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Courier-Post
When life paths that crossed in high school intersect
again
classmates in high school. We were not particularly close and I had no reason to be nervous, but I guess there is
something about seeing someone for the first time in 25 years.
We were in different crowds in high school. I was a good student; he was good at everything else. He was cool,
muscular and handsome, good at sports and popular with the girls. He was a happy-go-lucky kid who everyone
liked, even if some of the guys may have been a bit envious.
I entered the room and introduced myself. I waited for that moment of recognition, that prelude to our
reminiscing about our days in high school. I thought I saw him flinch when he saw me, but he gave no overt
indication of recognizing me.
"Matt", he introduced himself. He seemed strangely unaware of an awkwardness in the air. I hesitated for a
moment. His eyes evaded mine.
I thought of just keeping my mouth shut and treating him like any other patient, but my curiosity was gnawing at
me. Even after 25 years, I still easily recognized him. Okay, maybe I wasn't the most popular kid in high school, but
the high school wasn't that big. We were even in some of the same classes together. Sure, he had all his hair left
and I didn't, but I did not look that different. I still had the same name and it wasn't that common of a name. How
could he not recognize me?
"Do you remember me?" I asked.
He looked at me awkwardly and seemed to glance at my name on a diploma hanging on the wall.
"Hey, Tom," he said.
"Hey, Matt," I replied.
He smiled, but there was a sadness in his smile that made me wonder if I should have said anything. For the
first time it occurred to me that perhaps he didn't want me to recognize him.
I opened his chart to find an expired Medicaid card with his name, along with the names of his wife and three
children. Medicaid is a government-sponsored insurance for the underprivileged. There was a note that since his
Medicaid card was expired he agreed to pay cash for the visit.
"I didn't get my new card this month," he explained when he saw me looking at his card. He seemed to want to
get the doctor's visit over with.
I looked at him for the first time as a patient and realized how sick he looked. He had a bad cough and was
shivering with fever. I glanced down at a cane leaning against his chair.
"I got back problems," he explained. "I was working in construction all my life, but I haven't worked in two years.
I've got three herniated discs. I had a couple of back operations, but they didn't help much. I got nerve damage to
my right leg."
"Is there anything they can do to help you?" I asked.
"Not now," he answered, "I'm applying for disability."
I looked at his list of medications. He was on something for depression and another medication for anxiety. He
was on two pain killers.
"So how are you doing?" he asked, "I see you became a doctor."
"Yeah," I said with a shrug as I looked down at his chart.
I examined him and wrote him a prescription for an antibiotic.
"Doc," he said hesitantly, "your receptionist said I had to pay cash for my visit, but I'm a little short. Can I drop it
off later?"
"Don't worry about it," I said. "Just send me a copy of your new card when it comes in."
I then took back my prescription and replaced it with free samples of an antibiotic so he would not have the
same problem at the pharmacy.
He thanked me and shook my hand. He mentioned a few guys from high school and said we should get
together sometime. I told him that would be great, but I knew it would never happen.
He thanked me again for the medicine and for all I had done. I only wished I could have done more for him.
After all, we went to high school together.
Happy Birthday Jennifer
“Happy birthday, Jennifer,” I enthusiastically said, “how old are you?”
“Five,” she announced as she held up five little fingers.
“Wow, you’re a big girl,” I said. “Did you get those dolls for your birthday?”
“Yeah,” she answered as she held up the two dolls, “do you want to play Barbie?”
“Maybe in a little bit,” I replied as she handed me one of her dolls.
I glanced up at her parents as they huddled nervously behind her. She was an adorable little girl with bright
green eyes and short brown hair. I wished that I could have spent the afternoon playing Barbie with her. But
everyone knew why I was there. Everyone but her.
“I have to take you for some tests now, Jennifer,” I hesitantly explained, “we’re going to find out what’s wrong with
you so we can make you all better. You look like a brave little girl. It’s going to hurt a little bit but you’ll be fine. I’ll be
there with you. Everything will be fine.”
How do you explain to a 5-year-old girl what a bone marrow biopsy is? What a horrible way for a little girl to spend
her birthday. I looked to her parents for support, but they just sat there dazed. They had not heard a thing since the
pediatrician mentioned the word leukemia.
“Are you my doctor?” she asked.
“Not exactly,” I explained, “I’m a student doctor. I’m not a real doctor yet.”
“I want you to be my doctor,” she said.
“Okay, Jennifer,” I replied, “I’ll be your doctor.”
I took her by the hand and led her to the procedure room. She sat there bravely as blood was drawn, an IV was
placed, and the pediatric oncologist performed a bone marrow biopsy. When her tears had dried, I held her little
hand as she marched triumphantly back to her room. Then we played Barbie.
The next day she was diagnosed with Acute Lymphocytic Leukemia. The oncologist explained to the parents that
this was the good leukemia and that the vast majority of children survive.
I don’t think the parents believed that there was a good leukemia but over the next few weeks they overcame their
initial shock and were strong and supportive as their little girl began her journey through chemotherapy.
I continued to be Jennifer’s doctor for the next four weeks. She was a brave little girl and had good days and bad
days during her chemotherapy. Some days I would just stop by and examine her as she slept. Other days we would
play Barbie or color pictures or she would beat me at her version of Go Fish.
Eventually my pediatric rotation came to end. Her rotation through the oncology unit would last for several more
months.
I used to stop by the pediatric floor after my rotation was over and if Jennifer was there I would see her. I
exchanged a few letters with Jennifer’s mother over the next several months. Jennifer once drew me a picture that I
still have. Then the letters stopped.
Sixteen years have passed since that fateful day when Jennifer found out she had leukemia and later won my
heart. I often wonder what became of Jennifer.
I like to believe the oncologist’s encouraging prognosis and think that she grew up into a beautiful young woman
with her infectious laughter and resolute determination. My curiosity, however, is suppressed by the uncertainty as to
whether or not she survived her battle with leukemia. Or whether she even made it to her sixth birthday.
In my hopes she is a confident young woman, about to graduate college and make her mark on this world. In my
heart I will always remember her as a sweet, precocious little 5-year-old girl who I fell in love with during my pediatric
rotation.
Happy 21st birthday, Jennifer, wherever you may be.
An ailing patient, a dear person, a fight to survive
He did not have to tell me. I could see it in the way he hung his head, the difficulty he had in keeping his eyes
open, his parched lips and the way his clothes hung loosely on his emaciated body.
“What happened?” I asked. I should have known but it was difficult to keep up with everything. Letters from
specialists poured in almost daily. Most of his medical problems were beyond the care that I could provide and a
challenge to his specialists.
“He had pneumonia,” his wife said as she fought back tears, “his lung doctor wanted to put him in the hospital,
but he didn’t want to go.”
“I might not come out,” he said as he feebly lifted his head. “It’s just the pain.”
Ken Roder was a 67-year-old man with sparse gray hair and friendly demeanor. He had always been a big and
powerful man, always a gentleman.
He had been my patient for several years and suffered through many chronic conditions. The parts of his body
that required blood were all severely compromised. Unfortunately, that was every part.
A lifelong history of smoking and years of diabetes were the culprits; they usually are. He had suffered blot clots
in the veins of his legs for many years. His arteries were severely diseased. His kidneys had failed, requiring
dialysis. He had heart disease and strokes. His fingers and toes were gangrenous. His entire body seemed to be
rotting away. The pain from the dying tissue had become intolerable.
In spite of his enormous suffering, until recently he rarely let it slow him down. His office visits were full of stories
of his family, his new grandchild, or an upcoming trip. He loved to travel the world and was always heading to an
exotic location.
He endured his illnesses with a quiet courage. He was always so polite and affable that people who met him
would never suspect that he had so many medical problems.
No matter how bad he was, he would always ask me how I was and how my family was doing. His inquiries were
not just insincere pleasantries but concerned questions from a man who really cared. He would detail his medical
problems in an organized fashion but in all of the years I had known him I never once heard him complain. But as
he sat before me that day, his unfaltering will to live seemed no longer to be present.
As he slumped in his wheelchair and closed his eyes, I had a brief opportunity to talk privately with his wife. She
realized he was failing and was overwhelmed with seeing him suffer. I told her that I would arrange a visiting nurse
and suggested perhaps hospice. Her eyes widened at the suggestion but she realized that hospice would be the
next appropriate step.
I gently squeezed his hand and he raised his eyes towards me.
“I’m going to arrange for a nurse to come out to your house,” I explained. “You don’t have to keep suffering like
this. Many people decide enough is enough and stop the aggressive treatment. We can just try to keep you
comfortable.”
He seemed drowsily confused but able to grasp what I was telling him.
“I’m going to arrange for a hospice nurse to see you,” I cautiously added.
We think of patients in terms of medical diagnoses, test results, surgeries and medications. But a funny thing
happens over the years as a doctor-patient relationship deepens. We tend to think of people much less as cases
of heart disease, strokes or kidney failure and much more as just people, people who entrust us with their lives,
people who become like family.
I was well versed in all of Ken Roder’s medical problems. But that is not how I would remember him.
He softly shook his head to say no to hospice care. I stood there in silence. Because of his decision, he would
survive another three months in continual severe pain, in and out of hospitals, never getting the relief he was
seeking and inevitably dying in hospice care anyway.
But with his last bit of unyielding courage that typified his remarkable determination, he lifted his head and
looked me squarely in the eye.
“I want to keep fighting,” he valiantly declared.
And that is the way I will always remember Ken Roder.
