My brother-in-law, Ron, was a curmudgeon; grumpy, sullen, even downright mean at times.
By blood, he and my husband Bill were cousins. In the 1950s, when Bill was just a child, his mother died unexpectedly, and Ron's mother took Bill in to live with her and her four children. They were an African-American family living in the midst of a middle-class, predominantly white Connecticut township. Their home, located on a wealthy family's farmland, had one bedroom, wood heat and no running water. Each day, Ron's mother walked five miles to and from town, where she did laundry and cleaned houses to support the family.
Bill and Ron were close in age; they considered each other brothers. I met Bill when I was in my forties and he was in his late fifties, so I knew Ron only during the last few years of his life.
At that time, Ron was suffering from chronic obstructive pulmonary disease, hypertension, diabetes--the typical laundry list of someone who grew up in the era of the Marlboro Man. Bill was Ron's medical proxy, so we were routinely involved in his medical care.
Although I never knew Ron well, I always felt a strong connection to him, and he in turn seemed to trust me, perhaps because he trusted my husband. Bill confided that when Ron was very young, he'd been thought to have a developmental delay and had been institutionalized for a short time. Nevertheless, for his entire adult life Ron had worked and lived independently.
As I say, he was a curmudgeon--especially when he was in the hospital and not allowed to smoke.
On one such occasion, six years ago, we happened to be visiting him when his attending physician came calling, her entourage of medical students and residents in tow.
As they entered the room, Ron was sitting on the edge of his bed, elbows on his knees, looking at the floor.
Immediately, the doctor carefully backed up to the wall opposite Ron and leaned against it, her arms and legs crossed. Seeing this, I knew right away that she'd felt the sting of Ron's discontent at some point.
"How are you today, Mr. Scudder?" she asked warily.
"Lousy!" Ron snapped. "When can I go out for a cigarette? This place stinks!"
"Mr. Scudder, you've been hospitalized because your COPD has flared up," she said impassively. "People who have lung disease shouldn't smoke."
I winced at her cool tone and well-rehearsed words.
Ron must have felt the chill too. He looked at me, then said, "Lisa, give her that piece of paper I gave you earlier today."
I handed it to the doctor, knowing that I was giving her something very precious--something that Ron had written a decade earlier, in his mid-fifties. Here’s what it said:
Ronald Scudder's Story: Learning How to Read
All I wanted to do was to learn how to read. I spent fifteen years trying to learn with different organizations. This time was a stepping stone. I learned a little, but not a lot. Finally I wound up at the First Congregational Church of Old Lyme. I got two tutors. About two years later I was reading. About a year later, I learned to write. Then I wrote my first poem.
Lord you made the earth
And raised us from it
You brought the winds from the four corners
And gave us the breath of life
You gave us wisdom of life, love and compassion
Lost loved ones causes sadness.
So please lord allow the branches of the willow
To bend and weep for our sadness
Allow the drops to flow to the sea
And wash away our sadness of our lost loved ones
So we can love again
Lord we know your love will be there to see us through
Thank you Lord
As the doctor read, I watched her expression soften and her body relax. When she was done, she looked down at the floor and was very quiet for a moment.
"Mr. Scudder, may I make a copy of this and put it at the nurses' station?" she asked softly.
True to form, he snapped, "Sure, do whatever you want. I don't care."
I still carry that paper with me, tucked in my wallet. It's become ragged and worn, because every year I pull it out when I share this story with my students, who are training to become physician assistants.
"You're going to encounter patients with sharp edges--some sharper than others," I tell them. "You're going to bump into those edges, and you might get your feelings get hurt. But if you take it personally and allow it to be about you, you're missing something very important. Those sharp edges weren't always sharp: They came from somewhere--often out of very painful experiences and significant life challenges."
My brother-in-law didn't become a curmudgeon overnight: He grew up in extreme poverty and had a very difficult childhood. Beneath his sharp edges, though, was a beautiful soul and a man of faith who loved deeply.
In sharing Ron's story with my students, I hope that they'll respond, as his young physician did, by recognizing the value of their future patients’ stories and helping others to appreciate each patient’s unique journey. By giving Ron's other caregivers a glimpse of both his struggles and the inner beauty expressed in his newfound words, Ron’s physician was doing her best to make his hospital stay more tolerable--trying to soften his caregivers' edges, just as her own had been softened.
I will always be grateful to Ron for asking me to hand that simple piece of paper to his physician--for trusting me (and her); and for providing me with a personal story that so clearly illustrates why every patient should be treated with kindness and compassion. He has honored me with his legacy and with his story, which I’ve shared with hundreds of my students. And now I share it with you.
About the author:
Lisa Walker is a physician assistant and the director of the MGH Institute of Health Professions Department of PA Studies, in Boston, MA. She teaches patient-provider communication--or, as her students would call it, "the soft stuff." She often uses literature, film and art to help students process challenging situations in clinical practice. “Abstract concepts are more meaningful when they're reinforced through the lens of a real story about real people. In studying medicine, we learn about suffering and healing. Narrative medicine helps us to connect with the person who is suffering and to find new, more effective paths to healing, both for the patient and for ourselves as caregivers.”