Everybody Loves Me, Baby, What’s the Matter With You?

I’m in my clinic finishing a note on an obese, hypertensive, diabetic patient. My attending is reviewing a case with Pasteur. His patient’s come in with lower back pain and Pasteur renewed his antihypertensives and, after a bit of arguing, Lortabs.

Our attending is pointing out that the patient’s hypertension is uncontrolled and needs a third blood pressure agent. She asks when the patient’s last mammogram and colonoscopy were. Pasteur doesn’t know. The attending asks if I am done with my chart. I hand it to her.

‘She how nicely he does this,’ she says, looking over my documentation, referring to me by my title and surname in her thick German accent.

She points out how I’ve documented discussing the importance of blood pressure control when I prescribe a new medication, telling my patient that “every point over 130 systolic blood pressure increases your chances of having a stroke or heart attack in the next year.”

I’ve included obesity as a diagnosis and set a goal of one to two pounds weight loss per week for the next two years. Recording the phone number for the YMCA that I have given the patient so she can participate in water aerobics. I’ve given her a script for a mammogram in October, a referral for Ob/Gyn—who have special equipment for performing Pap smears on the morbidly obese—and document that she had a negative colonoscopy in 2002.

Pasteur is staring at the two of us. If I am reading his face right, he is trying to decide which of the two of us he hates more. I smile at him.

‘Yes, Erik,’ he says in a way that I should probably call drolly, but I’ve never liked the word. Let’s say sardonically, an awkward and perhaps archaic word, but one I prefer. ‘Sometimes I lay in bed at night, wishing I could be more like you.’

‘You know, Dr Pasteur,’ I say, laughing, ‘sometimes I wish I could be more like me.’