Physicals Aren’t Physical Any More?

As a child, our entire family saw the same doctor for decades.  Dr. Repasky was what was then called a GP, General Practitioner.  He was an older man when I was little.  He delivered everyone of us.  My oldest brother was named after him:  John.  I suspect this was more due to the fact that the bill was not going to get paid quickly than out of respect, but he was a fixture in our lives and we did, indeed, respect him.  He seemed to remain the same age the entire time I was growing up.  He was a nice man, but serious when it came to your health. He did it all, most of it right there in his office.  Not that it was primitive like going to see Doc Baker on Little House on the Prairie but a more modern version of a similar setup.

There was a long dark stairway leading up to his second floor office.  It was cool and dark in the narrow hall. You knew everything was highly polished from the way the sunlight snuck in with you when you opened the door at the bottom to meet the dim light from a single bulb at the top of the stairs.  The stairs were shiny where the light hit them.  You could see as well as feel the way they were worn into smooth depressions on each side from the many footsteps going up and down over decades before you.

At the top of the stairs there were a number of doors with glazed and yellowed windows to the right.  The first one was the entrance to his waiting room.  His name was etched on it in gold and black letters. When you entered, the nurse would pop out to see who was there.  No glass partitions.  No complicated insurance forms and cards required.  It was utilitarian – simple and plain, nothing fancy, no special children’s area, no big screen tv spewing ads, just a few plants by the window and a few old Reader’s Digest and Highlights Magazines on a table. It was efficient.

The Doctor’s exam room was a steampunk, vintage version of today’s doctor’s exam rooms.  Much of the furnishings in it were probably antiques then. It included his large roll-top desk with a million cubby holes, several glass fronted cabinets filled with medicines, some in mysterious dark amber bottles, and all of his implements of medical torture.  It had a very high, it seemed to me as a child, examination table in the middle of the room.  It could raise up at the head end for gynecological exams or delivering a baby or lay flat.  It was a dark colored leather, worn on the edges from all the patients who’d clutched at it.

As a child I knew he was someone to look up to, respect and be somewhat afraid of – after all he had all those sharp needles and things.  The exam you got was very thorough.  If you were going for a physical, you made sure you bathed and washed every possible orifice and crack that the doctor might want to peer into.  You could expect to be fully thumped and poked and squeezed and hammered – by the reflex hammer on your knees and elbows.  (Get your mind out of the gutter people, this isn’t that kind of story.)  You were exhausted by the time you were done standing on one foot, then the other, bending over to touch your toes.  It was thorough.  But as a little one he might tap your knees with the reflex hammer a couple extra times to make you giggle and you got a lollipop after.

I like the doctor I have found presently, a PCP – Primary Care Physician.  I don’t know him well.  I start any association like this with a certain level of respect for their position, which generally erodes when I witness the inefficiencies of the office and the office staff.  Still it is early in this relationship. He is a warm, friendly man that always shakes my hand when he greets me, sometimes holding on to it a little too long.  His accent is pretty thick so I listen carefully when he is trying to tell me something.

I went for an annual physical recently at his very new age-y doctor’s office.  The office is located in an old antique home rather than an office building.  The waiting room is similar to any doctor’s office, chairs, artwork, certificates, big screen television with medical programming and a sliding glass partition to the girls behind.  They are the ones you know you need to be nice to if things are going to go well.  The exam room is completely different from the waiting area.  It is in what was the old dining room of the house complete with the original natural woodwork and deep tray ceiling.  Much of it was left as the original space.  The bay window seat has been turned into storage for the johnnies – those fabulously stylish one size does not fit all “it ties in the back” gowns.  They’ve added an examination table that looks more like massage table, a few antique glass fronted cabinets containing boxes of latex gloves and other supplies are offset by large plants and dried decorative arrangements.

It has been a while since I’ve had an annual physical, so I was ready for anything and anxious about all of it.  I expected the full boat of prodding and thumping and frowny faced warnings about my weight and other things a “woman of my age” should be aware of.  I expected a bigger frowny face when I knew I would be declining a mammogram and refusing any other invasive testing.  Well, this was not the physical of my past.  It was not remotely physical at all.

The sweet little girl from the front that ushered me in weighed me, took my temperature and attempted my blood pressure.

“Does 128 over 80 sound right?” She asked.

“Sound right?”  I asked her back, “Yes….”

“It was really faint and hard to hear,” she explained. “I’m pretty sure that is what it is.”

She went over the history she had in the laptop patient record.  Dr. Repasky kept his records in his head.  I prefer paper.  “It ties in the back,”  she said, handing me a Johnnie from the window seat when she was done.  As she left she said,  “The Doctor will be in shortly.”

As I was struggling with the ties on the Johnnie, it half off, half on and providing no coverage at all, the doctor opened the door.  I clutched it to my chest.  Before I could say anything, he backed out and shut the door.  Damn, I thought, what if he gets distracted with someone else and I have to sit in here for a half hour in this thing that does not tie in the back unless you are a size two?

He didn’t,  he must have done a quick count to twenty or something and returned.  He shook my hand and took his place in the chair behind the laptop.  Ah modern medicine!  He then went over the information in the laptop record with me for the second time in ten minutes.  He asked about the medicine I was taking for acne, told me a story about another patient with acne, but never examined my face.  He was too far away.  When he did come to the table, he listened to my heart – front and back, looked at my legs, approached the topic of a mammogram and a colonoscopy, said he respected my wishes and that was it.

No eyes, no ears, no throat, no open and say ahhhhh, no bend over and say oooooh, no nothing.  He said, “I would like to order some blood work.  They will print out the paperwork at the front window.”   Poof! he shook my hand and was gone. I am pretty sure a timer went off on that laptop saying my fifteen minutes was up and he was on his way.  Why was I even needed in the office for this physical if no one needed to really look at me and hardly touched me?  I could have taken my blood pressure, temperature and weight at home and emailed it to them.

I should be relieved actually that it was less stressful than the physical I expected.  This makes it easier for next time.  My expectations have been lowered. Thank goodness there wasn’t really anything wrong with me….he’d never have found it.  Nice man, nice demeanor.  I would say he spent maybe two minutes longer with me than the laptop, this time.

It is just my opinion, but if I can’t bring my laptop, to which I am very attached, he should not be allowed to bring his.  It is in the way.  He seems to care, but I am not sure that “Care” should be included in the title: Primary Care Physician if the doctor is hardly going to interact with your body at all.  The systems in place seem to prevent him from showing traditional medical care.  I wonder if I could locate Doctor Who’s Tardis, travel back in time and visit with Dr. Repasky for next year’s physical?  The only other option I see as equally valid is finding a child with a Playskool doctor’s kit and asking them to do the exam.

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