little grandpa

I'm back at the VA again, on a slow-ish surgery service, keeping my head above water and rememebring how much I love to use my hands. I love my patients here, these birdlike old men with tiny wrists and spindly fingers, how they scoff when I ask them about their pain. "Young lady, I've been through worse than this," they all say, and you believe it, even though today they can barely reach the rails of the bed. The VA gives out these pajamas that they all wear, in navy or--my favorite-- Santa-Claus red, and in them these shuffling anachronistic men, toting walkers and IV poles and oxygen tanks around the floor, look like they wandered in from 1954 and never made their way back. They all have old fashioned names like Clarence and Alvin and Elmer. You can almost see their whole lives walking around next to them, all those decades of hard work and combat and love and kids and sickness and grief.

One of my favorites right now is this crotchety but beautiful man from the hills of east Oklahoma who has, it turns out, carcinoid tumors all over his body. He came in for what seemed to be simple stomach surgery, and his hospital course has been getting more and more complicated with each day. The general opinion is that he may or may not last the year. When we told him he had widely metastatic cancer he nodded in a slow and dignified way and said, "Well. That's some bad news. Thank you." A few days ago we met with a social worker to begin the process of helping his family put his affairs in order. He said he'd never realized he needed to do that before. Every time I go into his room he takes my hand in both of his and says, "Thank you for visiting, doctor. Tell me about your day."

The other day we had to go up to the chemo infusion room to reattach a feeding tube in an old man on hospice care who was dying of leukemia. When we went up to see him his head was wrapped up in a blanket so you couldn't see his face. We took down the blanket and I was amazed. He was so old and so sick that his skin was practically transparent. His eyes, which you could tell used to be black, were shiny and silver. It was like everything extra had been stripped away in this man, except what was absolutely necessary for him to go through the mechanics of living out his last days. He was with a beautiful young woman who called him "Little Grandpa." When I took his hand before we did the procedure I could watch every fiber in his face transform, one by one, into the brightest purest smile I've ever seen on a person. Holding that man's hand, so shiny and close to death, I felt like I was touching something holy.