By Emmanuel Fashakin M.D, Esq.
This true tale is from my “All in a Day’s Job” and “Tales my patients told me” series. I hope you like it.
A couple of weeks ago, Harry (NRN), 63, came into the office for his follow up care and renewal of medications. The visit was routine enough, Hypertension, Diabetes, High Cholesterol. As he rose to leave, Harry asked me, “Doc, what about this Zoster shot?” My jaw dropped. “What about it?”, I calmly asked him. “Oh, I heard that it is good for you, that catching the disease, Shingles is very painful, and worse than death, and I want to prevent that.”
My surprise stemmed from the fact that Harry did not strike me like someone who would ACCEPT a zoster vaccine, not to talk of him asking for one. It had taken months of persuasion to get him to accept taking the pneumococcal vaccine, Pneumovax, many years ago, which is strongly recommended for Diabetics to prevent pneumonia. He seldom agreed to take the annual flu shot since he enrolled in the practice nine years ago. Therefore Harry asking for zoster vaccine was a big surprise.
In my professional practice, I have come to recognize three categories of patients: Category 1: those who want everything done, even if it would lengthen life by only one or two hours; Category 2: those who would accept most approved standard of care, but would not ask for and seldom agrees to any novel treatment, and Category 3: those who want the absolute minimum done to sustain life, refusing virtually any optional care.
Harry is a permanent member of category 3. Category 1 patients come in to ask for zoster vaccine, after seeing the ad on TV or the web or hearing from a friend; category 2 patients will sometimes accept the vaccine if offered and strongly recommended by the Doctor, while category 3 patients will not accept a zoster vaccine under any circumstances.
After a few visits to the office, I would note what category a patient belongs to, and once I identify a category 3, I will ask them right away whether they want colonoscopy, pap, mammogram, pneumovax, flu, zoster etc and on getting the expected “Nay”, I will program my computer reminder system to “Never Remind” regarding that patient, to say precious time in future. Harry is on “Never Remind” for most things.
As soon as our friend Harry got his shot, he promptly reverted back to his old self. “Hey Doc, what is the side-effect of that shot I just received?”, he asked. “Isn’t that rather too late?”, I calmly replied. In my surprise about his asking for the zoster vaccine, I had forgotten to go through my routine of explaining indications, side effects etc.
“If I tell you the side effects now, and you change your mind, do you think that I can pull the shot out of your arm?”. At this, we both had a good laugh, and Harry went home.
Emmanuel O. Fashakin, M.D.,FRCS(Ed), FAAFP, Esq.Attorney at Law and Medical Director, Abbydek Family Medical Practice, P.C.79-35 153rd St., Flushing, NY 11367web address: www.abbydek.comalternative email: [email protected]
