The 11,306-foot summit of Mount Taylor in northwestern New Mexico was my destination one sunny autumn morning. But what I sought that day was something else: understanding and forgiveness.
During the early months of the COVID pandemic, the Utah medical school where I teach asked me to facilitate a small group of first-year students in Layers of Medicine—a course that covers what you might call the “messy” side of medicine, including end-of-life discussions.
Just after the course started, my dad was diagnosed with pancreatic cancer. All at once, I felt my personal and professional responsibilities intersect, unexpectedly and powerfully.
He’s wearing a Yankees T-shirt, an EpiPen holstered to his belt like a lightsaber. We’re old friends. Trevor has been my patient for four years—more than half his life.
This will be our last visit: After forty years, I’m retiring.
I can’t stop thinking about you.
Last night, at about midnight, the phone aroused me from my happy slumber. It was Vance, the on-call resident, needing advice from me, as the supervising physician, on how to help a worried mother—you—who’d called our family health center’s after-hours service about your daughter’s worsening asthma.
It was March 2020, and COVID was coming. The virus hadn’t yet reached my small suburban community in Pennsylvania, but already businesses were waning, streets were emptying, clinics were closing. Fear was widespread.
A collective refrain sounded: “Shut it down”—the university, the restaurants and, most of all, the public schools.
The last time I had alcohol was on a blustery night in February of 2020, right before my college-age son’s musical. I’d traveled from Los Angeles to his rural Ohio college campus, and I drank two glasses of cheap chardonnay in the college café with its burgundy walls and snug booths.
“He basically killed me,” Sam said flatly, sitting my office. “I don’t want to talk to him.”
I nodded sadly with understanding as his on-demand oxygen hissed away each moment, like the ticking of a clock. Why would a patient want to speak to a doctor who’d missed his diagnosis? Why should he?
I heard him coming before I saw him.
Kerflop…kerflop…kerflop….
The sound grew louder as a pale, gaunt man in a red Toyota pickup truck pulled into our clinic’s lot. He parked in front of the window where I was seated.
Last patient of the day, and of the work week! I was finishing what felt like my Thursday Night Endurance Test, after which I could go home to my family, and eventually to bed.
As on so many Thursdays, I was running behind. My final appointment was with a new patient, Ann Miller. Before entering the exam room, I did some fact-finding.
The exam room bears an odor; it’s a musty sweetness, not unpleasant, but one that I know well–fetor hepaticus, a sign of severe liver disease.
My patient, Ms. Atkins, slouches on the exam table, brooding. She’s thirty-four years old, and an alcoholic. She is joined by her mother and her five-year-old daughter, Mari, who skips to my side, long braids bouncing off her shoulders.
“As I hang up my uniform, she will put hers on,” my uncle proudly told my aunt when I announced my plan to attend medical school under the auspices of the US Air Force Health Professions Scholarship Program.
Two of my uncles had illustrious Indian Army careers–one as a brigadier general and the other as a lieutenant colonel–but my own military potential was less obvious. I was a stereotypical “girly girl,” a flop in sports
It has been said that we in health care carry a backpack of sorrows.
There is a sanctity to being on the inside, trusted to care for people in their weakest, darkest and most vulnerable moments. When it feels like control is gone, we steady our voices even when we too feel scared.
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