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A rocky road: Important lessons in life, love, and resilience from a special patient


Jim Van Steen is one of those patients who comes along rarely in a doctor's career: an ordinary man who faced extraordinary challenges with wisdom and humor.


Jim (all names throughout this article are pseudonyms) considered himself the black sheep of an outstanding family. His siblings all attended college, some earning advanced degrees. In contrast, Jim struggled in school, but he loved working with his hands and earned a good living in construction trades. Seeing a remodeling project come alive was immensely rewarding for this tall, lean, creative man.

Jim met the love of his life, Trish, on a double date for prom. Although Trish was his friend's date, it was Jim and Trish who clicked with early and enduring chemistry. They married in their early 20s.


From his teens, Jim honed a talent for rock guitar, composition, and recording. He played in several bands and even during his final illness he was hard at work on new material that he hoped to release on iTunes. His own compositions were often angry and strident, yet his bands also covered many classic rock hits. Unfortunately, the drinking and late nights of the rock lifestyle clashed with Trish's dreams of a stable life. After several years of arguments over his self-destructive habits, the marriage broke up.


While Trish relocated to the Southwest after their divorce, Jim kept working in construction, self-employed. In a brief rebound relationship, Trish conceived a daughter, Morgan, but soon broke up with Morgan's father. Soon thereafter, Trish moved back home when her own father became ill.

Ten years after splitting from Trish, Jim got to thinking about her and contacted a search service. Within 2 hours, he had located his first love. During their first phone conversation, he told Trish about a peculiar dream he'd had. In the dream, Trish had blue eyes instead of her actual brown. Trish replied, "That's my daughter, Morgan." Jim and Trish rekindled their romance and remarried. Jim, now sober and reliable, quickly came to love Morgan and raised her as his own daughter.

What was I doing during this time? Fifteen years ago, I started taking care of Trish's mother, Frances, who enrolled in an HMO served by my group practice. A shy woman with typical concerns of late middle age, Frances was one of many nice people I met in a sometimes overwhelming practice.


A few years later, Trish came to see me for an initial visit. She was in chronic pain and disabled, with a complex history of fibromyalgia, neck trouble, depression, migraine, and hyperlipidemia. I met Jim only in passing at first. He didn't like doctors, but he often brought Trish for her visits. He struck me as the little household's Rock of Gibraltar: a dedicated, dependable family man who worked hard to support his petite, fragile wife and their lively daughter.

I saw Trish often, and Jim and Morgan occasionally, always encouraging the parents to quit smoking, for their own sake as well as their daughter's. Jim often expressed worry about Trish's many ailments and stood by her through several difficult surgeries.

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© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health