April 9, 2007

• Saying Goodbye (The Maravich Paradox).

  She's my favorite patient.

  I'm breaking a rule here.  I'm not supposed to talk about patients.  But sometimes rules should be broken.

  One of the reasons why I chose my specialty is because it affords me a certain amount of continuity, being able to see a specific portion of my patients outside the hospital on a monthly basis without having to deal with things like back pain, narc seekers and people demanding antibiotics for a runny nose (although those people deserve love, too).

  She is an example of why I made the right choice, a member of the Greatest Generation with the spunk of Eleanor Roosevelt and the warmth of homemade apple pie.  Adorned in pearls similar to those my Grandma used to rock and always wearing those big, black headphones that would make her the envy of any Manhattan DJ, she would always greet me with a big smile.  In return I would clasp her hand with both of mine.  She is the only patient that I will greet by kneeling and saying, "hello, my dear, how are you doing?" and say goodbye with, "okay, dear, I'll see you later." 

  I'm not supposed to say, "dear," to patients as it can be considered a form of sexual harrassment.  But sometimes rules should be broken.

  One day her heart will give out, as it will with everyone else as most patients in my specialty will die from heart disease.  There are some hearts that I wish could beat forever.  But the rules of nature will not allow that. 

  I was running up and down the hallways that morning in a frenzy, trying to get all of my work done.  A resident pulled me aside to ask me for a consult and when she told me the name my heart went into a dizzying rhythm.  It was her.  My favorite patient. 

  It's a funny thing, the heart.  I call it the Maravich Paradox [see Pistol Pete Maravich], where strength and weakness can be one and the same.  No one ever doubted his heart on the court, and no doubt it was his heart that brought him glory and greatness...but in the end it was the weakness of that same heart that brought him to the end of his days while doing what his heart loved.  The strength of a heart is in its vulnerabilty.  It takes more bravery to let someone in than to cowardly shut out the world, more resilience to heal from the times you've been burned than to go through this world unscathed...and unloved.  And one day when you have given so much that strength will become your weakness.  That is the Maravich Paradox.  The reason why husbands and wives die so soon after one another, why we hurt and can be hurt by the ones we love, and why the good ones never seem to stay around long enough in our lives.

  And this beautiful woman with her beautiful heart...has her heart finally given so much to those around her that it has nothing left to give to itself?  I had planned to walk in with a big smile, clasp her hand in both of mine, kneel and ask her, "my dear, what happened?"   But when I walked in I knew that her heart had indeed given itself away for one final last gift. 

  I wasn't supposed to touch her without wearing gloves, but sometimes rules should be broken.  I wasn't going to allow my last contact with her to be hindered by the dehumanizing feel of 50 cents' worth of latex.  We already place too many barriers between us and those we care for as if they were our own children, our own parents.  So I clasped her hand in mine, squeezed it for one last time and softly said, "goodbye," before I hurriedly left the ICU and stormed past the waiting room full of broken hearts and impenetrable hopes.

  She was my favorite patient and I wanted her heart to beat forever, but sometimes rules cannot be broken, no matter how much I wish they could.

  See you later, my dear.  I hope that you will still be rockin' those pearls and headphones when we meet again on the other side of the dark curtain.

  • 9:32 am
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