Doctor's hand holding patient's hand

Introspection

Sunday, December 11, 2022

Often, I used to drop by to ask a patient of mine about his mood, and one day he just said I don't know what to say. When I did my clumsy screening for depression and asked if he felt like things didn't matter, he said, My great-grandson comes into my room in the morning and asks me to play dinosaurs, and then everything matters. That's a fair answer.

Around the same time, a different patient died early in the morning, just before I got there. His daughter came and said, matter-of-factly, with no ill will, wrapping her head around it all, And this is just another day for you. It wasn't. But also, it was, or — will be, maybe. For some reason I was thinking of her father saying, Then I went to Vietnam, where we searched fishing boats for guns. We never found any.

I wrote a hard note that day. It was hard because I had been at the hospital for sixteen hours the day before and it was right at the beginning of rounds, and everyone was watching. I wrote, We're so sorry for your loss. It was truly a privilege to get to know your father over this short time and to hear his story. Our thoughts are with you and your family.

Our attending said that if the death of a patient doesn't affect us, something is very wrong. I don't think I really had time to think about it all. When I got the chance sometimes, I'd look out the window in the workroom and often Lands' End was entirely lost in fog.

For the whole first week or two the lights in the workroom wouldn't turn on. I brought in a color-changing camping light, and we played instrumental music on a little portable speaker and outside the window everything was white.

Pigeons would make periodic warbling noises from the ledge, and I felt like I was floating and not just because I'd drunk too much coffee. Someone, at the beginning of the rotation, said that we wouldn't recognize ourselves when we came out. Another attending liked to say that we're just telling a story. We are just telling a story, aren't we?

After I wrote the letter on that morning the patient died, I gave it to his daughter. She was holding an oversized plastic bag full of his belongings. She asked me what she had to do next with the hospital and the funeral home, and I didn't know. I left her on a bench by the elevators while I ran upstairs and tried to reach Decedent Affairs.

She was sitting just where I left her when I got back. I told her she could go home; there was nothing more to do at the hospital. I don't like that I left her in that hallway by the elevators holding her father's things.

Her eyes seemed so wide, like she was looking for something, and they reminded me of her father's eyes the night before when it had been hard for him to breathe. I didn't think of all of this as so exciting until looking back, he had said as I asked him about his life.

Once, when I was younger, I lived somewhere that had summer every year, solid and dependable, and how lucky was I to have summer again and again and never worry whether the next one would come? Isn’t it worth it? Is it worth it?

I know, at least, that somewhere in time it’s raining outside a cafe in Philadelphia, that sometimes I’ll see someone out of the corner of my eye and think I know them, and that sometimes I’ll forget what it means — to be afternoon, to be mourning, to be asleep when a friend walks in hoping to borrow the big sheet pan and a bit of olive oil.

Sometimes I think about reasons I’m not who I’d like to be. Sometimes I try to be better, and instead end up — not necessarily more or less, but — sideways, reaching forward and finding myself three steps to the left and facing a different direction.

Sometimes I try to be better, and I’m not. And sometimes, I catch the thread of a larger story, and it almost all makes sense.