The Patient in Room Nine Says He's God

by Louis Profeta

  “…and once you leave the ER you still help the needy…just devoid of these same emotions you have at work,” he interrupted. “Let me ask you something, Louis…which do you think is tougher?”

  “What do you mean?” I inquired.

  “Which is tougher…being charitable, availing yourself of time and energy because you have a deep-seated spiritual mission or emotional attachment to the cause, or doing the same without that feeling of religious or spiritual self-fulfillment?”

  “The latter, I suppose.”

  “Hell yes, it’s the latter. Besides, you need to turn that empathy stuff off sometimes, except perhaps for your family and those closest to you…understand?”

  I smiled, understanding what he was getting at. The recipients of my benevolence were not dissimilar to those receiving mission aid in the Sudan. It made sense. God does not care how I feel about this, and for the most part, it doesn’t cross the mind of the poverty-stricken child, my family, friends, and so on. They just need. It’s not about me…it’s about them. The starving kid doesn’t consider the degree of spiritual enlightenment that seeps from the pores of the family in Lagotee, Indiana each time they sign and send that check. He just wants the clothes, the food, or a roof over his head.

  Suddenly, I felt a huge sense of accomplishment and looked at myself in a whole new light. It would be so easy to render assistance on my free time if I truly had a spiritual motivation to perform these simple deeds, but all along I had been giving of my time regardless. I was giving just because that is what you are supposed to do, like holding a door for a stranger or thanking the waiter. Somewhere deep in my soul, in my very being, I was doing what was right regardless of my own personal feelings. Where it came from…I don’t know. It certainly was a compilation of life experiences, good parenting, solid teachers, and role models sprinkled with a touch of the divine. So, for the first time in years, I stood a little straighter and thought to myself, “Maybe I’m not such a prick after all.”

  Chapter Twenty-two

  The Tylenol Anniversary

  I am not at all amazed at the longevity of some marriages. I am more amazed at how few marriages actually survive. It seems that so few people take their promises and commitments seriously. I love caring for patients where the husband and wife proudly proclaim fifty, sixty, even seventy years of marriage and devotion. It is even more gratifying when both still have their faculties into their eighth and ninth decades, and leave holding hands, arm in arm, caring for each other with the gentleness of a mother and child. The dynamics and interactions between spouses in the extreme age group are godly in the purest sense. There is unselfishness there that can be found nowhere else. It is a place where time stops, and the world only exists between the two of them—and I’m just some young tourist guide giving them directions on how to eke out a few more months or years, or simply how to get Herbert to pee more easily.

  I know there are paper, wood, silver, gold, and diamond anniversaries, but I think there should be a Tylenol anniversary, too. It should be the ‘get out of jail free card’ of marriage. You’re allowed one bad year every seven to ten, or so—a year when things don’t go so well: perhaps with health, finances, or simple interpersonal relations. The Tylenol anniversary would come to symbolize all the headaches you caused each other over the past year. It would serve to acknowledge those aches and pains of growing together, all those lean moments when everything was not all roses. It would reflect those years when pain was more prevalent than passion, when fear was more common than faith. I think every marriage could use a year like that, unless of course you and your wife see the problems of life as just another opportunity to find closeness in each other’s company. These partners need no help or panacea for what ails them; they just need each other, even if it involves months and years in the hospital.

  I came to know Sandy when he was lying in the Coronary Intensive Care Unit of Presbyterian Hospital in Pittsburgh. I was on the medicine service that month and took care of the patient in the room next to him. Sandy was not my patient, but somehow I struck up a conversation with him and his wife, Arlene, quickly becoming fascinated with the undying commitment they had to each other. Sandy was a victim of what we call piss poor protoplasm. He just had bad genes.

  Premature heart disease, though he had led a fairly healthy life, made him a victim of multiple heart attacks early in his thirties. This left his heart irreparably damaged, and now years later he was in need of a heart transplant. Unfortunately, his tissue and blood type made it quite difficult to find a donor, and he was too ill to wait at home. So, he lay in a hospital bed for months and months on end. At times, he was dependent on a balloon pump (a large plastic tube sewn into the main artery of the groin) to help his feeble heart maintain some semblance of function. He was sallow in color, always looking on the verge of death, and was a thin-waisted Nosferatu or vampirish shell of a younger man I always imagined him to be.

  Amazingly, though, he never complained. He just loved being alive, even if living meant being confined to a geriatric chair and a hospital bed. Sandy always had his wife at his side, never leaving his room. She not only served as an extra caregiver but was his rooting section, his confidant, keeping his spirits up, imploring him not to give up, and fighting for each and every second she could spend with him. Weeks turned to months, coalescing into years with the same activity day after day.

  Arlene would spend the night at the nearby Holiday Inn, arriving at the hospital early in the morning and leaving late in the evening, usually with no real news on when a donor would be available or what Sandy’s chances were to find one. When I was at the hospital or on a service that brought me near the CCU, I would come by and visit. I even stopped in with my own wife once to introduce her to this amazing couple. Sandy was always so alert and engaging that it was hard to tell he was using up his last few heartbeats. Even when he was most ill, he always had a smile and was grateful to just have visitors, friends, and most of all, a spouse who was there, no matter what the time or day. Thus, when it came time for Arlene to leave his side for a few days, it was very hard and very emotional for both of them.

  Their daughter was graduating from college—Cornell to be exact—and Sandy, who had been an English teacher in a previous life at Theodore Roosevelt High School in the Bronx, felt it was important for one of them to be there to celebrate this educational achievement. Arlene packed a small suitcase and hopped a plane at the exact moment that the heart donor, for which they had waited nearly seven months, was declared brain dead. Thus, the miracle for which they had been languishing for so many months was becoming a reality—a healthy heart for transplant into Sandy’s dying chest. On the same day that his daughter would graduate from college, Sandy himself would graduate to the world of the standing and walking living.

  It was around 2:00 A.M. when my wife and I were awakened by a phone call. Sheryl answered in a semi-sleep state. She heard a raspy voice on the other end of the phone. She quickly hung up, thinking it was a prank call. The phone rang again, and this time I answered.

  “Louis . . . this is Sandy,” the weak, hoarse voice called out to me.

  “Sandy . . . what’s up . . . what’s going on?” I was surprised he was calling me so early. But there was a sense of urgency in his voice that said: this call is important.

  “Louis . . . Arlene went out of town for our daughter’s graduation, and wouldn’t you know they found a donor . . . I’m going into surgery in about an hour . . . and if I don’t make it . . . well, I wanted to thank you and Sheryl, and tell you how much I love and appreciate all you have done for me.”

  I was speechless for a second. My wife was listening in on the other line, her hand cupped over the receiver.

  “Sandy . . . you’ll be fine . . . I know it. I have all the faith that you’ll pull through.” I gave him a few more comforting words, and then gently hung up. Sheryl returned to the bedroom and put her arm around me.

  “He’s scared . . . poor guy, isn’t he?
” I nodded. “Well, you need to go in and see him off to surgery. I’ll go with you,” she said, imploring me with a small degree of her own excitement. I looked at her, knowing that she was exactly right.

  We quickly threw on some sweats and hurried downtown to Presbyterian, arriving in the CCU just as they came to take him to the OR. A sense of relief and a smile crossed his face and filled the room. “You didn’t think we’d let you go to surgery without wishing you good luck, did you?” I asked.

  Tears filled his eyes. He could barely speak as he nodded and grabbed our hands with all the force his weakened body could muster.

  “You’ll be fine,” I reassured him. “I’ll be here when you wake up . . . both of us.” And with that, gowned orderlies silently lifted his fragile frame onto the gurney, and they left for parts unknown.

  We headed home to grab a few hours of sleep. I returned about six hours later to see Sandy in the postoperative ward. I remember thinking that even on the ventilator, with all the tubes and IV pumps, monitors, and lines attached to him, he looked better three hours after major surgery than he had in all of the time I had known him.

  You could just see that the new heart was thunderously pumping blood to muscles, skin, and tissue that were barely being fed by his old diseased heart. He looked full, healthy, and pink. I knew he would see many more days.

  Sandy’s own father had died at age fifty-five, so Sandy held out in Pittsburgh until he was fifty-six just to be ‘safe’. Shortly after his birthday, he gathered his belongings, clutched his wife to his new heart, and returned to the Bronx, to a home on a small street called Deb’s Place.

  A few more months passed before Sandy returned to see his physicians in Pittsburgh. He called me for dinner. When we met, I was struck by how tall he actually was. You see, I had never seen him standing up. He was strong and lean, having filled out his previously sagging skin and muscle bundles. He looked like a human being again. And as it was to be expected, Arlene clung to his side, so grateful to be in his presence, side by side—together. For six and a half years, Sandy did superbly, his borrowed heart beating strong in his chest. Unfortunately, as can happen, the anti-rejection medications took a toll on his kidneys. Once again, he found himself on a transplant list; this time it was for a new kidney.

  The next six years were a mixture of treatment failures and successes, hospitalizations, surgeries, infections, and the accompanying laughter and tears, ultimately ending in his death. He spent a total of three and a half years in the hospital as his kidneys and finally his heart failed, and Arlene spent most of this time with him, save for the nights in the Holiday Inn.

  “Do you think, if he could have done it all over again, would he have gone through the six years of dialysis, infection, pain . . . the treatment failures?” I asked Arlene after his death.

  “Absolutely . . . why do you ask?” she responded, almost incredulous.

  “Well, to be honest, most people would give up and say: I can’t take this anymore . . . it’s not worth it. I mean, did Sandy ever say this to you?”

  “Never,” she replied bluntly, without a hint of reservation.

  “Why do you think that is?”

  “Because he wanted to live; he wanted to be here for the children, and . . . he wanted to be here for me,” she said, her voice cracking. “He once told me, during the three years of hospitalization and being the sickest, that they were some of the best years of his life, because we got to be so close and spend so much time together, just the two of us . . . you understand?”

  I remained silent for a while. “I do . . . now.”

  A while back, I had major shoulder surgery and was confined to bed for two weeks, and I was unable to drive for a couple of months after that. I was dependent on my wife to feed me, bathe me, and drive me around town, and so on. It was humiliating on one level, but then I noticed how much extra time I was able to spend with her, and how much I needed her, not only for physical but for moral support. I appreciated how she was not only my partner in health, but in sickness too. I am thankful for those extra, inappreciable moments in time when it was just the two of us. We just celebrated our fifteenth anniversary by having dinner with our kids. I bought her flowers and a series of cards expressing my love and devotion. Even though it was a miserable year full of shoulder pain, surgery, and other maladies, I still think I’ll hold off on cashing in on the Tylenol anniversary. Because, when it comes down to it, any year you get to spend with your wife and kids, no matter how bad it gets—well, that’s a God-given gift, and a golden anniversary.

  Chapter Twenty-three

  Honor Thy Mother and Father

  “Don’t trust anyone over 30.” This famous mantra of the 60s has created a generation-gap catastrophe that can be felt in every hospital, nursing home, and ER in America. The result is one of the hidden disgraces of modern society. These few words have given rise to a cultural chasm separating baby boomers and their parents, and now boomers and their children. It might account for more interpersonal angst than any phrase in America’s history, which has left us on the verge of moral bankruptcy and has flooded our nursing homes with the not-so-dead as the dumping ground for those who just don’t know how to care.

  The chain of events is easy to follow. Somewhere around 1960 or so, a 40-year-old father gives his 18-year-old son some advice, the content of which doesn’t matter. The 18-year-old son, who has been fed a diet of ‘don’t trust anyone over 30’, tells dad to “go to hell,” or “you don’t know what you are talking about.” Over the years, the 18-year-old son, or daughter, grows into a 40, 50, and 60-year-old. And because the seeds were sown for the ‘I’m-smarter-and-wiser-than-you’ weed, they never really develop the heart to heart, father to son, mother to daughter relationship that should end with child opening his home to the same parents that gave him or her life. They have not assumed the responsibility to nourish the very parents who fed them, clothed them, and nurtured them into self-sufficiency.

  Instead of gradually and gracefully evolving into the role of the patriarch and matriarch of the family, they are thrust into that role by way of an illness or injury that robs mom or dad of their independence. Instead of slowly assuming the mantle, they kept a safe distance and then were suddenly appointed by way of a stroke, heart failure, mother’s hip fracture or any one of a hundred illnesses or injuries that now put the ‘burden’ of care on the children. Sometime after 1990, the word ‘burden’ replaced the standard lexicon of ‘responsibility’, and parents went from being keepers of our pasts and guides of our future to problems we needed to sequester away in long-term care facilities.

  So 80-year-old dad who fought in Normandy, and 80-year-old mom who rationed sugar and flour and sold war bonds are left to the impulsive healthcare whims of children who rarely make decisions greater than deciding: who picks Justin up at soccer practice, what color to paint the guest room, and should we opt for a 24- or 36-month lease? For thirty or forty years, these children have been removed from really talking, caring, and communicating with their parents. Grandma and Grandpa have simply become the home where one goes on the holidays. Once the baton was passed, they dropped it like a rattlesnake, right into the lap of the local ER or nursing home, and in its wake the spawn of the baby boomers is learning that the best way to care for their own parents is to have a nursing home on speed dial. The now grown-up boomer attaches a phrase like, “It’s in their best interest,” and ship mom or dad off to faux plantations with names like Sunny Acres, Oak Village Care, The Manor House, or Green Meadows.

  Once the child said, “I don’t trust you,” the parent-child dynamic became something else, and the baby boomers became lost sheep in a wilderness of scrutiny. And for some forty years like Moses in the desert, they have been wandering and searching, and wandering and searching. And still they can’t see that the answer to what they are missing lies not in a self-help book, or in a rerun of Oprah , but in the aging arms of their parents. For a while they tried to find comfort and solace in the coun
try clubs, the PTAs, the soccer fields and baseball diamonds, and a host of after-school activities and overindulgences of their own children. But something predictable happened. Just around the time they insisted that the friends of their children call them by their first names, their own kids looked at them and said, “I don’t trust you.” So what did the boomers do? They finally turned to talk to their own parents only to find that their eyes had slowly failed, their minds were not as sharp, and the passing years had faded from their memory. Once their own kids left for college, or fled to go backpacking across Costa Rica, they found themselves alone, usually in marriages that barely represented what their parents had.

  My grandmother lived under my parent’s roof for some forty of her 94 years of life. She had her own small kitchen that she would stink up with burnt fish and onions. On the stove sat a small copper Turkish coffee pot, blackened and scorched by years of thick coffee. In her later years, she would forget my name, pass gas in public, forget to shave her facial hair, walk around the house in a bra, but I loved every minute of it (except the whole bra thing). She died with us holding her hand, in the comfy recliner that had become her bed for the three months preceding her death.

  I know that there will be all sorts of excuses for why this arrangement will not work for some. Mom is too sick, dad won’t feed himself, she can’t walk without assistance, etc., etc., etc. Well, you can justify any sin, of omission as well as commission, if you try hard enough. When it comes to caring for elderly parents, people are only limited by two things: creativity and drive. There are, however, a few ground rules that need to be agreed upon beforehand to ensure that the transition is seamless. The most important being: when you stop eating, you will die. This is the necessity that all physicians understand, but most ignore and bury in the recesses of their treatment plans.