Before and after

Mr. C is a kind, elderly Lebanese gentleman that I have taken care of for two weeks on the cardiology service. He has been quite sick — his heart has trouble squeezing and sometimes beats in abnormal rhythms that are hardly compatible with life, let alone comfort. There were several nights when we almost lost him. Nights when his room became a battleground for doctors and disease, while he sat motionless, caught in the crossfire. But in a manner beyond our understanding (which I am realizing is much of medicine), he has recovered and will soon be leaving the hospital.

I head toward his room, contemplating how I will say goodbye — “I hope to see you soon” sounds more ominous than pleasant, yet “it was a pleasure to take care of you” seems to imply that I found joy in his pain. I will likely just smile and say thank you.

I enter his room to find him alone, sitting near the wall in an old chair usually reserved for friends and family. He looks majestic, in a casual way. He has traded his hospital gown for a beautiful pair of faded jean overalls that he wears over an old gray t-shirt. His few belongings are packed in a small bag that he hugs tightly on his lap. With his back toward me, he is looking calmly out the window at the bustling streets of Boston. I tap his shoulder, careful not to startle him. I smile, and give him the good news. He smiles back. He looks again toward the window and points at the pedestrians rushing between office buildings — “Believe it or not, there was a time when I used to be able to walk that fast,” he says in a reminiscent tone. It is important to him that I agree, so I do.

I try to imagine what he was like when he was 26 — long before his heart had failed and his body had weakened. I hope he sang loudly at concerts and danced wildly at weddings. Like me, I bet he hated flossing, loved road trips, and feared public speaking. I imagine he worked hard at his job and cared deeply about his family. And I am sure he used to walk fast.

As a young physician, I often wonder what my patients were like before they entered the dreaded doors of the hospital. I suppose it is our curse that we do not get to know their former strength or their future dignity. But perhaps it is a blessing that we meet them when they need us most.

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