“Maggie and Lynn Buxley*?” I scan the waiting room, and my eyes immediately land on two little old ladies, dressed to the nines, almost identical to one another despite not being twins. They look up simultaneously, smile demurely, and start gathering their luxurious wool coats, mohair berets, and patent leather purses. These are some of the fanciest looking patients I have seen yet. And the story gets better, just weight. I mean, wait… 😉
Time really does fly! I am already finished with my pediatrics rotation and onto the community rotation. This 5 weeks is spent in class, skills lab and one day of clinicals per week. As students, we are scattered all over the city in community clinics, visiting home nursing care, and teen pregnancy clinics to name a few. Since I have been contemplating a specialty in geriatrics, I was fortunate enough to land with one of my didactic instructors at a nurse-practitioner run clinic that serves the elderly as one of its primary populations. What I didn’t realize is that this clinic happens to be in one of the most pish-poshest neighborhoods of Manhattan, which I guess makes it also one of the fanciest in the country. Since I plan on working in a community health clinic for my career, I guess this might the most plush practice that I ever see, but hey, it’s a great learning experience!
So, back to Miss Maggie and Miss Lynn, 85 and 80 years old respectively. These are two sisters who presented to the clinic in all their daytime finery for…drumroll…flu shots. My instructor (the ARNP) warned me in advance that these two little ladies were “real characters” and that this visit would surely be more than “just” flu shots. The trot on in, and sit themselves down, one on the examining table and one in the chair. I perch myself on the windowsill in the corner – there’s not much room for all four of us! And the history-taking begins. It turns out that these ladies come in fairly regularly, but they are both on different doses of different blood pressure medication, as well as many other meds, so there’s lots to discuss. One of the sisters (the older one) speaks for the both of them and she knows everything, and I really mean it, about both of their health statuses. They are cracking me up with their NY-high society-talk (I’m not good enough to even try to imitate it) but my NP doesn’t even bat a lash, so I try hard to keep a straight face. Soon it’s time for me to take their vitals – weight, blood pressure, pulse and respirations. Both ladies start to moan and groan about the weight-taking immediately. I am completely startled because they are teensy-weensy minuscule little things, with not an ounce of extra fat anywhere on their bodies! I weight Lynn first who totals a whopping 86 pounds (but she refuses to face the scale because she is afraid to see it). Then she asks me what the number was anyways, and when I tell her, she grimaces and says, “Ah, I knew I felt my clothes getting tight, didn’t I tell you Maggie?”
And Maggies replies, “Well, Lynn, you know that I make up two of you!” Now this is just plain ridiculous because at most she is 10 pounds heavier, which hardly constitutes fat! She weighs in at an impressive 100 pounds, and sighs dramatically. Now, here’s the thing. Should we worry about them? Clearly they have some form of body dysmorphia but they’re 85 and 80 and healthy as can be, for their age! I guess my NP decided a long time ago that behavior change wasn’t likely to happen now, so I just let it go at that. Both of their blood pressures were also fairly well-controlled, another good sign. When I tried to roll up the sleeve of Maggie’s uber-soft and lovely sweater, I apologized for stretching it a bit. She just tinkled a little laugh and patted me on the shoulder saying, “Oh, this old thing? Don’t even bother worrying!” Now let me tell you, “this old thing” was something that I probably couldn’t afford unless I used 3 months of my food budget on it. It was beautiful and soft and perfectly in fashion, and if it wasn’t a huge HIPAA violation, I would totally look up their home address and go look through their dumpsters for the amazing clothes from last year’s Vogue styles that they are probably throwing away!
Oh, and I also got to give my first flu shot! Maggie gracefully told me I could practice on her (clearly, I didn’t divulge that she was my first victim, though). And so, with my NP watching over me, I squeezed her miniature deltoid muscle and gave my first attempt at “darting” the needle in, and then injecting the vaccine! It was quick and I was only a wee nervous, maybe a little shaky (I’ll admit) and she told me she barely felt it! Ah, those social graces. Gotta love ’em. 🙂
Upon leaving a few minutes later, they both donned their adorable little French berets, and bid us goodbye in the most proper but sweet way and hobbled out together arm in arm, probably headed home to their Park Place apartment that they share…
This may not be the kind of clinic that I want to end up in, but it sure is a lovely place to be for now. We saw so many patients, they were all so sweet, compliant, friendly – and for the most part – HEALTHY! What a concept! It’s refreshing to remember that not everyone super sick or on the road to recovery. Some people just need preventive care and I look forward to being one of the providers and educators.
*names changed to protect privacy