In the fable the tortoise and the hare, the tortoise is depicted as a wrinkled old man short of breath, blunted face, 1000 yard stare, carrying his home on his back, not allowing the events around him to change his demeanor. The hare is the anxious, sarcastic, egocentric, gaunt individual who thinks he can improve the world around him with his version of living. In the clinic:
-Mr tortoise always talks about metaphysical interpretations of his universe. Seems to only engage when asked about philosophy. Prefers organic when he can get it, otherwise nutrient dense foods and supplements. Very slow pulse rate and seems to close his eyes when not involved in conversation....but he isnt dozing off. Family history reveals his parents are still alive and only positive is a cousin with anger issues that snaps. Minimal disease present in close relatives. Cholesterol excellent. He works as a teacher with no financial investments, simple shell for a home, with minimal possessions. Enjoys breathing exercises, long walks, and stretches alot. Maintains visits when he can get in every 5-10years and has no complaints. Doesnt offer much information, somewhat withdrawn and occasionally doesnt come out of his shell, but overall healthy.
-Mr Hare has clear genergalized anxiety. Boarding to the point of paranoia about always thinking about abduction from UFO's. Comes in for physicals annually and averages a visit a month for symptom control from multiple medical problems. Eats alot of green but prefers processed foods for "energy". Sleeps poorly probably from urinating so often as he constantly drinks from his bottle. Has a dermatitis issue that flares up with season change or stress- always scratching. Possible over the counter nasal spray abuse as every time he comes in, his nose is constantly twitching. Complains of restless leg and has to constantly thump is lower extremity to feel better. Seeks out companionship and tends to involve himself in relationships that only cater to massaging him. Practices polygamy and is not sure of how many children he has. Fast heart rate and high blood pressure but excellent vision and hearing for his age. Possible irritable bowel disease in an issue with defecating anywhere. Family history reveals a very short life span for close relatives. Very wealthy with multiple investments always thinking about saving for next season with a few savings accounts he doesnt remember and cant find. Likes gardening and veggies. There is a question of abuse in a witness seeing him pick up is child by the neck. Earlier life was behind bars but cleared his record and now well loved by his young social network and often visits gradeschools.
I essentially advised the tortoise to avoid hiking near roadways, try to increase fluids and avoid the sun. I would like him to join social groups but he doesnt seem interested (truthfully I have trouble deciding his gender since its not obvious on physical exam). Told him ok to continue seafood diet but avoid foods containing too many parasites and worms. His diet his high in calcium so we postponed a bone scan for now. I suggested he come in for physicals whenever his deductible has been met but he says only has catastrophic coverage so probably wont see me for a few years. He does visit a chiropractor regularly for neck issues.
I had to get Mr Hare into therapy immediately so referred him over our behavioral health department. Kept on talking about the Mayan calendar, the end of the world and how he had multiple underground sites that he was prepping. Told him to change his diet as the processed pellets he eats were too high in binders that was causing him the stool problems. Had to schedule him for a consult with the STD clinic at county hospital since he didnt have insurance due to preexisting medical disease and jumped around from job to job. Will address drinking problem next week and after he sees therapist to start mind body programs and lower his heart rate. Have to postpone the relflux and sleep study for next month after his shots. Ran out of time this visit but as he will be seeing multiple providers, I will try to coordinate care. Until then ok for continued exercise as he seems to love long races and competition.
Interesting how these two characters are companions but at polar ends regarding healthcare. Guess with out one the other cant exist.
