Possible Clues:

• Very severe or serious
• Forceful and extreme
• Wine prescribed by physician, more or less extreme
• Does the doctor like a twitch if it's serious?
• Severe physician with a small neuralgic complaint
• Not a mild doctor like a jerk
• It's serious, and coming up it's in the card
• Severe and far-reaching
• Severe - powerful
• It's a bit extreme so to give the doctor a cane without an end