Note that the lady in the street also calls Phoenix "Grandma." While in many cases this would seem to be an endearing term, in this case it seems to have a tone of condescension. The lady is willing to help, but instead of "Grandma" she could have said "Miss" and this would have been a more formal greeting.
When she gets to the doctor's office, an attendant assumes that Phoenix is a "charity case" based upon her appearance. The attendant asks her a series of questions, but Phoenix is in a daze from her long journey. Instead of being polite and concerned, the attendant rudely yells "Are you deaf?"
Then the nurse comes in and informs the attendant that Phoenix is not seeking treatment for herself. She is there to help her grandson. Initially, the nurse is kind and tells Phoenix to take a seat after her long trip. The nurse calls her Aunt Phoenix. This is significantly more polite than "Grandma" because she has the courtesy to use Phoenix's name. The nurse does get frustrated when Phoenix doesn't answer her questions. The nurse scolds Phoenix, saying to her "Tell us quickly about your grandson, and get it over. He isn't dead, is he?" So, even though the nurse initially appeared kind, she quickly treats Phoenix like an annoyance. Rather than marvel at Phoenix's determination to help her grandson, in spite of her old age, the workers at the clinic treat her like a nuisance.
The nurse gives her the medicine, adding "But it's an obstinate case." Here, the nurse implies that either the grandson's ailment is persistent or that Phoenix is stubborn for continually trying to make him better with the medicine. After trying to "hush" Phoenix, who has begun talking too much for the nurse's taste, the nurse does offer some money to Phoenix because it is Christmas. This flippant act of charity is slightly admirable, but it has come after a series of condescending comments and gestures. Those at the clinic agree to help Phoenix, but in subtle and sometimes overt ways, they treat her like a nuisance.
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