Momma's legacy

February 17, 2006

Sometimes, the most unassuming patient turns out to have made the biggest impact on society.

Everyone was interested in the patient in room 516. Apparently, he was a local politician of some sort, and his hospitalization had been mentioned on the TV news.

I guess I should have realized right away that he was so important after he'd lectured me about having to wait in the admitting department for 20 minutes while the cleaning staff prepared his room. His medical condition was nothing serious. I sensed that his primary care doctor probably wanted him admitted more for the convenience and speed in working the patient up.

In contrast, my other new patient a few rooms down had an unassuming, relaxed manner-and a serious diagnosis. The years of smoking had caught up with her. Her bed was surrounded by young adults of various races who couldn't seem to do enough for her. They asked her to give them tasks, as if looking for ways to prove their love to her. If she drank a few sips of water, one of them would refill the cup immediately.

Another dozen of their sisters and brothers would be coming to town the next day to visit with my patient, one of them told me. This woman had essentially adopted about 30 children and adolescents over the years with her female partner, also called "momma." These "mommas" never gave birth, but they definitely had their own kids.

We talked at length about her emphysema. She said, "I suppose them cigarettes are not exactly a healthy choice."

"Not a healthy choice? Are you kidding me? Licking the weight bench at the gym is a healthier choice for you at this point!"

She obliged me with a laugh and stuck out her tongue at me. Her kids seemed pleased that I was up front with her and not condescending. It would have been inappropriate for me to be paternalistic toward someone more than twice my age. She had made her choices, and the evidence indicated that most of them were excellent. Judging her on a single addiction would have been unconscionable.

As I walked back towards the nurses' station, the man-of-importance yelled out to me, "Doctor, can you come in here one more time?"

"Sure, what's wrong?"

"The food on this tray is all cold."

"Okay, I'll have the nurse heat it up for you."

"Actually, if I could just get a new tray, that would be better, because I don't like most of this food anyway."

"We'll see what we can do."

As I sat down to dictate my notes, it struck me, as it often does, how being a doctor forces you to interact with an unusually diverse group of people. And it lets you see people behind the scenes, where their true selves emerge.

It struck me that the press and public had their priorities wrong that day. Not to diminish what a goodwilled politician can accomplish, but how often do we fail to acknowledge the miracles a simple person with a good heart can do? More than two dozen members of the next generation learned self-respect, learned to work hard, and learned how to love because of "momma." Their own children will, in turn, also be the beneficiaries of her legacy.

If the press wanted to report on somebody of major importance, they were concentrating on the wrong patient.