I had a patient earlier this year, “April,” who I just loved. She had muscle weakness because of an extended hospitalization and recovery period but was finally home and doing well. She was in her early 80’s but totally with it, quick and, my favorite, compliant. Her husband, “Dwayne,” had been a pharmacist in his earlier years  and he really was a hoot – he had this really gravely voice and had a mouth like a sewer. And besides their obviously having the excellent good judgment for taking my recommendations to heart,they followed through IMMEDIATELY. I mean, during my very first visit, when I had said perhaps we would talk about getting grab bars in the shower for April to hold onto, Dwayne had arranged for his neighbor to come over there on my next visit so I could tell him what size and where to put them. Between the good mix of personalities and the “husband is a pharmacist” link, it was very much a mutual admiration society between the three of us us and I enjoyed visited April just as much as, I daresay, April and Dwayne enjoyed my visits.

And then April died. All of a sudden. No warning, no nothing. I just got a call from the scheduler, telling me not to go to April’s house because she died the night before. No idea why.

Considering that I work in health care, I really hardly ever get patients who die in my care. Oh, I’ve had my share of ones who have died. But more often than not – MUCH more often – they go to the hospital first and I just never see them again. So the fact that the patient who I had just seen yesterday, who was FINE, was now confirmed to be gone…on top of the fact that she was a really cool lady, well, let’s just say it worked its way past that Health Care Worker Emotional Wall that I’ve built up over the past 20 years. I was bummed and even sent Dwayne a condolence card. April was a lady I’d remember for a long time.

And then I got a call from our scheduler last Monday. Did I remember April? Well, her husband needs therapy now and did I want him? Well, HELL yeah! So I visited him on Tuesday.

He had a heart attack but overall he’s doing OK. Putting his life back together after losing someone he was married to for 62 years. His sister and niece are staying with him for now – the niece will be leaving later this week to go back to her home and family near Pittsburgh, but the sister will stay for as long as she’s needed.

My initial evaluation wasn’t anything special. I did offer my condolences and he thanked me but brushed it off quickly, telling me in not so many words that the topic of April wouldn’t come up very often. I could appreciate that and made a mental note of same. I did ask the niece what happened, when I had a private moment with her. Apparently April has aspirated (choked to death). Wow…what a horrible, scary, tragic was to go, huh?

My one mistake was to ask him what had happened to him, which he took as an opportunity to complain profusely about his stay in the hospital. How they did nothing for him…how they wouldn’t do anything for he knee that was hurting and how he had this cough that no one paid attention to. I put on my “good therapist” mask and listened intently, with empathy thrown in where appropriate. However I did briefly explain to him that since he had had a heart attack, that may have been their main priority – that was something that could quickly kill him – a bum knee and a cough could not, at last not in the short term. To his credit, he really did seem to understand that on a very shallow level but in a very short period of time he would begin again about how badly his knee hurt and how his cough wouldn’t go away and how all of the doctors, “who all had that goddamn dark skin. I don’t know if they were from Pakistan or India or what but there were no fucking Americans in that hospital,” had done him wrong (or, as he said, “treated him like shit.”).

I could see his point about not thinking he had gotten the care he expected (he had gone to one of the crappier hospitals in the area and frankly, I wasn’t surprised that some of the staff there might not treat a demanding, cursing 80-something-year-old guy with a heart attack with the compassion or empathy that they could have) but I bit my tongue and didn’t suggest that if he ever did decide to make a formal complaint to the hospital, that keeping the blue language and the staff members’ skin color out of the letter or phone call might work oh so slightly more in his favor.

My initial evaluation proved that Dwayne did have some minor to moderate problems that required my professional skills so I scheduled myself to see him the next day. Good thing we had installed those shower grab bars for April because now he was going to need them. Besides that, hand and arm weakness were some of his issues so I was preparing to show him a very simple home exercise program that he could do in his spare time. Now, it’s been my experience that for most people, especially older ones, “spare time” meant “watching TV” but sometimes there will be the odd hobbyist, jigsaw puzzler, search-a-word person, etc. So I always make it my business to ask “What do you like to do in your spare time” so I don’t tell them to “do this while watching TV” and then they tell me that they haven’t watched TV since 1956 because that’s when Elvis Presley was on the Ed Sullivan Show and that’s what proved to them that television was the spawn of the devil. As it turned out, Dwayne said that he spent a lot of his spare time reading the Bible. Really, the Bible? REALLY? My only thought was, “You go on and on with your cursing and ‘God damns’ and prejudices against people with different skin color than you and you read the Bible in your spare time?” And no, I didn’t say it out loud.

But I wanted to.

I still love working with Dwayne, though. His religious hypocriticism aside (and really, besides it being none of my business who am I, of all people, to judge THAT?), he’s still a cool old guy to talk to, easy to schedule, as compliant as can be and, as his sister and niece have told me, he loves me to pieces (I say it’s because I don’t take any of his crap and he respects that). Hell, I even got to do “outdoor therapy” (doing therapy stuff outside on the porch, driveway, etc, instead of inside the house) with him one day last week , which, with our wacky weather and the level of sickness of most of my patients, is a rare treat that only happens about once or twice a year, tops. I take his “goddamns” and “shits” in stride and, as a fringe benefit, don’t even worry so much when I wind up forgetting to substitute certain words with “heck”, “darn” or the occasional “crap” (I usually ask permission of my patients before saying “crap”…just in case. Never even bothered with Dwayne). I’ve got 2 more weeks with Dwayne and I plan to enjoy them.

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