Black and White Checks

She’s the only person wearing a hat in the waiting room. Perhaps the dress is taffeta, whatever the fabric, it’s large blocked checks; black and white with a distinct waistline. She draws the stares of other more sedately dressed patients.
In the examination room she takes a seat opposite the doctor, and folds her hands delicately in her lap. She comments she lacks her gloves, then she inspects her manicured fingernails. The physician looks over at the younger woman, who wears a dress as well, and asks what brings them to the Parkinson clinic. The older woman volunteers she has noticed her left hand shakes at times. The doctor asks when she first noticed the symptom. She looks up but her focus seems indiscriminant, she responds it’s been awhile, a year or so, maybe longer…. and she looks over at the younger woman, who nods her head and takes a notebook from a large handbag at her feet. The blond much younger woman verifies the tremor in her left hand appeared three years ago when they were on a cruise.
The physician asks about the movement: does it happen at rest? Does it improve with a glass of wine? The older woman interrupts the questioning; it improves with vodka and tonic, and the physician smiles fleetingly, turns to the younger woman, and asks what relation they are to each other. The younger woman replies she is the granddaughter and lives down the block from her Nanna. She tips her head in the direction of the elder and relates she dreads having to visit a doctor, which is why she is present. She cancelled the appointment three times before a family member agreed to attend with her. Behind the desk, the doctor nods, gazing at the women in front of him.
The patient fixes the physician with her pale blue eyes and comments she heard he was among the most highly rated neurologists in the area. The specialist smiles, commenting she may suffer from an essential tremor. Does she recall her parents or grandparents having tremor? The woman gazes above the doctor’s head and recalls her grandmother’s head and hands shook. The doctor nods and asks her to raise her arms straight out in front of her. The skin visible from the three- quarter length sleeves is pale, almost translucent, but her hands appear curiously unwrinkled, her finger joints slim and her moderately long nails painted a soft pink. The right hand jitters quickly and the left also moves, though not as dramatically. He asks how old she is and the granddaughter answers eighty- five. Asking whether she has noticed any movement of her head, the woman looks to her granddaughter, though she answers herself; sometimes she feels her head jittering like one of the bobble- headed characters. The younger lifts her eyebrows and admits she has only heard her Nanna’s voice wavering on the phone.
The physician asks the patient to sit on the examination table and she turns and stands, leaving her black woven hat on the seat of the chair. Without the brim over her forehead, her face is more visible. She wears her white hair drawn back in a ponytail at the nape of her neck. Her leather shoes have a small rubber platform and a hole where her large toenail peeks through. The doctor explains to the medical student, the muscles at the joint of her arm are supple, without rigidity. Reflexes are normal, as are fine hand movements. He asks the patient to retake her seat, scans her medical history and comments she is a healthy woman.
Essential tremor, the doctor feels secure in the diagnosis and asks how debilitated she is by the movements; do they prevent her from participating in activities? Well, No she replies. Her sphere of social contacts all have their own issues, though sometimes she has trouble applying mascara, and her writing has suffered terribly, though she has taken to communicating via email. The doctor suggests a trial of Inderol, which is effective in reducing tremor, to see whether she appreciates its benefits. She nods once and agrees.


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