disconnect

i know i'm disconnected- but i'm not sure from what.  i got called this morning that mr. w died.  today, this morning, july 7th. my friend, another doctor who has taken care of him all week, called to tell me. he'd come in over the weekend, got his fluid tapped, but his belly had a lot of tumor, it probably got nicked, he began to bleed, the liver was broken and couldn't make the parts needed to clot things off, he didn't want any surgery, they tried to fly him home to die at home, to die with his people in new orleans, he was too sick to go, last night he 'slipped into a coma', a nurse sat with him all night, she gave comfort, he got pain meds, he was at peace.
my friend was crying as she told me, i was dry as a bone.  that is what happens when i'm disconnected.  or maybe i knew it was coming- maybe that is why i cried last week at work about him.  i kind of knew it was done.  mr. w taught me a lot- about being a patient and about being a doctor.

when i met him last summer, i liked him immediately.  he had a spark in his eye- and a sincerity that he could turn on and off- i could see how smart he was- street smart- people smart.  i met him at a time when he was making some real choices to turn things in his life around.  reaching out to his son who he'd left as a child- reconnecting- reaching out- making things right.  he knew his cancer was bad but he was going to live as long as he could- 'fight it' - not be told by anyone when his time was up.

over the past year he made several trips home- to see his mom- his siblings- his friends.  he wrestled with alcohol and probably other drugs- that love/hate relationship- that overcome/give-in dance people do with the substances that have always been there when people haven't been- that have brought much comfort and much pain.  i didn't care- i didn't mind- it was his process- it was his letting go- it was his dance.  i still gave him pain medicine- which he never abused.  i gave him my cell phone number- which he never abused.

over the year we trusted each other.  there were times when i told him things he didn't want to hear.  there were times when i didn't say anything- or do anything- but sit there when he was so angry that his cancer has spread and there were no more chemo options.  i watched him on the seesaw of acceptance and denial- and i learned it is a wiggling teetering- not a smooth process- this business of the acknowledgment of our dying- our finitude- the terminal condition of being human.

he'd spent much of his life homeless- on the street- disconnected from family and systems- and i wanted to know what that was like and what it was like now to plug back in- what it feels like to need the system again- to have to trust- and to be facing death.  and he allowed my medical student to spend hours with him- to interview him- to hear a different perspective- to hear his wisdom.  he gave of himself generously- shared his story- his life with us.  'if it's gonna help you- i'll do it'.

after thanksgiving he mentioned wanting to go home to louisiana.  i told him he'd better hurry- he'd better do it while he feels well enough.  (i thought he'd be gone by christmas).  and i learned, again, that i can be wrong.

'doc, i don't plan on going anywhere soon- you know what i mean.'

i hoped he was right- and he was.

in the winter and the spring he made several trips home to new orleans- he allowed hospice to begin to help him while he lived with his son.  he almost always came to his clinic appointments- even though he took several buses to get to me- even though it was 90 degrees- even though he'd lost 50 pounds-  always calling me on route to make sure i'd still be able to see him- even though morning clinic was over.
of course.

people need to be met where they are and where they've been.  their story is important to how we care for them now. 

perhaps we connected because his story wasn't pretty- but he tried.  because his life wasn't tied neatly in a bow- but he carried on.  because he lived out the process of redemption.  he teetered between the nature and the grace- and he chose the grace.

i don't know what his years were really like- i don't pretend to understand life as a homeless 60 year old african american male in the south with stage 4 lung cancer.  at.  all.  i don't even really know how much redemption he experienced with his family- with himself- with his God.

but i do know he inspired me.
i do know his is a story of Grace.
as is mine.
as is yours.