Saturday, April 22, 2017

Sometimes It’s Better Not to Know - The New York Times

"I don't know if I'm looking forward to being 98."

My 97-year-old patient revealed this to me during our first meeting in my clinic examination room. He had just moved to an assisted living facility in Cleveland to be near his son and daughter-in-law, who also sat in the room. They were quiet as they watched us interact.

"What do you mean?" I asked.

He rested both forearms on the high arms of his wheelchair, which caused his shoulders to hunch and gave the impression that he was about to spring into action. He spoke deliberately, choosing his words carefully. His eyes were rheumy but sharply focused, commanding my attention. I got the impression he was used to being in charge.

"I don't want to end up… you know, blotto," he said, quickly pantomiming a person slouched to one side of his chair, mouth open. His son and daughter-in-law glanced at each other and then at me as they arched their eyebrows in surprise.

"Why do you think that might happen?" I asked.

"Because of my medical condition, or whatever you're going to recommend I treat it with," he answered, matter-of-factly.

He had abnormal blood counts, but no established diagnosis. He was anemic, requiring a blood transfusion every two months, just often enough to be a nuisance for anybody. His platelets were low, but not low enough to put him at risk for bleeding or to require platelet transfusions. And his white blood cell count was decreased, though again, not enough to render him prone to infections.

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