Driving back from that funeral made me think of some other heroes I've known. Can't go too far into the memory bank and not think of Paw-Paw. I am ashamed to say I don't remember Dora's last name. Doesn't matter much. She knew how much I loved and respected her. Can still see her the morning she passed. It's a long story, but one I need to write about. That's about all I can do to honor her. She deserved that and a lot more.
I knew Dora from wayback. Her half-daughter had been a long time patient when I got into practice. It was the 1990's. Her daughter, by one of her several husbands, was a sweet girl. She got here with the curse of diabetes and high blood pressure. Overweight to an extreme, she spiralled into kidney failure in her late teens. If you don't know, kidney failure is not pretty. Especially with diabetics that have it early. The same small blood vessels that make up the hardwiring of the kidneys feed everything else. Legs. Arms. Eyes.
With the diabetic, a longer life from dialysis led to other sadness. Most days on dialysis rounds, I could count two score limbs missing on my folks. Leg prostheses lay plopped by the chairs. Looked like something from a sequel of "The Texas Chainsaw Massacre". Kinda funny, but not really. Each limb was another beat down to these courageous folks. No way that you could ignore sitting on a damn machine four hours a day, three days a week. FOREVER. Or losing legs, fingers, vision and not think that the game had been rigged from the start. I heard the term and it fit: children of a lesser god.
The miracle in all of this sadness was the good spirit of so many. I saw it often enough to know.
Diabetes was not the only predator. Bad genes. Lupus. High blood. Bad luck. They all did the same things. Changed your diet to bland options. Reduced the amount you could drink to a few glasses a day. Dictated what you could drink. NO orange juice. Took away your taste and libido. Made you itch like a demon. Little by little. Bits and pieces. Dreams of strong people got hacked away.
Knew one woman who had been on the machine for 23 years. 23 years, three days a week, four hours a treatment. Rain or shine, heat or cold. She did dialysis last shift of the day cause she worked full time. Raised two good kids. Was a single mom. Never, ever failed to smile and ask how my family was. That's just how she was. Knew another woman who had no family support. Which was really unusual in the Hispanic community. But, for years she would get dropped off by a neighbor, or someone from the church. The cash fund from the center usually paid for her cab ride home. No telling if she had heat or not. Probably not. Or how she felt alone on a bad night when she had the heaves or fever and must have felt abandoned. Or tormented. But, that was the same lady who had the best smile. Always gave me a hug, too. You could not kill her spirit. I thought the breast cancer and losing both breasts might. But no. She got a good wig from
somewhere and wore it like a crown. She put on her makeup and spoke good words to others much better off. I know she's dead now. I hope she did not go alone in the night, but had someone there to at least bear witness. God bless her.
The kidney failure respected little, especially cultural boundaries and money. Dr. English lived out his years on the
machine, same as Domingo Patino who lived on welfare. The mental changes plagued them both like lots of elderly folks who out lived their body. Dr. English would suprize you though. Maybe once a year he was as clear as a second year resident. He'd call me over and want to talk. I treasured those times. After he passed, I lived in the beautiful house his wife and he built. Raised a family in it. Always felt he approved of the way I treated "the folks". The last time we talked was sad though. He felt deep guilt about something he had done. He just cried his eyes out. Inconsolable. He'd just say, "I can't be forgiven. I can't be forgiven." He never went deeper than that. By the the next time I saw him he was blissfully back in his small, cloudy world. I know he carried something dark to his grave. I like the image from the Egyptian Book of the Dead. Your heart and good deeds it holds get weighed on some eternal scale then the fearce god Anubis judges. I know Dr. English would have passed with flying colors. At least from what I saw. And I saw a lot.
Domingo passed one Sunday afternoon in a lonely room at Methodist. By then he'd lost all limbs. He lost his penis too. Think about that. While he had one arm, he'd been able to live in a run down nursing home that fed him some. No family. But he smiled and meant it. One day he rode home on the bus. They did not buckle down his wheel chair. After a stop, he rolled from the back to the front. Crashed and burned. Broke his arm and it went south from there. You could not make this up. I was on the service the day he died. Saw him early in the morning. He was tired and had that look. I asked him if he wanted anything special. He said he'd die for a beer. He chuckled at the irony. I called the kitchen. They saved beer and wine for the high rollers who came into the VIP floor on 7 West. But, all they could find was Shaffer's. Later in the day, I went down to get the beer. Wouldn't you know it. They had not put the beer in the refigerator. Domingo Patino spent the last hours on this earth sipping a warm Shaffer's that I held and he drank with a straw. Lord I hope he is somewhere drinking beer and dancing with angels. He earned a lot of good karma by my way of thinking. There were many others.
Back to Paw-Paw. Her daughter got a transplant and did well for a spell. Her body slowly rejected it. All she had was the puffed up balloon face of high dose prednisone and need again for dialysis. When she came back her mother came to clinic a few times. In the old days, Dora had been very pretty and took good care of herself. But something had changed and she looked older by the month. Suprize when I saw her in clinic one day. SHE had kidney failure and needed dialysis soon. She could not stop crying when I told her. I cried too. All I could do.
The first couple of years Dora and her daughter did pretty well. No big hiccups. Then they started doing dialysis in the small unit in Big Spring. It was a small space, maybe 15' by 20' at the most. We had fine nurses. Old school. Could do dialysis in their sleep. Dialysis chairs were bunched up tight though. Eight per shift. It was a tough place however you cut it.
I always worried about a patient passing out and the nurses calling a code. You know, the things that they do to try and recussitate. The shock and terror were terrible built-ins for everybody. Patients and nurses alike. When the defibrillator was used to try and restart the heart it put it at whole other level. The body would flop with each shock. The the ER doc would rush up and try to intubate. Never went easy it seems. People screaming meds, defib, intubation. The others on the machine just had to look on. They were teathered like fish on a line. No escape.
So, imagine you are sitting in a chair on dialysis and your only daughter is just across the room. Close your eyes and think how it would feel for your daughter to go out. Right in front of you. They called a code. By what I could piece together she was dead immediately. Some arrythmia and she was gone. But, with Dora sobbing, the truama of the code went on. The shocks. The body jerks. The mouth to mouth. Your own precious daughter dies in a heap of paper and screaming nurses. Dante did not know this level of hell.
Dora was never the same afterward. How could you be? She rallied for a while. Did a little better. When I would see her on the machine on my trips down there, her eyes looked a little less sad. Maybe. Then the worst thing happened. Dora had a stroke. It was a full blown big infarct. Don't know how she survived, but they shipped her up to Lubbock and we kept her alive. If that's what you call it.
I rotated into the hospital every 3 weeks during my 14 years there. I thought Dora had passed. Went to Rehab on rounds and there she was. Propped in a wheel chair, hair clean, make-up someone had put on. She smiled a smile I cannot forget. It was really only half a smile. The stoke had claimed half of her and nothing worked on the right face and left body. It was a beautiful, crooked smile though. When she talked all that came out was, "Paw-paw, paw-paw".
I visited her over the months. She always seemed glad to see me. I felt the same. Linked at some unknown level. The the most radical thing happened: when Dora would say "Paw-paw" she did it with inflections and rhythm. And God as a witness: I could understand everything she was trying to say. I knew what she wanted to tell me.
This unnerved me in lots of ways. I don't think it would have done so had it happened before I went to treatment for alcohol. I was an arrogant prick for the most part. Maybe still am. I spent 6 months mopping floors in Atlanta and having my ass chewed by a wise old nurse. Something settled in and I was changed in-spite of me. Enough to keep me sober for twenty two years. So when this fluency came to me I was dumfounded, but grateful. I knew it was some sort of gift...to Dora. She was not locked in a world that could not understad her. Someone understood. Over time, she told me about seeing her daughter pass. Getting that out helped her a lot. What a terrible thing to be completely helpless. What a worse thing: to think oneself so insignificant as to not even be acknowledged. I cannot think about the whole picture to this day. And not cry.
I was on call the morning Paw-paw died. They called me at the house that she had "gone to ground". I rushed to the MICU from the house. She wasn't there. They called and said they were still coding her. I just could not go over to her part of the hospital and watch that. That was on me and something that sticks. But, honest, I prayed that she would pass. She did not. After 45 minutes of pounding on her chest, giving her untold amouts of bicarb and adrenaline. After shocking her time and again, they got a rhythm. They got a blood pressure then wheeled her to the Unit.
Celia the wise old charge nurse was there as they deposited her in a bed on the left, down near the exit. She was just trying to clean her up and I was just trying to do an assesment. Miraculously, they did not tube her in the code. She was able to gasp. She moved her mouth. It took a minute or two and she started to fishmouth. Celia and I looked at each other. "Dr. Newsom, she's dying." I knew that, hated it worse than you can know. But, we sat there and just held Dora's hand. She opened her eye once and , I think, she recognized me. She nodded. She really did. Then she whispered "Paw-paw" and was gone.
When I think about an afterlife, I hope only this: there is some justice. I hope those that are innocent and who live with unspeakable things happening to them and to their loved ones have some special place. Some walled off place where all good things come to pass, all the day..everyday. Special dispensation. For all the inoocents who suffered so while alive. I hope that's true. I hope Dora is there. Her daughter too. Both of them young, beautiful, and wearing white.
Me, I am honored to have known such good people. They really are my heroes. I mean that with the deepest reverence. They taught me a lot. More than I could have known. Best of all, they took care of my heart in special ways. And healed it in some magical way. And one special woman I owe a great debt to. She taught me a whole new language I would never have known. And when it's my time, I hope she comes to find me and lead me across. That would be heaven.
I knew Dora from wayback. Her half-daughter had been a long time patient when I got into practice. It was the 1990's. Her daughter, by one of her several husbands, was a sweet girl. She got here with the curse of diabetes and high blood pressure. Overweight to an extreme, she spiralled into kidney failure in her late teens. If you don't know, kidney failure is not pretty. Especially with diabetics that have it early. The same small blood vessels that make up the hardwiring of the kidneys feed everything else. Legs. Arms. Eyes.
With the diabetic, a longer life from dialysis led to other sadness. Most days on dialysis rounds, I could count two score limbs missing on my folks. Leg prostheses lay plopped by the chairs. Looked like something from a sequel of "The Texas Chainsaw Massacre". Kinda funny, but not really. Each limb was another beat down to these courageous folks. No way that you could ignore sitting on a damn machine four hours a day, three days a week. FOREVER. Or losing legs, fingers, vision and not think that the game had been rigged from the start. I heard the term and it fit: children of a lesser god.
The miracle in all of this sadness was the good spirit of so many. I saw it often enough to know.
Diabetes was not the only predator. Bad genes. Lupus. High blood. Bad luck. They all did the same things. Changed your diet to bland options. Reduced the amount you could drink to a few glasses a day. Dictated what you could drink. NO orange juice. Took away your taste and libido. Made you itch like a demon. Little by little. Bits and pieces. Dreams of strong people got hacked away.
Knew one woman who had been on the machine for 23 years. 23 years, three days a week, four hours a treatment. Rain or shine, heat or cold. She did dialysis last shift of the day cause she worked full time. Raised two good kids. Was a single mom. Never, ever failed to smile and ask how my family was. That's just how she was. Knew another woman who had no family support. Which was really unusual in the Hispanic community. But, for years she would get dropped off by a neighbor, or someone from the church. The cash fund from the center usually paid for her cab ride home. No telling if she had heat or not. Probably not. Or how she felt alone on a bad night when she had the heaves or fever and must have felt abandoned. Or tormented. But, that was the same lady who had the best smile. Always gave me a hug, too. You could not kill her spirit. I thought the breast cancer and losing both breasts might. But no. She got a good wig from
somewhere and wore it like a crown. She put on her makeup and spoke good words to others much better off. I know she's dead now. I hope she did not go alone in the night, but had someone there to at least bear witness. God bless her.
The kidney failure respected little, especially cultural boundaries and money. Dr. English lived out his years on the
machine, same as Domingo Patino who lived on welfare. The mental changes plagued them both like lots of elderly folks who out lived their body. Dr. English would suprize you though. Maybe once a year he was as clear as a second year resident. He'd call me over and want to talk. I treasured those times. After he passed, I lived in the beautiful house his wife and he built. Raised a family in it. Always felt he approved of the way I treated "the folks". The last time we talked was sad though. He felt deep guilt about something he had done. He just cried his eyes out. Inconsolable. He'd just say, "I can't be forgiven. I can't be forgiven." He never went deeper than that. By the the next time I saw him he was blissfully back in his small, cloudy world. I know he carried something dark to his grave. I like the image from the Egyptian Book of the Dead. Your heart and good deeds it holds get weighed on some eternal scale then the fearce god Anubis judges. I know Dr. English would have passed with flying colors. At least from what I saw. And I saw a lot.
Domingo passed one Sunday afternoon in a lonely room at Methodist. By then he'd lost all limbs. He lost his penis too. Think about that. While he had one arm, he'd been able to live in a run down nursing home that fed him some. No family. But he smiled and meant it. One day he rode home on the bus. They did not buckle down his wheel chair. After a stop, he rolled from the back to the front. Crashed and burned. Broke his arm and it went south from there. You could not make this up. I was on the service the day he died. Saw him early in the morning. He was tired and had that look. I asked him if he wanted anything special. He said he'd die for a beer. He chuckled at the irony. I called the kitchen. They saved beer and wine for the high rollers who came into the VIP floor on 7 West. But, all they could find was Shaffer's. Later in the day, I went down to get the beer. Wouldn't you know it. They had not put the beer in the refigerator. Domingo Patino spent the last hours on this earth sipping a warm Shaffer's that I held and he drank with a straw. Lord I hope he is somewhere drinking beer and dancing with angels. He earned a lot of good karma by my way of thinking. There were many others.
Back to Paw-Paw. Her daughter got a transplant and did well for a spell. Her body slowly rejected it. All she had was the puffed up balloon face of high dose prednisone and need again for dialysis. When she came back her mother came to clinic a few times. In the old days, Dora had been very pretty and took good care of herself. But something had changed and she looked older by the month. Suprize when I saw her in clinic one day. SHE had kidney failure and needed dialysis soon. She could not stop crying when I told her. I cried too. All I could do.
The first couple of years Dora and her daughter did pretty well. No big hiccups. Then they started doing dialysis in the small unit in Big Spring. It was a small space, maybe 15' by 20' at the most. We had fine nurses. Old school. Could do dialysis in their sleep. Dialysis chairs were bunched up tight though. Eight per shift. It was a tough place however you cut it.
I always worried about a patient passing out and the nurses calling a code. You know, the things that they do to try and recussitate. The shock and terror were terrible built-ins for everybody. Patients and nurses alike. When the defibrillator was used to try and restart the heart it put it at whole other level. The body would flop with each shock. The the ER doc would rush up and try to intubate. Never went easy it seems. People screaming meds, defib, intubation. The others on the machine just had to look on. They were teathered like fish on a line. No escape.
So, imagine you are sitting in a chair on dialysis and your only daughter is just across the room. Close your eyes and think how it would feel for your daughter to go out. Right in front of you. They called a code. By what I could piece together she was dead immediately. Some arrythmia and she was gone. But, with Dora sobbing, the truama of the code went on. The shocks. The body jerks. The mouth to mouth. Your own precious daughter dies in a heap of paper and screaming nurses. Dante did not know this level of hell.
Dora was never the same afterward. How could you be? She rallied for a while. Did a little better. When I would see her on the machine on my trips down there, her eyes looked a little less sad. Maybe. Then the worst thing happened. Dora had a stroke. It was a full blown big infarct. Don't know how she survived, but they shipped her up to Lubbock and we kept her alive. If that's what you call it.
I rotated into the hospital every 3 weeks during my 14 years there. I thought Dora had passed. Went to Rehab on rounds and there she was. Propped in a wheel chair, hair clean, make-up someone had put on. She smiled a smile I cannot forget. It was really only half a smile. The stoke had claimed half of her and nothing worked on the right face and left body. It was a beautiful, crooked smile though. When she talked all that came out was, "Paw-paw, paw-paw".
I visited her over the months. She always seemed glad to see me. I felt the same. Linked at some unknown level. The the most radical thing happened: when Dora would say "Paw-paw" she did it with inflections and rhythm. And God as a witness: I could understand everything she was trying to say. I knew what she wanted to tell me.
This unnerved me in lots of ways. I don't think it would have done so had it happened before I went to treatment for alcohol. I was an arrogant prick for the most part. Maybe still am. I spent 6 months mopping floors in Atlanta and having my ass chewed by a wise old nurse. Something settled in and I was changed in-spite of me. Enough to keep me sober for twenty two years. So when this fluency came to me I was dumfounded, but grateful. I knew it was some sort of gift...to Dora. She was not locked in a world that could not understad her. Someone understood. Over time, she told me about seeing her daughter pass. Getting that out helped her a lot. What a terrible thing to be completely helpless. What a worse thing: to think oneself so insignificant as to not even be acknowledged. I cannot think about the whole picture to this day. And not cry.
I was on call the morning Paw-paw died. They called me at the house that she had "gone to ground". I rushed to the MICU from the house. She wasn't there. They called and said they were still coding her. I just could not go over to her part of the hospital and watch that. That was on me and something that sticks. But, honest, I prayed that she would pass. She did not. After 45 minutes of pounding on her chest, giving her untold amouts of bicarb and adrenaline. After shocking her time and again, they got a rhythm. They got a blood pressure then wheeled her to the Unit.
Celia the wise old charge nurse was there as they deposited her in a bed on the left, down near the exit. She was just trying to clean her up and I was just trying to do an assesment. Miraculously, they did not tube her in the code. She was able to gasp. She moved her mouth. It took a minute or two and she started to fishmouth. Celia and I looked at each other. "Dr. Newsom, she's dying." I knew that, hated it worse than you can know. But, we sat there and just held Dora's hand. She opened her eye once and , I think, she recognized me. She nodded. She really did. Then she whispered "Paw-paw" and was gone.
When I think about an afterlife, I hope only this: there is some justice. I hope those that are innocent and who live with unspeakable things happening to them and to their loved ones have some special place. Some walled off place where all good things come to pass, all the day..everyday. Special dispensation. For all the inoocents who suffered so while alive. I hope that's true. I hope Dora is there. Her daughter too. Both of them young, beautiful, and wearing white.
Me, I am honored to have known such good people. They really are my heroes. I mean that with the deepest reverence. They taught me a lot. More than I could have known. Best of all, they took care of my heart in special ways. And healed it in some magical way. And one special woman I owe a great debt to. She taught me a whole new language I would never have known. And when it's my time, I hope she comes to find me and lead me across. That would be heaven.