I saw, especially on the second day, that alongside other ailments most of the patients had, a large number of them suffered from depression. Dr. Nguyen, being the insightful doctor he is, didn't hesitate to ask the patients what was bothering them. Despite me having seen this on the first day, I was still nonetheless pleasantly surprised at how genuinely the patients opened up the doctor, and told him their troubles - ranging from a rough time finding a job, to troubles within the home, to close relatives passing away. One of the most touching cases I saw that day was of a middle-aged woman whose father passed away just a few weeks earlier. Her mother had always been ill, but soon after her father's death, her mother became mentally deranged to an extremely high degree. The woman tearfully talked about how things suddenly cascaded one upon the other. On top of it all, the woman's son was leaving for college. She felt all alone. The woman described her story in such depth that I was feeling the pain that she was. I checked the time - it was over 40 minutes - but there was no rush from Dr. Nguyen. This woman needed to open up to someone. I was glad that the doctor took the time to listen to her worries. When she got up to leave, I felt a bit better - she basically had no one left at home, but she at least had someone she could count on to listen to her worries. She also wished me good luck in my medical ambitions, to which I thanked her.
What is striking about these patients that are depressed it that it is definitely not outwardly obvious. That woman whose father passed away didn't seem any different than any other patient until she walked in the room, and started talking to Dr. Nguyen, and crying thereafter. Another example was of a younger gentleman who was in for a followup.He seemed outwardly ok - but I later found out , as he was talking to Dr. Nguyen, that he was on antidepressants. He was a younger man, who had been through financial difficulty, and had spent a long time looking for a job. That day however, he was talking excitedly - he had finally found a job. He proudly described how he moved in on his own to a new apartment - his joy made me smile. I silently wished that his good fortune be forever lasting, and that he wouldn't be needing those antidepressants any longer. (PICTURE: DR.NGUYEN)
Another thing I learned during shadowing was that age isn't at all indicative of the well-being of an individual. Many patients I've seen walking in the office were just in their mid-forties, and were already suffering from heart disease, high blood pressure, and pain and sores. On the other side of the spectrum, I saw older people in their 60s or even 70s being in much better shape. In fact, on the third day of shadowing, I came across an elderly, 79-year old gentleman who came in for a pain in his back. When I saw his profile on the computer, I anticipated him to be extremely frail, judging from my own perceptions of what a 79-year old would look like. When he walked in the office, I had a double take - the man was wearing tennis shoes and shirt with gym shorts. He hoped on to the patient bed, with the agility that might even excel mine, given that I had probably gained like 15 pounds in my freshman year of college. It turned out that his back pain wasn't from some muscular stress due to age or anything, but rather that he had played an intense weekend of tennis, and hadn't hydrated enough, and thus sedimentary deposits in his kidneys might have started to cause pain. Dr. Nguyen simply recommended him to hydrate very well, and the problem would be solved. As the man left, I told him how I wanted to be just like him in when I turned to his age. He simply laughed, and wished me well. As the day went on, I was just amazed at this man's physique. He could physically rival people in their late 20s easily. He made me feel that I needed to hit the gym much more...man I've been slacking.
However, 2 patients later, a 76 year old man was up next. I saw the complete opposite of what I had just witnessed earlier from that limber 79-year old tennis player. This gentlemen was extremely frail - his movements were slow and pronounced. He slowly got up the patient bed, and gently put down what I thought was a lunch bag beside him. His skin was generously aged . To be fair, this is what I exactly had in mind when I thought of a 76 year old patient, but after seeing the 79 year old patient, I was truly stunned at the differences. To top it off, the frail 76 year old gentleman used to be a doctor!
There definitely was striking differences in well being between patients, regardless of age. While life style habits and choices can change one's well-being, genetics do have a role in it as well, as Dr. Nguyen was saying. It seemed like a cruel game that some people with great genetics could seemingly overcome things like high-blood pressure and aging. I truly hope that someday, gene therapy can advance to a degree where people can be in charge of their own destiny, and squeeze out the maximum well-being in their lives.
On the third day of shadowing, I stayed until 5, which was the clinic's closing time (before I left earlier to pick up my sister from school, which had since closed for the summer). As I packed up, I voiced my amazement of that 79 year old tennis player. Everyone of the doctors fondly talked of him. Dr. Murphy (one of the 2 other doctors that work alongside Dr. Nguyen at the Addison Internal Clinic) told me that the man came in for "injuries and problems that affect 25 year olds, not 79 year olds". In my head, I made a silent wish once again, to age just as nicely as this guy.
This marked the end of the 3rd day of shadowing. There was only 1 more day left -as I left the clinic for my car, I couldn't help but feel a bit sad. I still remember coming in Dr. Nguyen's office on the first day, that 27th of May morning. I was pretty nervous, but I was warmly invited in, and one of the nurses, Elizabeth, sat me down beside her. And over the next 2 days, I got to know her, and the rest of the office, including the other doctors - Dr. Murphy, and Dr. Ton (pictured on the left). My time shadowing Dr. Nguyen had been enjoyable thus far - and I look forward to the 4th day to see what is in store!