He’s only 25 years old. My daughter’s age.
But he’s dying, and there’s nothing I, just one of his doctors, can do to stop the dying.
We’re talking a good kid, a kid until March just living his life.
A kid not unlike most 25-year-olds.
Not unlike my daughter, my own 25-year-old daughter.
Hanging with friends. Living. Loving Iowa’s Hawkeyes. Never thinking the inevitable. Until three months ago, when a foot drop signaled, not just a problem, but the inevitable.
His tumor, his glioblastoma, is right now doing what glios do.
Making his brain its brain.
Short-circuiting everything that makes any 25-year-old a 25-year-old, let alone anyone, anyone.
But his smile.
His smile makes you think that tomorrow could truly still be tomorrow.
With all the promise of another day.
Another day to go to classes.
To text friends. To catch a round of ultimate Frisbee. Complain about cafeteria food. Wonder who that girl is. Whether she might be his.
But the boy, this boy, is dying.
And this morning, this boy—and, Lord knows, he’s still but a boy—curled to half his height in the bed, so soundly asleep after radiation that I cannot wake him, his shaved head the only glimmer in the darkness of this, his room, too likely his last room.
“I don’t get to make the rules of the world,” I tell him, one hand on his, the other on his shoulder. “If I did, you wouldn’t be here…you’d be doing what my own kids are doing. You’d be just twenty-five…doing what 25-year-olds do…”
Again, that smile.
That smile, in that darkened room, even if then just half a smile, a night-light from the door to his bed.
And, at light’s end, this boy, curled in that dark around this, his unwelcome death…
© 2011 Dónal Kevin Gordon
Sunday, June 12, 2011
Saturday, June 4, 2011
I Don’t Want to Die…
Who does.
Not you. Not me.
At least not yet.
Most patients I see in the course of most weeks, even if dying, only want to go home. Whether to some home you and I might think of as home; whether to a care facility; whether to the care of some caring son, daughter, sister, or, even more poignantly still, a mother, a father.
One and all, those patients all want to go home.
And you, who, wouldn’t?
Your home. Your room. Your bed. Your death. Your way.
For those of us in the business of shepherding the dying, ours is too often about the shepherding.
The dying itself is, after all, for the dying themselves.
Far be it from us to intrude.
And yet we do.
Want this?
We’ll crush your chest; we’ll crack your ribs. Not like TV, I tell patients.
Want that?
That tube down your throat. That tube to a machine. And you no longer you afterwards, even if you are, somewhere, still somehow you.
I don’t want that, most say.
“I’m 87,” one tells me, just the other day. “I’ve lived a long life. I’m done.”
And who am I, the palliative care doc, to say otherwise?
I’m not 87.
I’m not willing to say that my life, at almost sixty, is a long life. I don’t yet know when done is done.
Her choice, then, is not my choice.
“And if you die now. If you stop breathing now. If your heart all at once falls silent…”
Then, by your choice, I, standing nearby, stand nearby.
Watching death do what death does…
Me, cradling the rope to your small boat…
The pond beyond. That larger pond. And my hand opening…
The rope slipping from hand, my hand, slipping from my hand for good…
For good.
Surely, for good…
© 2011 Dónal Kevin Gordon
Not you. Not me.
At least not yet.
Most patients I see in the course of most weeks, even if dying, only want to go home. Whether to some home you and I might think of as home; whether to a care facility; whether to the care of some caring son, daughter, sister, or, even more poignantly still, a mother, a father.
One and all, those patients all want to go home.
And you, who, wouldn’t?
Your home. Your room. Your bed. Your death. Your way.
For those of us in the business of shepherding the dying, ours is too often about the shepherding.
The dying itself is, after all, for the dying themselves.
Far be it from us to intrude.
And yet we do.
Want this?
We’ll crush your chest; we’ll crack your ribs. Not like TV, I tell patients.
Want that?
That tube down your throat. That tube to a machine. And you no longer you afterwards, even if you are, somewhere, still somehow you.
I don’t want that, most say.
“I’m 87,” one tells me, just the other day. “I’ve lived a long life. I’m done.”
And who am I, the palliative care doc, to say otherwise?
I’m not 87.
I’m not willing to say that my life, at almost sixty, is a long life. I don’t yet know when done is done.
Her choice, then, is not my choice.
“And if you die now. If you stop breathing now. If your heart all at once falls silent…”
Then, by your choice, I, standing nearby, stand nearby.
Watching death do what death does…
Me, cradling the rope to your small boat…
The pond beyond. That larger pond. And my hand opening…
The rope slipping from hand, my hand, slipping from my hand for good…
For good.
Surely, for good…
© 2011 Dónal Kevin Gordon
Wednesday, May 25, 2011
Over the Rainbow
I am, I know, as I slip up on sixty, entering the age of imminent death.
Indeed, on any given day when I see palliative care patients, some, sometimes most, bracket my own age. Ordinary people living ordinary lives, no different than me living mine, than many I know or love, until life tosses a stick into the spokes and sends them over the handlebars.
Such a spill, in younger days, only meant scrapes that soon scabbed and healed.
But in my world now, over the handlebars too often means over the rainbow.
And bluebirds?
Not sure.
As for dreams that you dare to dream, all that’s important is all that ever was important, that they really do come true.
Which, of course, makes dreams still worth their dreaming.
And time, time all the more to cherish.
As in this, this very moment…
© 2011 Dónal Kevin Gordon
Indeed, on any given day when I see palliative care patients, some, sometimes most, bracket my own age. Ordinary people living ordinary lives, no different than me living mine, than many I know or love, until life tosses a stick into the spokes and sends them over the handlebars.
Such a spill, in younger days, only meant scrapes that soon scabbed and healed.
But in my world now, over the handlebars too often means over the rainbow.
And bluebirds?
Not sure.
As for dreams that you dare to dream, all that’s important is all that ever was important, that they really do come true.
Which, of course, makes dreams still worth their dreaming.
And time, time all the more to cherish.
As in this, this very moment…
© 2011 Dónal Kevin Gordon
Sunday, May 15, 2011
“Don’t put me out with the trash…”
His smile meets mine from the corridor, as I gown and glove to see him.
“I’m not contagious,” he tells me, weakly, his face still a smile, one nevertheless showing concern, even if his only contagion is he himself, his life, what he learned along the way, what he, my new friend, may now teach me.
“You’re not contagious,” I say immediately from the doorway, knowing that he is thinking only of the cancer, that wolf, the one as real at his throat as the central line taped to his jugular, and me, myself, thinking mere MRSA, mere VRE, bugs as ubiquitous in hospitals these days as charts or IVs, so common as to be irrelevant, certainly now, now in the face, the very face, of this man, this one man, and this cancer leaching his one life.
“The hospital has rules,” I say, arms into gown; “I have to abide by them,” hands into gloves; “I’m not worried, nor should you be worried,” me, stepping into the room, finally and quickly closing any space between us.
“How are you, my friend?” I ask, my gloved hand reaching for his, his own as bare, as warm, as human as his God first made it, that hand his mother once held, and this — both of us so well aware, both the sons of mothers killed young, so very young — the day before Mother’s Day, “How are you feeling?”
Go ahead.
Go ahead and dismiss him as yet another disheveled 57-year-old, any better days long behind him, one of those prior-to-his-hospitalization, living-in-his-own-care, living-in-his-own-car guys, and this, in a Wal-Mart lot, at that, a dog his only companion, a dog loved and loving to this, a bitter end.
Go ahead.
57, just turned, looking 77, and that generous.
Found by whomever in the car he called home.
Brought to the hospital. Noted to have a blood pressure of 60/30, something you wouldn’t want. Hemoglobin 5, and ditto on the you-wouldn’t-want-that list. Badness, in a familiar term familiar to physicians, lurking, with more tests pending. An interesting patient. And, from any patient’s perspective, you never, ever, want to be interesting to a physician.
But whatever you’re now thinking, none of that matters.
Not the necrotic, metastatic cancer in his belly, as in tissue dead and tumor spreading from somewhere. Not the fact that he is the very vision of cachectic, as in skin over bone. Not his anemia, that ebb of a blood pressure, his critically low potassium level, not anything anyone but a physician might care about, at least by the numbers physicians so care about.
“Don’t put me out with the trash,” my new friend suddenly tells me. “Please, don’t put me out with the trash.”
His face is all eyes, eyes the color of sky.
Eyes as blue as the bluest June meeting mine, my one hand covering his, my other embracing his face, the two of us a kiss, my yellow gown papering my bent form, white sheets shrouding the little left of the man who’d been, the two of us carving pietà from the room around us, from time itself, from all of time.
And his face shrunken by cancer to bone. His teeth rotted by time, by disease, maybe, it might be thought, by meth — and who cares, who cares now.
But those eyes, those blue eyes.
Listen to him, and you only guess at what those eyes have seen…
“I’ve made a lot of mistakes…”
“A marriage gone wrong,” he goes on, me letting him talk, my own plan to get home early after rounding, now nobody’s undone plan but mine, a plan all at once abandoned, as I let him talk — and talk.
A girl he loved. A girl at 17. A girl he, of course, had to love.
And children.
Later, a farm in Ohio, a farm lost, lost to another woman who took him for what he was worth.
A job in Iowa. Lost, too, with lost benefits. The flood in Cedar Rapids in 2008, it taking anything left.
And then a car.
A car suddenly a home.
And those kids, also lost now, so sadly lost. And his eyes saying that, just that. One son local, who can hardly bear to see him, even now, especially now. Two other sons in Afghanistan, both wishing dad dead.
And now this. Those sons all but getting their wish.
Cancer that would make Christmas of a PET scan, and no joyeux Noel in that.
“We all make mistakes,” I tell him, after he tells me that he had done that and more.
“I’m no angel," I go on to confide. "Just ask my kids.”
His face tilts to mine, skin stretched over bone, lips taut over teeth only remotely teeth. And those eyes, those eyes, my one gloved hand on his, my other on his shoulder.
And my own eyes, I confess, all at once a lover’s…
“Don’t put me out with the trash…” he pleads. “Please, don’t put me out with the trash.”
“I won’t,” I promise, meaning it.
“I trust you,” he says in a whisper, his hand tighter on mine. “I trust you,” the voice ever so stronger, those eyes again on mine, those blue eyes.
Twenty minutes later, note dictated, orders written, I leave the hospital, into Saturday, into sunshine, into May and all its warmth, toward the car that will take me away from this, from all of this, and me, me weeping as I walk.
© 2011 Dónal Kevin Gordon
“I’m not contagious,” he tells me, weakly, his face still a smile, one nevertheless showing concern, even if his only contagion is he himself, his life, what he learned along the way, what he, my new friend, may now teach me.
“You’re not contagious,” I say immediately from the doorway, knowing that he is thinking only of the cancer, that wolf, the one as real at his throat as the central line taped to his jugular, and me, myself, thinking mere MRSA, mere VRE, bugs as ubiquitous in hospitals these days as charts or IVs, so common as to be irrelevant, certainly now, now in the face, the very face, of this man, this one man, and this cancer leaching his one life.
“The hospital has rules,” I say, arms into gown; “I have to abide by them,” hands into gloves; “I’m not worried, nor should you be worried,” me, stepping into the room, finally and quickly closing any space between us.
“How are you, my friend?” I ask, my gloved hand reaching for his, his own as bare, as warm, as human as his God first made it, that hand his mother once held, and this — both of us so well aware, both the sons of mothers killed young, so very young — the day before Mother’s Day, “How are you feeling?”
Go ahead.
Go ahead and dismiss him as yet another disheveled 57-year-old, any better days long behind him, one of those prior-to-his-hospitalization, living-in-his-own-care, living-in-his-own-car guys, and this, in a Wal-Mart lot, at that, a dog his only companion, a dog loved and loving to this, a bitter end.
Go ahead.
57, just turned, looking 77, and that generous.
Found by whomever in the car he called home.
Brought to the hospital. Noted to have a blood pressure of 60/30, something you wouldn’t want. Hemoglobin 5, and ditto on the you-wouldn’t-want-that list. Badness, in a familiar term familiar to physicians, lurking, with more tests pending. An interesting patient. And, from any patient’s perspective, you never, ever, want to be interesting to a physician.
But whatever you’re now thinking, none of that matters.
Not the necrotic, metastatic cancer in his belly, as in tissue dead and tumor spreading from somewhere. Not the fact that he is the very vision of cachectic, as in skin over bone. Not his anemia, that ebb of a blood pressure, his critically low potassium level, not anything anyone but a physician might care about, at least by the numbers physicians so care about.
“Don’t put me out with the trash,” my new friend suddenly tells me. “Please, don’t put me out with the trash.”
His face is all eyes, eyes the color of sky.
Eyes as blue as the bluest June meeting mine, my one hand covering his, my other embracing his face, the two of us a kiss, my yellow gown papering my bent form, white sheets shrouding the little left of the man who’d been, the two of us carving pietà from the room around us, from time itself, from all of time.
And his face shrunken by cancer to bone. His teeth rotted by time, by disease, maybe, it might be thought, by meth — and who cares, who cares now.
But those eyes, those blue eyes.
Listen to him, and you only guess at what those eyes have seen…
“I’ve made a lot of mistakes…”
“A marriage gone wrong,” he goes on, me letting him talk, my own plan to get home early after rounding, now nobody’s undone plan but mine, a plan all at once abandoned, as I let him talk — and talk.
A girl he loved. A girl at 17. A girl he, of course, had to love.
And children.
Later, a farm in Ohio, a farm lost, lost to another woman who took him for what he was worth.
A job in Iowa. Lost, too, with lost benefits. The flood in Cedar Rapids in 2008, it taking anything left.
And then a car.
A car suddenly a home.
And those kids, also lost now, so sadly lost. And his eyes saying that, just that. One son local, who can hardly bear to see him, even now, especially now. Two other sons in Afghanistan, both wishing dad dead.
And now this. Those sons all but getting their wish.
Cancer that would make Christmas of a PET scan, and no joyeux Noel in that.
“We all make mistakes,” I tell him, after he tells me that he had done that and more.
“I’m no angel," I go on to confide. "Just ask my kids.”
His face tilts to mine, skin stretched over bone, lips taut over teeth only remotely teeth. And those eyes, those eyes, my one gloved hand on his, my other on his shoulder.
And my own eyes, I confess, all at once a lover’s…
“Don’t put me out with the trash…” he pleads. “Please, don’t put me out with the trash.”
“I won’t,” I promise, meaning it.
“I trust you,” he says in a whisper, his hand tighter on mine. “I trust you,” the voice ever so stronger, those eyes again on mine, those blue eyes.
Twenty minutes later, note dictated, orders written, I leave the hospital, into Saturday, into sunshine, into May and all its warmth, toward the car that will take me away from this, from all of this, and me, me weeping as I walk.
© 2011 Dónal Kevin Gordon
Sunday, May 1, 2011
Now, Karen, now...
Sunlight this night splayed by blinds and splashing, splintered, across the living room’s wooden floor. And again, and from more of a distance, some neighbor’s mower grinding air, to no effect but sound, to no effect but sound, that clamorously insistent sound, and, in its wake, plumes only of ground grass.
And me here tonight, one day nearer sixty, still contemplating now what…now, for goodness sake, what…and all the more so with yet another job offer now in the offing.
No need now to trouble readers with details; those are mine, as they have before been mine.
The question, rather, is older, as those who have long considered such questions were themselves so often older: who am I, what have I done, what more might I yet do?
To my son, Brendan, the answer is likely quicker: I’m 26, have so distant an end conceivably ahead, have already worked for years for others in New Orleans after Katrina, have twice been to Haiti and am now poised for post-tsunami Japan.
And my son is, truly, my son.
A younger me had similar inclinations, if fewer opportunities, with, alas, the shadow of the Vietnam War graying my teens, my early twenties. And time, as it is wont to do, then made itself the thief of later opportunities, with responsibility freighting daily, weekly, inevitably by the decade, any hope of, well, any hope.
Until now. And still now.
And still tonight the chance to do good, to do what I once set out to do, to not do what I’ve since done, what, arguably, is merely offered again. And now, my love, mindful that similar offers earlier have only gotten us here, now.
Here.
Now, Karen.
Now…
And me here tonight, one day nearer sixty, still contemplating now what…now, for goodness sake, what…and all the more so with yet another job offer now in the offing.
No need now to trouble readers with details; those are mine, as they have before been mine.
The question, rather, is older, as those who have long considered such questions were themselves so often older: who am I, what have I done, what more might I yet do?
To my son, Brendan, the answer is likely quicker: I’m 26, have so distant an end conceivably ahead, have already worked for years for others in New Orleans after Katrina, have twice been to Haiti and am now poised for post-tsunami Japan.
And my son is, truly, my son.
A younger me had similar inclinations, if fewer opportunities, with, alas, the shadow of the Vietnam War graying my teens, my early twenties. And time, as it is wont to do, then made itself the thief of later opportunities, with responsibility freighting daily, weekly, inevitably by the decade, any hope of, well, any hope.
Until now. And still now.
And still tonight the chance to do good, to do what I once set out to do, to not do what I’ve since done, what, arguably, is merely offered again. And now, my love, mindful that similar offers earlier have only gotten us here, now.
Here.
Now, Karen.
Now…
Sunday, April 24, 2011
Just April…
My neighbor is this evening mowing his lawn, and not just mowing, but giving it a burr-cut, the air around and between us just noise, just noise.
Still, we’re talking April 24th, as in April…again, just April. The same April that saw 85 degrees on the 10th, and me that day cursing every degree over freezing; me that Sunday in my drawers and only my drawers, in the living room, the windows open, fans fanning, the air otherwise dead and me, again, loudly cursing every degree over freezing.
Back in the Vermont I knew (and, yes, I already hear my children moaning, “There goes Dad again about Vermont, those perfect summers, winters walking through head-high snow—and that’s only after shoveling—and, any god knows, you were the better for the shoveling!”), April was April.
If lucky, April was a muddy month, and muddy only by inches, given how feet-deep the ground had frozen by winter’s nadir and how slow any thaw in any year.
And snow, in Aprils then, was still the not-unexpected stranger at the door. In fact, our youngest son was born on an April 17th, during a night softened by eight inches of snow, a snowfall that slowed the midwives and made their one-hour trip north, two, but still in time. And Mother’s Day, one year, yes, Mother’s Day in the middle of a month wanting to be May, itself dawned to eight inches of snow, although by then, by anyone’s reckoning, winter’s back was surely broken, and that particular snowfall, doomed at the outset, little more than fertilizer.
In April, in Vermont, no one would ever mow a lawn, not unless there were some question of sanity.
April was a month to be enjoyed for the temptation it was, and undoubtedly still is there—the odd day warming to 50 degrees; the night again reminding you of winter; the road ruts, warmed in the day’s sunlight, freezing again overnight and, in the chill of morning, claiming the odd water pump (our car’s, one year) or exhaust system, only for the wrong choice of a rut. And any snow then was short-lived, blanketing, only momentarily beautifying, with the writing already on the sky: the days longer, the nights less, any chance of any snow lingering for hours, let alone days, increasingly just that, a chance.
Spring when it came, when it truly came, was a gift and, almost always, languorous; no all-at-once pushing-90, no instant lawns, no mowers robbing this, or any, April evening of the peace April has earned and deserves.
What I remember, instead, was one day only gently warmer than the day before, spring greening the landscape by leaf and branch, a green barely green, its shimmer pilfered from an impressionist’s palette, a green which, as it deepened, melted the winter that had been.
And sometime, maybe May, more likely June, the need to mow.
Still, we’re talking April 24th, as in April…again, just April. The same April that saw 85 degrees on the 10th, and me that day cursing every degree over freezing; me that Sunday in my drawers and only my drawers, in the living room, the windows open, fans fanning, the air otherwise dead and me, again, loudly cursing every degree over freezing.
Back in the Vermont I knew (and, yes, I already hear my children moaning, “There goes Dad again about Vermont, those perfect summers, winters walking through head-high snow—and that’s only after shoveling—and, any god knows, you were the better for the shoveling!”), April was April.
If lucky, April was a muddy month, and muddy only by inches, given how feet-deep the ground had frozen by winter’s nadir and how slow any thaw in any year.
And snow, in Aprils then, was still the not-unexpected stranger at the door. In fact, our youngest son was born on an April 17th, during a night softened by eight inches of snow, a snowfall that slowed the midwives and made their one-hour trip north, two, but still in time. And Mother’s Day, one year, yes, Mother’s Day in the middle of a month wanting to be May, itself dawned to eight inches of snow, although by then, by anyone’s reckoning, winter’s back was surely broken, and that particular snowfall, doomed at the outset, little more than fertilizer.
In April, in Vermont, no one would ever mow a lawn, not unless there were some question of sanity.
April was a month to be enjoyed for the temptation it was, and undoubtedly still is there—the odd day warming to 50 degrees; the night again reminding you of winter; the road ruts, warmed in the day’s sunlight, freezing again overnight and, in the chill of morning, claiming the odd water pump (our car’s, one year) or exhaust system, only for the wrong choice of a rut. And any snow then was short-lived, blanketing, only momentarily beautifying, with the writing already on the sky: the days longer, the nights less, any chance of any snow lingering for hours, let alone days, increasingly just that, a chance.
Spring when it came, when it truly came, was a gift and, almost always, languorous; no all-at-once pushing-90, no instant lawns, no mowers robbing this, or any, April evening of the peace April has earned and deserves.
What I remember, instead, was one day only gently warmer than the day before, spring greening the landscape by leaf and branch, a green barely green, its shimmer pilfered from an impressionist’s palette, a green which, as it deepened, melted the winter that had been.
And sometime, maybe May, more likely June, the need to mow.
Saturday, February 19, 2011
Second Son, Second Stint
I left you last with Brendan talking Haiti.
Here’s what I’ve not told you: That Brendan went to Haiti. Started a blog. First link all about almost being kidnapped. Accosted by a car, guns bristling from windows.
Almost, happily enough, was the operative word.
Still, this, in an e-mail, was his first mention of his blog, as in, Brendan, this couldn’t wait until the ride home to Iowa from O’Hare?
O’Hare came. Went.
And a few months more. And back again to Haiti. This time only for weeks, not months.
Still…
As the father who loves him, I can only admire, even as I worry. This, my beloved son, in whom I, echoing an even more paternal father, am well pleased.
Brendan is now home again, home for him, back in New Orleans, and safely so, back where he has been almost since completing college, only a year or so after Katrina, ever since doing what he could do to undo what Katrina did.
And Brendan has done what I’ve not done.
I am a doctor, but…
Brendan, newly graduated from Beloit College, went to New Orleans, built homes, dozens of them, his mother, at one time, for a week helping to hammer nails.
I am a doctor, but…
Brendan left New Orleans for Haiti. And I, doctor that I am, hoped to join him there, but didn’t.
And Brendan went back to Haiti, and I am still doing what I do in Cedar Rapids.
And what I do, in light of what Brendan has done…
Here’s what I’ve not told you: That Brendan went to Haiti. Started a blog. First link all about almost being kidnapped. Accosted by a car, guns bristling from windows.
Almost, happily enough, was the operative word.
Still, this, in an e-mail, was his first mention of his blog, as in, Brendan, this couldn’t wait until the ride home to Iowa from O’Hare?
O’Hare came. Went.
And a few months more. And back again to Haiti. This time only for weeks, not months.
Still…
As the father who loves him, I can only admire, even as I worry. This, my beloved son, in whom I, echoing an even more paternal father, am well pleased.
Brendan is now home again, home for him, back in New Orleans, and safely so, back where he has been almost since completing college, only a year or so after Katrina, ever since doing what he could do to undo what Katrina did.
And Brendan has done what I’ve not done.
I am a doctor, but…
Brendan, newly graduated from Beloit College, went to New Orleans, built homes, dozens of them, his mother, at one time, for a week helping to hammer nails.
I am a doctor, but…
Brendan left New Orleans for Haiti. And I, doctor that I am, hoped to join him there, but didn’t.
And Brendan went back to Haiti, and I am still doing what I do in Cedar Rapids.
And what I do, in light of what Brendan has done…
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