The joy of her company

Ethel is 82 year-old retired school cafeteria matron who has colon cancer, which has metastasized to her liver. Fortunately, the cancer has been stable on oral chemotherapy for over a year. Ethel visits me each month, and insists on being seen alone, leaving her daughter in the waiting room.  I  enjoy Ethel’s visits.  I learn about her children and grandchildren.  I learn about her husband and friends.  I even learn about her cat.  That is well and good, because when we talk I rarely learn anything about Ethel:

“Good morning, Ethel, you look good, how are you feeling?”

“Much worse, but what do you expect, I am getting old.”

“How are you worse?”

 “I am old.”

“What part of you feels worse?”

“All of me.”

“Are you having pain?”

 “Of course I am having pain.”

“What hurts?”

“My hands and feet.”

“When do they bother you?”

 “All the time.”

“Are you having pain right now?”


“Are your hands and feet hurting more than last month?”

“They hurt more in the morning and the afternoon. I think it is arthritis because I am old and worse.  Or it could be cancer.  Cancer of the hands.  My cousin Lil had cancer of the feet.  She fell all the time.  She died.”

“I am sorry … she died from foot cancer?”

 “No, she died in a car accident.”

“Is the pain more than last month?”

 “What pain?”

“The pain in your hands and feet.”

 “I have arthritis because I am getting old.”

“Is anything worse than it was last month or over the summer?”

 “Nothing could be worse than this summer, the heat was horrible and made me tired.”

“I hope you were careful to drink a lot of fluid when you went outside.”

 “I never went outside … I have air conditioning.”

“Are you getting more tired?”

 “When I don’t sleep.”

“Do you sleep well?”

 “No.  I am too old.”

“Ethel, are you having any shortness of breath?”

 “If I walk too far.”

“How far can you walk without getting short of breath?”

 “I don’t walk.”

“How is your stomach feeling?”

 “I have colon cancer and take chemo pills everyday.”

“Do you take the pills in the morning or the afternoon?”

 “With water or juice.”

“Does your stomach bother you when you take the pills?”

 “The problem with the pill bottle is the arthritis. I told you that I have pain in my hands…. Are you listening?”

“Are you eating OK?  How is your appetite?”

 “Well, it is hard cooking for one person.”

“Don’t you and your husband live with your daughter?”

Yes, but my neighbor Sue lives by herself and she says, it is hard cooking for one person. “

“Are you having any problem with your bowels?”

“No, my bowels are fine.”

“No diarrhea when you take the chemo pills?”

 “I get diarrhea all the time.”

“When was the last time you had diarrhea?”

 “Last winter, I think.  My brother had diarrhea, from the war.”

“Which war?”

 “He never talked about it.”

“Do the chemo pills give you diarrhea?”

“No, they bind me.”

“What do you take?”

 “Chemo pills … doctor you gave them to me. I think you better start writing things down, you keep forgetting.”

“It is the time of the year to get a flu shot.”

 “What time?”

“It is the fall, and that is when you need a flu shot.”

“I am allergic.”

“I don’t think you are allergic, you get the shot each year and do not have a problem. I checked with your daughter.”

“Then, let her get the flu shot, I’m allergic.”

Ethel, is there anything new that is bothering you today?

 “Well, I am much worse, but what do you expect …. I am getting old.”



  • Hilarious and no doubt frustrating exchange with a woman who evidently is not used to placing herself in the centre of her universe...many of her observations seem to come from a sense of empathy with others. Long may she tell you to let her daughter get the flu shot!
    • James Salwitz, MD
      So true! Almost as if she finds her own frailty a bother which interferes with her life's role of caring for others. Thanks... very sightful. jcs
    • James Salwitz, MD
      Should you be looking for another doctor? jcs
  • Bill Wickart
    Been there. At a certain mental state, one I learned to associate with my elderly in-laws, it seems that much of life's social pleasure comes from asking a couple of leading questions and letting your family member talk from there. Their lives seemed so slow and restricted due to the natural pains of aging that they adjusted to living vicariously through the rest of us. Asking them questions seemed to run in circles, or to be an uphill climb into their self-perceived daily sameness. Thanks for giving us the lighter side of this condition. It brings to mind quite a few old medical jokes. It also brings back memories from relatives who are no longer with us, and how, even in their later years, the sheer joy in seeing my family and me walk through the door made the entire trip worthwhile in just a few seconds. My wife used to remark at how a medical appointment was as much a social event as anything -- a chance for her mom to talk with another highly-educated person about topics that other people rarely discussed -- at least, not in the same way. It was a visit to *hope*.
    • James Salwitz, MD
      A "visit to hope." I like that very much. Says my entire blog in 3 words. Thanks very much. jcs
  • [...] See:  The Joy of her Company,9/14/2012 [...]

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