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Curmudgeon

Lisa Walker

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.”

Story editor:

Diane Guernsey

Comments

10 thoughts on “Curmudgeon”

  1. Thank you for sharing Ron’s story. As a psychotherapist I urge medical providers to see beyond people’s crusty exterior!

  2. I have been practicing for over 30 years as a PA and I have met many sharp edges through out my career. They are the challenges of my practice and I look forward to them. The rough exterior often is the crustaceous coat of the inner soft soul and I dig for that inner self. That is where healing begins. I try to teach my students this concept. Your story is so familiar to me. My brother was a Curmedgeon. thank you for sharing.

  3. Denise Katterhagen

    Such a poignant and touching story to read this morning as I head back into work on a Monday. We all bear witness to each others pain and to be able to take a few minutes and reflect on how someone might have arrived at a place of “curmudgeon-ness” is a gift this beautiful day. Thanks to you and Ron for sharing both his story and his poem.

  4. The “soft stuff” is so often lacking in young residents coming into practice today. As a sixty something woman, wife of 35 years, some good, some not so good, and mother of two sons, I no longer seek validation that I am worthy of their time and attention, but I am still taken aback by their cold and often dismissive disinterest in me. Older and experienced physicians tend to be grounded in a way that allows them to distract with humor or lighten the mood and then move back to the important points with emphasis but without judgment . I love when I am recognized as a person, when my family members are treated with dignity and respect. I feel better. We are not numbers on a piece of paper. Our pain is not a psychological value based on an inability to deal with pain. We are human with stories and feelings and pride and joy. Let me assure the young doctor that I am willing to suspend my personal judgment if he or she could only do the same.

  5. Thank you so much for this story! It not only speaks to the medical profession. It reminds all of us what a gift written language, that we often take for granted, is.

  6. Dear Lisa,

    Good article, showing how narrative medicine humanizes the patient-physician interchange which can lead to healing. There are two types of learning (at least): factual and experiential – and I believe that the latter lasts longer.

    Good luck to you in your teaching “soft stuff” medicine. Both Patients and HealthCareers benefit from low-tech, high touch medical care.

  7. A perfect example of the expression “curiosity and judgement cannot occupy the same space at the same time”. A special magic occurred when the doctor was given an entry door to melt her judgement and kickstart her curiosity.

  8. Not all curmudgeons are as transparent to their soft side. Ron is a blessing to medical students and staff. Thanks for this uplifting story.

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