I stare at the clock, resenting each minute wasted. I am now the centre of my own tiny universe in the midst of the pandemic. My attention span has withered. A year of digital lectures and the spectre of high-stakes exams has sucked all the joy out of learning; now, each day is only about my comfort and my career. When I’m asked what fields I’m interested in, the true answer has become “none.” No, I don’t want to be here at this clinic. My increasingly reclusive soul was dragged here to fulfill a requirement. So, when the nurse leads my patient in, I’m disappointed. I could have gone home early if he had been a little later. I have exams to prepare for.
The dispenser purrs and proudly delivers precisely too much sanitizer, and I wipe, knock and enter. I ask how he’s doing. Words gush forth between his rapid breaths. He isn’t well. In fact, he’s terrible. He’d received a text before I came in; his mother was found pulseless on the floor by his panicked brother, and first responders were now attempting to resuscitate her. Before I fully register that “not well” has nothing to do with his laboured breathing, he’s sobbing. Suddenly, I forget myself and my petty mood. The clipboard disappears as I hold his shoulder and silently attempt to comfort a man twice my age. “They’re doing that thing to her,” he wheezes, “the one with those paddles, and the shocks.”
My gut says she’s already gone, and that he should not be here. He’ll regret not seeing her in her last moments or being there for his brother. How can he pay attention to my dry medical questions right now? I offer to end the visit, suggesting that there are certain things in life too important to miss and that this might be one of them. But he declines, worried that if he misses this visit too … . He trails off. A semaphorism — the Dictionary of Obscure Sorrows’ fictitious word for the subtle hinting toward a deeper personal story.1 A warning that, for once, maybe I should just listen. So, while paramedics crush the chest that once nursed him, he swallows his anguish and we begin.
He had chosen to leave his job and move to Phoenix to care for his ailing mother, sacrificing all his savings in the process. He lost his health, too busy to care for himself. Coughing followed him like a shadow, he spent nights sleeping in chairs and he gained more and more weight until he was admitted to the hospital 2 months ago. “Water pills” helped, but he had started them too late — he had lost precious ground. And how will he afford to continue his treatments? He can barely afford food, and he had missed his interview for food stamps to be at this appointment. All of this distracted him from managing his rising blood glucose levels.
I accidentally surprise him with the bad news that he has diabetes; I had assumed this was not a new diagnosis. I tell him this right as the central figure of his life is dying. The shock of this news is nothing to the guilt he feels related to his mother, who he left absolutely alone at 3 am to walk the 15 miles here because he didn’t have the $2 for a bus ticket. He worries it’s his fault she’s dying.
I run out of questions. Noticing that he frequently mentioned his faith throughout the visit, the rawness of his grief compels me to offer a prayer. It’s something I would normally feel too self-conscious to offer, but he reassures me with his look of relief and appreciation, so I pray for strength, for understanding and for peace.
He opens his eyes and checks his buzzing phone. I brace myself. “Mom died at 10:37.”
It’s 10:40 am. Sobs seize his burly frame. I watch him weep until, feeling awkward and powerless, I step out to give him space and to explain his story to my attending. Then, mostly to honour the 6 hours he spent walking here, my attending and I return together, prod his feet, fill his meds and buy him an Uber.
I last see him with his head bowed, sitting beneath the outstretched arms of a sun-beaten statue. Struck by the poetry of the moment, I ask if he had been surprised to walk outside and see the sun still shining. Yes, indeed. He had already been grieving the death of his father earlier this year, and now, losing his mother is almost too much to bear. But he knows he’s not alone. He says God is with him, that the mother of Jesus watched her son suffer worse. Despite his anguish, I see him try to shift the meaning of his day from himself and his pain, to something far bigger, leaving me marvelling as I run to flag down his ride.
Like glances toward the brilliant sun, achieving clarity is a bright, brief, often painful moment. I sit in my kitchen, grasping at the after-image. When patients come to me, it’s easy to see myself as a central part of their orbit, but really, I am a vague, blurry periphery in most of their lives, which, in turn, swirl around their own vibrant stars. These can be relationships like family, simple joys like hobbies, or even intangible. They are certainly not me in clinic. I realize this now, reflecting on today’s encounter. How did I turn so cold in these 2 years of learning to care? I was so absorbed in my sunless world of Zoom-based medicine that everything took on the same dark hue. Now, for the first time in months, I feel I chose the right career, one where I can perhaps help people cherish whatever brightens their lives for a just little longer.
Still, I’m missing something. Something important. What is it? The clarity fades so fast, and stress about coursework grows yet again. And then it hits me. I pick up my phone. A voice answers, happy I called. I tell my mom the story of my day, and savour our fragile connection for the precious moment that it is.
Footnotes
This article has been peer reviewed. The patient gave consent for this story to be told.
This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/