Crush the ribcage, the brittle trappings of these four chambers, and force the blood to course through this fibrillating muscle.
Wield lightning and crash it into flesh and bone, reset the circuitry, wipe away the aberrancy.
Restart the heart, with these brutal jolts. 1/
Wield lightning and crash it into flesh and bone, reset the circuitry, wipe away the aberrancy.
Restart the heart, with these brutal jolts. 1/
It’s different this time, for me.
Different because I know this person well.
As I watch the Code Blue team work, I’m not there.
I’m far away, remembering my last visit with the patient, outside the hospital.
Terrible moments sometimes bring a piercing clarity. 2/
Different because I know this person well.
As I watch the Code Blue team work, I’m not there.
I’m far away, remembering my last visit with the patient, outside the hospital.
Terrible moments sometimes bring a piercing clarity. 2/
Every time we really get to know someone, some small part of an essence gets woven together.
To be a physician means carrying a thousand lifetimes within you.
A rising sun, an infinite horizon. 3/
To be a physician means carrying a thousand lifetimes within you.
A rising sun, an infinite horizon. 3/
He sits before me with his sleeves rolled up as if he means business, as if it’s time to work.
His face is drawn, wizened by the many decades that have gone by.
His arms are folded across his chest, and he looks down his nose at me, passing judgment.
“You’re late.” 4/
His face is drawn, wizened by the many decades that have gone by.
His arms are folded across his chest, and he looks down his nose at me, passing judgment.
“You’re late.” 4/
I glance at my watch as I sit down across from him in the exam room, “I’m four minutes late.”
His lips are pressed together in a thin line of disapproval, “At my age, every minute counts.”
We stare at each other defiantly.
Finally I break, and smile.
He grins, “Hi doc.” 5/
His lips are pressed together in a thin line of disapproval, “At my age, every minute counts.”
We stare at each other defiantly.
Finally I break, and smile.
He grins, “Hi doc.” 5/
I have a group of patients for whom the best kind of medicine I can provide is being a social support, maybe even a friend.
He is one of these patients.
He has lived life intensely and now, in the twilight of it all, he finds himself intensely lonely.
Disconnected. 6/
He is one of these patients.
He has lived life intensely and now, in the twilight of it all, he finds himself intensely lonely.
Disconnected. 6/
We go through the rituals of the visit, the discussions of markers and methods, means and medicines.
And then we talk about whatever he wants to talk about.
His golf game is suffering, “I’m slicing everything. Swing is all off.”
I offer advice, “Has your grip changed?” 7/
And then we talk about whatever he wants to talk about.
His golf game is suffering, “I’m slicing everything. Swing is all off.”
I offer advice, “Has your grip changed?” 7/
From golf we move on to his favorite subject: recollections of his past.
“I used to have this relative who ran a distillery. When I was little, I would visit him. He would give me a shot of rum, and tell me sternly, ‘don’t get drunk!’ Like I was some kind of alcoholic.” 8/
“I used to have this relative who ran a distillery. When I was little, I would visit him. He would give me a shot of rum, and tell me sternly, ‘don’t get drunk!’ Like I was some kind of alcoholic.” 8/
He laughs, “I was just a kid! Remember it clear as day.”
His laughter trails off, and he rubs his forehead, “You know doc, as I get older, it’s like my oldest memories are getting clearer. It’s the new memories that are fuzzy. My body goes forward, but my mind goes back.” 9/
His laughter trails off, and he rubs his forehead, “You know doc, as I get older, it’s like my oldest memories are getting clearer. It’s the new memories that are fuzzy. My body goes forward, but my mind goes back.” 9/
I nod. I feel like I should say something here, but nothing comes to mind. I lower my gaze to my hands resting on my knees.
He finally breaks the silence, “Sometimes I wish I could go back in time, do some things different. You ever wish that, doc?”
I nod, “Every day.” 10/
He finally breaks the silence, “Sometimes I wish I could go back in time, do some things different. You ever wish that, doc?”
I nod, “Every day.” 10/
Our visits always run a little late. Today is no exception. He has a way of weaving stories.
As the visit finally ends, he gets up to go.
I smile and shake his hand, “I’ll see you in four months sir, take care of yourself.”
He laughs, “I’m too angry at the world to die.” 11/
As the visit finally ends, he gets up to go.
I smile and shake his hand, “I’ll see you in four months sir, take care of yourself.”
He laughs, “I’m too angry at the world to die.” 11/
That was months ago. Right now I’m watching him lying on a hospital bed, being coded by the ICU team.
And I’m thinking about a boy visiting his relative, who ran a distillery.
Being a physician means carrying a thousand lifetimes within you.
And sometimes letting them go. 12/
And I’m thinking about a boy visiting his relative, who ran a distillery.
Being a physician means carrying a thousand lifetimes within you.
And sometimes letting them go. 12/
He survives. Of course he does.
The first thing he says to me when he is taken off the ventilator is, “You’re late.”
I can’t help but smile, “Nah, I’ve been here. Where’ve you been?”
He is sleepy, still groggy with residual sedation, “I’ve been here… and there.” 13/
The first thing he says to me when he is taken off the ventilator is, “You’re late.”
I can’t help but smile, “Nah, I’ve been here. Where’ve you been?”
He is sleepy, still groggy with residual sedation, “I’ve been here… and there.” 13/
With time he recovers, and eventually is transferred to a rehab floor.
I visit him there and overhear him grumbling at the staff.
He’s returning to his irritable ways.
The man who was too angry at the world to die.
I enter his room, and he scowls at me first, then smiles. 14/
I visit him there and overhear him grumbling at the staff.
He’s returning to his irritable ways.
The man who was too angry at the world to die.
I enter his room, and he scowls at me first, then smiles. 14/
Smiling in return, I sit down at the bedside.
He listens in silence as I go over his kidney function with him. Then I ask him what I’ve been wanting to ask.
“Do you remember it at all?”
“Remember what?”
“Dying. Coming back.”
He seems to ponder my question for a while. 15/
He listens in silence as I go over his kidney function with him. Then I ask him what I’ve been wanting to ask.
“Do you remember it at all?”
“Remember what?”
“Dying. Coming back.”
He seems to ponder my question for a while. 15/
Finally, he speaks, “I felt like I was part of something.”
I quirk a brow, “Something?”
He takes a deep breath, “Something… big. Like the sky.”
I nod, falling silent.
He smiles, then looks to the window in his room.
At the lingering sun, on the edge of an infinite horizon.
I quirk a brow, “Something?”
He takes a deep breath, “Something… big. Like the sky.”
I nod, falling silent.
He smiles, then looks to the window in his room.
At the lingering sun, on the edge of an infinite horizon.
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