My receptionist announced that Dr. S.Q. Lapius had arrived. I told her to send him in.
Snow was melting on his collar, and when he doffed his astrakhan lamb’s wool
hat that Gumbenich had sent him from
“Don’t tell me I have to wait till you finish all those insurance forms, Harry. We’ll be here all night. You know I have a chess match later. Have you forgotten why I’ve come over?”
“No of course not, Simon.”
“Well then, where’s her chart?”
I looked at him blankly.
“Of course you’ve forgotten. I want to go over the case I sent you today. Dr. Burton’s mother, Jennie Burton.”
“Simon, let me ask you a question. How did you come to refer that case to me?”
“Quite a case.”
”Can you help her?”
“Not a chance.”
“Really? That serious? Goodness, what shall I
“Tell him that he should stop minding his mother’s business.”
“Harry you’re acting very strangely. You must have had a difficult day.”
“Sure it was
“I said, ‘there must be some mistake, Mrs. Burton, your son the doctor, made the appointment.’”
“’Good, she says, then examine him. I don’t want no examination. I’m all right.’”
“’But your son says you are not all right.’”
“’Shows you what kind of doctor he is,’” she says. Then she picks up the cane again and says, “’if you touch me I’ll scream.’”
“I figure I better talk
“’Are you her guardian?’ I ask him.”
“’No of course not. I haven’t declared her legally incompetent. But she is nevertheless.’”
“’You know quite well,
“Well, Harry,” Lapius, said frowning, “of course you were correct.
I’m sorry I got you into that. I didn’t realize what the situation
was. But it seems that once people reach a certain age and develop a
certain level of infirmity, their children assume a guardianship they don’t
legally possess. They reverse the generations.” He paused and
brooded for a moment. “I’ll bet this problem will play havoc in some of
these geriatric hospitals. For example, say that there is an old lady,
senile, with a sudden gall bladder attack. She requires surgery.
The hospital calls the nearest of kin who signs permission for surgery.
There are complications. A son in
“So what’s the answer, Simon.”
“Not all problems have answers, Harry.”
About 10 years after this article was written I had a patient 90 years of age who needed a pacemaker. She was mentally intact, but insecure, and instructed me to talk to her daughter about the problems she faced. I spoke with the daughter and explained the problem and the need for the pacemaker, and how simple a procedure it was. The daughter nodded. I subsequently returned to the patient requesting that she read the “informed consent” and sign permission for the pacemaker.. She refused and said her daughter would take care of all these matters. The daughter refused to sign the documents. During the time that passed while I was searching for another relative, the patient died. When I accosted the daughter to demand why she refused permission for her mother to have a pacemaker she said, “I have been caring for her my entire adult life. Now I am seventy years old. I need a life too!”