In death as well as life

September 1, 2006

It took just a few hours to show this physician how much he meant to one patient, one family, and one community.

It was a cold, rainy Saturday afternoon in March and I was on call. I'd been at the hospital all morning and about half the afternoon, and had only been home a short while when my beeper went off. I called the operator, who told me I had a message from a local police sergeant regarding one of my partner's patients.

When I connected with the police officer, I was told that "Joey" (not his real name) had died and needed to be pronounced by a doctor before the body could be removed to the funeral home. It was a great irony that the rare instances we made house calls were mostly to pronounce patients dead; the local medical examiner usually passed on those cases.

Inwardly, I groaned as I contemplated leaving my two young children, whose time with me that day had already been brief, just to drive over in awful weather and confirm to the police that someone was dead. I mean, really, couldn't they tell?

I'd reached into the back seat to retrieve my doctor's bag and headed towards the building when I noticed three policeman standing around their cruisers. As I approached, one of them called out, "You the doc?" I told him, Yes, I was, and said that I was there to see Joey. The officer looked at my doctor's bag and quipped, "Believe me, Doc, you ain't gonna need that!"

I followed the officer's directions up to the floor where Joey lived and proceeded down the hallway. Behind the neighbors' closed doors, I heard the canned laughter of a TV show, the strains of a classical music piece, and hushed voices. No doors opened. No one seemed to be interested.

The door to the apartment was slightly ajar. I gave it a gentle push and it creaked open. I entered what was a small and disheveled kitchen. The refrigerator was adorned with postcards, photos of his grandchildren, and samples of their artwork.

As I surveyed the kitchen table, I noticed the trappings of a life that seemed to have one focus: health maintenance. A handout on the table described the recommended diabetic nutrition plan. Doctors' appointment cards were lined up in neat piles. They were in sequential order: a cardiologist's appointment in one week; an endocrinology visit in a few weeks; his primary care doctor (my partner) in a month; and so on. There was a tremendous array of medications-tonics, elixirs, inhalers, and pill bottles of all sizes, including pill trays with their small dated plastic doors tilted back, up to four days ago.

I thought to myself how complicated this poor man's life had been. I'd met Joey a few times in the office and the hospital during previous admissions, and found him to be a jolly man who was proud of his family and very reliable in keeping his follow-up appointments. I wondered how a man with so many health problems and things to keep track of medically could have always had a smile on his face.

I knew that I couldn't dwell here long, contemplating this man and his life and that I had to move on to the business at hand. I wasn't really sure where he was or the layout of the apartment so I just walked out of the kitchen into the living room. I noticed an open bedroom door to my right. What I also noticed now was that many of the windows in the apartment were open, despite the chilly night. And I noticed the smell.