RALPH

I entered the exam room and greeted Jolene but was surprised to see that since the last visit she had obviously gained weight, wearing a white, figured, baggy blouse, and looser than usual pants that covered a small abdominal fold that lapped over her side.
“Good morning,” I said.
“Good morning.”
“How are you today, Jolene?” I’d been seeing Jolene for twelve years. During that time she had struggled mightily with being markedly overweight.
“Not so bad. Could be better if it weren’t for this cold.”
“What do you have – this sinus crud that’s been going around?”
“Yes. Been trying to get rid of it for about two weeks now. It just keeps hanging on.”
“Like the song?” I said. She smiled.
“Have you been running fever? Had a cough? Or sore throat?”
“No fever, but my throat is a little scratchy,” she said.
“Okay, let’s sit up here on the exam table and see what’s going on.”
Jolene’s exam revealed a slightly inflamed throat, nasal congestion, but no abnormal lung sounds.
“Okay, looks like you got the crud. Really, sinus congestion with an upper respiratory infection. Your lungs sound clear.”
I told Jolene to have a seat as I sat back down to write prescriptions. As I was writing Jolene said, “Doc, I have something else I’d like to ask you about.” She looked down and appearing somewhat coy said, “I don’t how to bring it up….” She paused.
“Well, whatever it is, I’ve probably heard it before but we’ll never know unless you ask it now. What is it?”
“Well,” she said, “it’s about my husband. He just doesn’t seem to be interested anymore.”
“Interested in what…you? Or maybe sex.”
“Yeah,” she said, “sex. It’s like for the past year or so he’s just gotten to where he’s not affectionate anymore.”
“Are you communicating this to him? Do y’all talk about it, and have you brought it to his attention and asked him why he’s changed so?”
“Well, kind of.” She shook her head. “He really doesn’t seem to want to talk about it or even care.”
“Has he ever told you why he’s not interested in you or sex?”
“Not really.”
“And this has been going on for over a year?”
“Yep. For about a year all he does when he comes home from work is get something to snack on, sit on the couch and watch TV. Then I fix supper, he eats and goes back and watches TV till he goes to bed.”
“Does he complain about being tired or anything at all?”
“No, but he’s gained a lot of weight. He weighs about 240 pounds. He’s gained about 60 pounds this past year.”
“Do you know if he’s even able to have sex? To get an erection?”
“I don’t know. He says he can.”
“Have you tried putting a little spice in the tea, if you know what I mean? Like maybe appearing in something seductive or attractive?”
Jolene smiled, and said, “Not really.”
“What about trying a different venue or situation?”
“Nah.”
I finish writing the prescriptions. “Well, I’ll be glad to talk to him to see if there’s a medical reason he might be having a problem. It could be a number of things ranging from depression, diabetes, blood pressure problem, testosterone deficiency….How old is he?”
“52,” she says, “Okay. I guess I’ll talk to him and try to get him to come in but knowing him he’s kind of hard-headed and really doesn’t want to be bothered.”
“He’s not seeing another woman? Or into pornography?”
“No, no. He’s just lazy and acting like he’s not interested in much of anything.”
“Well, yeah, he might very well be depressed and not really wanting to admit it or talk about it. That happens.”
“Okay. Well I’ll see if I can get him in. But don’t hold your breath.”