Touching Lives

"A mensch, do you know what a mensch is?"  I had to admit that I had no clue but it didn't sound good.  With the ever present twinkle in his eye, Aaron declared that my education was insufficient and that he would take it upon himself to teach me the important words to know in Yiddish.  It was the least that this good old Jewish boy could do for his "mormon" doctor.  Through the next few years we grew closer together as he overcame lung cancer, struggled to control gout and progressively deteriorated as his emphysema progressively sapped his body of strength.  Knowing he could not live forever, we discussed his goals for the end of his life.  He did not want to linger on machines but he was certainly not wanting to give up on life either.  At the end it was a massive heart attack that took his life.  He was rushed to the hospital, the cardiologists tried to open up the blockage but his frail body could not take the damage and he did not make it back up to the intensive care unit.  Not knowing these details at the time, I was on my way to see him and happened to meet his family in the lobby of the hospital and learned that they had been called urgently to come up to the ICU.  I ran up the stairs before them, only to learn of his demise.  It broke my heart to turn and notify his loving family of his passing.  Tears were shed together.  As I told his daughter how much I cared for him, she responded, "he loved you, you were such a mensch."  To what seemed to be harsh sounding consonants those years before, now rang with sweet praise.  What an honor!

A few short days prior to saying goodbye to Aaron, I had to also say goodby to Thomas.  I dare say that was not his given name, having been born in China, being a soldier in the Japanese War many years ago.  He and his wife have lived in St. Louis for a very long time.  Though they hold on to their beloved Chinese traditions, they have readily embraced America and love being here.  He worked as a Chinese cook.  We made it through a severe staph pneumonia together, managed his diabetes but watched him slowly decline in strength the last six months or more of his life.  We tried physical therapy, adjusted his medication but at the end it was a simple fall that sealed his fate.  It resulted in a fractured hip and then a devastating stroke that left him partially paralyzed and unable to safely swallow.  He had previously made his wife promise him that she would not let him "rot in a nursing home" but now she was being told that he must have a feeding tube placed and that he would have to be cared for in a facility.  Together we had heart felt discussion about end of life care.  We agreed that his care should be tailored to making his last days as comfortable as possible, not making those days last as long as possible.  Hospice services were arranged and he was able to pass relatively peacefully at home.  On my shelf in my office sits a jade colored plaque inscribed with Chinese characters.  It sits as a reminder of the sweet spirit of that noble man.  He gave it to me about a year prior to his passing.  When I asked him what it means he said, "Good Doctor."  I call it my doctor trophy.

The last farewell that I will share started with Shirley and ended with Millard.  Having dealt with repeated lung issues, Shirley was declining and was adamant that she did not want to go back to the hospital ever again.  Her family called me in a panic on a weekend, as her breathing had become worse and she was struggling to breath.  They wanted desperately to do something for her but did not want to go against her wishes.  I told them that I would meet them at her house and arrange for nurses to come by.  I then called the hospice team and arranged for them to meet me there.  My wife was out of town, so I brought my boys with me to the visit.  I calmed the family's fears and promised that their wife and mother would not be allowed to suffer.  The hospice nurses did a wonderful job and she was allowed to stay at home until the end.  That night as we turned to leave their home, her husband, Millard, turned to my boys and told them how grateful he was to me, their "angel" father.  His kind words to my sons deeply touched my soul.  Over the next 5-6 years, Millard himself slowly declined.  Once an avid cyclist, he was discouraged by his inability to get around as he would have liked.  He had to give up his beloved home.  He made the best of his situation, taking up his oil paint brushes which had long laid dormant.  In the last few years of his life he completed portraits of his dear wife, his two children and of himself.  I saw him regularly, keeping an eye on his kidney function but in the end his old body just started to give out.  He developed Parkinson's which made it difficult to move around.  I received a call from his daughter who told me he had become too weak to even go downstairs to eat.  I told her I would stop by.  He knew it was the end.  We arranged for the hospice nurses to come again.  He did not last long, passing quietly at home.

It is hard to say goodbye to these friends I have made, patients of mine.  My whole goal as a physician is to keep people healthy but at the right time, my job is to relieve suffering, to minimize pain as well.  Success is often measured in the quantity of life but one's quality is equally as important.  I view my interaction with my patients as a wholly satisfying experience.  Each one touches my life for good.  I certainly feel that I receive more than I could ever give.  I wanted to pay tribute to all of my patients, those who have left us and those still living.  To touch a life is a sacred experience, a solemn honor that I take seriously.