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Old People

 I grew up hating old people. As a young child, I was engulfed in a sea of gray hair and wrinkles and had no playmates. Mama was forty-one when I was born; Daddy was forty-five. My siblings and cousins were older than me by at least eleven years. None of our neighbors had children. The people we visited were all in my parents’ age group or older.

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Accepting the Inevitable

Simon and Garfunkel said it best: “How terribly strange to be seventy.” When I turned seventy in 2017, I felt old for the first time in my life. Nothing external changed except for a few more wrinkles and gray hairs; I kept my part-time teaching job, continued to usher at theatres, and kept up my reading marathon. However, internally, I felt mortal; most of the chapters in my life have ended, and only a few chapters and the epilogue remain.

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An Editor’s Invitation: Aging

It’s recently come to my attention that I am aging.
I used to find it easy to ignore this particular phenomenon, but as the decades have passed, as my two daughters have now reached their mid- and late-twenties, and as my morning body becomes increasingly creaky, I find this reality staring me in the face–sometimes literally, as I look in the mirror.
The most disconcerting aspect of this aging business: the vanishing names.

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Last Day

Last Day

It’s my job to empty a plastic bag
filled with meds both past and present
and read out loud the labels of those we stopped,
and explain why, and while we’re on why
why he needs oxygen at night, and the rescue inhaler.
Between pills it’s my job to ask in a generic way
about life outside the clinic? He takes out his phone
because his story needs a prop.
His ex called yesterday, Only one ex, one’s enough,

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Dead, Slightly Dead and More Dead

When the walls of his failed heart collapse, he suffers a damaging heart attack. He lacks any blood flow, so the EMTs declare him dead. Shocked, he fluctuates between slightly dead and more dead. The ambulance volunteers bring him to Northern Westchester’s cath lab.

Unafraid, he sees The Light. He meets Moses carrying tablets down Mt. Sinai, greeting newcomers going up. Relatives weigh his mitzvahs: pro bono work with clients, sick friends, nursing home visits. The judge calls his wife to the witness stand. She says, “He should live.” They await the verdict.

 

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“You Need to Stop Drinking”

Early in my family medicine residency, I admitted a woman to the hospital for complications of alcoholism. She was young. She didn’t look like a chronic alcoholic. She continued to work. Even her fingernails were polished. Yet she had alcoholic pancreatitis. She was in severe abdominal pain and was vomiting uncontrollably. As the level of alcohol in her body dropped, she started to shake, indicating withdrawal. We admitted her for intravenous hydration and detoxification from alcohol.
I felt drawn to her; she was someone who, like me, had made wrong choices. I wanted to do my best for her.  Her physical symptoms improved quickly; she would only be in the hospital for a few days. Her real problem was the alcoholism itself. She acknowledged that. She was ready to change her life.

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Desperate Measures

Desperate Measures

In my very first job as a doctor, working in a London hospital in the 1980s, I always took a ridiculously detailed past medical history for every patient I saw. I started to notice how many elderly women had had septicemia, a life-threatening infection in which enormous amounts of bacteria enter the bloodstream.

The neighborhood surrounding the hospital had once been the worst slum in London, and it didn’t take me long to guess that these infections were probably caused by illegal self-induced abortions during the hungry years of the Depression.

When I asked–slowly, carefully, subtly–I was told some intensely personal and secret stories.

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Breadwinner

Breadwinner

The first thing I notice are the dark circles under Mr. Jones’s eyes.

It’s 4:30 pm on a Wednesday during my third year of medical school. I’m in the fifth week of my family-medicine rotation, and we’re deep into our daily routine: triage, history, physical examination, differential diagnosis, present the case to the attending physician, repeat.

Mr. Jones is a new patient. His face and belly are round, his arms and legs lanky. His unkempt facial hair and calloused hands reflect a life of physical labor that has worn him down. According to his chart, he’s just started an office job. Slumped apathetically in a chair in the corner, he seems apprehensive and hesitant to talk to me. Understandably so: I’m a stranger with the word “student” attached to my name.
“I can’t remember how long it’s been since I’ve seen a primary-care doctor,” he begins.

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The Third Wheel

I am trying to move the language from forever to this moment, in the aiport departure lounge. To loosen up on declaring “You’re always” and “You’re never” and instead say “Right now you are …”

I might think I know what’s coming, but I have no idea exactly what it will look like and when it might happen. For now, the “what ifs” are not dormant, but also not dominant. Regardless, an illness becomes an uninvited third person in a two-person marriage.

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