A 31-year-old patient told me that he'd responded to a personal ad for a “beautiful, intelligent, interesting, active, and successful” woman. To make a long story short, Tim said that he began corresponding with this dream-come-true person and, two months later, learned that the person he had been interacting with was her mother. Mom claimed that she placed the ad for her shy daughter and was screening the responses to weed out undesirable men. OK, that's understandable, but two months? Wouldn't an FBI background check have been a lot quicker?

However, this did not dissuade Tim, who corresponded with her for another month before she proposed meeting him for the final check. By now, Tim told me that he was growing weary of jumping through all of her hoops, but he'd seen a picture of her daughter and was so enticed by the prospect of being able to meet her that he was willing to do just about anything.

Poor guy. They met and the Mom finally confessed that she placed the ad hoping for some extramarital activity. She said she first tried the honest approach, but she had a penchant for young men and she could not find anyone interested in someone a few decades older. By using her drawn-out screening process, the Mom hoped to find a young man who was, well, desperate. Bingo.

Tim said that he was extremely disappointed at first, but with the assistance of several wine coolers that letdown soon melted into an “ah, what the heck” attitude that culminated in intercourse. Let's join Tim in the ER as he continued speaking.

Tim: I need a work excuse.

Dr. Pezzi: Why do you need a work excuse?

Tim: Because I'm not going into work today.

Dr. Pezzi: Why aren't you going into work today?

Tim: Because I'm meeting my girlfriend.

Dr. Pezzi: You finally met the daughter?

Tim: No, I'm still dating her mother.

I hate to admit this, but I gave him the excuse he requested. These days, medicine is degenerating from a profession into a business, and ER doctors are under intense pressure from their bosses to give patients what they want as along as it's not too harmful to them (the word too in this sentence is not an oversight; a good example of this is when doctors knuckle under and give antibiotics to people with viral infections). However, whenever I wrote a work excuse for a nonmedical reason, I would phrase it like this:

I'd just think of “Tim will not be able to work today—” as an incomplete sentence, the completion of which is “—because he will be fornicating in a motel with a woman old enough to be his mother.”

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