Maan was born on my daughter’s sixth birthday, after an uncomplicated pregnancy. Husband, both grandmothers (sisters to each other), all from Southern India, were present and supportive. The birth was greeted with great joy, but within an hour, that joy was marred by a sudden seizure. I called in my pediatric colleagues, and we transferred the infant to the tertiary care center an hour up the road.
When most people hear the term “house call,” I’m sure the picture in their mind is of a black-bag-toting physician tending to a patient in the patient’s own home.
But when I hear the term “house call,” the picture in my mind is of a time, 49 years ago, when my family physician tended to me at his home.
I used to tell myself that my work in health communications was about more than earning a paycheck or typing words on a page. Yes, I didn’t provide clinical care, but didn’t I make a small contribution, too?
When I left home for medical training, I knew distance would be hard, but I didn’t understand how distance could change time itself. As a medical student, my schedule is packed tight, and traveling home has become a kind of emotional arithmetic: three visits a year, maybe four if I’m lucky, each only a handful of days. Somewhere along the way, my time with my mother stopped being measured in years and became measured in holidays, long weekends and whatever small windows my training allows.
Years ago, two of my patients were retired nurses and close friends. They were so inseparable that they saw me together for their office visits.
Gladys always wore a sour face and complained about her aches and overwhelming fatigue. I never could get her to talk about the hysterectomy she had at a young age that left her childless, but it clearly was the reason she swore off any surgery, even the minor procedure I was convinced would eliminate most of her symptoms.
Just as one never forgets a first kiss, one also never forgets a first house call. And specializing as I did in geriatrics included becoming a specialist in house calls.
At the university where I did my fellowship, the university contracted with a hospice company, which provided me with my first exposure to house calls, as well as to interdisciplinary teams—including social workers, chaplains, and volunteers. The hospice case manager was Nurse R, a seasoned 30-year veteran. She invited me to ride with her, zipping through Chicago’s narrow streets in her station wagon and parking in impossibly tight spots.
Twice Dr. Eddy made a house call because of me.
The first time was on a hot July day in 1953 when I, age seven, ran a fever during a polio outbreak. I didn’t have the poliovirus—but a year later I got the vaccine before my big sisters did.
The other time was when I was nine and had the mumps. I asked Mommy to take down “the hanging thing in the hall”—which nobody else saw. She tried to take my temperature, and I bit off the thermometer, fortunately above the mercury bulb. I spit it out on her order.
Daddy called Dr. Eddy, who used his thermometer: 103. He asked me to bring my pointer finger to my nose. I poked myself in the eye.
Even when the sun shone, our apartment was enveloped in darkness. A look of confusion or pain replaced Dad’s usual smile; I frowned all the time, caught up in a period of pre-grief as I prepared for the inevitable passing of my beloved father. Dad was tired of trying to live, and I was exhausted of trying to help him maintain some quality of life. Then, a miracle occurred. A diagnosis of pancreatic cancer made Dad eligible for hospice at home. The light returned to our lives.
Dear readers,
I can recall my pediatrician, Dr. Stone, making a house call when I was about five and sick with a fever. I was lying in my parent’s bed–a special treat. Dr. Stone, a kindly, balding man, entered the room wearing a coat and carrying a black bag. In the office, seated at his desk, he did not seem to be a big man, but in this apartment bedroom he became a looming presence.
He took off his coat and examined me as I lay there. I don’t know what he found–I’m guessing not much other than a high temperature–or what he prescribed. In any event, I got better, so from that perspective, the house call was a great success. His visit also reinforced our life-affirming belief that Dr. Stone really cared about us.
My pain is a cruel and jealous lover. It dictates my days and dominates my nights. It sulks and whines when it feels ignored. It consumes me.
I bargain with it. “Just give me one night, one night to sleep without you, and you can have me tomorrow.” Pain acquiesces. I nestle myself in a barricade of pillows and heated herbal packs that soothe my twisted limbs and drift gratefully off to sleep, only to have Pain invade my dreams. I cry out, though the torture is phantom. I awake, exhausted, to find Pain perched by my bedside, gleefully prepared to exact my promise.
Grimacing, my middle-aged patient described a somatic pain radiating out from a deep-seated void. This decades-old ache manifested itself as intractable muscle tension or tenacious migraines or debilitating heartburn and was always accompanied by emotional anguish.
At the void’s root lay existential angst, exacerbated by dark skies, loneliness, major decisions, and life’s transitions. Her genogram revealed deeply entrenched generational trauma. Her lab workup was normal. She sought out various modalities—medication, acupuncture, psychotherapy, psychic readings, herbal remedies. Her flares were fewer, but they struck randomly, disrupting her life for days.
Like everyone, I was taught as a child how to walk across a room on my own and how to hold a spoon to feed myself. As an adult, I never paused to marvel at these ordinary acts, while strolling to the mailbox or eating dinner with my family—until they slipped from my reach, replaced by chronic pain and deformed limbs.
Now, a week before my sixty-fifth birthday, as my home health care aide gently drapes a towel over my chest so I can attempt to feed myself, my embarrassment over the mess I will undoubtedly make of my cottage cheese and baked beans on that towel reminds me all too sharply of what I’ve lost.
