Cibyl's Complaint

CIBYL, AN UNHAPPY, DEPENDANT WOMAN with a host of somatic complaints, came to me as a referral from Dr. George Joyce Hall, an early self-taught Sacramento endocrinologist. Over the years, Cibyl had consulted many physicians, at least one from every specialty in the Sacramento area. Despite their best efforts using the contemporary therapies of the day-numerous tests, endless procedures, multiple pills and injections-her symptoms waned and waxed. Like the moon, they never went away. When she initially came to me, she was seeing only one other specialist, a urologist, Dr. Edward Beach. Some years before, when she first consulted him, she suffered from recurrent lower abdominal pain that made life, in her words, "unbearable."

Dr. Beach did what urologists do. Using a cystoscope, he looked into her bladder. This gave her spectacular relief-enough, according to her husband, to "make her a good wife." This statement made me quite curious. I refrained from asking questions because the couple was older than I-contemporaries to my parents and a decade younger than Dr. Beach.

Like the moon, her symptoms recurred. She returned to Dr. Beach. Unwilling to subject her to the discomfort and expense of a cystoscopic examination, he passed a sound to dilate her urethra. It worked. It gave her relief. Since then she saw him with regularity every four to six weeks for a urethral dilatation.

Cibyl had enough other symptoms to keep me busy. Each visit she told me how much Dr. Beach's treatments helped her and how wonderful he was. She wished she could see him more often but he had set a strict rule limiting dilations to one per month.

Nearing retirement after a long surgical practice, Dr. Beach took long vacations. One, I recall, lasted almost three months. After six weeks, unable to tolerate the ever-increasing pain, Cibyl sought succor from a younger, highly qualified urologist. Using Dr. Beach's clinical notes, he dilated the urethra. The procedure gave her a bit of relief for just a few days.

The pain recurred. A repeat helped some. Finally, word came that Dr. Beach would be in his office the following week. When she heard this, the pain began to lessen.

One day, the front page of the Sacramento Bee featured the death of Dr. Edward Beach. The news shocked me. It occupied my thoughts as I made hospital rounds and drove to my office. My staff met me at the door and asked if I knew about Dr. Beach. I assured them I did.

"Cibyl is in a treatment room," said my office assistant. "She doesn't know that Dr. Beach is dead and her husband wants to talk to you, before you see her."

They brought her husband to me. Without a salutation, he blurted out, "Cibyl will go all to pieces when she finds out that Dr. Beach is dead. Can you? Will you tell her?" I assured him that I could and would,

In the treatment room Cibyl sat on the end of the examining table, poised and ready to begin her usual litany of complaints. When she saw me, she exploded with a torrent of symptoms. My attempts to interrupt did little. Finally she had to stop to catch her breath. As calmly as I could be, I said, "Cibyl, Dr. Beach died last night."

She let out a blood-curdling scream and wailed, "Who's going to take care of my bladder? Who's going to take care of my bladder?"

drrlj@colusanet.com