high cholesterol and a low-functioning prostate. I asked him what that “other insulin” was doing in this pharma mix.

“Somebody in my doctor’s office gave it to me,” he said.

“Who?”

“He’s kind of like the doctor’s deputy,” he said.

“Where do you go to school for that?”

My father shrugged.

I asked, “Is he a doctor?”

“No.”

“So who is he?”

“He wears a suit.”

My father does not have Alzheimer’s Disease and the last thing he is is stupid. The problem is that he has a chronic case of veneratio immodicus — excessive reverence — for doctors and for the drug pushers who visit their offices.

“Did you ask your doctor if it was okay to take this 70/30 insulin combo?” I asked.

“No. Read the box and see if I can take it.”

“Do I look like a doctor to you?”

When I dialed his primary care doctor’s phone number to ask him about the insulin, my father got angry at me. Why was I bothering the doctor? A few minutes earlier he had chewed me out for talking to a family friend about a neurologist for my mother. “I don’t need favors from anybody!” he said.

Two minutes later, when we learned that the neurologist had a good reputation, my father suddenly remembered that he had met the guy in synagogue. “Such a nice man,” he said. “He gives me his hand every time he sees me.”

*

I get on the phone with the primary care doctor’s office and I ask a nurse there about my father’s insulin.

“We don’t have that information,” she said.

I am an idiot and I don’t know what to say. Why would I expect a primary care doctor to know what medications he has prescribed to his patient?

The nurse comes to my rescue. “They changed his insulin in the hospital, didn’t they?” she asks.

“He’s still using the same insulin since before the stroke,” I said.

“You’ll have to check with his endocrinologist,” she said.

As it happens, my father has an appointment with the endocrinologist this afternoon. But what if he didn’t? What if he had used up his insulin, say, yesterday, or on Shabbat when my father would refuse to use the phone to call anybody?

*

The endocrinologist is an older man with silvery coifed hair and good teeth. Straight out of the “Mad Men” era. He is delightfully rough around the edges and chews my father out for not keeping his blood sugar under control.

“Do you stick your finger regularly?” he asks him.

We are in the thick of a Clintonian moment because my father’s answer depends on what “regularly” means. He says yes. I bite my tongue.

“What’s your sugar level in the morning?” the endocrinologist asks him.

My father appears to search his memory. “Around 150,” he says.

This doctor homes in on my father’s equivocation. “Is it ever in the 200s?” he asks.

My father says yes.

“What about later in the day?”

“It can go up into the 200s.”

It routinely goes up into the 400s.

“How long have you had diabetes?”

My father gives an answer that should be shocking, but I see that it entertains him. “Thirty-five years,” he says.

Time for me to play Goneril. “My father has been checking his blood only since he had the stroke,” I say.

“When was that?” asks the doctor.

“Last Tuesday.”

Dr. Mad Men surveys my father sitting on the examining table in his bare feet. For an 84-year-old man one-week post-stroke, my father looks good. He jokes with this nuts-and-bolts gent, who keeps shooting me a look that says, “Your dad’s a real card, eh?” My father tries to tell the doctor that he can’t share his family medical history with him because everyone was killed during the Holocaust. The doctor doesn’t comprehend what that means and asks him again if anybody in his family had diabetes. 

“I was fifteen years old when they were all killed!” my father says.

“Do you remember if anyone had diabetes?” the doctor asks.

“How could I possibly remember?”

My mother wisely explains that nobody in pre-war Poland had gotten a diagnosis of diabetes.

The upshot of my parents’ remarks finally seems to register in the doctor’s brain. 

“What’s this?” he asks. He examines my father’s toenails. One of them is blackened by a fungal infection. My mother wears a mortified expression. She has tried to get my father to see a podiatrist, but he always refuses.

“Make an appointment with a podiatrist and get this taken care of,” the doctor says. Blunt.

He wants to know why my father won’t let anybody get his blood sugars under control.

“You are not going to experience any further old age if you don’t take your diabetes seriously,” the doctor says.

Up until my father’s stroke, I have had a prejudice against osteopathic doctors. But this crusty coot is knowledgeable in a way that doesn’t waste anybody’s time. He has none of that condescending happiness I have encountered in some of my own interactions with MDs. I am starting to think that for a disease like diabetes, you do not have to be a brilliant. You just need to pay attention to the matter at hand. You just need to be good at your job.

“In one week from today, you will fax me your blood sugar levels,” the doctor said. “Without knowing what they are, I can only guess at the amount of insulin you need. And guessing will never get it right.”

Why hadn’t my father’s primary care doctor insisted on seeing a record of his blood sugar?

“Am I going to get that from you?” Dr. DO-right asks my father.

My father nods in agreement.

Meanwhile, I tell the doctor, my father doesn’t have any more insulin. The doctor thinks he has some in his office and leaves the examining room to retrieve it. Nobody, including me, talks about a prescription renewal. I am just as bad as my father. As soon as the immediate problem is solved, I don’t think farther out into the future.

At home, I remind my father that he has agreed to check his blood sugar four times a day.

“Three times is enough,” he says.

NEXT: My father’s stroke: 2

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6 Comments »

  1. Amy said

    Whew – you father is a tough customer. And guess who is an osteopath??
    Louis, my ex-dearly beloved.

  2. modestine said

    Hi Amy, I knew that about your ex. Like taxi drivers, dairy farmers, school principal, etc., some people are good at their job, some aren’t. I discovered that this holds for DOs too.

    My father IS a tough customer. In some ways, his toughness makes for comic reading. When he threatened to throw Pesha and me out of the house, we were laughing so hard we had to leave the room. He is wonderful in spite of his crabbiness.

    Thanks for reading and commenting! — B

  3. Anita (Fonseca) Brown said

    Once again I am struck by how beautifully you write and have the ability to transport me to where the story is taking place, as if I were in the room. It is both comical and typical, your father’s suspicion, reverence and acceptance of the physician and his edicts. You go, Mr. Finklestein!!

  4. modestine said

    Hi Anita. My father could live to 200 and not understand that doctors are mere mortals. Therein lies the comedy and tragedy! Thanks so much for reading and commenting. — B

  5. Darlene Shely said

    Barbara, wonderful writing as usual. Send it in essay form to AARP…anyway, my father hated all shrinks but he did love a certain internist in Riverdale many years ago and tell him all his problems. I used to call him Dr. G-d. Dr. G-d disappeared one day and went to live in Woodstock because some crazy stuff was going on in the office….so there went someone to complain to (mostly about me who ran off to Israel at the time).

    Refuah Shelemah, better come visit me and my swimming pool

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