OBSERVATIONS: Patient Leimbacher (im-patient would be more accurate) claims to be losing weight, shrinking and aging at an accelerated rate. While the first may be true (and indeed would be desirable in his case), the other claims are not yet verifiable. What can be observed is that Leimbacher alternates between despondency and rage--or to be less melodramatic, frustration and irritation--and he certainly resists the nurse staff's cajolings and friendly endearments, and our own attempts at mild joking and a convivial bonhomie. With a sneering demeanor he has responded to more than one of us, something like: "You clearly ain't to the bedside manner born." And then adds the bitter half-witticism that has become his tired rejoinder: "If it struts like a doc and prates like a doc, then it must be a quack." (Ho-ho. Tres droll.)
ADDITIONAL: Leimbacher's own walk and talk seem perfectly serviceable--his movements less confident perhaps, and his voice more of a harsh, hushed gargle, anecdotally at least--but society demands less of 71-year-old geezers anyway. As for those windmills-gone-wild he laughably calls arms, well, he's no busier than the proverbial one-legged pharma rep at the aspirin-kicking contest; let him try meditation, a little yoga maybe--or join the herbal revolution, the Greening of Old Weird America. (Yah, mon! He should live so long.) On the real medication front, we're pulling him off Selegiline as well as Ropinirole; that'll sweat him for a few more weeks. He thinks he's got hallucinations now...? He imagines a couple of hypno-therapy sessions can actually quell those all-in-his-head heebie-jeebies? Leimbacher, quite literally, ain't seen nothin' yet! (Speaking of things unseen... biggest joke: that Obama cares when we don't.)
PROGNOSIS: Break out your long-johns and straitjackets. It's gonna be a long, cold Winter.