April 19, 2015 § Leave a comment

I had a patient the other day with a resting tremor. It was something that ran in his family, and as we sat there, chatting about his arthritis and recent divorce, my eyes kept darting to his hands, quivering just so in his lap.

“Things haven’t been right since Marge left,” he said. “My daughter comes to visit and helps out, you know, making meals and things, but I’m alone a lot. Things haven’t been right for a long time now.”

His hands quivered furiously. His eyes darted down, past his hands and to his shoelaces – a lifetime with the tremors had normalized them, and he seemed to barely realize how his hands shook harder as his voice broke.

He’d been a mover at the MFA, shifting art pieces and installing them onto the high ceilinged walls for exhibits during his career. I reached out and felt his palms, rough at the edges, worn palms, hard fingertips, given, across a lifetime, to the service of beauty. Those little joints in the middle of his fingers were thickened and knobbed, bearing evidence to the painful arthritis stiffening his movements. His arthritis had showed up over twenty years ago, but he’d only retired five years back.

“How did you manage to keep moving those art pieces when the arthritis started?” I asked. “They must have been so heavy, and the work so painful.”

He’d move them, he said. He’d shift pressure from hand to hand, moving up to use the crooks of his elbows, and leaning them back onto his shoulders. He rolled stacks of art up with his back. He clenched his abdomen and derived his strength from the core. He uttered oaths. He moved pieces with colleagues, each bearing the burden equally, quickening the task and lightening the load. A drink at the end of the day, with feet up on the coffee table helped, he said. As his disease progressed, he took on lighter tasks, lighter and lighter, and finally one day, at a ripe old age, he retired.

“Sounds like grief,” I said. He stared at me.

“I’ll get past this,” he said nodding.

Later, when we moved to the physical exam, I asked him to touch his nose, and then reach out to touch my finger, hovering three feet away. His hands quivered like crazy as he touched his face, but magically, miraculously, stopped doing so as he reached out for me. I asked him to repeat the maneuver, repositioning my finger even farther away. And again, the tremor disappeared as his arm arched out.

“Keep things moving,” I said, as I finished jotting down a couple things and turned to go get my preceptor. “Keep things moving, and you’ll be alright.”

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