Friday, June 29, 2012

Patient #6: "Prayer"

      I draw up a cortisone injection and return to the exam room where Mrs. M. is sitting on the table with her legs dangling.  Although I am trying to conceal the capped needle in my cupped hand I can see her peering down at it.
     Mrs. M's knee is hot, swollen, and tender.  There is deformity of the bony structures, typical of advanced arthritis.  She's been in so much pain she couldn't stand up to sing in the church choir Sunday, which is finally what brought her in to see me.
     None of the usual treatments have worked:  ice, rest, eucalyptus rubs, anti-inflammatory pills.  I have always wondered why doctors prescribe one of the thirty-odd arthritis pills--so costly and carrying the risk of stomach and kidney toxicity--for arthritis, when cortisone is a cheap, quick fix.
     "Tomorrow you'll be dancing!" I tell her, and she squeezes out a small laugh.  Her mouth is dry, and she's busy smoothing her bright, flowered dress.  I know she'd like to bolt.
     "Is it gonna hurt?" she asks in a timid voice.
     "Not really," I say.  My nurse is standing next to me and nods. "We'll freeze your skin so it shouldn't be a big deal."
     "I be scared," she admits.  "I don't know if I can do it.  I hates needles."
     "I hate needles, too," I tell her.  "Everyone hates shots."
     Suddenly her situation reminds me of the past.
     "I remember your grandma!" I blurt out.  "She'd be in so much pain, coming in with her gouty toe or knee, begging for a cortisone shot.  Do you remember?  You'd bring her in sometimes."
     "Oh yes!" Mrs M. says, brightening up.  "She loved you!  She always said, 'Dr. C. is the best!  God bless her!  Dr. C. is the onliest one can fix me!'"
     Her ninety-nine year old grandmother had suffered from weak kidneys, which predisposes one to gout, a terrifically painful condition caused by crystals that shift like broken glass in the joint spaces.  Cortisone shots are nothing short of a miracle for this condition.  Every few months she'd arrive in a wheelchair with one or another of her large, dutiful family, asking for "one of them wonder-shots."
     "Remember how she'd shout, just as I injected the medicine, 'Dear Jesus, forgive Dr. C. for what she be doin' me, for the suffering she be causing me...for she knows not what she does!"
     "Oh, I remember," Mrs. M. laughed heartily.  "She was somethin' now, Big Momma was, wasn't she?  That was one tough lady!"
     "You're tough too.  You're all made of the same stuff.  In fact, you remind me of her."
     "I couldn't be strong without the Lord Jesus Christ," she says.  "He's my Cross, and he's my Savior!"
     "I understand," I reply.  "I hope he guides my hand as I give you this shot."
     "We don't do nothin' without God!" she exclaims, and a rather stern look crosses her face, directed at whomsoever might harbor doubt.  "And I mean nothin'!"
     "Please God, help me to do this properly, and to get Mrs. M. out of pain so she can praise your name this Sunday in church," I pray out loud, as the nurse sprays ethyl chloride onto the skin just below Mrs. M.'s left patella.
     "Hallelujah!  Praise God!" she is now singing out, carried away by the Spirit.  "We don't do nothin' without Jesus!  I'm so glad my doctor knows that!  Thank-you-Jesus-for-my-doctor!"  She is looking upward and smiling radiantly when I finish the shot.
     "All done!" I tell her as I place the syringe in the sharps container on the wall.
     "You finished already?" she exclaims.  You already done?"
     "Yes, I am."
     "I didn't feels a thing!  Not one thing!"
     "Isn't that great?" I remark, as I finish writing the note in her chart.
     The nurse helps her from the table to her feet.  "I don't feels the pain!" she announces.  Perhaps the lidocaine I used with cortisone is starting to be effective.  Who knows?
     "Wow," I say, smiling with her and sharing the moment of collusion.
     "Now, listen here," she says as I get up to open the exam room door for her.  She puts her two hands on my shoulders, looks right into my face, and speaks with authority. "You see how God works?  You see?  He performs miracles!"
     "Praise be to God!" I say.
     "And don't you forget it!  We don't do nothin' without Him.  Nothin'!  Praise the Lord!  Praise be to God!" she exclaims, walking without a limp down the hallway to the check-out counter.

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