Kansas Snapshots by Gloria Freeland - July 10, 2020

"Apple, table, penny"

I recently went to the doctor for my annual exam. It had originally been scheduled for earlier this year, but first the practice rescheduled it and then I did, wanting to see how the current pandemic situation would sort out. But I was not quite ready for what happened.

I was somewhat apprehensive. I've never found appealing the idea of going to a place where a bunch of sick people congregate. And with the current contagion on the loose, that feeling was stronger. I think another factor is that I hadn’t ventured out much since mid-March. Husband Art has been buying our groceries, and the only places I've been are to my office to clean out file cabinets, to family's and friends' homes for appropriate "socially-distanced" visits and to the veterinary medicine clinic with our cat. The latter exchanges were outdoor hand-off affairs with everyone wearing masks.

When you are a bit anxious, familiarity can help. Instead, I was met with change. The good thing is they were reassuring ones. A nurse took my temperature at the front door. Inside, the waiting-room chairs were at least eight feet apart and everyone was wearing masks. Only a few patients were waiting, and hand-sanitizer bottles were in great supply.

Still, the effect was mixed. The adjustments made me feel better, while also emphasizing that things were different.

Another source of unease can be gleaned from how I began. For nearly 40 years, I would have said I was going to see "my" doctor instead of "the" doctor. Our family physician, who had treated my parents, our daughters, Art and me, and on occasion, my sister and her family as well, retired last summer. This was my first meeting with my new doctor.

Art says he has really been impressed with my response to the current situation because I tend to be an "auto-pilot" person. When cues are absent, I tend to go about my life in the usual way, so he thought he would have to remind me to wear a mask, keep distant and so on. Instead, after checking in, I even sat on the edge of a chair so as not to place my arms on the rests. This was probably an overreaction, but as they say, "better safe than sorry."

I wished I'd worn a long-sleeved shirt or taken along a sweater because the room was quite cool and I wasn’t called back for my 10:15 appointment until 10:45. To be fair, a 30-minute wait in a doctor's office isn't unusual, but when you are cold and apprehensive, well, it doesn't help.

The exam began in the usual fashion. I was weighed and my height measured and then I was ushered into an exam room. The doctor came in and introduced herself. "So young!" I was thinking. I also had the vague feeling she was thinking, "So old."

But she was very nice. After a few questions, she left and a nurse came and gave me a questionnaire to fill out. Among the questions:

Have you fallen in the last six months?
Are you able to get around by car or public transportation on your own?
Can you still handle your finances?
Can you prepare meals for yourself?

Geez, despite being a bit anxious when I arrived, I still felt competent. Now I was beginning to wonder if I should be checking out nursing homes.

The nurse returned and told me she was going to give me three words that she would ask me to repeat a bit later: "Apple, table, penny."

We chatted a bit and then she asked me to draw a clock face with the numbers in the correct positions. Then she added, "Draw the hour and minute hands so it shows 11:10 a.m. or p.m."

That caused me to pause ... I was pretty sure they were the same.

I did that and then she asked for the three words.

"Apple, table, penny," I dutifully replied.

To check my hearing, she turned away from me, requesting I repeat what she whispered. "Yellow, green, blue, brown, white ..." I passed that test.

An hour before, I was feeling fit. Yet despite passing the tests, simply being asked to do them somehow made me feel otherwise.

The doctor returned and shortly asked if we had installed grab bars on our shower.

That didn't improve my mood!

Then came the capper. She said I should complete a durable-power-of-attorney-for-health-care form and a do-not-resuscitate form, adding she'd take the DNR form THEN.

OK, I know I need to do these, but it was all a bit much and I told her I wasn't quite ready to fill them out yet.

In reality, how the visit unfolded and its effect on me was more my fault than theirs. The doctor and nurses were very nice and were only doing what they are required to do by Medicare. If I had read my Medicare booklet and done some research, I would have known that as of January 2011, physicians are required to include detection of cognitive impairment as part of their health-risk assessment in the annual "Wellness" visit.

But many of the tests had also prompted my remembering my parents completing similar tests at a time that doesn’t seem so long ago.

When I got home, I shared this with Art. He laughed! That wasn't the reaction I was looking for!

But then he explained that he wasn't laughing at me, but was remembering an occasion when he had accompanied my mom to our doctor. Doc also did the three-word test with her, but he never asked her what the three words were. Finally mom asked if he didn't want to know the three words. He just laughed and said, "I don’t remember them!"

Then Art suggested I should call the office, and when someone answers, I should very slowly whisper, "Apple, table, penny!"