Tuesday, April 5, 2011. Office of Dr. James Strickland. 9 a.m.
Over the next few years of successive appointments, Denise got to know the staff at her neurologist’s office very well. They all greeted her as she wound through to the examination room for her neurology appointments. Emily, her primary nurse, had an experienced eye. Her cousin, she once told her, had MS.
Emily got Denise through tough times, encouraging her to compete in this race without a line.
On this day, after a particularly tough week, Emily took Denise’s blood pressure and asked her an interesting question. “You’re not working. Have you applied for Social Security disability benefits?”
After a pause, Denise looked dejected. “Yes, I did. That was two years ago. I was denied.”
“Did you appeal?” Emily took off the cuff.
“No. The government said no.”
Emily put her hands in Denise’s and looked into Denise’s eyes. “Our patients tell me that everyone gets denied at first. They told me they needed to appeal a few times and get a lawyer.”
“We can’t afford a lawyer.” The sides of Denise’s mouth turned down as she formed the last word. “We can barely afford our insurance.”
“Well, a couple of patients have told me about a firm that doesn’t charge unless you win. A large one. Right here in the cities.
Denise perked up. “Do you know if I can apply again?” Emily nodded no and handed her a piece of paper she grabbed from the examination room drawer.
“Ask them,” said Emily. A law office name and phone number were on the piece of paper. Were they on commercials? “You never know, but I heard they are good.”
Denise thanked her and committed to calling the law fir6m that next day. She slowly folded it up and tucked it into her back jean pocket. Emily left the room.
Outside the examination room, a chart rattled against door. A few minutes later, it opened. “Good morning, Denise. You are looking good today.” Dr. Strickland entered rooms with efficiency. His jet black hair was parted neatly and streaked with grey.
Sitting across from her, he said, “How are things going?”
“Well, about the same, doctor. But my right arm is more clumsy now. I can’t write letters worth reading.” She laughed to herself. “My writing looks like I drank a 12-pack.” She looked up, embarrassed. “I don’t drink, doctor.”
“I know.” He nodded gently like an approving father.
“And my recent relapse made my fatigue worse, much worse than before. Isn’t the medication working?”
Dr. Strickland took a measured breath. “Yes, these injectable medication regimens can lose their efficacy over time. We could consider changing it, but my patients have not noticed much short-time improvement doing so.” He looked at her chart. Your numbers don’t look too bad.”
“But I’m not feeling well.” She swallowed hard. “Doctor. Do you think I can work? I mean, do you think I am disabled.” The question hung in the air.
“Well, Denise, you have relapsing-remitting MS. You are showing the normal symptoms associated with it, including loss of coordination and fatigue. Your vision does appear better. Were you thinking of going back to work?”
“No. I’m just too tired. I’m applying for disability.” Denise looked across at the examination table. A new examination paper sat on top, drawn from a large supply roll of paper on the side. It looked like a big roll of toilet paper. The timing of the thought confused her.
“You certainly have followed our recommendations. Your recent MRI confirmed the progression of the lesions. Have you thought about sit-down work, maybe part-time?”
“Yes, I had one at the hospital. My husband and I could really use the money. But I’m not coordinated enough anymore to type, and I just cannot function in the afternoon. I’m a klutz and I just get so tired.”
“Yes, that would be consistent with your objective findings. I’ll tell you what. I will perform some extra testing today to confirm how you are doing clinically. One test reproduces fatigue. I might not know if you could work at all, but a full-time schedule would seem out of the question at this point.” He wrote down some notes.
Denise underwent a longer physical examination than normal, moving her arms and walking on her heels. The tests made her feel tired and clumsy – more than ever before. Her husband picked her up outside the clinic. Looking through the car window, she worried about his job. He takes a lot of time off for my appointments.
Her husband came out to her side of the car and helped her into their old fire red Buick. Maybe, she thought to herself, I could make appointments late in the afternoon after school and Krissy could pick me up. Her oldest daughter was a careful driver. Denise planned to write that down. Her memory was getting worse.
As her husband buckled his seat belt, she turned to him. He was looking at her as if he had said something. “What, honey. Did you say something?” He nodded his head disapprovingly and started to drive. Had he really said something? She was too afraid to ask.
A few minutes later into the trip home, she told her husband about filing a new claim for Social Security disability. He was quiet for a while. He was not skeptical by nature, but he never got excited about what he could not see.
Then, with half-effort, he spoke. “We lost before. We need good help.” He became quiet again. He stared at the road, mouth unmoving.
Looking out the passenger window, she was lost in her thoughts. The Buick’s engine droned. To no one in particular, she whispered, “We do.”
She became nervous. Will the law firm want to help me? She soon found out.