I guess you would call it a nervous tic because it didn't seem to serve any useful purpose. From analyzing the rhythm of the movement, I can tell you that she had repeated it thousands of times. From head to toe she was fat and droopy in a cozy kind of way. She had the sort of lap that a kid or a cat would just naturally nestle into and fall asleep. Every few minutes she would flex her right elbow and, with a hooked right index finger, brush aside the collar of her blouse, snare her right bra strap, and yank the strap up and out while curling her shoulders and jostling her breasts. If a cat had been on her lap it wouldn't have awoken because the whole movement was as fluid and comforting as a deep breath. She smelled like baby powder but her clothes and hair were a little disheveled and grungy. She was about 60 or 70 years old. She had a big sack purse from which she pulled 10 or 12 empty medication bottles. Her physician had died recently and I was to replace him.
"How long has your shoulder been bothering you, Mrs. Platt?"
"Oh, I been sufferin' with that shoulder for years. Doctor said it can only be an infection or a cancer in the bone, and we know it ain't no infection 'cause it ain't never had no heat an' ain't never had no pus. Doctor said never to let no one cut on it though, 'cause'n if that cancer were let alone it would cure up on its own, but if'n you cut on it, it'll spread all over the body. Damn if he warn't right neither 'cause that's been 10 years ago and it ain't no worser and it don't cripple me none. Hell, my brother got cancer in his bones and he was dead 6 months after they startin' cuttin' and foolin' with it".
"Do any of your other joints bother you?"
"Oh, sure, my hips and knees pain me so much I had to take to the stick but it don't really help none".
"What do you mean, ‘take to the stick’?"
"A walkin' stick. A cane, you know. Doctor said I gots a cancer in them joints. One fool thought it was rheumatism and had me takin' aspirins but doctor said them aspirins make you bleed on the insides where no one can see it till yer dead. Sure enough they was tearin' me up too 'cause they put that hose in me and filled up my guts and found a hidin' hernia. Doctor said these pills would cut the acid". She held up an empty bottle. (There went the tic). She was out of breath after a string of two or three sentences.
"How long have you been having trouble with your breathing?"
"Oh, I've been sufferin' with emphysema for 5 year or more. Doctor said it probably come on me from livin' in the city. Been usin' some breathin' pills fer it and they been doin' all right by me".
"Do you smoke cigarettes?"
"Yep, I ain't gonna lie to ya, I lit up my first one when I was no more 'an 12. They don't seem to affect me none. Hell, my daddy smoked till he was 85 and they never done him no harm. I can take 'em or leave 'em myself but I never had no cause to stop. One time I gave 'em up and I got to shakin' and my heart was racing and skippin'. Doctor said it was on account of goin' cold turkey".
"Have you ever been hospitalized because of breathing difficulties?"
"Never did need no hospital. I had a complete physical every year in the spring and doctor said I'm healthy as a horse. Course I git antibiotics once or twiced a year for walkin' pneumonia but doctor said that was on account a me workin' in the weather. I need some antibiotics today 'cause I noticed some yeller when I spit this morning. Doctor said to take antibiotics whenever it turns yeller".
"What sort of trouble do you have with your heart?"
"Well, I built up some fat around the outsides of my heart that keeps its from pumpin' just so. Doctor said I'm damn lucky to be alive; said most others he's" (tic again) "seen with a case as bad as mine is dead and gone. Doctor said he caught it just in time. I'm takin' a heart pill and water pills and a pill fer nerves to keep my heart steady".
"You seem to be taking quite a number of medications, Mrs. Platt. Maybe we should spend some time today on straightening out your medical regimen".
"Ya, I need 'em all refilled 'cause I'm out".
"Well, that's what I would like to talk about, I'd like to change a couple of your medications and probably stop ... . ".
As soon as she sensed my intentions, she edged forward in her chair and her droopy and cozy countenance perked up like the quills on a porcupine. I stopped in midsentence because I figured if I didn't let her vent immediately she would start firing off spines in my direction. (There went the tic, but this time the cat would have been flung to the floor in a heap.)
"Now you seem like a fine young doctor and I don't mine someone as young as you doctorin' on me 'ceptin if you're fixin' to fool with somethin' that ain't broke. Ever time some new doctor tries to go messin' with my pills I end up a hackin' and wheezin' and painin'. I ain't had no trouble long as I'm takin' these here pills. Doctor said fer me ta stay on 'em fer good and by my way of thinkin', he'd know better what's good fer me and what ain't than someone who's jus' laid eyes on me".
She held her fire to allow me a chance to surrender but I wasn't backin' down; who's the doctor here anyway? I prepared my face to resemble more closely my obvious experience with these matters and I stroked my mid-upper lip with a hooked right index finger. I silently outlined the first few sentences of my rebuttal: polypharmacy, ahem, ahem, data from recent clinical trials ahem, ahem, and so forth, and so on, and furthermore. Her quills began to prick up again. I hunched over the chart on my lap and began tapping my pen on it like a drum. Who was this old doc anyway and why should I refill all these medicines when they're probably not doin' much good? Cancer in the bone? Surely she misunderstood him. Why would she put so much faith in what this doctor said? How am I supposed to counter the assertions of some ghost authority whose colloquial explanations 10 years ago have been transformed by time into medical fact? I pushed up my glasses and, rubbing my neck, continued my silent debate. I guess they're not really hurtin' any and she's been takin' 'em for years. I'm not sure what I would do differently anyway. 'Spect it wouldn't hurt ta go ahead and fill 'em this time. Hell, she made it this far, you can't argue with that; whatever the doctor said, she certainly believes whatever she thinks she heard him say. I pushed up my glasses and, tapping the chart, I responded diplomatically.
"You do seem to be getting along quite well, Mrs. Platt, and I certainly don't wanna rock the boat any. Maybe over the next few years," I said, pushing up my glasses and rubbing my chin, "if you're doing as well as you are now, you won't require quite so many different pills".
"How bad's that cancer anyway?" she asked, as I began transcribing her numerous prescriptions.
"Well, strictly speaking, the problem with your shoulder is probably due to degeneration of the joint space from wear and tear. What started out many years ago as a little discomfort and inflammation of minor severity has mushroomed into a severely damaged joint. We can treat your symptoms to some degree but we can't really do much to heal the damage incurred over the last 25 years".
"They still don't have a cure for cancer, do they, doc?"
"Uh, well, not for most cancers, no ma'am". I handed her the stack of prescriptions and she thumbed through them methodically.
"You forgot the antibiotic, I usually take ampicillin".
"Oh, sorry, that's right, here ya go," I replied lamely. She placed the prescriptions neatly in her handbag and left the room. Her companion greeted her as she departed and I heard him ask her what the doctor said.
"Same as the other'n, take the pills, they ain't got no cure. Doctor said that cancer in my shoulder's somethin' like a mushroom ... . ".
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