Tuesday, January 17, 2012

A Two Way Street

As I approached the room, the nurse stormed out with an exasperated look on her face. Half way to the computer bank, she turned back to warn me:

I wouldn't get too close if I were you. She kicked the CNA in the chest

I entered the room to find Myrna pinned to the bed by her middle aged son. Russian curses spewed from her mouth intermixed with deeply accented English. Her legs kicked and her arms tried to flail against human flesh. The fatigue on her son's face showed as he let her go and sprung back to stand beside me.

Myrna was delirious. Her brain encumbered by plaques and tangles was unable to stave off the ill effects of fever and dehydration. Her usually calm demeanor was replaced by demonic screaming and unwieldy thrashing. Her ninety year old body was suddenly strong and agile.

Myrna looked up at us from the bed like a tiger ready to pounce. Her eyes rested on her son's face and then moved in my direction. My muscles tensed reflexively awaiting the possible onslaught. Her face softened.

The baby girl. How's the baby girl?

And then she smiled and looked at me knowingly as if we shared an intimate secret that no one else was aware of.

Even through the thick foliage of delirium,

she remembered.

*

I reclined in the chair and placed my legs on the desk in front of me. Just one more patient before lunch, and then I was done. My wife was thirty eight weeks pregnant and I looked forward to another weekend of peace before the new baby complicated our quiet lives.

My cell phone began to buzz and ring loudly. I almost fell out of my seat as I yanked my legs off the desk and dove into my pocket. Moments later, I listened as my wife spoke quickly on the other end of the line.

The ultrasound showed a problem. The doctor wanted her in the obstetrics ward immediately to be induced. My wife's voice was calm but firm.

Come home now!

I threw my lab coat on the chair and grabbed my jacket. I ran down the hall with one arm pulled through the sleeve and the other dangling out. As I passed my office manager, I spit out directions to cancel my last appointment and clear the next week.

The secretary and medical assistants huddled in the doorway and wished me good luck as I flew out of the office onto the landing, and jumped down the stairs in groupings of two. When I arrived at the bottom, I bumped into Myrna and her son who were making their way up to the office for an appointment.

They looked at me questioningly. I turned briefly and exhaled an explanation as I gasped for breath. Myrna shook her head and smiled. Even with her deep accent, I caught her words while racing out the door and into the parking lot.

It will be OK!

And it was.

Four years later, this memory came back to me as I sat with Myrna in her hospital room. Although her sensorium had not completely cleared, she was calm now. In time her fever would break and her mind would return.

*

I often marvel at how as a physician I am present during critical moments in my patients lives. I witness birth and death. I fight alongside them when it is time to fight, and console them when it's time to stop.

But every once in awhile a patient bears witness to one of my moments. And it is only then that true intimacy occurs.

Because between Myrna and I,

it was a two way street.

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