Now and then I do a bit of housekeeping, cleaning out drawers and such. Recently I came across a big stack of cards. It was a mixed batch. Sympathy cards after my dad's death. Thank you cards from families of robotics students. Well wishes on my retirement from family practice 16 years ago. When you switch over to the less personal ER work you don't get quite as much in the way of personal thank yous.
One note was about 20 years old. It was from the family of a long time patient and thanked me for a story I had told at his visitation. This was something I had entirely forgotten about, but I sure remember both the patient and the story.
The Old Lieutenant was a classic example of The Greatest Generation. Small town boy. Joined the Army. Became a combat officer in Italy. Came home, started a career, married his sweetheart and had a bunch of great kids.
Unfortunately he also was of the "smoke 'em if you got 'em" generation, and carried his pack a day habit with him when he took off the olive drab and put on civvies. He had emphysema, and bad.
I took care of him for many years. After a while he and I both had things pretty well figured out. What combination of breathing treatments, steroids, antibiotics and oxygen would pull him through a flare up. Usually we were on the same page. But the man could be stubborn.
Once I had him in the office and could see that he was heading for trouble. His color was not good. He was breathing a little faster than he should. The long ago sweetheart and I both wanted him admitted but he refused. Well I was always of the opinion that I work for him not the other way around, so we opted to try him with home treatment.
I was expecting to get a late night call that he was on his way in by ambulance but instead he turned up a few days later in the office doing better.
He did admit that it was touch and go for a while. Between lack of sleep, low oxygen levels and the side effects of big doses of steroids he was both short of breath and feeling confused. He found that at least the breathing aspect of this was better if he sat in his lawn chair in his garage with the door open. A gentle breeze, a little cool air.....it was a minor bit of relief but a welcome one.
And then he looked up and saw a large, hostile raccoon staring at him.
Now, when you have been hallucinating there are limited options for deciding whether a sinister apparition like this is real or not. He yelled at it. Nothing. He waited for it to go away. It did not. Finally he decided that either the raccoon was imaginary or it was a seriously ill and deranged critter. The raccoon perhaps had a similar notion.But what the raccoon did not have was a shovel.
Mustering his considerable determination he stood up, grabbed the nearest garden tool and beat the potentially rabid raccoon to death.
That's how he knew he'd make it through this flare up, and in fact I had the privilege of caring for him for several years after that.