Too close to home

Issue: BCMJ, vol. 61, No. 7, September 2019, Page 274 Editorials

It’s interesting to me to think about the patients who have left an imprint on my life. What did they have in common that causes me to remember them? What part of our relationship is so memorable for me, and why?

During the early stages of medical school, I volunteered as an ambulance attendant in my home town. It was exhilarating work that brought me into contact with many memorable people who were far removed from my way of life—alcoholics, gangsters, and victims of violence were our usual clients. A memorable event was the night I was called on to deliver my first baby on the floor of a shack by kerosene lamp—before I had done my obstetrics rotation in medical school. The homes in the area had no address numbers, so when we got close to where we were meant to be, the neighbors responded to our flashing lights and blaring sirens by coming out to direct us to the right shack. In my capacity as an ambulance attendant, I was only permitted to clamp the umbilical cord with a piece of string. The placenta was placed in a plastic bag and remained attached to the newborn until we reached the hospital. 

Another call that I remember well involved us transporting a deceased man from his residence to the city morgue. He had been discharged from hospital after a myocardial infarction. Two aspects of that call make it memorable for me. The first was the sound he made when we moved him from his bed onto our stretcher. It was the first time that I had dealt with a lifeless body. I had never even been that close to someone who had died. He was heavier than we expected, so his landing on the stretcher was less than graceful, which is when air was expelled from his lungs through his partially closed vocal cords. He made a loud groaning sound that scared the heck out of me. The second, and more memorable, was how old the man was: he was close in both age and appearance to my father, who was in his early 50s at the time. 

After delivering the body to the city morgue, my partner and I stood outside and smoked a cigarette. I wasn’t a smoker and didn’t inhale, but I felt quite shaken up and it seemed like the right thing to do at the time. I recall arriving home after my shift as my parents were waking up and feeling very relieved that they were alive and well. At the time, that experience felt too close to home, although thankfully my father lived for another 30 years. It was his birthday in August.

There are patients from throughout my medical career who remain embedded in my memory for various reasons. Their impact on me usually stems from the good relationship that we shared, and the fact that they passed away too early in their lives. One man in particular stands out. We were close in age and life stage (he was slightly younger). He developed an aggressive cancer in his late 30s. He was a kind and generous man with a beautiful family. He had a mischievous sense of humor. He loved his wife and daughters, and they loved him. The anniversary of his untimely passing was also in August.

His journey, in some respects, is too close to home for me as well. Perhaps his illness and untimely passing brings up my existential angst. Why am I here? What is my purpose? What is the point? What is the meaning of life? Although I don’t have all the answers, I continue on my life journey with faith and optimism. His words of optimism and hope are a comfort to me.

David B. Chapman, MBChB. Too close to home. BCMJ, Vol. 61, No. 7, September, 2019, Page(s) 274 - Editorials.

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Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

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