Screening in the Digital Age

I never thought it would happen to me, but all the same: ‘I grow old … I grow old … I shall wear the bottoms of my trousers rolled’. Or at least some days in the office feel like that. Perhaps it’s the clientel who’ve worn the years with me –people whose children I delivered who are now patients of mine, with their babies, in turn, waiting for liberation: Samsara… the eternal round of birth and death.

Or maybe its just the mood that Ellen drags along with her on her annual visits. Lennie, as she insists on being called, seems to straddle that razor edge between then and now. Like someone dressed in layers to cope with changing climate, she seems to wear Time like a jacket that she can don or shed as the mood strikes. And just when I think she has lost all contact with the here and now -that dementia has finally arrived- like a bodhisattva she doffs her jacket and enters my world again. Or is that giving both of us too much credit? We are each of an age when the past is retrospectively falsifiable to endorse the visions we have created for ourselves –our personal myths. The trick, of course, is finding a buyer. I think this is why Lennie insists on returning to me year after year for a pap smear despite my insistence that in her case, with her pristine and otherwise untouched cervix, the interval is too short. And in my region, if the pap smears have always been normal, we stop doing them at 69, so I don’t know what she’s going to do next year…

“Can’t you make and exception in my case, doctor?” she said, anticipating my usual advisory monologue. Then she moved her chair so close to the desk it hit the edge, rattling the little wooden statue I’d hidden behind a plant for some reason. She always did that. And she was always dressed the same: a black, knee-length skirt with a white frilly blouse that hugged her neck like a noose. Her hair was short and died dark brown. She managed to wear it like a bathing cap that was so impeccably arranged, it could have been painted in place. She was tall and slender –too slender perhaps, but the hair style suited her.

“You’re 69 now Lennie and your pap smears have always been normal. You won’t need them after this.”

A coy look that I’d never seen her use before, gradually crept onto her face. “You told me the reason you stop doing paps at my age is because most of us don’t get exposed to new sexual partners and the sex virus…”

“HPV you mean?” I thought I’d add that for clarity.

She brushed off my attempt at information with a dramatic flick of her wrist. “Whatever.” She stared at me sternly in silence for a moment to heighten the suspense. Then her face relaxed and the wrinkles reappeared around a broad smile. “My girlfriend, Shirley, has been helping me to learn the computer,” she said proudly. “She’s showed me how to enroll in a dating site… And she lent me her tablet… It was a gift from her daughter, but she can’t figure it out. Touching the screen makes her nervous, for some reason.” She studied my expression for a moment, then apparently satisfied that she hadn’t shocked me with her technological savvy, continued sotto voce. “Problem is, I can’t figure out what to do some of the time either.” She shook her head slowly. “Kinda gets away on me sometimes. And then when I touch the screen to try to enlarge one of the…”-she searched her memory banks for the word- “…one of the apps to see what it says, the stupid thing thinks I’ve chosen it and I get rerouted onto something I don’t want.” She shrugged, as if to admit that it’s an adventure that all techies have to endure. “Ever happen to you?” she asked -to be polite, I suppose.

I sat back in my chair, remembering my visit that morning to the cash machine. They’d installed a newer, faster model over the weekend. But, whereas on the old one –the one I was used to- you actually had to touch the screen to make a selection, the new one seemed to sense my finger when it was a few millimeters away while I was on my way to another choice. It took me a few seconds and several more attempts to figure out what I was doing wrong. I suddenly felt old.

And what was I doing discussing dating sites in the consulting room anyway? I was running an office, not a coffee shop. But she was looking at me as a child might for validation that it wasn’t just her that was struggling with technology. So I nodded.

There was a recent article I’d noticed on the IPhone BBC app I routinely read at breakfast that had addressed that very same issue: ‘The response time for icons on an Apple screen is 0.7 seconds, but the over-65s have a response time of about one second’ Or perhaps more worrisome –I’m a surgeon after all: ‘And tests suggest that if an older person has a slight tremor, it can be registered on a device as a swipe rather than a touch.’  Wow! Was age so apparently disabling that they realized they’d have design stuff differently for us? New apps? New screens? New innovations to deal with tremors? Were we being offered technological walkers? Worse, was Lennie trying to include me in that group?

“So,” I began, trying to change the subject -trying, in fact, to change the mood in the room, “how did we get on to this subject anyway?”

“My dating site,” she said, but seemed a bit uncertain herself. I sighed a little too obviously I’m afraid, and she noticed it. Her eyes narrowed for a second. “But I don’t trust it, you know.” She chuckled softly and looked at me. “Shirley tried it, too, she said. The guy was in a nursing home and didn’t tell her –it wasn’t in his profile… But she had trouble with the apps as well; she probably hit the wrong one.” She blinked -a cautionary flicker of her eyelids. “Scary, eh? I mean it’s not worth it to go through that just to get another pap smear.”

She stared at the wall behind me for a second. “Maybe next year I could see you for my osteoporosis…”

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