Can't See, Can't Hear, Can't Afford Viagra

June 2026 | Vol. 70, No. 2
By Samuel Garloff, DO, PCOM '78

Well, I can afford Viagra, but with the nitrates I take, it would be as sensible as adding C-4 to a completed IED. Every morning, I wake up searching for my eyeglasses and hearing aids. Then after my established morning ritual, I settle down to a mug of coffee to kick-start my chest pump. Mug number 2 is for swallowing my morning meds…all 13 of them. Remember learning that more than five meds is potentially dangerous due to the possibility of reduced efficacy and possible interactions? I get yearly thank-you cards from the sons and daughters of pharmacists acknowledging my part in paying for their university education.

It doesn’t stop there. An hour or two later I consume 3 additional meds with my morning bagel or oatmeal. This ritual is repeated with my evening meal. Nighttime signals the consumption of an additional 8. This brings the daily total to 13+3+3+8=27. That, of course, is if I don’t use any Nitro sl prn.

When I take off my shirt, my chest and abdomen demonstrate the sequelae of long-forgotten surgical interventions. Not to brag, but Rand-McNally has purchased my integument to study and learn how to add red lines to their atlas maps after my demise.

What prompts these ravings? I have recently experienced once again the joys of emergency hospitalization and surgery. On 1/29 I made reservations for lunch with my better 9/10s at a restaurant we hadn’t frequented for 10-12 years. Upon arrival, we were met by the maître d’ and assigned a table. Instead of walking, my left foot and leg remained stationary while my body moved. I fell and immediately knew I had earned an ambulance ride to the ER.

Now, it so happened that I slept in that morning, so all I had consumed was my 2 mugs of Joe and my morning meds. It took forever for the ambulance to arrive. They laughingly explained how they misunderstood directions and responded to a different location. Oh, the hilarity. Imagine if it had been a cardiac event. The ride to the ER was, of course, interesting. I was being asked for information. My wife answered as best she could, and the ambulance crew finally garnered all pertinent data from the hospital admission sheet.

Then the fun began. I was an ER hall patient. My gurney was visited by an endless slew of residents, each unaware of their contemporaries' questioning and recorded answers. A few presented themselves in non-standard hospital garb, looking more like street people than physicians. Wheeled into radiology, I was greeted by a perky young woman who told me to transfer to the X-ray table. I informed her that my femur would strongly object to such a request and advanced the concept of portable film collection. At that moment, a more seasoned attendant entered and performed the examination.

Wheeled back into the hallway, I was parked next to a gentleman surrounded by Chicago’s finest and handcuffed to his gurney. A rather polite officer apologized to my wife, who never left my side. An ER physician briefly visited, informing me that I had a fracture needing surgery within 24 hours but there were no beds available in orthopedics. I continued to pass the day and evening on the gurney without benefit of an IV or analgesia. Finally, that night a bed opened up, and I was sent to a staging area and prepared for orthopedic admission. Still no IV or pain meds. MEDICAL PEARL: To any student who may be reading this, it is not a good idea to not treat a DM II also presenting with an elevated BUN and creatinine.

Finally, I was admitted to orthopedics and hospital-level care was initiated. My experience improved dramatically at that time. Arrangements were made to accommodate my wife overnight, and I was afforded pain relief. Later the following day, successful surgery was performed by an excellent surgical team headed by an experienced, highly qualified orthopedic surgeon and an anesthetist who had carefully read and understood my medical history.

Over the next few days, I was visited by physical therapy and a social worker. The SW reported that after discharge I would be admitted for in-patient PT for 1-2 weeks at a different facility. On the day of discharge, PT visited and pronounced me eligible for d/c to in-home PT. Having been VPMA at a medical center, I knew that my PT bed was most likely reassigned to a patient with an insurance provider paying more than Medicare. It didn’t matter. I wanted to go home. Then the fun began.

I was sent home with a bare-bones walker. A government special. I had ideas of having it redone with acrylic paint highlighting flames bilaterally but put those plans on hold until I took stock of mundane, yet necessary devices needed to allow me to function in our condo. Fortunately, the necessary items arrived overnight from Amazon as I awaited word from my in-home PT provider.

A week after my discharge, a therapist was scheduled to arrive to evaluate and prescribe treatment. Just before my appointment time, I received a text from a substitute therapist stating that the therapist assigned to me twisted her ankle and was unavailable. I didn’t care. The sub was quite good. She quickly sized me up and dictated exercise orders to my wife, aka the scribe. She was a hoot. Semi-retired, she traversed the streets of Chicago on her bicycle. She informed us that she lived 10 miles from us. We never saw her again.

The next week the assigned therapist arrived. She made no changes to my regimen and engaged my wife in discussion of our houseplants. Shortly after leaving, she returned as she left her phone behind. Just before her next arrival time, she phoned and said she would be late as it was windy outside. The next visit was again delayed as she found a less expensive parking lot and it took longer to walk from there. Fortunately, upon her arrival she was able to once again engage in horticultural dialogue with my spouse. Two weeks later, my exercises were not advanced, but we had knowledge of the apartment she was sharing with others and learned that she “wanted to be a doctor, but couldn’t afford it.”

Then on a Thursday, she stated that she would contact me over the weekend to schedule our next two visits. The weekend passed without a call. I waited until a full week passed before informing ortho that I was firing my in-home PT. Amazingly, I received multiple calls and texts over the next few days to reschedule PT. Finally, in the nicest voice I could muster, I again told the therapist her services were no longer required.

With a newfound sense of freedom and purpose, I escalated my exercise program and ordered a rollator to replace my walker. Forcing my long-suffering wife to accompany me, I started traversing the streets. Rain, hail, snow, and freezing cold didn’t matter. We walked to restaurants, to FedEx; I even got a haircut. Oh, the humanity!

Amazingly, without in-home professional help, without medically approved billable services, I am improving. I exit this tirade with some professional advice.

Don’t fall and break your (anything)… It just isn’t as cool as it sounds.

I wonder how her plants are doing, WGRP in Chicago.