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Internal medicine physician and mom of 4

A story untold

The contrast was stark. It had been an unusual day, to be sure. This day did not start with five home visits on the schedule. And yet, here I am driving through the beautiful countryside for miles on end - leaves falling, colors changing almost while they fall.  Nothing but the hum of the road in my ear.

In a land too far for radio waves or cell coverage to reach, I round each bend in the road with less and less speed. I am relaxing into the afternoon, a forced slowing to a too-busy day.

After the final mile on a freshly graveled road, I turn into what must be the address, albeit unmarked. Sure enough, there is a familiar face waiting on the stoop.

The plywood door is opened for me, revealing a matching floor. “It’s uneven, watch your step”, he says while welcoming me inside.

One step, two, and I am in the midst of a warmly glowing two room home. The walls are thin, the dirt floor clean, and the smiles beautiful.

“Let me wash my hands”, I say. “Here, we have a bowl and soap. Let me get a clean towel”.

There is no running water or plumbing to this home.

Books line the walls, inviting guests to peruse and cozy up in one of the two only chairs. “Who’s first?”

“He is”, she insists.

So we start in the visit, vitals quickly taken and the main event soon arrives.

“How is your pain?” I ask. Several days prior, he had been rushed 45 minutes to the ER in intractable pain from the tumors winding around his spinal cord, their tentacles spearing white-hot spasms of pain down both legs.

The pain had completely resolved, not even a need for Tylenol – no, they haven’t started the pain patches. Catching the surprise on my face, she prompts “Tell her what you were doing that hurt your back, honey”.

Reluctantly, slowly, somewhat regrettably and almost with shame, he describes his preceding two weeks spent splitting wood. “We have just the wood burning stove for cooking and heating” he explained. “And now I know that there is enough wood to get her through the winter without me”.

“He’s been chopping wood for me since high school, 35 years now” she explained with a catch in her voice.

Soon, we have exchanged one set of vitals for another and the focus is on her. “She has been doing well, the new meds are helping, she hasn’t had any hallucinations this week”. She has an unusual constellation of physical and mental illness that took me about 6 months to fully process, stretching my training nearly past its limit. Sleeping well, eating meals, joining in the weekly one hour trip to town, reading.

He worries about how she will coordinate cashing in the food stamps and arranging transportation to town without him. She worries about his pain. True loves, terrified eyes belying gentle smiles.

Much too quickly, the time has come. Prescriptions left, instructions written, and hugs all around. Off to the next home visit.

Everyone has a story, you see, and too seldom do I stop to think about the story in 20 minute installments throughout the day. I have seen this couple regularly over the past year, walking alongside them in their journey through an inpatient psych stay, chemo, radiation, and recent hospice referral. Never once have I pictured them living in a 2 room shack without running water.

It would prove to be a stark contrast, indeed. For the day was not yet over.

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