Don't Be a Stranger

W.B. didn't smell good, spoke like he had thick gauze stuck in his mouth, pestered the nurses for narcotics every half hour, and was introduced to me by all the staff as "not the nicest guy." Today, we took off W.B's last remaining leg.

Having never seen an amputation before, my initial reaction to seeing a heavy human leg wrapped up in sterile blue plastic and tossed in a biohazard bin was an immediate image of slaughterhouse meat. It was uncanny how much like a prime cut of beef it looked. But of course, it was not the same. It was a piece of a person, and as I watched him struggle out of his anesthesia-induced sleep, I wondered how it must feel to have reached your old age literally only half of the man you used to be.

I no longer wish to go into geriatric medicine, but the thought that attracted me to that field remains: That our characters and lives should be more reflective of who we are as we age, that old age should be a culmination of self and not a destruction of self. For a good number of individuals, that is what happens. Yes, the body ails, but for some people, the physical defects in no way diminish who they are.

But then there are the others - the ones whose health problems have precipitated a landslide of events that swallow up the self. You can tell who these people are because they are the quiet ones, the drug-seeking assholes, the one-track minds, the incessant babblers, the ones who have nothing left to focus on except the small and mundane. They usually have no supportive family, and because of the way they are, will be unlikely to get any support in the future. They come at random times to the hospital and inevitably leave in a wake of aggravated relief. They are the ones who get lost to medical care, the ones who come in sicker each time, until they finally, ignobly die.

Medicine, at times, is breaking my heart.

They say no effort is too little, but I'm not convinced that a lot of little efforts add up to enough. This is the talk of the medical pessimists, of course, the stuff that no one says in the hospital, and certainly not in front of your *gasp* attendings. Doctors are an optimistic bunch, you see, and I agree that we can do amazing good. But we don't heal as many lives as I wish we could. There is always so much left to do, and perhaps too much that we can never do.

If I were to be honest, I would say that the best I can do for W.B. is to send him home tomorrow with a genuine smile and some pain pills, and maybe he will remember me for a day or two. After all, in his life, I'm just passing through.