Geriatric Alone

My oldest patient, Lola Leoncia. Still vibrant at 94 years old. Everytime she visits me, she brags about her great-grandchildren. Wow...

As chief resident, part of my job description, though unwritten, is to see patients from all the big guys in the business: my esteemed consultants, the PGH director and administrators, college deans, university officials, politicians from all over, even the secretary of DSWD. I take care of indigent patients who seek their help, the families of their drivers, household helpers, or special people who are not part of their immediate families. As long as these patients do not resort to name-dropping and subsequently mandating me to grant them special privileges (my pet peeve, grrr), I really don’t mind. This enhances my people-skills, I get to pretend I'm actually in private practice and I simply miss talking to patients.

This morning, the secretary of the Dean's Office called. The dean was sending someone - a retired professor of Pathology who was having bipedal edema. The secretary said they were having difficulty talking to the old lady, since she already had dementia, with severe memory problems, an annoying attention span deficit, and some tangentiality of speech. I readily accepted. I have such a soft spot for old people that I maintained all of my Continuity Clinic patients who were more than 70 years old.

Thirty minutes after the secretary's phone call, a diminutive, adorable old lady shuffled into my office. She had an air of dignity around her. She radiated an aura of wisdom and wealth of experience that can only come from a well-lived life. Very simply dressed, hunched back with age, her hair gray, her skin shrivelled, she immediately proceeded to look at the portraits of previous department chairs hanging on the walls. She was talking to herself. "Patay na yan. Ay, kaklase ko yan. Patay na rin yan."

I approached her and almost bowing, I greeted her like I would a UP professor emeritus. I knew I was not worthy to be treating this great woman, someone who has probably trained some of my most esteemed teachers. She warmly clasped my hands, looked at me with a joy and innocence of a child. Seeing her eyes, I knew it was the look of dementia - a huged amount of wisdom clouded by so much innocence creating an almost painful cocktail of sheer detachment from the rest of the world. I was touched. And she prudly said, "Doctor ako."

Wow. So much pride of our profession. She must have accomplished so much. She must have loved this profession so much that even in her demented state, it still preoccupies her. I proceeded to examine her. I took her blood pressure, examined her eyes, neck, abdomen. Took out my stethoscope to listen to her heart and lungs. Checked her swollen legs. I asked several questions to the young woman with her, someone obviously hired, who answered most of my questions with I-don't-know and I-don't-care shrugs.

It was insensitive of me but I had to ask, "Ilang taon na po kayo?" She said, "Seventy-eight. UPCM Class '56 ako iha, ikaw?" "Twenty-eight po, UPCM Class 2004. Nasaan po ang mga anak n'yo?"

And then the old lady said, "Single ako. Ikaw, may asawa ka ba?"

Uh-oh...

Her insensitive maid even added, "Kawawa sya 'no. Single kasi e." And just like that, my heart raced wildly. The old lady, in a bout of dementia, was repeating the statement over and over again, to the amusement of everyone in the office, "Single ako e. Doctor ako. Taga-UP. Single ako. Ikaw, single ka rin?"

With a straight face but a frightened heart, I proudly replied, "Opo. Single rin."

I finished looking at the old doctor-professor. I was proud to have served her. Because I didn't trust her maid (I doubt she understood any of my instructions), I had to write down a detailed history (whatever her fragmented thoughts told me), my physical examination and plan of management, hoping that she has a nice former student who would read it and assist her and carry out the plans, someone she previously helped who would take care of her.

I hugged her before she left my office, and she hugged me back. Then she started rattling the names of her dead medical school classmates, and the names of her former students who are now well-known clinicians. To me, she seemed happy.

Seemed.

I hugged her again.

When she was out the door, I wondered, did I just give the me 50 years from now a hug?