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THE WAITING ROOM TABLE OF CONTENTS The
Waiting Room - Entire Contents © 2001 Eric S. Fishman, M.D. INTRODUCTION
THE
SYMPTOMS
Ever on a tight schedule and juggling
four or five proverbial balls in the air at once, David Beck leaves
little to chance. He
dislikes spending time away from the productive pursuits which define his
life and so has calculated that the
shortest wait in a doctor’s office is for the first appointment on a
Friday morning.
He likes to begin
his duties at the investment banking firm of Mostern Lytt by seven thirty. Except
for his secretary Robin he is always the first one in.
At thirty he is the most successful trader executing over 70 trades per day. Thirty
is not terribly young in investment banking but it is early to amass a
fortune like his. After work
he pushes himself even harder in his pursuit of excellence at polo and
tennis
When David first experienced intermittent numbness and tingling in
his left thumb and index finger he attributed it to stress and ignored it.
David takes pride in the fact that he takes care of his body by
adhering to a strict regime of proper nutrition and exercise and he has
long regarded his good health and strength as an unimpregnable fortress.
When he awakened in the middle of the night two times in one week
to find himself shaking his hand to restore sensation as if it had fallen
asleep, he began to keep a mental record of his symptoms.
Six weeks later he found himself dropping light objects, such as
files and sunglasses. He noticed he was having trouble using his keys and opening
the car door. Realizing that
the symptoms were worsening David consulted with Dr. Daniel Berg, a
chiropractor with whom he works out three times a week.
Dr. Berg performed a chiropractic adjustment and the symptoms
seemed to diminish.
David stopped thinking about his hand altogether during a seven day
Christmas holiday in Aspen with his girlfriend Tanya.
They skied the black diamonds on Aspen Mountain during the day and
wined and dined with friends in the evening.
David didn’t experience any symptoms at all.
It could have been due to the fact that all of his attention was
focused on evading Tanya’s persistent demand for a formal commitment in
that tangible expression of good intentions known as an engagement ring.
The fact that she favored something in the neighborhood of a seven
or eight carat emerald cut wasn’t the obstacle.
By his reckoning, that would be a good investment - something along
the lines of an option contract. He
wanted to take Tanya out of the dating market but he just wasn’t certain
how to maneuver a withdrawal if he found himself unable to bring himself
to marrying her when the time came. Love
wasn’t the issue. He loved
her. He just happened to see marriage as a long term investment
without a reliable prospectus upon which to base an appraisal of the
merits of the risk.
David returned to work eager to master new challenges and somewhat
relieved to be out of Tanya’s tender grasp twenty four hours a day.
On his second morning back to work, while clicking his mouse to
sell one thousand shares of Microsoft, his left middle finger began to
cramp and almost locked up.
David telephoned Dr. Berg who offered to see him at lunchtime.
After an examination and discussion, Dr. Berg diagnosed carpal
tunnel syndrome and referred David for orthopedic surgical care.
The Gold Coast receptionist opened her window at 9:00 a.m. to
survey the waiting room and said “Good morning David.
I am sorry to tell you this but the doctor was called out on an
emergency so there is going to be a bit of a wait.
Would you like some coffee or a newspaper?”
This was only David’s second visit but as was usually the case he
had made a big impression on the receptionist the first time.
David hesitated to calculate how he could make the most of his time
and replied, while scanning the contents of his briefcase, “I’ll take
coffee, thank you, and work on some spread sheets.
Is it OK if I plug my portable computer in here?”
“Sure. I’ll be right back with some coffee” she answered and
closed the window.
Just as David was booting up, he looked up into the attractive face
of a blue-eyed blonde woman in her late thirties who was standing next to
him and looking over his shoulder down at his computer.
“Excuse me but is it lightweight?” she asked with a faint
Southern accent. By
his reckoning she sounded like Savannah but looked like a Charleston girl.
David had a gift for picking up the most imperceptible trace of an
accent. He could decipher
where you had been born, where you had been educated and where you lived
when you decided to obliterate the evidence of the former two by a
conscious change of diction.
“Excuse me?” He
knew exactly what she was referring to but he wanted to pinpoint her on
the map.
“I’ve been looking for a portable computer.
Is yours lightweight?”
David replied, “Well yes it is.”
“Does it have modem?” she continued.
“Yes. Yes in fact it
does. You know you look
awfully familiar but I can’t quite place you.”
“Oh, well my picture has been in the newspapers a lot lately.
I am Jill Saunders. You
know, the Jill Saunders who is being divorced by Gil Saunders.”
He
sized her up as having been born and bred in Charleston with frequent
vacations south of Savannah and probably a couple of years in Atlanta.
Maybe an Emory girl. Or
a Delta Airlines stewardess. That
would fit Gil Saunders. Tycoons
can hold their own against anything but an attractive stewardess.
At least that’s the way it is with the older tycoons before a
private Gulfstream became an indispensable accessory.
“Oh yes, I have seen your photos.
I am sorry about that.”
“It’s OK. I am getting used to being maligned in the press. And in the
courtroom,” Jill sighed. As
she walked up to the receptionist’s window to check in, David noticed
that she was carrying a briefcase identical to his, brown leather Gucci.
He liked that in a woman.
After checking in she took a seat across from David.
“What was it like being married to the tenth richest man in the
free world?” David couldn’t resist asking.
“A lot better than being divorced by him,” Jill replied.
“I suppose so”, he said laughing.
“Why are you here?”
“Well, both of my arms had been going numb.
I finally convinced my therapist that I am not crazy so he referred
me here.”
“So have you been seeing the doctor long?”
“You ask a lot of questions. Do you work here or are you planning
to write a book about me?”
“Excuse me but you started this conversation.” “I
guess I did. So do you work here or are you planning to write a book about
me?” “Neither.
I am just a curious guy.” Jill
knew that flirting with attractive men was a hobby she had to abandon for
the time being given the intense and vicious scrutiny appurtenant to the divorce proceedings. But even the most no-nonsense of females were surprised to
find themselves acting more than a little kittenish around David.
She wondered if he doubted that she really does need a portable
computer.
“Well, this is my fourth visit.
And maybe my last for a while.”
“Really, you’re better already?” he asked incredulously.
“I am a lot better than I was.
I had tingling in all of my fingers.”
“Which hand?”
“Both hands,” Jill explained.
“Not only that. I had numbness in both arms.
I had pain in my hands. Pain
in my shoulders. Pain in my
neck. I had muscle spasms,
cramping and I couldn’t type. At
first I noticed it at the end of a long day typing.
A week later, it started at noon.
By the time I came here I couldn’t even type for a
minute.”
David paused and then leaned forward.
“At the risk of sounding like a tabloid reporter, may I ask why
Mrs. Gil Saunders needs to type?”
“Mrs. Gil Saunders doesn’t need to type.
However, the soon to be ex Mrs. Saunders needs to type - an expose
about Mr. Gil Traitor Saunders that should topple him off his high horse
and rock the sleepers in this town right out of their cradles.”
“Oh, I see. So what are you planning to expose?”
“You’ll just have to buy the book.”
“Do you have a publisher?”
“Yes I do.”
“And it is?”
“Gotham Press.”
“Oh that’s too bad,” David said while shaking his head.
“And why is that?”
“Because,” he whispered, “I happen to know that they are
going to be taken private by the majority shareholder who is then going to
sell off the …..
“And how do you know that?” Jill asked.
“Well, my dear I am paid to know these things.”
Just then, the receptionist entered into the waiting room carrying
a small tray on which were
carefully arranged, atop a doiley, a
cup of coffee, a small pitcher of cream, two packets of sugar and her
phone number written on a page from the doctor’s prescription pad.
“Here is your coffee. It
shouldn’t be too much longer. The
doctor is on his way back to the office.”
“Thank you very much. “ Just as Jill was going to press David for an explanation of his provocative insight into her publisher, three people walked into the office. First was a striking woman of about seventy five who was impeccably dressed in a white wool pantsuit, Channel pumps and perfect white South Sea pearls the size of gumballs on her ears and around her neck. She was accompanied by her maid who sat Madame down and then walked up to the receptionist’s window.
“Madame Marie-Helene Fourtier is here for her appointment,”
Shira told the receptionist. Madame had settled into her chair clutching the pile of
magazines she had brought to read between her forearm and chest – W,
French Vogue and Vanity Fair. “Shira,
come look at the cover of Vogue. Can
you believe it? The model – which one is this, she must be new, I
don’t know her – is wearing gloves! You know I started the comeback of
gloves last spring and now everybody is copying.
Can you believe it! I
wonder if they will mention me.”
“Who Madame. Who should mention you?” Shira asked.
“Why, the fashion editors and the designers.
But they won’t. They’ll
just steal the credit for my ideas.”
Into the office walked a pretty young woman, seven months pregnant,
who took the seat next to Madame and buried her head in a magazine about
parenting. Madame
looked at the pregnant woman and recalled silently that her first symptoms
of carpal tunnel syndrome appeared when she was pregnant forty five years
ago but they spontaneously resolved after the birth of her twin daughters,
Arielle and Alexandra. She
could hardly believe that her children were born so long ago.
She felt a little sad but just as a forlorn look began to descend
upon her visage, she effected a smile. She had been taught early in life
to guard outward appearances at all costs.
No matter what. Madame
Marie-Helene especially didn’t like to talk about her medical condition
considering it a very personal matter unsuitable for discussion with
anyone but her physician. Not
even Shira knew why she was consulting the doctor.
Paradoxically, while Madame consummately performs the duties
attendant to a socialite, the inane term which says so much and yet so
little, in her constant interchange with the world she succeeds in
revealing very little about herself.
Madame
Marie Helene was brought up in Paris in the 1930’s. Neither of her parents had jobs but both worked very hard at
the business of living life as high profile aristocrats. There was an unending stream of parties, balls, galas,
openings and closings, lunches and dinners, and receptions. And then there was all of the good breeding that was to be in
evidence in order to make a satisfactory presentation of oneself at these
affairs: fluency in several languages, literacy in the classics and the
hottest gossip, proficiency in the social sports, the acquisition of the
proper additions to the family art collection, and, most important, the
cultivation of relationships with the right people which was a very time
consuming task indeed. Marie-Helene
learned the art of social politics from her mother and in her training
discerned that the proper appearance is indispensable to scaling the
heights of society. And a gay
attitude was the proper appearance. Marie-Helene
also learned that the seductive power of regular correspondence was
greatly overlooked and she made it her calling card.
She regularly corresponds with everyone from casual acquaintances
to intimate friends. From new
relations to old, Marie-Helene devotes four hours each morning to writing
notes and letters to be dispatched each afternoon to the four corners of
the globe, so wide was her circle. And
each one had to be handwritten on her pink silk linen note paper embossed
with her 24karat gold monogram. During
the last ten years it was harder and harder for her to write.
She thought she was just getting older.
Friends began to comment on the loss of the fleshy part of her
thumb when shaking hands. She
starting proffering her left hand, palm down, to avoid the glare of
curious eyes. Eventually
she began to wear gloves even when inappropriate.
She did in fact reignite a trend.
She didn’t want Shira or anyone else to know that the gloves were
worn to hide her affliction. It
was better that people ascribed to her affectation rather than an
unsightly medical condition. Forty
years ago she had been injected with cortisone. She knows now that the injections actually made her condition
worse despite the fact that her symptoms abated after she gave birth to
her twin daughters. Recently,
she has suffered weakness, wasting, and a lack of coordination which has
incapacitated her writing. She
noticed a dense numbness in her thumb, index and long fingers.
At best it feels as if she is wearing a leather glove on her right
hand, even when she is not wearing her fashionable gloves.
At worse she has had experiences in which she has burned herself
almost without noticing. She
had always expected that as she aged she would develop arthritis – that
she would have stiffness of her fingers – that she would develop those
ugly knobs that so many of her friends and family developed. But no, she had none of this.
She had no morning stiffness – in fact no stiffness at all.
Her hand was still as supple as it was fifty years ago.
Just as she was beginning to get lost in her thoughts, a warm voice
brought her back to the waiting room,
“Comment est Madame?” She
looked up and smiled. Looking
down at her was Daniel Simone.
“Madame, I am fine.” Again
she offered her gloved hand and, despite the discomfort, deliberately did
not withdraw it. “Daniel,
whenever I go to the hotel for my little
luncheons I stop to see you
but I have only been told that you have been away.
They are quite secretive about your whereabouts.
Are you well?”
“Madame, I have not worked for several months.
My hand has debilitated me for some time and I am just now
rehabilitating.”
“Oh, Daniel, no. I
am very troubled to hear that. It
is unbelievable in fact.” Madame now lowered her voice to a whisper.
“ I believe I will sit next to you. May I?”
“Delighted.” Everything
about Daniel delighted Madame: his smile, his gestures, his hands, his
tone of voice, his style. Pleasing
was his business. As
the concierge at the Royalton, he excelled as mediator between diplomats,
moguls, socialites, movie directors and royalty and their whims – large
and small, sublime and ridiculous.
Through fifteen years of purveying caviar at four a.m.,
an impromptu circus for a sheik’s young son on a day’s notice,
a private jet fueled for transit the Atlantic in two hours, he learned a
few things about how to do his job and it could be summed up in
“Whatever you wish sir,” “It
would be my pleasure Madame,” and “Of course.”
He
never used his hands except to dial the telephone. He rarely made notes because discretion demanded an utter
absence of evidence. Daniel
had earned the reputation as a gentlemen who could accommodate any
request, even the most delicate, in utmost secrecy. He
had become something of a cult figure in fact.
In certain circles it was considered de rigeur to have him make
one’s arrangements while in Palm Beach.
It could be said that Madame had done a great deal to add lustre to
his standing. Anyone she
favored soon found themselves followed, photographed and written about in
the society papers and magazines. Such
was the destiny of Daniel. SUMMARY OF SYMPTOMS OF CARPAL TUNNEL SYNDROME Obviously there are a large number of presentations consistent with CTS. Many patients complain of the classical symptoms:
Numbness and tingling in 3 ˝ digits If you
have enjoyed reading the beginning of The Waiting Room Carpal Tunnel story, please let
us know. Entire
Contents Copyright © 2001 Eric S. Fishman, M.D. |
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