Geez. This is my first blog since I started my residency training in Hawaii six months ago. I don't know if anyone really reads these things anymore... but I guess I'm writing this more for myself than for anyone else anyway. Being a doctor these past 6 months has been the hardest thing I've ever had to do. The medicine actually, is the easy part. Its keeping your sanity while working over 80 hours a week and being on call every 4th night... that's the part that sucks. I feel both sad and nostalgic every time I step through the hospital doors on to the wards. In the words of Death Cab, hospitals are places you go to say "good bye." I've seen a lot of people say "farewell" to loved ones these past few months. Some do it quietly, and others you can hear from clear across the hall. But I can't stop thinking about Ellen and Henry (whose names have been changed for patient confidentiality) and how they said "good bye."
Ellen was old and sick. It was as simple as that. Every time she came into the hospital, it was for something I was morbidly certain would end her life. This time it was pneumonia. Ellen's husband was Henry. He too was frail and weak but somehow still able to get around. And both of them were blissfully demented.
Ellen wasn't a good "eater". We did several "swallowing tests" that showed food backing up into the esophagus with every sip of water or bite of food. Like a sink that didn't quite drain all the way, food particles would eventually backup from her esophagus into her lungs where she would develop some horrible infection. It's termed "aspiration pneumonia" and with every day she seem to get worse.
Henry seemed to disagree. In actuality, he seemed completely unaware of how this wife was fairing. I know I should've tried harder to tell him, but I just didn't have the heart. Every single day, Henry came at noon with a small lunch box filled with soup and rice porridge, food he had faithfully prepared the evening before. And every afternoon he sat next to her bedside, spoon in hand, feeding her with the patience of a zen monk. It was heart wrenching to see him feeding her knowing that with each spoonful of nutrition that Henry delivered, Ellen was at an incredible risk of aspirating the fluid into her lungs thus making the pneumonia worse. But thats how he loved her. We all mentioned to Henry how feeding Ellen was dangerous, but Henry was so diligent.
Ellen died not too long after this. The pneumonia made it difficult to breath and she passed away peacefully in her sleep. I think about Henry and Ellen often. I always imagine seeing Henry with his plastic white spoon and Ellen lying in bed unwilling to have anyone else feed her. In the beginning, I just assumed them both demented beyond the reach of reality. But looking back, I wonder what Ellen was thinking in her last moments. I don't think Ellen knew anything about aspiration pneumonia or how each spoonful of food she ingested was a life-threatening action. But I'd like to think that every day with each meal, Ellen knew that she was being loved. Ellen died knowing beyond a doubt that Henry was never going to leave her side. In my experience, people who die are usually most afraid of dying alone. Ellen died unafraid.
There's days that I think about Ellen and Henry. Some days I wish that I could be Henry. And some days I wish I could be like Ellen. Find some way to remind her everyday that you love her even when it hurts.
I'll be in San Diego till Mother's day for the eager arrival of my second nephew. Anyone in town who wants to hang out in socal? Gimme a holla.
Anyone want a kiss? I'll also be Graduating from medschool on the 18th of May. If any one is interested in coming out to see me walk in Pennsylvania.... don't. It sucks out here. Pennsylvania was founded before fun was invented because its not. My absolute favorite thing to do out here is friggin' leave. If you REALLY insist on coming out to see me, find a pile of horse poop and shove your nose it in for a few hours and then you'll get a general feel of how much it sucks to be here. Otherwise, I'll look forward to seeing you all before the big move to Hawaii (which incase you don't know, is way better than Pennsylvania).