The Measure of the Man

In the Yellowstone River Valley of Montana, a handshake is still important. Here, handshakes are used to settle the sale of land, timber, and cattle. A handshake is always offered in greeting and in farewell. Montanans believe that a handshake provides important information about a person's character, and therefore it is never taken lightly.

Toyvo and his wife were new to my practice. They were an elderly couple who were native Montanans. After introducing myself, I offered my hand to Toyvo and was surprised when I was greeted with a powerful grip that seemed out of proportion to the short, elderly man who stood in front of me. Not to be outdone, I decided to meet his handshake with an equally firm one, only to find that he would increase the strength of his grip each time I increased mine. When we reached the point where I was beginning to feel frank pain, a side-long glance at his wife's face revealed that she had seen this ritual many times before. I realized that I was not going to win this battle and relented. Toyvo laughed and flashed a knowing smile as he released my hand. I felt Toyvo had made a proper introduction, as opposed to my more questionable one.

I took his medical history and performed a complete physical examination. In addition to learning about medications and surgeries, I learned about his wife, his family, and …