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Donald Stewart


My career in medicine began when I was three years old.

Holding tightly to my father's hand at the end of a dark hospital corridor, I couldn't keep up with the heavy, sibilant stream of conversation flowing between Daddy and Dr. Mashburn, the man who had delivered me, who had sewn up my chin after I'd slipped in the bathtub a month before and who was now explaining the details of Mommy's condition. Something, I knew, was making her bad. Sometimes her arms and her back hurt so much she couldn't even pick me up.

My attention slipped away from the confusing drone of grown-up words and fixed on a bright black-and-white picture shining down from a lighted box on the wall. The "x-array" film clearly showed a gleaming white shaft of bone (my mother's clavicle, a word unknown to me at the time) with a perfectly round, dark spot in the middle. One day I would understand this spot to be a hole in my mother's skeleton. Such x-ray findings were evidence of eosinophilic granuloma, a disease that causes white blood cells to multiply and clump together at various points in the body. This illness was the source of my mother's pain.

I knew that children weren't supposed to interrupt their parents, especially when they were talking to the doctor. I also knew, even at that age, that there weren't supposed to be dark round holes in people's bodies. Tapping into my preschool fund of medical knowledge, I generated my first working differential diagnosis, eliminated the least likely possibilities and posited a clinical hypothesis. Tugging on my father's hand and pointing up to the radiograph, I asked: "Is that Mommy's belly button?"
* * * * *

The doctors blasted my mother's disease with high doses of radiation. In the early 1960s, X-rays were the technological hammer that for half a century had turned every conceivable medical malady into a nail. As expected, the globules of cells that were eroding my mother's skeleton simply melted away, and for a time she was pain-free.

Eventually, though, the ache in her bones returned. No benign tumors this time: In less than a year, the cancer that had been hiding deep inside her invaded her abdomen and her skeleton, consuming her thin frame as relentlessly as the radiation had liquefied her granulomas. The insidious disease abbreviated her thirtieth year, claiming her life just a week before my fifth birthday.

We never knew where her cancer came from. My father believed that it was a result of the radiation treatments. Years later, Dr. Mashburn recalled it as a straightforward bone cancer. Laboratory tests indicated that it had originated in the thyroid, while the pattern of abdominal spread strongly suggested ovarian disease. Given the rudimentary understanding of cancer in the 1960s, we'll probably never know for sure what killed my mother. What we do know is that she was taken from us very quickly.

For weeks, my family watched her grow sicker and weaker. My brother, a first grader, was obliged to stay at home. Daddy managed to keep my mother fed, bathed and medicated and as comfortable as possible at night and over the long weekends. But he had to go to work every morning, which left her daily care in the hands of my maternal grandmother.

Too little to go to school, I stayed home, too, for as long as possible. My only understanding of my mother's medical condition was an awareness that she stayed in bed a lot and couldn't be disturbed. I remember being left alone in my room, expected to play quietly with my toys and not get into anything. Instead, I explored--discovering wonderful hiding places in the laundry hamper and the kitchen cabinets and attempting basic research in the medicine chest, which I could barely reach by climbing up on the toilet and leaning far out over the sink.

By the summer of 1964, my mother's cancer had spread to her liver and was blocking the flow of her digestive fluids. Her nausea returned, her pale skin bloomed from sallow to orange, and her eyes became as yellow as country egg yolks. Concerned doctors kept shifting their diagnosis back and forth between cancer and a possible hepatitis, which would have put the entire family at risk of infection.

By now the constant strain of terminal illness was leaving too few eyes and hands available to manage a precocious toddler who very much resented the loss of his mother's attention. When my behavior grew from distracting to destructive (I delighted in removing the satin edging from blankets), I was sent away to live with my paternal grandparents, at least until my mother had a chance to regain some of her strength.

The last time I saw my mother alive, she was not allowed to touch me, nor I her, for fear that she'd infect me with the imagined hepatitis. Morning sun spilled through the curtains of her bedroom, illuminating her golden skin and her bright, mustard-yellow eyes. She motioned me toward her.

"I can't kiss you," she said. "But come here--let me give you a hug."

When I tried to climb up into her bed, Grandma stepped in and pulled me away. For my own good, she said. Other hands ushered me firmly out of the room as my Mommy, tears in her eyes, blew me her last kiss.

After the funeral I grew quiet, my grandparents told me later, and stayed that way for a long time. I remember Grandma cradling me in her arms, explaining quietly that Mommy was gone. She had fallen asleep and woke with Jesus, Grandma said, and she wasn't hurting any more. Somehow that was enough for me--the simple, loving assurance that things would be okay.

In time my energy and personality returned full force, and at five years old I announced that I was going to be a doctor.

I have no clear recollection of making the decision. I just knew that some day I would wear a white coat like Dr. Mashburn and work in a hospital like the doctors on daytime TV.

Over the years I encountered many others with a similar history: a sudden illness, a tragic accident, and someone dear to them was lost. Whether we shared some hidden sense of guilt, a subconscious desire to save the one who died or a need to prevent a similar tragedy from happening again, each of us emerged from the trauma following a similar path.

It's possible that my mother's death made me want to become a doctor. It's also possible that my decision was made long before, in a hospital corridor in front of an X-ray box, when I was three years old.

About the author:


Don Stewart earned his bachelor's degree in biology and art at Birmingham-Southern College, where he enrolled in art classes as a change of pace from his premedical studies. Don continued to pursue artistic interests as a hobby at the University of Alabama School of Medicine and during a surgical internship at the Mayo Clinic, where he received awards for both short fiction and poetry and published his first two composite drawings. He has since worked as an artist and writer at theĀ DS Art Studio, where he continues to refine his signature style of visual humor.

Story editor:

Diane Guernsey