Saturday, June 13, 2009

Caterpillar to Butterfly

I walk in the room and see a husband and wife sitting on opposite sides of the exam table. I've seen him before. He's a gentle and sweet African American man. I've never seen his wife, my patient today. She has a heaviness about her; brows furrowed, shoulders slumped. I start talking about her medical issues and she asks her husband to leave the room.

"You look depressed. Do you feel sad about something?" I ask her. I have no idea what will unravel. She tells me her aunt recently passed away. She passed away two years to the day after her mother passed away. "I visited my aunt in Tennessee before she died. She didn't know who I was." She continues her story in a monotone voice telling me she doesn't understand why this woman would die on the same day as her mother. "Why would God do that? My mother and aunt were so close. They were best friends." I tell her that hospice workers notice people holding their death for a special day. "Maybe she chose this day so she could be with her best friend. Maybe this is the day SHE wanted to die," I tell her. She looks down and then back at me. "I never thought of that. Is that really true? People do that?" "Yes" I tell her. "It's true" She waits a few moments and then says, "I like thinking of that. My heart feels better than it's felt in two years."

As some sadness lifts from her heart, she now smiles and sits up taller. She begins the story of her childhood. "My mother was fierce and wonderful" she tells me, eyes now sparkling. She tells me she grew up in Memphis and her mother and aunt took her to civil rights marches. She was a little girl when they took her to hear Martin Luther King speak. She says kids were at the marches to protect the adults from being attacked by dogs. She looks at me in the eye and speaks slowly and deliberately. She's drawing me into your childhood. I'm convinced to pay attention. She remembers being a little girl at a civil rights march. A dog was growling at her, pulling on the leash ready to attack. At the other end of the leash was a "mean son of a bitch looking cop." She says, "I can still remember thinking that dog was going to attack me. I dream about it sometimes." She tells me how much white people did for them. "They put their lives on the line for us and they didn't have to do that. They haven't been thanked enough for what they did. I really think so. They need to be thanked. We couldn't have done it without them." She continues, "My mother always loved Tony Bennett and so do I. He wasn't afraid to be a part of the civil rights movement."

She's animated now and looks like a different person than she did ten minutes earlier. "I remember when we were first allowed to go in a store through the front entrance. People were still afraid to do that so not many people did. But my mother? She would roll her shoulders back (she sits up tall and demonstrates her shoulders rolling back), grab my hand and we'd walk proudly through the front door." I find myself fighting back tears. I want to stay all day and listen to her.

She tells me her kids have no idea how lucky they are. They say, 'Hey dude, whatever.' "They don't know how they got here. "They think they've always had it this good," she says. I tell her she needs to write these stories down. Write them down for her grief, for her children, for all of us.

She tells me she has never told these stories out loud and thanks me. I tell her she has given me a gift, sharing something so intimate to her. We hug each other and both have tears in our eyes. We have come from two different backgrounds, fighting for the same cause, meeting in a clinic room, embracing each other. I walk out of the room and feel like I've gotten up too fast. I'm lightheaded and in a daze. I've been listening to greatness, something so wonderful and deep. I stepped back in time and now I need to adjust to life on the other side of the clinic door. I've watched a caterpillar turn into a butterfly before my eyes. I realize she has so much more to say.

She and her family helped change our country. Her mother was "fierce and wonderful" and together they fought a fierce and wonderful fight. They helped us elect the first African American president. This warrior is poor and has no health insurance and that isn't right. I can't stop thinking about her.

Saturday, June 6, 2009

Knife Attack

He's 22 years old and a new patient to the clinic. He's hispanic with a crewcut. He's wearing shorts, sandals, and an undershirt. He's here with his mother. He says he needs to have a knife wound repacked. As he takes off his undershirt his mother winces and looks away; I drop my jaw in amazement. His abdomen had been filleted open and after a long surgery is now stapled shut. The wound extends from below his breastbone to his pubic bone, about 12 inches. "Can you take out these staples?" "Oh no, you need to go back to the hospital for that", I say. I see a bandage taped on his left side and a long gash on his left arm which is closed with stitches. "What happened?" I ask as I inspect how perfectly his core had been stapled shut. "I don't know man. I don't really remember. Some guys came at me with a knife." His mother winces some more and says, "I have hard time looking." Spanish is her first language. 

He says he drove to his mother's house after he was attacked outside a Mexican restaurant and then was taken by a medic to the hospital. "You drove?!" I imagined his guts spilling out in his car. "Your car must be full of blood." "Yeah man. The cops have my car now. Do you think I'll get it back?" "So you were able to drive to your mom's house but you don't remember who attacked you?" It occurs to me I'm not the only one to ask him that. When the police questioned him in the hospital they must have said the same thing to him 15 different ways. 

He was put back together at a county hospital which is also a trauma center. This kind of attack, unfortunately, isn't new to these doctors. I imagine a young doctor, anxious for the trauma training, hurrying to be the first to scrub in. Stomach, spleen, liver all closely inspected for damage, guts put back to their proper position, then meticulously stapled shut. 

"Can you pack this wound again for me?" pointing at the bandage on his left side. "The nurse at the hospital told me it's 7 inches deep." (Wounds like this need to be repacked everyday so they can heal from the inside out). He tells me his mother feels sick when she does it so he does it himself. I pull what seems like an endless amount of gauze from his side. His wound looks good. He's done a good job these last couple days. I clean it and repack it. As I push the packing tape in, I don't feel any resistance for just about 7 inches. Then, finally, I can't put anymore tape in. I clean the gash on his arm and rebandage it. I send him home with enough supplies to pack his gaping hole by himself over the weekend, keeping in mind that most people wouldn't be able to do this on their own.

A drug deal gone bad? A gang attack gone good? A random slaughter? For a moment I put myself in his mother's place, one of my kids brutally attacked with a knife. But then as quickly as I'm in her shoes, I'm out. It's too unimaginable.