The Reverend Mr Black was a 93-year-old patient of mine. I had been treating his duodenal ulcer for four weeks when he came to my office with melena. I asked him if he had been taking his medications and sticking to his diet. Shamefaced, he told me that he was taking the medication but that his wife bought only foods he was not supposed to eat, leaving him no choice but to eat them.
I had met his 73-year-old wife on a few occasions when she had accompanied the patient to my office. She was a very active feminist and went only to female physicians. If she needed a consultation in a field represented locally only by male physicians, she either did without or went to a nearby city.
After examining the Reverend Mr Black, I determined that he required surgery. I hospitalized him and called in a surgeon. The