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| Mr and Mrs. H have been married 57 years and both are in their eighth decade of life. They lived an adventurous life, he traveling the world as an academic political scientist specializing in latin American culture, and she as a teacher. They lived in Spain, Mexico, Argentina, Maryland, New York, and finally Michigan.
Neither has any illusion about their current situation. As an introduction, Mr. H said “She is doing well, it’s my body that’s falling apart right now.”
Three strokes had left him paralyzed in his left side, a diagnosis of aortic stenosis, heart rate in the low 40 beats per minute, and chronic knee pain, Mr. H is near the end of life. He seems to have come to a calm acceptance of this fact. He mentioned during the interview that they were considering placing a pacemaker, but “we decided against it. I’m not sure my heart is going to be beating for much longer.” Mrs. H nodded in quiet consent. She has relatively few health concerns. Sometimes she has issues with bladder control after her thyroid was removed, she has a prosthetic hip which is working wonderfully, and a bit of arthritis like most women her age.
Mrs. H has taken the role of caretaker because Mr. H can no longer walk. I surmise that she is likely going to outlive him for a number of years because of her remarkably good health.
It was hard for me to comprehend how resigned she was to his encroaching death. Would she not fight for his health, just a few years more, to see out their 60th anniversary?
Her quiet acceptance of his condition mirrored the ideal that I think all physicians should strive for. The asymmetry of health, between the unwell patient and well physician does not necessarily mean that the physician should push the patient to follow every possible scenic detour to delay arriving at their final destination. Mrs. H loved Mr. J dearly, more than any physician or anyone else in the world could ever, and she could let him progress. So could I, if that is what my future patients ask of me.
Mrs. H showed us the door as Mr. H remained sitting in the chair. It was a hard image to cope with to see him there while the rest of us stood up to leave, but I know even harder for Mrs. H. | | |
| I was sitting in the room with the patient, a pleasant middle aged man, slightly overweight, with a case of multiple myeloma.
Dr. M was very professional, but not any more. She introduced herself briskly to me and the patient, then stood in the corner of the room and wrestled with paperwork. Without looking up, she asked the patient a few questions, and made small talk about the Tigers game. Then, after a quick physical exam, she left the room as painlessly as she entered.
The patient too looked inert. He sat on the examination chair and never left it throughout the visit. He raised his arms when he was told to do so, so she could check his lymph nodes. Then he asked about the result of the PET scan, which she promptly supplied.
Dr. M’s deflated approach to the visit was unsettling for me. It rattled my expectations of how a physician would interact with their terminally ill patient. Perhaps she was tired. I had come in the late afternoon, and it was the middle of the week.
I thought to myself how if I were the physician, I would have aimed for something more, aimed for one moment of intense empathy that would leave both me and the patient glowing with trust after our encounter.
On the way to the door leaving the room, Dr. M added a word of explanation to me. “We’re very social with J. It’s been six years, one stem cell transplant, and two rounds of chemo.” The patient looked at me and nodded solemnly to agree. I began to understand a little better the doctor-patient relationship that was there, floating just an inch above my comprehension.
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Devastating isn't it? In a nostalgic relapse last night, partially born out of an existential questioning about whether I actually like med school (that's an another topic), I read through Point and found out that Tom Yum Goong had burnt down.
I ate at Tom Yum Goong on June 26th, a month before the story was published. I was there unsure why I was there. Sigh.
Dinner was served with a side of reluctance and distraction. Which is probably why everything about Tom Yum Goong sits so unevenly in the memory. It was well lit, a lavender-red interior typical of an Asian restaurant. We were tucked away at a corner table, glass window to my right, elephant tapestry to my back.
As I slurped the last strands of crazy noodle, I suspected that this was perhaps the last time I had any excuse to go to Princeton. I was right too, the rest of the summer was all about Philadelphia, which, looking back, was one of the happiest times of my life.
That dinner at Tom Yum Goong is just a memory. As it is now, a pile of ashes on the far side of Nassau street, the restaurant itself exists more as a memory than anything else. So it is with everything about Princeton, about Plainsboro, about life back home. They've all irrecoverably lost except to memory.
Here I sit on a hot Michigan's summer night. I feel powerless.
Here's to memories in gray and cinder.
_________________
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Dear Jasmine. You were a good cat. Thank you for you devotion. God bless you.
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| "What are those mountains
that sit on your back?
they remind me of the bosom
that men do lack"
"My brother, my brother
I will answer with the truth
but to ask it at all
is highly uncouth.
You see every camel,
has another camel in part
someone for whom they
regard with their heart
these lumps that I bear
all brutish and stern
nourish me quietly
through the miles I burn
each step is closer
each pant brings me near
to the one that I had left
who merits my tears"
so the jackal said
with a slight wink
"I wish you dear brother
to have another drink"
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