We seem to specialize in the following areas: paperwork, gerontology, maladies of the central nervous system, and what they call talkdown. I sit there in my white coat, with my reflex hammer, tuning forks, small flashlight, tongue blades, pins, needles. My patients are even older than I am. It has to be said that they usually look fairly cheerful on their way in. They turn, and sit, and nod bravely. “Good,” says Tod. The old party then says, uThank you, Doctor,” and hands over his prescription. Tod takes the scrap of paper and does his little stunt with the pen and pad.
“I’m going to let you have something,” Tod says grandly, “that will make you feel better.” Which is the purest bull, I know: any second now—so invasively, so grimly, and on the basis of so little acquaintance—Tod’s going to stick his finger up the poor guy’s ass.
“More scared,” says the patient, unbuckling his belt.
“You seem fine to me,” says Tod. “For your age. Do you feel depressed?”
After the business on the couch (a rotten deal for both of us: how we all whimper), Tod’ll do stuff like palpate the carotid arteries in the neck and the temporal arteries just in front of the ears. Then the wrists. Then the bell of the stethoscope is deployed, low on the forehead, just above the orbits. “Close your eyes,” says Tod to the patient, who, of course, immediately opens them. “Take my hand. Raise your left arm. Good. Just relax for a while.” Then it’s talk-down, which will typically go like this:
Tod: “It might start a panic.”
Patient: “Shout fire”
Tod: “What would you do if you were in a theater and you saw flames and smoke?”
Patient: “Sir?”
Tod pauses. “That’s an abnormal response. The normal response would be: ‘Nobody’s perfect, so don’t criticize others.’ ”
“They’ll break the glass,” says the patient, frowning.
“What is meant by the saying ‘People in glass houses shouldn’t throw stones?’ ‘
“Uh, seventy-six. Eighty-six.”
“What’s ninety-three minus seven?”
“1914-1918.”
“What are the dates of the First World War?”
“Okay,” says the patient, sitting up straight.
“I’m now going to ask you some questions.”
“No.”
“Sleeping okay? Any digestive problems?”
“I’ll be eighty-one in January.”
“And you’re . . . what?”
“I don’t feel myself.”
“Well, what seems to be the problem?”
And that’s it. They certainly don’t look too cheerful on their way out. They back off from me with their eyes wide. And they’re gone. Pausing only to do that creepy thing— knocking, quietly, on your door. At least I can say that I do these old guys no real or lasting harm. Unlike nearly all the other patients at AMS, they go out of here in no worse shape than when they came in.
The social standing enjoyed by doctors is of course formidably high. When you move, as a doctor, through society, with your white coat, your black bag, the eyes of others seek you upward. Mothers express it best: their postures seem to concede that you have the power over their children; as a doctor, you can leave the children alone, and you can take them away, and you can bring them back, if you choose to. Yes, we walk tall. Us doctors. Our presence chastens others, renders other serious. The tilted eyes of the others gives the doctor his heroic, questing mein, his humorless nimbus. The biological soldier. And for what? . . . One thing that’s helping me through it, aside from my chats with Irene, is that Tod and I are feeling so damn good these days: physically. I can’t understand why Tod doesn’t show more gratitude for the improvement. When I think back to how things were out in Wellport, man, we were still walking, but only just. It was taking us twenty-five minutes to cross the room. We can bend over now with scarcely a groan, scarcely a knee-crackle. We’re up and down those stairs—hey, where’s the fire? Occasionally we get spare bits of our body back, from the trash. A tooth, a nail. Extra hair. The effortful shepherding of one’s confusion and faint nausea, which I assumed was the basic existential package, turns out to have been a temporary condition. And sometimes, and sometimes for minutes on end (especially if you’re lying down), nothing hurts.