From the Doctor’s Office…The September Update From Watervalley

library-3 Last Friday started with a house call, pushing me to be an hour late to the clinic that morning. When I finally arrived through the back entrance, the noise from the reception area hit me like a palpable wave. It was Friday before a holiday and we had a packed house. Great.

Normally the staff would be scurrying about; getting patients in to rooms, taking vital signs, and whispering about how someone’s shoes didn’t match their outfit. But on this morning they were nowhere to be found. I eventually discovered all of them in the break room, chatting it up so intensely that my presence in the doorway went completely unnoticed.

I scratched my head and spoke above the din. “Well darn, ladies. Looks like somebody left the front door unlocked again and now we have actual patients in the waiting room.”

This brought the conversation to a halt. Curiously, however, no one moved. Instead they sat tight-lipped, amused; exchanging sly and impish glances.

“Okay, what am I missing here?”

It turned out that the fellows sitting around in the lobby were the old farmers that normally hung out in the Co-op tack room every morning. Temporary renovations had forced them to find new venues. Nancy, kind soul that she is, had agreed to let them use the clinic on slow days. Only in Watervalley.

I shrugged and went to my office to catch up on paperwork, but the uproar from the front was unbelievable. The sheer volume rattled everything; floors, windows, furniture…nerves.

Apparently, all of these old Watervalley farmers had reached hearing-impaired mass. The random conversations sounded like an amiable yelling tournament. Dogs in Nebraska could make out the words. Major philosophical issues were being discussed at a volume two decibels below the threshold of pain. Understandably, the merits of square versus round bales were at the top of list.

When the topics of debate waned, one of them would stir the pot by reading through the newspaper, out loud. Particular attention was paid to the obituaries, which might explain any absences. Admittedly, other than the occasional argument over whose turn is was to play with the waiting room Etch-A-Sketch, they were a pretty jovial old bunch, telling stories, stomping their feet, and laughing themselves in to various levels of coronary failure.

By half past nine they were gone and the normal business of healing the sick, repairing the injured, and tending to to the otherwise feeble resumed. Sort of.

Later that morning, Margie Reynolds, who had just turned forty-five, came in with a most unusual request. She wanted Botox injections.

Margie was the mother of a daughter in college and a two-year old; a bonus baby that had come as quite the surprise. A tall, big-boned woman with large, expressive features, she had a quick wit and a ready laugh. Nevertheless, she always struck me as someone who wanted her appearance to embody a certain level of style and sophistication, but not so much as to take herself too seriously. We were friends and I adored her. But even for Margie, Botox seemed a bit of a leap.

She was sitting casually on the exam room table when I entered. I straddled a nearby stool and rubbed my chin. “Talk to me Margie. Tell me what your thinking is about getting the injections.”

“Hmm, let me think. Oh, yeah. I just remembered…. I’m getting old! I think every inch of my body is circling the biological toilet. I’ve got crows feet the size of the Mississippi Delta and my skin’s so rough, alligators are mistakenly offering to buy me drinks.”

“Well, okay. There’s nothing wrong about wanting to look your best. But generally I like for patients to be on some kind of structured diet and exercise program before doing something cosmetic like Botox.”

“Luke, you’re sweet. But you’re not listening. I want to loose twenty years, not twenty pounds.”

She frowned, briefly looking to the side. “Okay, I admit it, a little weight loss wouldn’t be a bad thing. I was hoping it was just my clothes. Everywhere I go if feel out of place, like I was wearing a burlap bag, and last years’ burlap bag at that. My body is loaded with little fat pockets that never seem to go away, living memorials to every cupcake I’ve ever eaten.”

I laughed. Margie was such a delight and collectively adorable, yet clearly she was troubled. I wanted to reassure her, but I knew from general experience that this was a near impossible thing to do. Every woman I had ever known, regardless of their looks, had some perceived physical flaw that convinced them they were a woofer. Conversely, when it comes to looks, most men, even if they have B.O. that disrupts cell tower signals, think they’re pretty much on par with George Clooney.

“Margie, you look just fine for…” I hesitated.

“For what?”

“Okay, I’ll say it. For a woman of forty-five.”

“Gee, doc. Thanks for dropping that little truth bomb.”

“Margie, this just isn’t making any sense. I wonder if there is something chemical that’s triggering this? Maybe we should run some test to see if you might need some hormone replacement therapy.”

“Forget the hormones, doc. I can think of plenty other things I need to replace first.”

I still wasn’t convinced. “Margie, has something happened that’s upset you?”

“Why do you ask?”

“Because this just isn’t like you. You’re one of the happiest people I know. I’ve never see you take yourself this seriously. Something’s bugging you but you don’t want to admit it. It’s like you’re in denial.”


“Yeah, denial. It’s the first of the five stages of grief.”

Margie was undaunted. “Doc, I’m too busy to go through five stages of anything. What say I just pick two of them and get the Botox injections? And while you’re at it, do you have a procedure that can suck coffee cake out of my thighs?”

Again I laughed and shook my head. She seemed determined but I knew that something deeper was behind all this. I set the chart down, reached for her hand, and spoke with all the compassion and candor I could muster.

“Margie, we’ve known each other for quite a while. So let me ask you this question. Do you want to be the kind of superficial, imprudent person who wants a purely cosmetic change, a fast and easy outer polish that might temporarily make you look young and healthy, but actually has no enduring value?”

Margie never flinched. “Sure do.”

I recoiled back, pushed my stool against the wall, and folded my arms. “Okay, this isn’t working.” I shrugged and shook my head. “Margie, I can get you the Botox injections…granted, they cost about the same as a semester at Harvard. But I can’t help but think there’s something here that you’re not telling me.”

Again, I studied her for a moment. Then a simple realization washed over me. Her two-year old, Abigail, was not with her.

“Margie, where’s Abigail?”

Margie didn’t answer at first. She squirmed uncomfortably on the exam room table. “She’s um, she’s at Mother’s Day Out. I take her there twice a week.”


“And what?”

“How’s that going?”

“Great. She loves it.”

“And how’s it going for Abigail’s mom?”

Margie cast her eyes toward the floor and, after exhaling a long sigh, spoke in a half whisper, “Not so great.”

She pressed her lips firmly together and it seemed that instantly, her entire countenance de-glossed. After putting her hand over her mouth, large tears began to roll down her cheeks. Clearly distressed, her swallowed words revealed a private desperation. “I’m so old.”

Like most men, I was completely inept at comforting a woman in tears. I was useless. My first thought was to pat her hand and say, “there, there” and maybe offer to buy her lunch. But her sobs only escalated. I wanted her to think happy thoughts, like fluffy white clouds, grilled cheese, raindrops on roses. Finally, I simply put my arms around her and whispered softly, “it’s okay, it’s okay.”

In time she wiped her eyes. Now, flush with embarrassment, she gushed an arrested laugh, trying to make light of her tears. “I’m sorry, Luke. I didn’t mean to have a melt down. It’s just that, I’m twenty years older than the other moms and they get all quiet whenever I come around. I mean, they’re nice and everything. But, it’s like I’m an outsider and they don’t know what to say to me. And the truth is, I get it and I’m okay with that. But I worry about Abigail. I’m worried that she’ll end up being an outsider too. I know it’s dumb, but I thought that maybe if I looked younger I’d feel more confident and I could blend in better.”

I looked her squarely in the eyes. “Margie, the only thing you need to do to blend in is just be you. Good heavens. You probably intimidate the crap out of every one of them. Your older daughter Lacy is athletic, pretty as a peach, an honor-roll student at UT, and was liked by everybody in her high school class. They look at you and think “she’s already broken the code.” If they keep to themselves, it’s probably because they’re scared to death to show how little they know about raising kids. And as far as Abigail is concerned, you raise her to be just like you and she’ll do fabulous. You’re great, Margie. You’re smart, attractive, and funny as hell.”

I had been on a roll and had meant every word. But suddenly, I had run out of things to say. So, to wrap it up, I added, “Trust me. I’m a doctor. I know what I’m talking about.”

Margie pursed her lips and nodded her head affirmatively, alternating between stifled sobs and the occasional eruption of a gasping laugh. In time, she wiped away the last of her tears and looked up at me with a face of tender gratitude. Her words were still tinged with unease. “Thanks, Luke, for saying those things. It’s just that, all my regular friends have been raptured to empty-nester heaven. I just didn’t feel like they would understand all this or why I even cared.”

“Sure. I understand. It’s okay, though. I’m always glad to listen.”

“Thanks. I’m better now.” She now regarded me with an irrepressible smile. “If you weren’t ten years younger than me, I’d give you a big old sloppy kiss.”

“Well, if you didn’t look like an old woman who needed Botox, I’d probably kiss you back.”

Her expression immediately soured. “Not funny, doctor.”

“Too soon?”

“Epic failure.”

She thanked me again and gave me a big hug before leaving.

Then, on Tuesday afternoon I saw her at the grocery and asked her how it was going. Margie laughed. She was back to her old self.

She shouldered up next to me and spoke in a jovial whisper. “When I picked Abigail up on Friday one of the young moms was having a fit with her two-year old. The belligerent little rascal was kicking and screaming like a wolverine. She just looked at me and asked, ‘How do you have so much patience?’”

“So, what happened?”

“I just laughed and said, ‘Sweetie, patience is what parents have when witnesses are present.’ Well, that seemed to break the ice and she and another of the young moms and I ended up talking for twenty minutes. We’re not planning a girl’s weekend or anything yet, but it’s a start.”

“Margie, I’m glad. That all sounds good.”

“Yeah, but that’s not the best part of it.”


She leaned in closer and spoke in the kind of serious, confidential voice someone would use to tell you that the president had just been shot. “Both of these moms are mid twenties at best. Cute as can be and small enough to wear outfit’s made for Abigail’s dolls.” She paused and cut her eyes at me. “Actually, I kind of hate them a little for that. Anyway, we started talking about exercise and getting in shape and guess what?”


“Both of them, my dear Dr. Bradford, want to get Botox.” Margie lifted her chin, offered me a superior “humph,” and then smiled and winked before loftily pushing her cart towards check out.

And for now, that’s the news from Watervalley.

Until next time!


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