I have never considered leaving a patients room before because I couldn't control the urge to laugh. Uncontrollably. It happened today.
I stare at the dandruff on her hairline. I imagine myself in my morning commute, frustrated and stressed and tired. I cover my mouth with my hand and clench my jaw. I will not laugh, I will not laugh, I. WILL. NOT. LAUGH. I am the doctor, the professional this woman has come to see.
And all I want to do is laugh.
She has come to see me to request a bidet toilet. She went to her primary care doctor, who told her no, she would not recommend this so the insurance would pay for it. Undeterred, the patient came to me.
"I need you to give me a bidet." She doesn't say hello.
I fight the urge to tell her that they are in the back, along with all of our other plumbing devices, light fixtures, and home improvement hardware. Instead, I quell my snide thoughts and already present dislike for this patient and ask "Why do you need a bidet?"
"I can't wipe my butt."
I indulge her. "why can't you wipe your butt?"
"my arms are too short."
I clench my jaw and try to forcibly turn the corners of my mouth down. "how long have your arms been too short to wipe your butt?"
"about four years, since I got fat."
So, I am to assume that she has been able to wipe her butt successfully for the prior 63 years?
"I can't reach my butt. Look, I'll show you". She starts to get up.
"No, no. That's all right. You don't have to show me."
*please note, at time of this conversation she is seated with her hands below butt.
The patient narrows her eyes at me. "I'm not leaving until you give me a bidet."
I glance through her history. No recurrent infections that would suggest that she indeed cannot maintain hygiene. A note from her PCP that I completely agree with. So what do I do?
I pass the buck.
I tell her that I can put in a prosthetics request form for them to evaluate her necessity, while writing all over my note that I do not think she medically needs one. I tell her that in the meantime, I can give her a pericare squeeze bottle to help clean herself. I dont have any in the clinic, but tell her I can bring one in from the hospital if she wants to come back.
No, she will wait, she says, and proceeds to sit in my waiting room for three hours until I have it. Her problem is, she doesn't have anywhere else to be.
I get back to my office, shut the door, and howl with laughter.