TAKING A HISTORY | Anand Jayanti
Medical school has a way of making one feel like a charlatan. Often, standing before a patient as part of a healthcare team, the medical student is the only one wearing a white coat, often the only one taking extensive notes, and nevertheless amusingly the least useful person in the room. Encountering strangers in hallways, medical students often command more respect than their attendings who dress with a complete lack of pretense, with seldom more than a stethoscope slung over their shoulders. At least for the first two years, going to the clinic feels like some kind of a theatre production, memorizing lines and trying to look convincing to patients who may themselves be acting for the purposes of our education.
In this environment, the world of actual healing feels like a far away fable. The self-worth of any student, moreover, any who struggles with loneliness or academic difficulties is held to ransom every day. This was my experience during the fall of my second year. The wind grew colder with September's departure, finding its way into the openings of my jacket in the evenings, and a restlessness seemed to infiltrate my mind in the same manner.
It was in the context of this restlessness that I visited a 94-year-old nursing home patient named Doris. The nurses informed me she was not permitted to eat the Thanksgiving popcorn I'd brought her as it posed a choking hazard, so instead I decided to just sit and talk to her. For 2 hours she bestowed a wealth of life experience: her humble beginnings, the Great Depression's effect on her and her 12 siblings, and the small joys that were to be found in the cracks of the cold wall of destitution her cheek seemed always pressed against. I obtained her permission to use her name, and then spent the holidays illustrating her story as a Christmas present for her. I printed and bound the final copy, and then notified my classmates that I'd be leaving it in the library for them to sign with good wishes. By the end of the week, there were nearly two-hundred signatures and messages, including those of many professors and the deans of my school.
Having made all the preparations, I returned to the nursing home where we'd met, only to find she was no longer there. I drove in the subsequent days, book in hand, to three different facilities, each pointing to some other hamlet, before finally discovering that due to a terrible fall, Doris was in a hospice and would be on powerful pain management for the rest of her life.
The few remaining times I visited, I pulled a chair close and sat in solitude watching the sun's rays pass over her delicate frame from the window, and over our book sitting untouched on the nightstand. Occasionally, she seemed to awaken briefly to a pang of discomfort that wrinkled the features of her face, a raspy plea barely escaping her lips. I would summon a nurse in those instances. Over time, however, I learned that some of these things just happen "as people die".
I noted then how similar the very elderly were to the very young. When we are born, we don't remember it. Our memory of conscious life seems to phase gradually into existence, our initial recollections and insights and moods illuminating our lives more like a sunrise than a light switch turning on. Similarly do we die, our vision, hearing, and memory relieving us piecemeal, people ensuring we have enough food and water, clasping around any invited hand with our delicate fingers, simple pleasures like the offer of apple juice punctuating the days into increments. We leave then like a sunset, silencing the natural world into a cool night that gives way to some new sunrise. Besides apple juice, I discovered one of Doris's simple pleasures was being read to. Once, when her face contorted in pain, I opened the book and read her words back to her.
“What was hardest on Mom was that she didn't believe in not having kids. She believed if the Good Lord got her pregnant that meant He wanted her to have it!”
From somewhere far away, I thought I saw a smile surface onto her face, and joy creep into the fog behind her eyes. I kept reading to her in this manner whenever I thought she'd awoken.
"I would ask Momma, 'Why'd you have so many kids?'
She'd say, 'What'd you want me to do, stop right before you?'"
Occasionally I found myself searching for what it was like to be ninety-four years old, to have a heart that has beat time for four generations, to look at your hands and catalog the birth of your children or the moon landing in their valleys.
That January I met Doris’s niece and granddaughter, and we forged an immediate bond, smiling as we once in a while glanced in unison toward the sleeping woman responsible for our unlikely friendship. Over their family photo album, I learned that Doris wasn't the blonde she’d told me she was, but rather just a very imaginative redhead. I learned that she was very beautiful notwithstanding. I learned that she loved birthday parties.
Doris passed in February of this year, and her family left our book out at her funeral service. For a long time, I lamented the distinct possibility that Doris never truly registered my presence after her fall, and wondered if she understood in any meaningful sense how much she had affected me. But perhaps it was enough that she had affected me. Our collaboration brought a school together, forged friendship between a family and a restless medical student, and brought that medical student closer to the reason why he’s doing it. Where physicians may not always be able to do something for our patients, perhaps with some imagination we can enable them to do something for the world. Had she known the warmth she’d brought us in that cold winter, she might have reiterated something she once said to me:
We all worked together, and so we made it.
Dedicated to the memory of Doris Drake and the generosity of her family.
Permission obtained from Doris Drake to use her name and photograph.
Anand Jayanti is a third year medical student who spends his time running, whether it’s along a street in the evening or after writing an elusive ending to a poem, but usually both. He was born and raised as both Indian and American, and now feels both young and old, as he learns a trade that is both art and science. Jayanti notes: “I have heard tell that as these dualities mount, we become wiser, but alas at this writing I am still waiting to feel wise.”