Too old to be gay?

2 days ago we were on long call so I was staying overnight at the hospital and getting new patients admitted to my care. I got a call from the ER with a new patient that I would be responsible for, she was an 83 year old woman who had come in via ambulance after experiencing a fall and some mental confusion. She also had hypertensive urgency / emergency  that needed to be controlled. 

The case its self seemed rather boring and before I had even hung up the phone I was pretty sure of my diagnosis. I was pretty sure that she had a Transient Ischemic Attack (TIA) and it turned out that she had a history of TIA's. This is not an interesting story because of the diagnosis or medical mystery. 

I went into the patient's room to introduce myself and perform a complete exam. This is how we handle every new patient. Part of the exam includes a ton of questions that many seasoned doctors do not bother to ask but as a medical student I am required to be very thorough. This lady was adorable. She was feeling fine and had quite the personality. She told me, she was ready to get home and did not know why she even had to stay. SHe had a friend there with her who had witnessed the TIA and was able to answer many of the questions I had regarding the event. Her friend was also in her 80's and was surprised how well she knew the patient's medical history. When I asked the patient about medications or past surgeries, she would often reply with "I do not remember or I do not know" but her friend would fill in all the gaps and tell me exactly what I wanted to know.

During an exam we have a section called a social history. During this portion we ask questions about tobacco use, alcohol use, illicit drugs, sexual behaviors and history. We also ask about living circumstances, marital status, number of children etc. When I go to this section of my exam, I said to the patient "do you have any grand children?" Usually when I ask an elderly person about their grandkids they get a big smile and begin to tell me all about their wonderful grandchildren and their latest adventures. This patient simply replied with "I never had any children so I do not have any grandkids but I do have some nieces and nephews that I spoil." I asked "are you married" she replied "no, I never got married". I asked her is she lived alone and she said no and pointed to her friend and said we have lived together for more than 45 years and she continued to explain how wonderful their life had been and that they have each other and they are both very happy. The patient's friend added more details about the spectacular life they have had together. 

As we continued the exam it became more and more clear to me how connected these 2 ladies were and it also became apparent how much they loved each other. So I finished up my physical exam and before I left the room to go run some labs I looked at the 2 ladies and said "Do you want to know the secret of your happiness and the success of your relationship?" The smiled and said sure tell us why we are so happy. I said with a smile "it is because you never involved a man, they tend to just screw things up" They both turned a little red and laughed and laughed and then the patient said "well, we could of told you that!"