The Doctor's Appointment

The Doctor’s Appointment

“Mrs. Kelly, your father has developed a new…symptom. No, more like a new condition in addition to his dementia.” Dr. Howard continued to explain, “In the time that he has been with us at Oak Tree Rest, he has become less verbal with each passing week. That in its self is not unusual, but he has begun saying…” the doctor paused and collected his thoughts, “seemingly random phrases.”

Maria Kelly leaned forward in her chair, toward the doctor. She asked, “Exactly what do you mean by random phrases?”

“Well, it is a little difficult to explain. I have never had this condition occur before. I do not believe that it’s life threatening, but holding a conversation with him is becoming very difficult.”

“Dr. Howard, my father is eighty years old, he has dementia. Holding a conversation with him has been a trying experience for quite some time now. Please stop beating around the bush and get to your diagnosis!”

The doctor smiled and stifled a chuckle.

“What are you laughing about?” Maria glared at the physician in her indignation.

“Mrs. Kelly, please don’t be offended. You just used a perfect example of the phrases that your father is saying. It took me off guard.” Dr. Howard rushed on with his explanation, now that he had an idea on how to. “These phrases are proverbs, idioms, and colloquialisms. At first his nurses and caregivers thought he was being witty. A moment of clarity for someone at such an advanced state. Let me give you a brief example.”

Maria relaxed a little and settled back into her chair. “Ok, I’m listening,” she said.

“The orderly was wheeling him through the hallway. They were coming from a therapy session and as they passed the aquarium, your father shouts out ‘There’s more fish in the sea.’ Several of the staff heard him and giggled a little. Sometimes the outbursts of the elderly and children can be so amusing, you know.”

“Yes, doctor, I know. Please continue, how is this unusual?”

Dr. Howard took a deep breath. “For the rest of the day, he would add that phrase to any encounter. At dinner, he looked at his tray and said ‘There’s more fish in the sea.’ Oddly enough, they were having fish that night. The staff thought he meant that he wanted seconds, and assured him that he could have more fish if he finished what was already on the plate. He seemed to accept that and ate some of his dinner. After a while, he stood up and shouted at the top of his lungs, ‘There’s more fish in the sea!’ He picked up his plate, then threw it in the floor. He continued to loudly chant that phrase as the orderlies took him back to his room. The next morning, he seemed back to his usual self and no other incidents happened for a while.”

Maria nodded her head, but then turned an unfriendly eye on the doctor. “I am by no means an expert, such as yourself, but I don’t think that kind of outburst is all that unusual for a nursing home. I am quite aware that that elderly and children share tantrums as well as amusing moments. You contacted me with a concern about my dad and asked me to come for a meeting. I live half way across the country. I took time off from work, paid for a plane ticket and came here. Only to hear about an old man spouting riddles and having childish outbursts. Surely this cannot be why you asked me here!”

“You’re correct. I wanted to inform you of this new condition, which I believe is a rare form of Tourette syndrome and to discuss some treatment options. These outbursts and riddles, as you call them, are becoming more frequent. The staff and other residents are uncomfortable. They shy away from him because his behavior has become so unpredictable. Your father has to spend more time alone in his room. He is isolated and lonely. His physical health has begun to diminish. As his doctor, I need to see that the gets the best care that we can provide here. This treatment is, of course, experimental. A new condition requires a new treatment. I need your permission to begin. I believe that the sooner we start the better the result will be. As your father would say, ‘A stitch, in time, saves nine.’”