Sunday, April 22, 2012

What my Patient Said

We were asked to write a response paper for another humanities class (Medicine in Literature). I asked to write something creative in response to Raymond Carver's "What The Doctor Said." Here is the original poem:
He said it doesn't look good
he said it looks bad in fact real bad
he said I counted thirty-two of them on one lung before
I quit counting them
I said I'm glad I wouldn't want to know
about any more being there than that
he said are you a religious man do you kneel down
in forest groves and let yourself ask for help
when you come to a waterfall
mist blowing against your face and arms
do you stop and ask for understanding at those moments
I said not yet but I intend to start today
he said I'm real sorry he said
I wish I had some other kind of news to give you
I said Amen and he said something else
I didn't catch and not knowing what else to do
and not wanting him to have to repeat it
and me to have to fully digest it
I just looked at him
for a minute and he looked back it was then
I jumped up and shook hands with this man who'd just given me
something no one else on earth had ever given me
I may have even thanked him habit being so strong
This poem describes a scene so loosely (as a sign of that, the author has used no punctuation) that zillions of interpretations are possible. I offer one.
My fingers traced up and down the scroll wheel as I moved through the planes of Mr. Baker’s MRI. I already had the report from the in-town radiologist (I almost never interpret films any more), but I wanted to look at this one.

The report lined the bottom of the computer screen as I rolled through horizontal cuts of his lungs. “32+ enhancing lesions between 0.5 and 3cm on right lung, suggestive of metastases from previous oral cancer….” I didn’t need the radiologist’s assessment. Mr. Baker, my 79-year-old retired machinist, came in with a vague history of mouth cancer fifteen years ago that had been removed by one of those surgeons that moves through a county like a cold front. Details and records were minimal, but at least he had stopped smoking.

He was a good patient, a nice fellow, a father left behind by adult children who were sprayed out all over the country. He was gentle to this young doctor as I tried to pay off loans by serving the middle of Texas. When I blew into town with some federal program he loosely grandfathered me, introducing me to his wife, his friends, his home. He had me come to dinner every Tuesday with a few others, after which we’d play checkers (sometimes cards) and talk about everything. It was an interesting relationship: I was half his age with a greater IQ, but he was twice my soul with a greater wisdom.

And now I was skipping through his MRI, whose report should have read “Death in 5 months.” I was not sure how to deliver bad news to this man. I had only done it once before and completely blundered it; he was a man so superior to me I was nervous; and I was attached this time, myself in the shock stage of grief as I scrolled.

The door to my little office opened and Becky poked her head through. “Mr. Baker is here,” she said softly, but not so softly as to be melodramatic. Becky was a gem, the kind of gem I didn’t know existed before I (thinking mostly of dollar signs) moved to rural nowhere.

In stepped my patient grandfather.

He met my eyes. “It doesn’t look good,” he immediately said.

“No,” I answered.

“It looks bad.”

“Real bad.”

His eyes went to his hands which, despite their years of retirement, looked like they still had grease in the fingerprints. Was he thinking of his wife?

I was still uncomfortable with silence, so I said more. “There were at least thirty-two on the right lung,” I offered stupidly. He whistled.

There was a longer silence. I didn’t watch his face because I was trying to formulate what I was going to say next. “Do you have a coping mechanism during this time?”

He didn’t seem to hear the clumsiness of my question. His gaze was off in a corner. “Not yet,” he said, but not to me. “But I intend to start today.”

“I’m so sorry,” I said, not caring whether I was saying the correct thing any more. “I wish I had some other kind of news to give you.”

“Amen,” he answered, meeting my eyes again and coming out of his daze.

“I’ll have Becky call the minister if you want,” I said. It occurred to me that it was Tuesday. “And I hope checkers night tonight isn’t cancelled.” He shook his head, though I wasn’t sure if it was about checkers.

Then he met my eyes for many seconds, saying ineffable things that were beyond my pusillanimous comprehension.

Then he rose and extended his hand, which I shook meaningfully and firmly. I shook hands with this man, who’d given me something no one else on earth had ever given me. So overawed was I by my lesson that I thanked him, the start of a new habit.

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