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Im
looking at the chart on the wall showing that my mother has no white
blood cells left. Theyve been gone for three days now. Im
at her bedside, where Ive been, 12 hours a day, every day, in
a hospital in a city that is not ours. Its been a hard week.
To treat her multiple myeloma, a cancer of the blood, her doctors have
given my mother a massive dose of chemotherapy that wiped out her bodys
ability to defend itself. A few months before, they had stimulated growth
of her own stem cells and then harvested them, putting them on ice for
the months it took to get the disease under control. A couple of weeks
ago she was deemed strong enough to withstand this new assault on her
fragile self. They eliminated her immune system and gave her back her
stem cells, protean soldiers who come in, see what needs to be done,
then set about doing it.
Her body has reacted as expected. She has felt increasingly fatigued,
developed painful sores in her mouth and throat, and then, last night,
spiked a fever.
In medicine bad things often happen at night, when the experienced attending
docs are home watching television or sleeping. Those left minding the
store are residentspeople who have been doctors from 15 minutes
to a couple of years, and who rotate through various services, becoming
on-call experts for a few months at a time.
A long time ago I lived with a doctor, Andrew, and overheard many late
night phone calls from flummoxed residents needing help and advice.
Andrew always thanked them for calling, and usually he told them that
their assessments were correct. But Ive also heard stories of
fatal screw-ups, and understand that medicine is as much of an art as
it is a science. Often what a physician has to go on is a good gutthe
experience of having seen a lot of patients, having lived with the vicissitudes
of a particular disease.
The resident on call came in. He looked like he was about twelve. He
asked my mother a couple of questions about the reaction to penicillin
shed had when she was a kid. He decided it was more likely an
intolerance than a true allergy and said he was going to give her a
drug in the same class.
On my friendliest days, I am a pit bull. Around my sick mother, I make
harpies look seductive. Why give her something that may cause a bad
reaction? Why risk it? I whipped out my cell phone and called Andrew.
He said the line about intolerance versus allergy was a classic resident
stance. But, he said, Why risk it? There are plenty of other antibiotics.
What about cipro?
I said to the resident, What about cipro?
We squared off. In my corner theres me, exhausted, depleted, and
anxious, but having, on my cell phone, the director of a Duke clinic
telling me to tell the resident to call his attending physician. In
his corner, weighing in at maybe 180 on a five-and-a-half-foot frame
is a fresh-faced guy with a ready smile who¹s working overnight shifts
and learning to be a doctor.
He said hed check with the pharmacist.
Then we started chatting. Or rather, I started grilling him. I found
out hed gone to med school near where I used to live. A couple
of quick jabs about basketball, then he allowed that hed had a
lot of time between college and med school. I asked what hed done.
He said hed been a professional track athlete and then a middle
school teaching assistant.
Which events?
Mile and 5,000 meters. Mile and 5,000 meters.
PRs?
Close to four minutes flat for the mile; 14:21 in the 5K, when, he said,
he had mono. Why didnt you run a faster 5K when you were healthy?
(Pit bull, I know.) Hed ruptured discs in his back that ended
his career and kept him from the Olympic Trials in 1996. He took off
11 months, gained 60 pounds, and missed his window.
He left the room. I calmed down. My mother was getting sleepy.
Then Guy McCrea popped back into the room and asked to see me. He sat
me down at a computer and showed me protocols the doctors had written;
he explained what everything meant with the patience and gentleness
of a parent. Well give her cipro, he said.
We sat side by side and realized we had friends in common, having lived
in the same place at the same time. Hed run against my buddies,
and beaten all of them. Because he stayed on the track, I didnt
recognize his name. But I recognized something in him.
I asked, three times, if it bugged him that hed never broken four
minutes. He just smiled and said no. I pushed, wanting to know what
had motivated him. Running was something I knew I could do, he said.
He told me that he had grown up here, in upstate New York, and was the
first of his five siblings to go to college. Same for his wife, who
hed been with for 20 years. He talked about her with the twinkle
and blush you see in the recently smitten.
No one thought I could make it to college, he said. No one thought I
could be a track athlete. Or go to medical school. But I knew I could.
I knew I could.
When the resident had first come into my mothers room, I noticed
hed touched her lightly as he spoke. Doctors can diagnose many
ailments without ever doing a physical examination. But there is something
powerful about touch; when we are weak we need connection. Good docs
know this.
That night, as my mothers fever began to wane, I knew that her
doctor had touched me as well. Its not that I need my mothers
caregivers to be runners, to know the things I know, to share a passion.
But that night, when I was scared and confused, it sure didnt
hurt.
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