Earnest Tipp was very overdue for his blood pressure follow-up. Almost a year and a half overdue, as a matter of fact. The last few times I had refilled his medications, I had added “needs follow-up” to the signum on his scripts.

The other day I finally saw him in my schedule. I thought about him all morning. A tall, muscular 90-year old widower with an appetite for golf and fine food, he always exuded contentment and gratitude over his good health.

After Autumn had checked him in, I looked at his vital signs screen. His weight was stable, and his blood pressure was still well controlled.

“He’ll tell you why he didn’t come back sooner,” she said. “And he’s pretty smug about it because you had joked with him about staying away from doctors!”

I remembered. Somehow, the topic of health screenings and medicalizing common ailments had come up and I had jokingly, as I often do, said “and stay away from doctors.”

As I entered the exam room, Earnest told the story of how he had taken my advice seriously and stayed away from all doctors, including me.

It didn’t take long to establish that Earnest seemed to be in good health, and, at age 90, how you seem to be is generally all that matters. No screening tests are indicated at that age, even whether and how to treat many diseases and risk factors for disease is usually controversial in that age group.

I remember the nephrologist I send my toughest hypertension patients to sometimes points out how little we actually know about treating people over 80 years old. That is even more true when it comes to 90-year-olds.

The other thing I remembered about my previous visit with Earnest was how he had told me he was about to have lunch with his prom date from seventy years ago. I asked him if he was still seeing her.

“Yes, we see each other almost every week,” he smiled.

I renewed his prescriptions and asked him to come back in a year. “Keep your good diet, play lots of golf this summer, enjoy your prom date …”

“And stay away from doctors,” he interrupted.

“Yes, by all means,” I answered. He stood up and offered a firm handshake. I have nothing to teach this man, I thought to myself.

“A Country Doctor” is a family physician who blogs at A Country Doctor Writes:.

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