Winnie's expectations

Edworthy, John

My story starts on a regular day in my office. Before starting to see patients I was going through my mail and phone messages. Right on top was "Phone Winnie". I didn't need any more information than that. Winnie was a delightful, but somewhat manipulative 85 year old woman from Jamaica. She had been in my practice for many years and I was asked to call her often. I knew her telephone number and address by heart. She was very sweet and often gave me small gifts at Christmas, including gifts for my wife and children. She was the matron of her family and expected, and received, regular visits to her small apartment from her children, grandchildren and great grandchildren. She also expected regular visits from her doctor.

Winnie had some heart disease and would generally call to say that she was a little short of breath or feeling weak. She also had arthritis and used acetaminophen regularly and the occasional Tylenol #3. I would visit and she would always seem very pleased to see me. She would make me a cup of tea and emphasize how I had been in her prayers. These were always very pleasant visits and I sometimes felt a little guilty billing for house calls when I didn't really do much "doctor work". Sometimes she would genuinely be in a little heart failure or have a respiratory infection that required some added treatment or adjustment of her medication but, more often than not, she just needed a routine refill of her medication or wanted a recheck of her sore shoulder or knee or her blood pressure checked or just wanted a social visit. On a few occasions I visited when a neighbour or family member was also visiting. It was always clear who was "in charge" of this family.

On this particular visit she didn't, as usual, look to be in any distress. We shared a cup of tea and she told me about recent marriages in her clan and other important family news. She then asked me if I knew what day it was today. My lack of an immediate response confirmed to Winnie my clear negligence as a physician as she pointed out to me, as I should know from her chart, that today was her birthday. She was 86 today. I offered my congratulations and assured her that, in my opinion, she was doing very well for an 86 year old woman. After arranging to call in a couple of her prescriptions to her pharmacy, I prepared to leave. At this point she said,

"Dr. Edworthy, have you seen my birthday cards?"
"Why no Winnie, I'd love to see them"
"Well you can see them all here"

On the mantel above her fireplace she had many birthday cards evenly lined up. She pointed out how she had cards from her daughters and grandchildren, her neighbours and her minister, pointing to each card as she went.

I noticed that with all the cards evenly lined up there was a clear gap right in the middle of the mantle.

"Winnie, why is there a gap? Did one of the cards fall?

Winnie looked at me disapprovingly.

"That, Dr. Edworthy, is where I put the card from my doctor"

About four years later Winnie had a stroke and was admitted to a long term care facility. She was no longer able to speak after her stroke. She died a year later at 91. She received a birthday card from her doctor the last 5 years of her life.

Theme: Patients | Patients
Theme: Relationships | Relations

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --.




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