This patient’s story has been on my mind more intensely as the holiday rush quickly approaches. It occurred several years ago when I was working back in my hometown of Augusta while my mother was battling a recurrence of breast cancer.
Living the life of a secretly scared daughter, an overworked emergency room doctor, and mother of a young toddler did not always leave a lot of time for my consciousness to wander to those who were also struggling. Certainly in my line of work, I was exposed to those who experienced all sorts of trauma and misfortune, but I had long ago numbed myself against their humanity, attempting to survive my vocation and my own troubles.
Christmas, however, had always been a special time of year that seemed to at least wake me a little from the slumber that was my life back then, even if for just a month. Family, joy, kindness, and love would waft through the crowded ER hallways and overshadow the pain, distress, and smell of vomit to which I had grown so accustomed.
This particular holiday season, however, demanded that I would forever rearrange that brief feeling the spirit of Christmas instilled and carry it with me as a daily reminder for the rest of my life. I was given a very special gift that season and I would like to share it with you.
He didn’t strike me as much when I entered his room. He was my bread and butter: I knew he was a classic case of congestive heart failure before I had even ordered a test. It was clear to me from a quick history and the way he was pursing his lips to try to force more oxygen into his body that water had been building up in his lungs over the last several weeks. Finally, that feeling of drowning in your own bodily fluids had scared him enough to force him into my ER.
This man had no medical history, but I knew from experience this was only because he never saw a doctor. His blood pressure was dangerously high, his diet was crap and clearly, he had not had much exercise – probably since birth. He appeared to be your standard, Southern, ticking time bomb, whose heart had finally been strained to the point of sure death if he carried on much longer ignoring his symptoms.
When his labs and X-ray came back, confirming my suspicions, I quickly got him admitted. This was almost too easy for me now. I could do this kind of medicine in my sleep. I had already shot him up with the drugs to rid his body of the excess fluid, and the blood thinners to protect his heart as much as possible from the mild heart attack that he had suffered.
It was now up to his admitting doctor and cardiologist to take care of the rest. My job was done as far as I was concerned. I had moved on to more exciting things, like pulling a vibrating Mickey Mouse toothbrush out of the opposite orifice the manufacturer had intended for its use from an inebriated patient.
My annoyance was palpable when the admitting doctor entered my office to inform me that the puffer was checking himself out of the ER and refusing any further care. This doctor was a known hard-ass with little empathy for anyone, especially her patients. She had burned out long ago as far as I was concerned and clearly had not tried hard enough to get this guy to stay.
“Charlotte, I have spent over an hour explaining to this man why he would be an idiot to leave.”
Clearly, her bedside manner sucked, so after rolling my eyes and giving her a “watch this” attitude, I marched myself straight off to his room, determined to end this nonsense. My patients never left against medical advice. Maybe it was my own Southern charm or maybe it was my down-to-earth medical explanations, but I was always quite convincing. Rarely did patients defy my advice.
But that is exactly what this headstrong patient decided to do. Clearly, this guy must have a learning disability, so I actually took a seat, put a hand on his shoulder, looked him straight in the eye and went over his findings for the third time.
His eyes softened and a sad smile came over his face as if he was concerned that I was, in fact, the one that was mentally challenged. “Doc, I hear you. I understand everything you are saying and I’m really grateful for your help and your concern. But I just can’t stay.”
It was time to pull out the big guns. My sharp-shooting tongue was up for the challenge and I laid it out straight, determined to get through to this sweet knucklehead.
“Sir, you surely are not hearing me. I can guarantee you that if you walk out that door, you are going to drop dead. Your heart has a blockage and if it is not corrected now, you will not live to see Christmas. You are going to die.”
His eyes misted over. Finally, we were getting somewhere. I hated being that blunt but I was confident in my words. The light bulb had finally been switched on. And then he spoke, dropping whatever pride he had managed to hold on to.
“You don’t understand. I would rather be dead than be back on the streets. And if I stay in this hospital, that is exactly where I will have to go. I won’t go back there. I would rather go to my grave first than back to the streets.”
A fleeting thought of committing him against his will crossed my mind, since he had basically admitted he would be committing suicide by leaving, but then he went on to share his story. My mind stopped manipulating and just listened. I stopped being the doctor for a few brief moments and in essence, I became his patient as he taught me about life – his life.
As a young man, he admitted that he had made some pretty bad choices that had led to drug abuse and ultimately his own homelessness. He shuddered as he recalled sleeping underneath a bridge at night as shelter from the cold rain, not taking a hot shower for weeks, the way people looked down at him when he did go out finally looking for a job, the pangs of hunger, and the pure fear and defeat that had overtaken his soul.
That life was too much to bear. He had come close to just ending it a few times, but then he found an organization that helped him back on his feet. He was now able to hold down a steady job in a meat packing plant. He didn’t make a lot but it was enough for food and a warm place to lay his head at night.
He usually worked six days a week. There was no time to see a doctor about his worsening medical state even if he had the money, which he didn’t. He had managed to hold out until Sunday, his day off, to even come to the ER. Barely able to walk a few feet without gasping for air, he now admitted that he had collapsed a few times but had refused to let the ambulance come, as he couldn’t afford not to work.
“So you see Doc, as embarrassing as this is for me to tell you, I just can’t go back to the streets. I won’t go back to that life. I have to go to work to pay my rent for the week. It’s due every Friday and once you miss a payment, they don’t give you a second chance.”
My mind had stopped thinking and my heart had opened. I heard myself ask before my brain even connected to what I was saying: “How much is your rent?”
Shaking his head as if he was trying to buy the Taj Mahal, he replied “It’s one hundred and seventy-five dollars.”
“Will you promise to stay in the hospital and get your heart fixed if I go down and personally pay your rent for the week?”
I guess he thought it was April Fools and not Christmas, as he looked at me like I was playing some sick joke on him. “Are you serious?” he sobbed.
Nodding my head yes, holding back my own tears, I demanded the address and name of his extended stay motel. With a promise to take care of his rent as a Christmas gift to him, I turned to exit his room with the lightest heart I had felt in some time, only to find his nurse blocking the door, just staring at me in disbelief.
“So this is how you convince your patients to stay in the hospital?” she teasingly smiled and squeezed my shoulder. “You did a good thing.”
Yes, I had and it felt wonderful – but I wasn’t done. Marching off to call the cardiologist, I begged for a personal favor. Sharing this man’s story, he promised to make every effort to expedite his care in case he needed major surgery to correct his heart. He was moved too. I could hear it in his voice, and he had known me long enough to know that I didn’t ask for favors.
The next morning, I followed through on my promise. Taking Mia’s grandfather as protection, we drove into the seediest part of Augusta. I had never even been down to this sad, dilapidated area of town, well known as “crack head alley”. The man behind the bulletproof glass exchanged the cash for a receipt. I dropped it by my patient’s hospital room while he was getting his procedure to determine if his heart was as blocked as I had suspected.
Later that afternoon as I was starting my shift, I received a phone call.
“Charlotte, he had a ninety-five percent blockage in his heart. If he had walked out of there, he would have surely died, probably in the parking lot as he was leaving. I stented the artery easily and he did extremely well, one of my easiest cases. I thought you might like to know what you did for him most likely saved his life. He will be back home in a few days and able to celebrate Christmas.”
Thanking the cardiologist for the update and the role he played in extending this man’s life through the holidays, I found out shortly exactly how he spent that precious day.
He went down to the homeless shelter that had helped him get his life back together and served a Christmas dinner to those that were still living under that bridge that had once been his homeless home. He went down there to give them some hope and inspiration when he knew most had very little. He had been there. He understood their situation better than most. He also knew that if it had not been for the kindness and generosity of the many people that helped him along his way, my little intervention would have really meant nothing. And so he gave back.
In reality, this man gave me one of the biggest gifts I have ever received. He gave me the pure joy of truly helping another, straight from the heart, because it just felt good.
He reminded me why I truly love this season of giving. He serves as a reminder to continue that giving whether that is through my time, money, or just listening to a friend in need throughout the entire year, not just for one month. You never really know what a difference you can make and what a ripple effect can occur when you just give from your heart. That’s how gratitude grows and the world changes, one person at a time.
Happy Holidays, dear friends!
Image: DepositPhotos.com
