Start any day on Palliative Medicine, and you already know that your day is anything but that which you might otherwise predict.
Family meeting, half past nine, but no family there.
Move on to the ten o’clock family meeting, son there, not the daughter. Try to squeeze in a follow-up, only to find that that patient is down in radiology. Back to the half-past-nine, hoping against hope, in this, this our own mission of hope…
Our days, our agendas, we all know, are fluid.
We start with lists of patients. We plan to see most in some timely manner. And then…
Lovely woman, 58 years old. Her husband at the bedside.
She had come in with pain, pain in her fingertips, with, studies confirm, micro-embolisms in those fingertips.
Only ten days earlier, however, she had learned of her Stage IV lung cancer, she still absorbing that.
Radiation not an option. Chemo still out there, waiting, waiting for the oncologist to call the score.
“They give me a year,” she tells me and tells the nurse with me. “And that, that, they say, is generous,” tears starting.
Her husband, now and all this time, stoic, even as we continue to talk, talk about those things no one wants to talk about. His chin, once or twice in all that time trembling, the weight of her future, theirs, all at once nothing but that, a weight.
And then from nowhere…
“I do love you,” she tells him, her eyes, her eyes brimming with tears. “I just never told you.”
All at once, his eyes turning to hers.
Hers to his.
His surprised.
Decades married. Two adult children.
And love.
Love this very afternoon, a surprise.
Friday, August 26, 2011
Thursday, August 11, 2011
Letting go…
She is eating her lunch, as I interrupt that lunch.
Yet, she, she already knows.
Already knows that some kind of cancer, maybe lung from above, maybe pancreatic from below, has already charted a path from here to tomorrow. A path other than the one she and her husband of some fifty years might otherwise have wished, have ever imagined.
Still, here I am, the palliative care physician, the one echoing the oncologist’s bad news.
The patient herself, frail, gray hair cropped short, quietly forking food to mouth, mostly ignoring me, anything I have to say.
And her husband—her husband now of decades, his love so very obvious, so obviously obvious. Even as he, like so many men of any age, tries to make that love, any love, seem somehow less noticeable. At least to eyes, any eyes, especially eyes, eyes as inquisitive as mine.
And he, to my eyes, losing already what he never envisioned losing.
Looking to me, then quickly to her.
And his eyes—oh, my God, his eyes—his eyes right now damming tears, even as those eyes redden, their lids swell. And he struggling to keep me, the nurse with me, from ever, ever noticing.
How to give up what we love…
I myself love poetry.
Love the interplay of word with word within any given line.
Love line tumbling after line, those lines forming a stanza, stanzas a poem, the poem itself music. The music that of my life, your life, all lives.
To lose it, that poetry, is, in a sense, to lose life.
But to lose those we love…oh, to lose those we love…
My own loved mother, dead at 49 of breast cancer. My father, loved at least as much, gone at 66 of pancreatic cancer.
Their ghosts, their ghosts in the room, this room, this morning, with me.
Their own son, these decades later, still freighted himself with those memories.
And me now, talking to this woman, her husband.
Me, thinking at the same time, of all I myself have ever lost. And, at the same time, all I still have.
My wife Karen, our children; my siblings, Karen’s; that next generation, the one extending ours.
All of us, hope against hope, tumbling day after day, no less than those lines of poetry I love. Lines rippling iambically or otherwise one after another. The music, that music. That of lives, mine, yours, ours, everyone’s, now and forever.
And still, she, this patient, fork to mouth, no eye contact whatsoever.
And her husband, straddling some moto-chair, cowboying his own emotions: ignore this, his body seems to say; ignore this, like all those rashes ignored this life long, like any and all colds.
And maybe, just maybe, everything, all this, will, will just go away.
But those eyes, his eyes…
Those eyes…
Those eyes pooling tears even as they say what ineluctably is:
“This will kill you, my love, you I have loved so long, these fifty years.
Kill you no less than any knife, the gun in any murderer’s hand.
You, my lover, you I held so often, so long. Mother of our children. The woman, the woman I remember young, so very young.
The murderer here, the murderer it has always been, the murderer life itself.
And all you love, all I love, all who ever loved you, ending in some instant.
Some instant so soon to come.
A moment you, I, those you love, are now cruelly left to imagine…"
© 2011, Dónal Kevin Gordon
Yet, she, she already knows.
Already knows that some kind of cancer, maybe lung from above, maybe pancreatic from below, has already charted a path from here to tomorrow. A path other than the one she and her husband of some fifty years might otherwise have wished, have ever imagined.
Still, here I am, the palliative care physician, the one echoing the oncologist’s bad news.
The patient herself, frail, gray hair cropped short, quietly forking food to mouth, mostly ignoring me, anything I have to say.
And her husband—her husband now of decades, his love so very obvious, so obviously obvious. Even as he, like so many men of any age, tries to make that love, any love, seem somehow less noticeable. At least to eyes, any eyes, especially eyes, eyes as inquisitive as mine.
And he, to my eyes, losing already what he never envisioned losing.
Looking to me, then quickly to her.
And his eyes—oh, my God, his eyes—his eyes right now damming tears, even as those eyes redden, their lids swell. And he struggling to keep me, the nurse with me, from ever, ever noticing.
How to give up what we love…
I myself love poetry.
Love the interplay of word with word within any given line.
Love line tumbling after line, those lines forming a stanza, stanzas a poem, the poem itself music. The music that of my life, your life, all lives.
To lose it, that poetry, is, in a sense, to lose life.
But to lose those we love…oh, to lose those we love…
My own loved mother, dead at 49 of breast cancer. My father, loved at least as much, gone at 66 of pancreatic cancer.
Their ghosts, their ghosts in the room, this room, this morning, with me.
Their own son, these decades later, still freighted himself with those memories.
And me now, talking to this woman, her husband.
Me, thinking at the same time, of all I myself have ever lost. And, at the same time, all I still have.
My wife Karen, our children; my siblings, Karen’s; that next generation, the one extending ours.
All of us, hope against hope, tumbling day after day, no less than those lines of poetry I love. Lines rippling iambically or otherwise one after another. The music, that music. That of lives, mine, yours, ours, everyone’s, now and forever.
And still, she, this patient, fork to mouth, no eye contact whatsoever.
And her husband, straddling some moto-chair, cowboying his own emotions: ignore this, his body seems to say; ignore this, like all those rashes ignored this life long, like any and all colds.
And maybe, just maybe, everything, all this, will, will just go away.
But those eyes, his eyes…
Those eyes…
Those eyes pooling tears even as they say what ineluctably is:
“This will kill you, my love, you I have loved so long, these fifty years.
Kill you no less than any knife, the gun in any murderer’s hand.
You, my lover, you I held so often, so long. Mother of our children. The woman, the woman I remember young, so very young.
The murderer here, the murderer it has always been, the murderer life itself.
And all you love, all I love, all who ever loved you, ending in some instant.
Some instant so soon to come.
A moment you, I, those you love, are now cruelly left to imagine…"
© 2011, Dónal Kevin Gordon
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