Photo by Thomas M. Evans on Unsplash
Andrea met him nine years ago. She doesn’t remember his name. Was it Mr. Barnes, or Baker, or Bennett? Something that begins with a B. She calls him The Hot Sauce Man.
June 4th Monday (2016)
Andrea drives her yellow Toyota Corolla, a second-hand sedan to the hospital. She parks it. Half of the parking lot is still empty. She walks fast with light steps as if she were floating. Her ponytail in the back flaps.
In three weeks, Andrea will start a new job, a real doctor’s six-figure paying job. At the age of thirty, she feels she has spent all her life in schools and residency training. It’s about time to make a living. The thought of this makes her heartbeat quicken.
The moment she enters the hospital building, she sees Dr. Wu in the hallway, walking toward her.
“Good morning, Andrea. You’re early,” Dr. Wu greets her.
“Good morning, Dr. Wu. Well, you’re early too.”
“I’m used to it. I’m heading to my outpatient clinic now.”
“Okay. I will check on our patients. See you in the afternoon.”
“Good,” Dr. Wu says. She notices sparkles in Andrea’s eyes and adds, “You look happy today. You must be excited about your new job. Are you ready?”
“Yes. I’m happy. But, I’m also afraid.”
“That’s normal. I felt the same years ago. You’ll be fine. Don’t be afraid.”
“I put a calendar on my refrigerator. I cross off each day to count down.”
“Time will go very fast,” Dr. Wu says, nodding slowly as if she wishes to make time slowing down.
Andrea replies, “I know. I still have a lot to do before my new job. See, I need some new clothes.” She looks down at her attire, a white cotton shirt and a pair of blue pants. Then she shakes her head and runs her right hand on her pony tail. “I also need a haircut. I want to have short hair like yours.” Will look more respectable, she thinks.
Dr. Wu smiles. She likes Andrea. Is it because they share some similarities? Maybe. They both have straight hair. Andrea’s is blonde, tied in the back with a simple elastic band; hers is black and short at jaw length. They both wear plain color clothes: either white, grey, or light blue etc. None of them wear jewelry or heavy makeup.
Andrea likes Dr. Wu too. She is at least twenty years older than herself. She is always calm and has a humble demeanor. She makes residents (her trainees) feel respected. She listens to her patients and unit staff, especially nurses and therapists. She is never in a hurry. Where did she get so much patience?
Dr. Wu smiles and says, “You look just fine.”
“Thanks. I feel like I’m ready. I’ve learned a lot in four years of residency training. I’m glad I have had a chance to rotate at the VA hospitals. Here, we don’t have the insurance hassles. And I can spend more time with each patient without being rushed. And since I’m a senior resident, you give me the independence to run the inpatient unit. This is good for me.”
“You’re doing well. You’re thorough and listen to your patients.”
“Thanks. Another thing I like is that we have a good range of patient categories. You see currently we have two stroke patients, one patient with brain injury, one patient with Multiple Sclerosis exacerbation, two patients had a heart surgery and one elderly had hip replacement. It’s really a good mixture for me to learn.”
“And you’re doing a good job so far.”
“Thanks. I really appreciate our daily discussion about our patient in the afternoon. I appreciate your insights.”
Dr. Wu looks at the clock on the wall by the entrance, then says, “Thanks. It’s time for me to go to my clinic now. I saw we have a new patient today. An eighty-year-old who had a hip replacement two days ago. You can go ahead to see him. Hopefully he’s ready to start therapy. We’ll discuss the case in detail in the afternoon.”
“I will. See you this afternoon,” Andrea says confidently.
After parting with Dr. Wu, Andrea goes to her office and turns on the computer. She begins to review medical records. She checks if something happened to her patients overnight. Did nurses report any particular issues, such as insomnia, constipation, agitation, pain, mood changes, or injuries? Are there new blood test results back from previous days (some blood tests may take days)? What are the therapists’ updates on her patients: are they able to get out of bed, walk, put on their clothes independently, or climb stairs?
Then she reads about her new patient, Mr. B. Mr. B doesn’t have major medical conditions, such as heart disease, high blood pressure, or diabetes. He weighs 190 pounds and is 5”11’ and has a BMI (body mass index) of 26.5, which puts him in the overweight (not obese) category. He is married and was independent before the surgery. Andrea makes a mental note of all the information.
Five years ago, this kind of admission to inpatient rehab wouldn’t raise a question mark. But now, Medicare has tightened admission criteria for patients who have had a simple joint (hip or knee) replacement. It requires joint replacement patients to be either eighty-five years old or older, being obese, have joint replacements on both sides, or have serious medical comorbidities, such as heart failure.
Andrea is glad that those rules aren’t too rigid. Although Mr. B doesn’t meet any of the above, he is in a so-called gray area: an elder and overweight. He can benefit more therapy before going home. She puts on her white coat, hangs her stethoscope on her neck, and heads to the inpatient unit.
Andrea arrives at Mr. B’s room at the end of the hallway. The moment she appears at the door, her patient becomes teary.
Alarmed, Andrea thinks perhaps Mr. B is in pain or uncomfortable? Or maybe he’s unhappy with nursing care? Before she opens her mouth, Mr. B says with a quivering voice, “They treat me like a king!”
Ah. Andrea is relieved. He’s overwhelmed by the quality of nursing care, not the opposite. Andrea agrees. She confesses in her mind that she has wondered many times how can nurses do their job day in, day out. They get patients in and out of bed, clean them up after they had a bowel accident, walk with them, and talk to them, even if a patient doesn’t understand a word of what they say. I wouldn’t be able to do what they do.
Nodding her head, she says, “You deserve it, Sir.”
Andrea has heard staff using these words at the VA, but not in other private hospitals where she has rotated. She knows that veterans deserve the best care. But, in the back of her mind, she questions, Don’t all patients deserve the best care? Yet, in the private hospitals, doctors don’t use the same words; instead they’d say You’re welcome or It’s our job.
Mr. B glances at the young doctor, who has blue eyes and a ponytail. He estimates, She must be a doctor in training, isn’t a real doctor yet.
Andrea sees the patient has calmed down, she changes the topic, guiding him toward clinical concerns. “So, how are you today? Did you have a good sleep last night?”
“Well, I couldn’t sleep at first. Around midnight, the night nurse gave me a pill. I guess I fell asleep afterward. But I woke up early. So, I’d say I slept a few hours. The first night is always hard.”
“I see. Mr. B, you should take the pill earlier today. I can schedule it for you so that you don’t need to ask. This way, you’ll have a better sleep tonight.”
“I don’t know. I have too much on my mind.”
“What’s on your mind, Sir? You’re here for rehab. Don’t think about anything else,” Andrea suggests.
The patient shakes his head.
Andrea tilts her head and frowns as if to say tell me what’s on your mind.
“Look at my size.” Mr. B lowers his eyes, scanning his body from chest to toes. Andrea follows his gaze subconsciously. Her patient has a large-boned body, long and muscular, and his big feet barely fit against the bed board. 5’11”. She remembers the height from the medical record.
Mr. B continues. “They told me not to bend my hip more than 90 degrees, or to cross it beyond midline; otherwise, the new hip could pop out. But it’s easier said than done. My leg is weak and heavy. It feels like a dead weight. Yesterday, the nurse had to lift it up for me to get into bed. I’m not used to...I don’t like to be helped. I’m afraid to hurt them. They’re petite.”
“I understand.” Andrea nods, then assures him, “That’s why you’re here, Sir. You’ll learn how to do things by yourself. You’ll learn how to get in and out of bed and put on your clothes. You’ll get better soon once you start moving. As a matter of fact, the therapists will see you today.”
Soon? What do you mean? You don’t know my body.
Andrea cautions him. “In the meantime, please call nurses when you want to get up to sit in the chair or to use the toilet. Safety is number one.” She points to a palm-sized plastic box with a red button on it next to the patient.
Mr. B turns his head to look at the call button. He nods, still thinking, But I hate asking for help.
Andrea wants to move on. She continues. “May I examine your incision quickly?” Without waiting for his answer, she goes to the sink to wash her hands. She takes a pack of gauze, alcohol pads, a roll of tape, and a clean blue pad that are on the top of the dresser by the wall and lays them on the bed.
Looking at her swift movement, Mr. B groans silently, Everything has to be done quickly.
Andrea closes the curtains around the bed and pulls up the hospital gown to expose the surgical site. She bends down and inspects: the two-by six-inch white bandage looks clean without blood stain. She removes the bandage carefully and looks at the incision: it is dry. No drainage or signs of infection.
“It looks good,” she tells him.
He nods.
She cleans the wound with an alcohol pad a few times, then covers it with a new piece of gauze. “In a couple of days, you won’t need any dressing,” she explains.
Mr. B senses the young doctor’s assertiveness. Hmm, she isn’t a new resident. It looks like she knows. Let’s see what the “real” doctor (the attending) will say later.
Then, Andrea puts her stethoscope on his abdomen and listens. She hears some gurgling sounds. She asks, “Have you had a bowel movement yet?”
“No. But I haven’t had much food. I don’t have an appetite. To be honest, the hospital food doesn’t give me any appetite.”
“Well, you’re not the first one to say that. I can’t blame you. The hospital isn’t the Hilton Hotel. However, you need to eat. You should drink a lot of water at least. Once you start moving around with therapists, you’ll feel hungry and hopefully have a better appetite. Physical activities can help you to move your bowels as well.”
“I hope so.”
“Since you haven’t had a bowel movement for almost four days, I’m going to give you a stronger medication for that. Stool softeners won’t do. You need a laxative. You don’t need to take it now. But, if by nine o’clock this evening you still don’t move your bowels, I’d like you to take the laxative. Is it clear?”
He nods, annoyed by her bossy tone.
Andrea feels Mr. B is medically sound to start therapy. She says, “You look good, Sir. I’m going to put in an order for you to start therapy. You’ll PT (Physical Therapy) and OT (Occupational Therapy) everyday. And hopefully, you’ll be up in the chair and walk with the help of nurses during your free time. Do you have questions?”
Mr. B says no. Since he didn’t sleep well, he is tired. He is glad he can rest before PT or OT comes. I’m no longer thirty years old he realizes.
In the afternoon, Andrea meets with Dr. Wu in her office. She presents her first impression about Mr. B. “This is a straightforward case of a hip replacement. He doesn’t have hypertension, diabetes, or heart failure. The surgical incision looks clean and dry. There are no signs of infection. His only challenge is his weight and size. But he looks muscular and his mind seems sharp. I anticipate he’ll get better very soon and probably will stay here for about five or six days.”
Andrea’s estimation is close. Most joint replacement patients can walk inside a room, about fifty feet, on day one on the rehab unit. In one or two days, they can walk in the hallway, about two hundred feet, with a walker. By the fifth or sixth day, they can walk with either a walker or a cane up to three hundred feet. By that time, if they have stairs, they can climb at least one flight of stairs.
Dr. Wu listens and nods as Andrea speaks. She appreciates Andrea’s sound medical knowledge and clinical judgment. But she doesn’t like to make a prediction just yet.
Remembering what happened this morning, Andrea adds, “By the way, he’s quite emotional this morning. It worries me that he said he didn’t like asking for help.”
“Yes, he’s a proud man. He’s more worried about hurting others. I’ve known him as an outpatient before. I did advise him about calling nurses. I said it’s better to be safe than sorry. He said he understood and he’ll be cautious and call for help.”
“I’m glad he listened to you.”
“That’s the advantage of having gray hair.”
June 5th Tuesday
On Tuesday, Andrea visits Mr. B first. She is eager to know if Mr. B feels better today. Has he had a bowel movement? How is his appetite? Did he sleep well last night? Is he strong enough to get out of bed? A list of questions floods her mind.
When she arrives at his room, she notices Mr. B is sitting in bed in a reclined position. She frowns, Why isn’t he out of bed? All rehab patients should be out of beds early in the morning. They aren’t here for a vacation. Andrea takes a deep breath to hide her disappointment.
Seeing Andrea entering the room, Mr. B begins, “They treat me like a king! A king!” He pounds his chest with a fist.
Again? “You deserve it, Sir,” Andrea replies without missing a beat.
The patient shakes his head as if to say you don’t understand.
Andrea comes to his bedside and pulls the curtains around him. Then she asks, “How was your sleep last night, Sir?”
“Terrible.”
How come? She raises her eyebrows that ask Did you take the sleeping pill?
Mr. B shakes his head again. He pauses a moment, then cedes to the doctor’s questioning gaze. “I...had a bowel movement.”
“Oh...that’s good news.” Andrea feels triumphant. She knew the laxative would do the trick. This result is what she was waiting for. One box on her list of questions is checked in her mind.
“Good news? An explosive one. It’s all because of the pill that you ordered for me.” He gives her a scornful look. “It was a mess... a big one, right here.” He points to the middle of bed.
“Don’t worry about that. This is good news. Don’t you feel better now?”
Mr. B takes a deep breath to continue, “Uh, it was terrible. The nurse gave me a bedpan. But it didn’t help. It was all over. They had to clean me up afterward. They cleaned me like they do with a baby. Then they changed the sheets and everything. They made me feel comfortable. I’ve never been treated like this before, like a king.”
“That’s why you’re here, Sir. It’s our job,” Andrea assures him.
“That’s what they said too. They are angels. Angels.”
“You deserve it. You deserve the best.”
Mr. B stares at Andrea and pauses. Does she mean it? Suddenly, he raises his hand with the index and third fingers up and announces, “I’m going to be here for two weeks.”
Andrea is taken back. Wait a moment. Does he like it here so much that he wants to stay for two weeks? I know you’re a service-connected veteran. Being service-connected doesn’t mean you’re entitled. Besides, I am the doctor, the one who decides how long you’ll stay on the rehab unit.
Andrea stays cool. She wants to stay tactical. After all, one can’t catch bees with vinegar. She doesn’t want to argue with her patient. Not on day one or day two. She decides to talk to him about the discharge plan the next day when he will feel even better.
Andrea swallows her pride and keeps her agitated mind under the surface. She says calmly, “Mr. B, I understand your suggestion.” She avoids the words, “two weeks” and continues. “It’s still early. Let’s see how you’ll do today and tomorrow. Trust me. We’ve seen many patients like you. Most of the patients don’t need more than a week. Of course, everyone is different. So, don’t worry.”
Mr. B looks at her suspiciously. Don’t worry? How?
“Your wife at home, right?” Andrea gently reminds him about his support at home.
“Yes. That’s exactly my concern. My wife can’t help me. She’s a tiny woman.” He gestures her height at Andrea’s shoulder level.
Andrea detects a defensive and anxious tone. From the height of his raised hand, she estimates his wife’s height is about five feet tall. To assure him, she says, “I see. Obviously, your wife can’t physically support you. We don’t want her to do that. Don’t worry. We won’t send you home unless you can take care of yourself. But, I suspect your wife can do cooking, grocery shopping and light house chores, such as laundry. Am I right?”
“Yes. She’s healthy, but you know she isn’t young. She’s about my age.”
Before Andrea replies, they hear a knock on the door, followed by a raised voice, “Excuse me. May I come in?”
Andrea realizes it is breakfast time. She peeks between the curtains and sees a kitchen staff in a white costume and a white hat, holding a tray. Perfect timing, she thinks. I want to see how much he eats now. She makes sure the patient’s body is covered with a blanket, then pulls the curtain open and replies, “Yes, come in, please.”
The kitchen staff walks over. He places the tray on the overbed table next to his bed. The table has a four wheeled-base and an adjustable metal stem that connects the base and the small table surface. The staff pulls the table over to the patient and makes sure it’s close enough. As he adjusts the distance and height, he asks, “Is it okay like this?”
Mr. B puts his hands on the table and feels the height, then he says, “Yes, thank you.”
The staff says you’re welcome and then turns to leave.
Mr. B waves at him to say thank you again.
Andrea reaches out her hand and touches the cover of the plate, then she says, “Mr. B, it’s still warm. Why don’t you eat first before it gets cold? I can come back to see you later.” She adjusts the bed to help him sit up straighter as she speaks.
“Okay.” The patient nods and then pulls the table closer. He removes the cover of the plate and picks up the fork and the knife with his large hands. He stares at the plate without moving.
Andrea doesn’t leave. She wants to see if her patient is going to eat.
She sees on the tray there is a bowl of oatmeal, so dry the top layer shows some cracks; a rubbery looking sunny-side up egg, two wrinkled finger-sized sausages, and a soggy piece of French toast. On the side, there is one plastic container of blueberry jam, a container of honey, a small plastic bowl of canned fruit, a carton of O.J. and another carton of skim milk. There is also a sachet of sugar and two small tubings of salt and pepper.
No wonder he doesn’t have an appetite.
Mr. B lays down the utensils.
“I’m sorry, Sir. The food doesn’t look tasty. I asked the kitchen about this before. I was told that the food is made from an outside facility and then is delivered here. That’s why they look like airline food.”
Mr. B doesn’t say anything.
“Is it too cold for you? I can ask a nurse to warm it up. We have a microwave on the unit just for that,” Andrea suggests apologetically.
Mr. B says no. He doesn’t want to bother the nurses. Not for food. They are busy enough.
“How about I bring some yogurt or pudding for you? I know where they are. We have several flavors: vanilla, strawberry, and chocolate. That’ll give you some energy,” Andrea tells him. She wants him to eat, at least something.
“No, thank you,” Mr. B replies. He feels that he is giving the doctor a hard time, and he doesn’t mean it. His mouth is dry and he has no appetite.
“You need to eat,” Andrea says.
Mr. B gives her a nod that says “I know.” He tears the packets of salt and pepper and sprinkles them onto the egg in slow motion. He pours some honey into the oatmeal and spreads the jam on the soggy toast. He pauses and contemplates as if something is missing. Then he turns to the doctor and asks, “Doctor, can you open the top drawer for me?” He points his chin toward the night table next to him.
“Sure.” Andrea walks to the night table, bends down, and opens the top drawer. “What do you want?”
“Can you give me the hot sauce bottle.”
Hmm, he’s hiding something here. Andrea picks up a bottle that looks like catchup and glances at the label. It’s not a brand that she recognizes. She shows it to him. “Is this the one?”
“Yeah, that’s the one.”
The patient takes it from the doctor and opens the bottle. He shakes it a little, then dumps a big chunk of the red sauce onto his plate.
“Wow, that looks hot.”
“Yup.” The patient smacks his dry lips.
With that sauce, he can swallow anything. Andrea presses her lips trying not to laugh.
Mr. B picks up the utensils one more time. He cuts the egg in half. Then he picks up one piece, dips it in the red sauce, and wolfs it down.
Andrea is relieved. He’s finally eating. Her patient is on the right track. He moved his bowels last night and today he begins to eat. Two items on her list of questions are checked out now.
In the afternoon, Andrea reports the good news about Mr. B to Dr. Wu. “He’s eating now and he had a good bowel movement last night. But he was teary again this morning.”
“He’s moved by the way he’s treated by nurses,” Dr. Wu says.
“I told him that he deserves it.”
Dr. Wu smiles approvingly. If you knew what happened to him in the past, you’d know why.
“But he demanded to stay here for two weeks.”
“I believe these two days, he’s overwhelmed by the amount of assistance he needs. He’s scared to be a burden to his wife.”
“I understand. But that’s not the point. The point is that he can’t stay here for two weeks. He doesn’t need to. Most of our joint replacement patients need only one week the most. Plus, he isn’t the one who decides it anyway. We can’t let him to take advantage of the system.”
“Let’s see,” Dr. Wu says calmly.
See what? Andrea feels frustrated. She adds firmly, “He’s one of those who thinks he’s entitled.”
“Who can say if he is or isn’t entitled.”
How absurd! This is the first time that Andrea hears a question like this. Nobody is entitled! Period. This is as simple as black and white.
“Be patient. Give him two more days, then we’ll have a better idea. He may change his mind, too.”
“Fine,” Andrea shrugs, thinking, Anyway, I’m going to be out of here in two and a half weeks.
Dr. Wu can tell Andrea isn’t convinced. She doesn’t want to force Andrea to accept her opinion. She’s like when I was young, righteous and assertive.
June 6th Wednesday
The next day when Andrea goes to see Mr. B at 7:30 in the morning, the patient is already up in chair.
Good. Andrea is happy to see that. She says cheerfully, “Mr. B, you got up early today. You look better sitting up in the chair.”
Mr. B nods. “I’ve been an early bird all my life.”
“That’s good. I heard Dr. Wu removed your dressing yesterday. You must feel better about that.”
“Yeah. Much better.”
“How about your strength? Can you get out of bed by yourself now?”
“Ur huh. The nurse just stood by me and watched. I got into the chair all by myself.” He then lifts his surgical leg up to show his strength.
Andrea can hear the pride in his voice. She notices his body lean back while lifting his leg, a sign of weakness. She waves her index finger left and right jokingly, “Oh, oh, you’re not supposed to do that. That’s cheating.”
The patient gives her a defiant look that says, Don’t laugh at me. Wait until you get to my age and have an operation like mine.
Andrea gives him a thumbs up and smiles. “I was joking. Good job. You see, you’re making progress. You’re pretty healthy. I knew you’d do very well.”
Mr. B doesn’t reply. He doesn’t want her to think he is strong.
Andrea turns to her next concern, “So, how was your sleep last night?”
The mention of last night brings tears to Mr. B’s eyes again. He replies, “They treat me like a king.”
Again? Don’t you have something else to say? What did nurses do?
Mr. B waits a moment to keep his composure. Then he says, “The night nurse bathed me last night. She scraped my body, my legs and my feet.” He glances at the doctor to see if she is listening. Then he points his index finger at his feet and continues. “Even between my toes. Nobody...” he drums his fist on his chest, “nobody has ever treated me like this before. Not ever.” He stops.
Andrea can’t understand why Mr. B is so emotional. She is young and healthy and has no idea how Mr. B feels about losing his independence because of the surgery. It’s not only about independence, it’s about dignity. It’s the fact that he has to submit himself to people’s mercy and kindnesses. And these nurses have helped him with all their heart without the least complaint.
Andrea thinks, it’s been three days in a row that Mr. B is on the brink of crying. Andrea wants to say “you deserve it,” since these are the only words to tell him, but she refrains. Last time, when she said this, Mr. B replied he would stay here for two weeks. She can’t give him the chance to say that again. So, she decides to cheer him up. “That’s what nurses do, if bathing and cleansing make people a king, then most of our patients here are kings.”
Mr. B doesn’t smile. He sits up with a straight back looking dignified and aloof.
Did I offend him? Andrea is puzzled. Then she notices Mr. B wears a special jacket today. The jacket is gray—or more precisely, it is a faded blue jacket. The original color probably was navy blue. Multiple military patches and emblems are pinned to the left upper chest. It is quite an impressive collection. Is this his manifesto of entitlement? Why does he wear this jacket in the hospital? Andrea is on guard. She has made up her mind: no matter what he wears, I’m the doctor and I go by his functional levels. If he can walk two hundred feet and can put on his clothes and use the toilet by himself, I can send him home with home therapy.
The patient sees the young doctor’s eyes lingering on the relics of his jacket. He tells himself, It’s time. So, he asks, “Do you want to know how I got these?”
Not knowing what she’s getting into, Andrea replies, “Sure.”
Mr. B starts. “I applied to the Army when I was 15.” He stops and watches the doctor’s face to see if she reacts to the mentioned age.
Andrea senses his probing gaze. She doesn’t believe him. He’s either lying or bragging. Or, the Army didn’t care. She conceals her doubt.
He continues. “It was in 1951. I couldn’t find a job. Many people couldn’t. There were no jobs. So, I lied about my age to join the Army.” He pauses and glances at her face again.
Of course, you did. The doctor doesn’t say anything.
He adds, “But they found out, so they didn’t let me in. But I turned around and applied to the Marine Corp, and they took me.” Unable to disguise his delight, he chuckles at his own cleverness.
Really? The doctor tries not to show surprise on her face.
“You got to be resourceful.” His voice is filled with pride. “But my brother was in the Marine Corps too. He told them my real age, so I couldn’t go to the front. They assigned me to repair airplane engines.”
Hmm, had he gone to the front..., the doctor ponders. She has read that the Korean War was one of the bloodiest wars in U.S. military history.
Mr. B stops.
That’s all? Is he tired? Or, he doesn’t want to take too much of my time? Or, is he having painful memories?
Remembering her list of rehab goals, Andrea asks the patient if he can walk. Mr. B says yes and stands up to demonstrate. He walks slowly and cautiously, pressing hard on his walker, from the door to the window and back. Andrea gives him a thumbs up and says, “Good job! I think you can add some activities with our recreational therapist. There is a room next to the dining hall. They have singing, bingo, drawing activities. And you can also watch movies and do other things. Don’t sit in your room all day long. This way, you’ll be out of the bed, build endurance, and not feel bored.”
He says he’d like to go there to do some drawings or to make puzzles.
“That’s great.”
As Andrea is about to discuss the discharge plan, Kate, a PT (Physical Therapist), enters the room. Andrea says, “Hi, Kate. Good morning. You see Mr. B has been up for a while. He’s ready to work with you.”
“Are you sure? I don’t want to interrupt you. I can wait,” Kate asks politely.
“Yes. I’m done. Your time is more precious. Mr. B, I’ll see you tomorrow.”
In the afternoon, Andrea meets with Dr. Wu. She says, “Mr. B is doing very well. I saw him stand up from his chair and walk with his walker inside his room without help this morning. He still puts a lot of weight on the walker. But, if he keeps up this pace, he’ll probably be ready to leave in a few days. He’s definitely on the right track.”
Dr. Wu says, “Good. Let’s see.” Having worked as a rehab physician for twenty-plus years, Dr. Wu knows even the simplest case can go wrong.
June 7th Thursday
Even before Andrea comes to work this morning, she tells herself that she has to talk to Mr. B about when he can go home with home therapy.
Before going to see him, she talks to the therapists about Mr. B. Both PT and OT tell her that Mr. B has accomplished most of his rehab goals, including getting in and out of bed, donning and doffing his clothes, toileting, taking a shower, and walking with a walker. All he has to do is practice climbing stairs and perhaps preparing a simple microwavable meal. It is reasonable to achieve these tasks in one to two days.
“I agree. I think he should be able to go home in a couple of days too.” She thanks the therapists and goes to see Mr. B.
Once she arrives, she greets him first. Afraid if her patient talks about being “king” again, she speaks a bit fast, almost in one breath. “Mr. B, I hope you’re doing well today. I saw you walk in the hallway yesterday afternoon. You looked more comfortable, not pressing on your walker as much as you did before.”
“That’s right. I walked two hundred feet already this morning with a nurse. I’m slow, but I’m getting there.”
“Two hundred feet is a good distance. That’s what we call ‘household distance’.”
The patient knows what she is trying to convey. Kate told him already that if he can walk two hundred feet, he can go home, theoretically. He doesn’t reply.
Andrea continues. “By the way, you have stairs at home, right? How many steps?”
“Just outside. Maybe five or six of them. I have railings too.”
“That’s even better, so you can hold on to it. Your therapist will practice stairs with you soon, hopefully today.”
She’s pushy again, Mr. B thinks, but, he says, “I’ll try.”
Try? Andrea notices a tone of reluctance. She says, “Good. But try hard. I’m pretty sure you can do it.”
Mr. B ignores her. He changes the topic. “Remember what I told you yesterday?”
Andrea raises her eyebrows and nods. “About how you joined the Army.”
“Marine. Marine Corps,” he corrects her.
What’s the difference? Why does he make a fuss about this minor detail?
Mr. B adds, “I wasn’t the only one. There were thousands of us who were about my age. During the Korean War, they needed bodies. They couldn’t care too much. There were no computers at that time. Nobody could verify how old we were. As long as you had a name and swore on a Bible, they accepted your word.” He speaks calmly as if he is not talking about himself but reading from a book about others.
Andrea listens. She has never heard anything like this before. So, that was real war time.
The patient goes on. “I was discharged two years later when the war ended. But I liked being in the military, so the next day, I applied again and was accepted at a legal age. I stayed in the Marine Corp for the next twenty years.”
Twenty years! She glimpses at the relics on his jacket. There is at least a dozen.
Mr. B sees Andrea glimpse at the relics. He pauses, then looks at the clock on the wall.
While Andrea waits for him to continue, Kate walks in. Andrea smiles and says to Kate, “Good morning, Kate. You’re here already. We were just talking about how Mr. B’s doing.”
“He’s doing very well. Should I wait for you to finish?”
“Oh no. We’re done. It’s perfect timing,” Andrea replies, then waves at Mr. B to say goodbye. “Mr. B, I’ll see you tomorrow to hear the rest of your stories.”
The patient says, “Doctor, I forgot to tell you that I made a few drawings yesterday in the recreational room. I’m not very good at drawing, but I did it. It helps me to release some dark thoughts. I don’t know if you’d care to look at them.”
“Of course, I will. I’ll stop by and take a look at your artwork.” Andrea nods and gives him a thumbs up. Then she goes on to see her other inpatients.
Andrea is very thorough. She always checks on her patients to make sure they are medically stable enough to participate in therapy. If a patient’s blood pressure or blood sugar level is too high or too low, she adjusts the patient’s medication dosage or frequency. Sometimes, she has to add or change the medications. There are other medical problems, such as blood thinner level, or electrolytes (potassium or sodium) level can be out of the normal range. Andrea is good at monitoring and managing these.
Even though Andrea has gone by the paintings on the wall in the hallway before, she has never paid attention to them. She has always been busy. She has heard nurses praise the drawings in front of the patients. She thinks, Naturally, they are just being kind and supportive.
Today, since Mr. B mentioned about his paintings, Andrea feels obliged to take a look. If he’ll ask me about it tomorrow, I can say I’ve seen them. She decides to spend five minutes.
She stops by the displays in the hallway. There are several of them. All are water colors. The strokes are simple. Some are out of proportion. They look like the drawings by my nephews and nieces when they were five or eight. Andrea tries to guess which ones are by Mr. B. But, it’s hard to tell. Finally, a few drawings catch her attention. One landscape of the sea with the back of a vague, small figure standing on the shore. Another still life of fruits such as apples and green grapes, on a table top. The fruits have cracks and dark spots on them. On the right side there is a landscape of a vast cornfield with a small run-down cottage in the middle. Who lives there? Is this some version of Van Gogh’s? Somehow, most of the paintings have a sense of sadness.
When Andrea meets with Dr. Wu in the afternoon, she says, “You know Mr. B talked to me about how he joined the Army.”
Dr. Wu smiles as if to say I heard about it too.
“He said he joined the military when he was fifteen. Can you believe that? He’s lucky that he didn’t go to the front.”
Dr. Wu nods.
“He’s doing well and can walk about two hundred feet now. But he has several steps outside of his house. I’m pretty sure PT will work with him today on the stairs.”
“Probably,” Dr. Wu says.
Dr. Wu doesn’t like to impose her own ideas on her trainees. Especially for Andrea, at this stage of her training, it is important to let her make decisions. She keeps her interference to a minimum. She will learn every patient is different even though they have the same diagnosis. Not only do patients have different co-morbidities they also present with a distinct psychological or behavioral state, such as anxiety, fear, agitation or imprudence. A good doctor has to take all of these into account.
June 8th Friday
Andrea has a busy morning on Friday. She prepares for a couple of her patients to go home and two new patients to be admitted. By the time she’s done, it has passed lunchtime. Andrea doesn’t want to delay the discussion about when Mr. B can go home, so she visits him anyway. When she arrives at his room, she sees Mr. B is sitting in his chair, watching TV. She is relieved that he isn’t napping. She has no idea that the patient is actually waiting for her.
After a brief greeting, Andrea asks how Mr. B has done on the stairs?
“I practiced stairs once this morning. I was too tired,” he says, admitting its difficulty.
Once only? Andrea glances at this big man and imagines how he lifts himself up the stairs. Hmm, to lift his weight up can be taxing, especially his leg on the surgical side is still weak and can give out if he isn’t careful. Andrea wants to be cautious. She says unhurriedly, “You have time. You’ve done it once and there will be a second time. The first time is always the hardest. Practice makes it better.”
Mr. B nods, thinking, this doctor seems to be not as pushy as I thought. He looks at the clock on the wall. It’s 12:30. His therapy doesn’t start until 1 p.m, so he asks, “Do you want to hear more about my life?”
“Of course. But are you sure you don’t want to take a break? I don’t want you to be too tired this afternoon.”
“No. I’m good. I’ve been eating better. So, I have more energy now. Do you remember what we talked about yesterday?”
“You said that you had stayed in the service for twenty years.”
“Ah, you have a good memory. Doctors have good memories.”
Andrea smiles. Who doesn’t like to be praised?
The patient pauses, then says, “I also remember a lot of things. Unfortunately, some of them I wish I could forget about. But I can’t.” He looks into the empty space in front of him.
The patient’s words sadden Andrea. She stands quietly with her hands in her pockets, as if to say Go ahead, I’m listening.
Mr. B says, “I had been in Vietnam for five years.”
That’s a long time.
“I’ve seen it all. I still have flashbacks of seeing dead bodies, carrying dead bodies, and the killings.” He stops, staring into the empty space.
Andrea looks at his face discretely and sees no tears. Perhaps he has told his story too many times and become numb? What is he looking at? The images of war and the bodies?
There is no way for Andrea to understand him no matter how hard she tries. She hasn’t been there. All she knows is the statistics from Wikipedia: more than fifty-eight thousand U.S. soldiers died during the Vietnam War, plus two million Vietnamese civilians. But numbers don’t tell all the stories.
There is a silence, like a suspense. Andrea can’t find words to change the topic and to talk about letting him to go home. Well, I’ll see him on the weekend and talk to him then. Maybe he’ll feel better, be more cheerful. A couple more days won’t change much.
At her meeting with Dr. Wu in the afternoon, they both agree that Mr. B can stay a bit longer. Dr. Wu says appreciatively, “I’m glad you listen to him and are sensitive to his needs.”
“He likes to share his stories with me. He said he was in Vietnam for five years.” Andrea raises her hand up and spreads her figures.
Dr. Wu nods. “Yes. He has a hard time forgetting those years.”
Who wouldn’t?
June 9th Saturday
On Saturday, Andrea plans to go shopping after visiting her inpatients. She needs some new clothes for her new job. And next weekend, she plans to have a haircut. She knows a youthful look is detrimental to her credibility as a doctor. Patients want to have experienced doctors. She has an idea: a short one, like that of Dr. Wu’s. No more ponytail. That will make her at least five years older.
Andrea visits other inpatients first. She checks on her patients’ surgical incisions, asks if they eat well and sleep well, and makes sure that they have adequate pain control. She adjusts medication dosage and frequency as necessary. After all is done, she goes to Mr. B’s room. Since he always has stories to tell, Andrea leaves ample time for him.
When she enters Mr. B’s room, the patient has just used the washroom and is walking toward his chair.
“Hi, Mr. B, you look great,” Andrea says with an upbeat tone.
Mr. B approaches the chair by his bed. He grabs on the bedrail and sits down slowly. The chair is low for his height and Andrea can see he almost throws himself down toward the end.
That’s a bit too fast. It must hurt. She scans the patient’s face.
Mr. B doesn’t groan. His face stays still.
Andrea watches him adjust his position in his chair and remembers Dr. Wu told her once, “Marines are tough guys.” Indeed.
After Mr. B sits comfortably in his chair, he begins talking. “Hello, doctor. Good to see you on the weekend.” He turns to the calendar on the wall as if to verify the date.
Andrea replies, “You’re right, Mr. B. It’s Saturday. I’m glad you keep track of the days of the week. Many patients don’t. It’s hard to remember the days when you’re in the hospital. And yes, we always check patients out on the weekend.”
Mr. B nods.
“So, how are you doing? Did you put on your clothes by yourself?”
“Of course, I’ve been doing that for days.”
“Even your pants?”
“Yes,” he says. He picks up a stick with a hook at the tip by the bed side and shows it to Andrea. “I use this.”
“That’s good.” Andrea nods appreciatively. To be able to put on his pants without help or bending his hip to a right angle (90 degrees) isn’t easy for someone of his height.
Mr. B glances at the clock on the wall and asks, “Are you in a hurry today?”
“No,” she lies, thinking about her shopping plan.
The patient senses a fraction of a second hesitation in her voice.
Andrea puts her hands in her pockets and gives him a look that says, go ahead.
Mr. B starts. “When I came back from Vietnam to my home in Oakland, California, I was spat on.” To make sure the doctor hears him, he repeats slowly, “I-was-spat-on” waiting to tell me this.
Mr. B continues. “I fought for my country. My country! So I thought. So I was told.”
He felt (maybe still feels) betrayed and deserted. The antiwar protesters were against the wrong people—he was just a soldier who followed orders. He had walked through the “valley of death” for what?
The patient stares into space.
Is he seeing the protesters yell at him, spit and throw bottles and eggs at him?
“I know you’re with them, so called antiwar. I don’t blame you. I’ve figured it out.” He speaks in an even tone. “They (the protesters) thought they knew, but they didn’t know. I didn’t know either. Nobody knew.” He stops and doesn’t continue.
Andrea doesn’t speak. Mr. B’s words leave a bad taste in her mouth. She feels torn. Yes, he is right. She is antiwar. But, that doesn’t mean she would do things that those protesters did.
Mr. B stops talking. Perhaps he is lost too?
Andrea leaves the rehab unit. She goes shopping to distract herself. She fails. She keeps on hearing her patient’s voice “I was spat on” and “I fought for my country.” I hear you, Mr. B. I wasn’t there. I didn’t spit on you. But why do I feel guilty?
Andrea buys nothing. She goes to the parking lot, finds her car and drives home.
June 10th Sunday
On Sunday, Andrea refocuses her mind. Since Sunday is not very busy because patients have less therapy, she has time to talk to Mr. B about his progress and when he can go home. When she enters Mr. B’s room, she sees that he is up in his chair. She thinks, Is he waiting for me? Does he have more to tell?
Indeed, Mr. B is waiting for her. When he sees her appearing at the door, he says, “There you are. I want to tell you the rest of my story.”
Hmm, he can’t wait. Andrea puts her hands in her pockets and replies, “Okay." I’m listening,”
Mr. B stretches out his right hand, points his index finger at the floor, and says, “I was bad. I was very bad. The first time I came to this hospital many years ago, I was handcuffed. I was escorted by two policemen. I was mad, very mad at the government. I was angry and violent.”
Silence.
“I did many things, bad things. I wanted revenge, tear down things. I did drugs and robbery...you name it.”
Silence.
“I was put in county jail...in jail.” He repeats. His speech seems without order or logic.
Andrea listens.
“I had one son.”
Oh? Andrea is surprised since she didn’t see this information in the medical record.
“After I left the military service, I drove long-distance trucks. It was a good job for me. I liked to be alone and see places.”
A loner.
“Until one day...”
Andrea listens.
“I stopped at a small inn in the middle of Indiana for one night. It was late, around midnight. When I walked in, I saw a drunk guy trying to grab the young woman behind the front desk. The woman screamed. Clearly, she was fearful and helpless as there was no one else in the lobby. I shouted at the guy and ran toward them. I clamped the guy’s neck with my hands.” He flips his large calloused palms up and looks at them as if he is in disbelief about what he did.
Andrea tries not to gasp.
“Don’t worry. I didn’t want to choke him to death. When he let go of the girl, I let him go too. I pushed him hard to the ground. He stumbled. I told him, ‘Don’t you ever come back here again.’”
You saved her.
“The girl almost fell to the ground like a noodle. I held her up with my arms, kept her close to my chest. After a while, she recovered. She thanked me and dried the tears off her face with the back of her hands.”
You remember that so vividly.
“Believe it or not, that night she gave me the best room that I ever had in that inn.” He chuckles.
How else could she thank you? I would have done exactly the same.
“Don’t look at me like that. I’m not a hero. Sometimes, people do what I did to show off strength. It happened on an impulse. That’s all.”
An honest man.
“After that incidence, each time when I drove the same road and stopped at the same inn, she was always on duty no matter how late I arrived.”
She liked you, someone dependable.
“Unfortunately, our relationship didn’t last. I was always on the road. No. That’s an excuse. I think it’s a mental thing. I couldn’t commit myself. I was afraid of the responsibility. She was too young for me. She was religious, traditional, and wanted to have a family and children. I wasn’t ready.”
Hmm.
“It wasn’t easy for me to say no, because I liked her. She was kind and sweet.”
Hmm.
“So, she left me. I don’t blame her. I don’t.”
Silence. Andrea senses a tint of regret in the air.
“I didn’t know she was pregnant. She didn’t tell me. I wish she did. I might’ve changed my mind. Who knows?”
Who knows?
“The boy was born in 1986.”
Oh.
“He went to the Iraq War in 2004.”
“He did?” Andrea asks with her widened eyes.
“He was 18.”
So young.
“He went for two tours in Iraq.”
Two tours!?
“And two tours in Afghanistan.”
Did he have to go? Why so many tours?
“He wanted to go.”
Did he?
Mr. B sees question marks on her face, he confirms. “He did.”
Andrea nods to say she understands. She lies.
Mr. B shakes his head.
He knows I don’t and can’t understand.
“The boy had a tough childhood.”
Andrea listens, staring at him.
“When he was ten, his father, in fact he wasn’t his biological father, but the boy didn’t know, killed his mother with a gun, in front of him. The guy was an alcoholic.”
No! Andrea’s hands curl up into fists in her pockets.
“So, the guy was put in jail. And the boy went to live with his grandparents on his mother’s side in Indiana.”
Thank God he had grandparents.
“The grandparents had heard of me from their daughter. So, they called me and told me about the whole thing.”
Oh?
“At first I didn’t believe them. I didn’t believe the boy was mine.”
Then?
“They sent me some pictures of him.”
And?
“I could see he had features that are mine: his eyes, his nose, and his jaw...”
Andrea holds her breath.
“My wife looked at the pictures too. She said he’s you in miniature.”
“The grandparents told me that my son didn’t know who his real father was. So, it’s better to keep it that way. They didn’t want to hurt the poor child even more.”
Hmm.
“Later, my wife told me that I should call and talk to the boy. She said, ‘He needs you.’”
Yeah, every child needs a Dad.
“The grandparents were reluctant. They didn’t know me well enough to trust me. So, we came up with a plan. I told my son that I was a close friend of the family and told him to call me uncle Jim. That’s how we got connected.”
And then?
“We only talked on the phone, mostly on holidays and his birthdays.”
Andrea wonders if Mr. B felt closer to his son by talking to him.
“I told him my stories.”
You did?
“I think he liked them. When he was older, I could hear his voice was like mine too, low and soft.”
Oh.
“He called me before he went to war.”
What did you say?
“I was worried, naturally. But, he was eighteen, an adult. He came back and went again many times. He felt lonely back home. Finally, he came home for good in 2008.”
Andrea exhales.
“He told me he got an honorable discharge.”
You must be proud of him.
“I thought I could sleep then. But, no. My son had a hard time coping. Alone in a small town in Indiana...in the middle of a cornfield.”
A cornfield? Is that...?
“Nobody understood him. He’s young. He’s asking too much. Nobody understands anyone. He didn’t know. Like me when I was young.”
Oh.
“Since he was an adult now, I told him the truth. I had the impulse to tell him before, but I didn’t have the guts. I told him I was his dad. I was sorry that I didn’t tell him earlier. I said I want to meet him. But... he didn’t reply. I don’t blame him. He needed time. I told him that I loved him.”
Silence.
“I’m a marine. Marines are tough. It was hard for me to say the words I love you. But I’m glad I did. I’m glad I did.”
Me too. Andrea tells him with her gaze.
“He said he had always considered me as his dad. He said he wanted to make me proud.”
Don’t all boys want to make their dads proud?
The patient stares into the space.
Is he looking at the cornfield?
“I wish I didn’t tell him my stories. Then, perhaps he wouldn’t go to war...to make me proud.”
Silence.
“He told me he had nightmares every day.”
“Did he see doctors for that?”
“He did. Many doctors. They gave survey questionnaires to fill. They told him those were for research. He’s completed the forms many times.”
I’ve seen these. Did the survey help or make him feel worse?
“They gave him pills. Those didn’t work, or perhaps he didn’t take them.”
Andrea inhales.
“Some of the pills made him feel worse.”
But doctors don’t have much choice either. She asks, “Did he see a psychologist? Someone that he could talk to?”
“I think so.” He sighs and shakes his head.
Andrea waits.
“He’s a proud man, too proud. I asked him to come to live with us. He wouldn’t.”
Silence.
“He...” Mr. B pauses to collect himself, “he finally gave up and killed himself with a gun.”
Oh no. Andrea wants to scream. She sees a lonely figure in the cornfield, a hopeless and helpless figure.
Mr. B’s face is blank. No tears. No trembling lips. Only a numb and stone heart.
Andrea is in despair.
Mr. B stops.
Andrea realizes that he’s not tired but simply can’t continue. She stands there for a moment until she judges that Mr. B has calmed down, then she leaves him alone.
June 11th Monday
Andrea can’t believe that it has been a whole week, and she has not discussed a discharge plan with Mr. B. She knows Mr. B is ready to go home. He has accomplished all his goals. She rehearses her speech in her mind: Look, Mr. B, you can walk more than two hundred feet, can put on your clothes, and can use the toilet by yourself. You don’t need anyone to assist you. You really don’t need to stay here. All you need is home therapy. At home, I’m sure you can sleep better, eat better...”.
While she is preparing her conversation, her phone rings. She picks up the phone and answers, “Hello, this is Andrea.”
“Doctor, can you come please? Mr. B fell off the bed.”
“Mr. B fell? Okay. I’m coming.”
Andrea hangs up the phone. She stands up, grabs the stethoscope and the hammer and rushes out of her office.
When she arrives at Mr. B’s room, the patient is in his bed. He looks calm.
“What happened? Are you okay?”
“Yes. I had a bad dream.”
“May I examine you?”
He nods.
Andrea asks him to move his arms and legs and bend his ankles and elbows. She knocks his knees, Achilles tendons, and elbows with the rubber hammer and inspects his body. She sees no bruise or skin abrasions. While she scans his body, she asks, “Do you have pain anywhere?”
He shakes his head and says. “I’m sorry.”
“Don’t be sorry. The most important thing is that you’re not hurt.” She walks to the bed board by his feet and checks on his legs. She is relieved to see they are the same length. If the surgical side is shorter, that’s a sign that the prosthetic hip is popped out of the socket and moved upward. Hmm, he’s lucked out.
Mr. B looks at her concerned face and says, “I don’t think I broke anything.” He touches the bed rail and adds, “The bed is low and I just slid down.”
Thank God, she says to herself. She is happy that the nurses follow their safety precautions and keep the beds low at night.
“So, what happened? How did you fall?” she asks.
“Well, I shouldn’t have talked to you about my son yesterday. Every time I think of him, I can’t sleep. So, I took a sleeping pill late. I didn’t fall asleep until four o’clock. That’s why I’m still in bed.”
Why didn’t you take the pill earlier? Andrea scolds him silently.
“I had a dream. In my dream, I heard him calling me. He was far in the field. I couldn’t reach him. I ran. I told him to wait...I was coming. Then I flew....”
“Maybe you shouldn’t...”
“I know,” he says.
“I don’t mean...”
“I know what you mean. You have a good heart.”
She is speechless. She shakes her head. He is too generous to say that.
Mr. B closes his eyes for a moment, then says, “You know what?”
“Uh huh?” She looks into his eyes.
“You want to know how I met my wife?”
She nods.
“My PTSD flared up often back then. Once I got into trouble with a police officer. He stopped me at a gas station for no reason and took my license. Then he sat in his car for half an hour. I lost my patience and came out of my car and asked him what he was doing and how long do I have to wait. His front window was down and his left arm hung on the door. He gave me a look that said I can take as long as I want.”
Andrea inhales slowly.
“I lost my cool and hit him on his head with my fist.” He flips his hands, palms up and looks at them again.
Andrea tried not to shake her head.
“I paid the price. I was jailed for assaulting a police officer.”
You really shouldn’t.
“That was in 1995. When I was in jail, an old priest visited me. I remember him very well. He had white hair and a kind face, looked like Pope John Paul II. The priest spent a long time with me as if I was the only one there. I needed to talk to someone. I told him everything. I told him I was too proud and it was why I got into trouble. He accepted me and wanted me to be his brother. He said one thing that make men brothers is love, not pride, or fist. I didn’t believe in God at the time. Not at my age, almost sixty. I questioned if life was worth living? The priest said everyone’s life is worth living. Not if you had my life, I thought. But I promised him to visit the church once I’d be out of there.”
Oh.
“I got out of jail early. Apparently, that officer got into trouble himself too. They figured out that my case wasn’t as random as they thought. Someone reported on that officer, so he was disciplined. That was why I was released early. When I came out, I thought this must be God’s doing. So, I kept my promise.”
Hmm.
“I went to the church and sat in the front row in this jacket.” He points to the one he is wearing.
Hmm?
“He, the priest, noticed me. Then, a woman about my age came and sat beside me.”
Andrea realizes where he is going. She smiles, He’s a good storyteller.
“I can still remember. The woman wore a red cardigan and had curly hair. She wore a golden chain with a cross on her neck.”
Andrea pictures the woman.
“It’s like magic. She looked like someone in a movie. Someone who is kind and graceful. Perhaps that was what I needed at that time. After all those years, with all the struggles.”
Someone to calm his anguished soul.
“I stared at her. She turned and saw me. Our eyes locked for a moment. I smiled. I think she saw the other side of me. The human side. Not the demon’s side.”
Andrea smiles.
“So, I kept on going to the church, not for God, but...you know for what.” He chuckles shyly.
Andrea smiles too.
“Then, I invited her for dinner. I couldn’t believe that she accepted and came. So, I invited her again. I told her all about me and my madness. Her name is Gloria. She told me that I should think of a different way, a new way to live. Not to live in the past but in the present.”
That’s true.
“I said the world was too dark to find new ways. She said the Lord didn’t make things dark, men did. God only made day and night with the Sun and the stars. It’s us, the humans, who made fire, wars, and darkness.”
Hmm.
“So, I thought and thought. By then I was ready, ready for a new life. I told her the new way of living is to get married,” he says.
People say everything has its own time.
“Soon, we got married. After that, I began to tell my life stories to the church people, then to my neighbors, and even to my doctors, therapists, and nurses.”
You’re still doing it.
“To be honest, I don’t know why I do it. Sometimes, it’s hard to tell them. But each time when I tell them, I find new meanings.”
Hmm.
“It’s like I look at myself in a mirror. Every time I look, I see something new, a different me.”
A story...a mirror...? For him, for me, and for whomever who listens?
At this moment, Mr. B’s PT appears at the door. Andrea leaves. She feels relieved. Relieved to know Gloria is waiting for him at home.
When Andrea meets Dr. Wu later, Dr. Wu already knew about the fall. “I’m glad he wasn’t hurt,” she says.
“Me too,” Andrea says, then adds, “he told me that he feels his stories are like a mirror today.”
“For patients with PTSD, talking about their experience can be part of their treatment. He put it so well, a mirror...a sort of reflection.”
“I thought telling stories was his way of protesting.”
“Why did you think so?”
“Just think of the way he was treated when he came back from Vietnam. And he probably wanted to meet his son in person at some point in his life. Now, that hope is gone.”
“I see. So, if not protesting, why is he telling his stories?”
“He said each time when he tells his stories, he understands more.”
“You see, he does it for himself, I think. He tries to understand what it means to be a human being.”
“I’ve never heard stories like these before. To be honest, I haven’t given much thought to people like him. His stories actually make me reflect too.”
“Then perhaps that’s also why he’s telling, although he doesn’t even know it. You’re young and think life is long. Usually, after, say fifty or sixty or even older for some, people realize life is short. When people get older, they tend to feel the urge to tell their life stories, for themselves and for others. You see, we human beings repeat the same mistakes over and over, like fighting wars. We read war novels, but we can’t actually see the extent of miseries, only glories and tombs. You see the status and monuments of generals and conquerors everywhere when you travel. People are nearsighted. We can only see what’s happening under our nose.”
“Only if more people read or listen to stories. I like the way he put it, Stories are mirrors. It’s so true. Fables, fairy tales, fictions, nonfictions...I see myself in them.”
June 12th Tuesday
Because of Mr. B’s fall on Monday, Andrea and Dr. Wu decide to give him time to gain more strength, get better coordination and stay steady. Therapists can also teach him “fall recovery” techniques.
Andrea is not as stressed to discharge him as she was previously. She wants to see him go home in stable condition. In his case, it means being stable physically and mentally. She is eager to see if Mr. B had a good sleep last night.
When she comes to his room around noontime, she sees him just finishing up his lunch. The food on the tray is gone, and she sees a trace of red sauce on the plate.
“Mr. B, how are you? It looks like you eat well now.”
He nods and smacks his lips. He picks up the bottle of hot sauce and says, joking, “Yes. With this. Does it count as cheating?”
“That’s okay. I suspect this was part of your home diet.”
“Yeah. My wife and I love spicy stuff.”
“Me too. But I can’t handle hot stuff, only mild. So, how was your sleep last night?”
“Better. My wife talked to me on the phone. That helped.”
“Good.” Andrea nods, thinking, Better than the sleeping pill.
Mr. B asks, “Remember my brother?”
“The one who told the Army about your real age?”
“Ur huh, that one, in the Marine Corp.”
Andrea nods, noticing he corrected her again about Marine Corp.
“He, too, went to Vietnam.”
“He did?” Her throat tightens.
“Yes.”
Andrea tilts her head as if to say, and then?
“He came back. But, he also had PTSD.”
Of course.
“He lived in hell.”
Andrea listens.
“He’s dead.”
Dead? How? Andrea doesn’t dare to ask questions. What if he’ll have nightmares again tonight?
“Sometimes, it’s better dead than living.”
I’ve heard this kind of saying.
“He had a Vietnamese girlfriend there.”
Oh?
“She was very sweet and pretty. He really loved her.”
And?
“He wanted to bring her back with him. He promised her. But... she was killed by friendly fire.”
Oh, that’s awful.
“He was forty at the time and she was only twenty-two. He had never loved a woman that much before. He was a very sentimental guy.”
Silence.
“He couldn’t forget her and had kept a photo of two of them until his death.”
Andrea asks, “Did he see a doctor for his PTSD?”
“Yes, but nobody could help him. He thought he had failed to protect her and was buried in guilt.”
Silence.
“He had kept on looking for her... her ghost.” He sighs.
That’s sort of madness too.
“I told him to get over it and move on.”
And?
“His doctors told him that too.”
So?
“He just couldn’t. Many times he stalked young Asian-looking women, thinking they were her.”
Andrea pictures the scene: The brother, heart pounding, thinking he found her; and the woman, noticing a man stalking her, quickened her steps...
“Sometimes for days or weeks.”
That’s gut wrenching.
“Can you imagine? A couple of times, some women called police.”
My God.
“He was questioned. But they didn’t keep him.”
Oh.
“The police knew him. They warned him and made him promise to see his doctors.”
Andrea listens.
“He died on Christmas Eve when he was seventy years old. It was the beginning of the Iraq war. I wonder if it was a coincidence.”
“I’m sorry to hear that.” Andrea’s palms sweat in her pockets.
“They said he died of carbon monoxide intoxication, an accident.”
Silence.
“In his hand, he held the picture of the two of them.”
How sad.
“He’s my only brother.” Mr. B pauses, staring ahead.
“I...I hate to say this. Maybe it’s ...” She can’t continue. She can’t say the word “better.” Better for whom? People say they are together now or he’s with the Lord. But that is just a saying for the living.
“No. I don’t believe it. Why on Christmas Eve?”
Why? I was watching It’s a Wonderful Life with my parents, as it’s been our tradition. But, he, the brother...was alone and waiting for...
“He was too tired of looking for her. He lost faith...after thirty years.”
On her way back to her office, Andrea passes by the paintings in the hallway. She has the urge to look at these again. This cornfield painting must be his. The yellow color in the painting appears to have a sad tone today. It’s not bright yellow, but darker, brownish. The sky is not blue, but a little pinkish. Is it mixed with blood? The faraway cottage looks smaller today, swallowed by the cornfield. She notices some scribbled words at the bottom of the painting. She bends down and reads, “I’m not a mad man (Does he mean Van Gogh?); just a man with holes in my heart.”
“With holes in my heart?” Andrea turns to the still-life painting: the cracks and dark spots on the fruits look darker and deep like scars today. Are these permanent scars? A son and a brother...how many more have been or will be lost in wars?
And the next picture: Who is the man standing on the shore? Is he waiting for someone? Is he searching for light?
In the afternoon, Andrea shares the story about Mr. B’s brother with Dr. Wu. and says, “The Vietnam War ended long ago, but suffering goes on. I can see it in their drawings. I used to ignore the drawings by patients. I thought they were naïve and simple, like those of children’s. They weren’t masterpieces. But, today, when I look at them, they evoke an equal level of emotion if not more in me than the ‘Wheatfield with Crows’ or ‘The Starry Night.’”
Dr. Wu says, “Indeed. Only if we listen and look. Remember Hemingway called it “the lost generation” in his novel, The Sun Also Rises? We have to make that plural. It’s not only in WWI there was a lost generation, but in all wars.”
“Sadly, they are all caused by us, the humans, in the name of...”
“I’m not a sexist, but I like what E. M. Forster said in Howards End, If the mothers of various nations could meet, there would be no more wars.”
“I hope that’s true. That idea does give me some hope, but that’s an uphill battle,” Andrea says.
June 13th Wednesday
Andrea is eager to see Mr. B early in the morning. She worries he might have another bad night after talking about his brother yesterday. She decides to see him before visiting other patients. He may need someone to talk to, or to listen to him.
Mr. B sits up in his chair. He wears the same gray jacket and gym shoes. Seeing Andrea enter the room, he nods slightly. He has a calm composure and looks relaxed.
Andrea says, “Good morning, Mr. B. How was your night? Did you sleep okay?”
“Yes. I called my wife last night. We talked.”
That’s good.
“My wife is my therapist. She knows me and listens to me. That’s all I need. Someone who listens.”
“You’re blessed to have Mrs. B.”
“You’re right. You can call her Gloria. I’ve had ringing in my ears all the time since I came back from Vietnam, from working with running engines. Even now. It’s worse when I get anxious. I’m also hypervigilant. I can’t stand anyone standing or coming up behind me.” He points to the empty space behind his wheelchair. “I used to hear the voices of the Vietnamese and my comrades. Even after we got married, twice, I hit my wife when she got into bed while I was asleep.”
Andrea almost gasps. She pictures Gloria curled up in the bed, hands cupping her head and screaming for help. She wonders if her scream would make things worse. Poor woman. Please don’t harm her. She’s going to leave you.
Mr. B can see the fear on her face, so he adds, “We’ve worked out a plan. Whenever my wife wants to get into the bed when I’m asleep already, she has to wake me up first. It works. It hasn’t happened since.”
Andrea nods and forces herself to smile as best she can.
By now, Mr. B begins to like Andrea. This doctor, although young, isn’t ignorant or always in a hurry to leave. He has seen some who were that way. This one listens. She seems to care. One day, she’ll understand my stories. By then I’ll be gone.
“I haven’t told you about my secret,” he says.
Oh? Andrea wonders does this mean that he doesn’t tell this to others? Do I have his trust?
“I’m a Baptist. This is the only thing that keeps me going.”
Ah, that’s a secret? Andrea remembers he said he went to church, not for God. So, he has changed. Is he too proud to admit it?
“I’ve survived two cancers, a colon cancer and a prostate cancer. I had surgeries and chemotherapy in this hospital.” He points to the ground.
Andrea hasn’t seen the detailed cancer diagnosis and treatment. “I’m glad you’re doing well now.”
“The colon cancer was in early stage. It was removed. But my prostate cancer was advanced, stage III. I was devastated. It was the year after I lost my brother and my son went to Iraq. I was stressed out.”
“How did you find out?”
“I had blood in the urine and I lost a lot of weight. I weighed only 150 pounds. I looked like a stick.”
Hmm.
“When I went to see my oncologist, he insisted to check it out. He knew.”
Of course.
“It was late and bad.”
And?
“Gloria told me not to give up. I had surgery, radiation and chemotherapy. It was hell, but I went through all the treatments.”
“And you made it.”
“They saved me, my doctors,” he says with an air of gratitude.
“You deserve the best,” Andrea says. These words sound more meaningful to her today.
“My doctor told me that I survived two cancers because of my wife. Gloria was at my side everyday with the Bible.”
Unbelievable.
“That’s why I’m a Baptist now.”
Andrea nods, still thinking, but why is it a secret?
In the afternoon, Andrea and Dr. Wu talk about Mr. B’s cancer history. Dr. Wu says, “I’ve met his wife twice in my clinic. She’s a positive and spiritual woman.”
“Do you think his wife changed his mind?”
“Changed his mind about...?”
“About believing in God.”
“Perhaps. She’s certainly one of the factors. But having survived a brush of death from cancers, two wars and the loss of loved ones, can certainly change people.”
“I bet. Or, perhaps, after all those years of telling his stories, he’s finally figured out that he has to leave things in God’s hands.”
“Maybe.”
As if waking up from a dream, Andrea says, “I haven’t talked to him about going home. I’ve been so distracted by his stories. I almost don’t want him to leave anymore.”
“Don’t worry. I know him. He won’t stay here forever,” Dr. Wu says.
June 14th Thursday
Mr. B is getting stronger everyday. When Andrea comes to see him in the morning, he is moving around in his room. Seeing the doctor at the door, he raises his hand up in the air and says, “Look, I can walk with a cane only. I’ve already walked three hundred feet with a nurse this morning.”
Andrea can see the pride on his face. “That’s good. That’s what we call community ambulation distance.”
“Can I go home tomorrow?”
Andrea is surprised, since she and Dr. Wu talked about this yesterday. And surely, she knows him. She asks, “Well, do you feel comfortable to go home?”
“Yes.”
“Have you talked to your wife?”
“Yes, we talked last night. We both feel comfortable. No matter how much I appreciate it here, there is no place like home.”
“That’s right. In that case, I’ll arrange home therapy and transportation for you.”
“Thank you,” he nods. Then he turns and walks to the night table. He picks up the hot sauce bottle on it and says, “I haven’t told you that my wife and I have a company.”
Running a company at your age? Her eyes widen. She glimpses him up and down discretely. She knows some people who can’t wait to retire at sixty.
“We make hot sauces.”
“You do?” When will he stop surprising me?
“Yes. And we’re doing well.”
“Did you make this one?” She points to the bottle in his hand.
“Yes,” he replies, looking proud.
“Wow.”
“It’s a lot of work.”
Andrea has no idea how to make hot sauce. She pictures the way she makes chili. They probably have bigger pots and many of them.
“We buy hot peppers from the farmers. There are different ones. Some are milder than others. We only buy from the best ones. Then we make the sauce, bottle it, pack it, and finally ship it. I have a truck and I deliver by myself. That’s why I have to go home. My wife can’t handle it all by herself.”
“That is a lot of work. You have to be careful. Remember, you can’t bend your hip too much and your leg isn’t strong enough yet to climb the steep step on a truck or to lift heavy stuff.”
“I know. I’ve practiced getting in and out of a truck with PT already. It was hard, but I did it. I’ll be careful.”
No wonder he looks young. He’s been active.
“Gloria said we have to keep ourselves busy and do what we love so that we won’t have time to think about the bad times. She always tells me, ‘God wants us to think forward.’”
“She’s right.”
Before she leaves, Andrea checks on his surgical incision one last time. Everything looking good.
Andrea and Dr. Wu agree to discharge Mr. B the next day. Andrea is half-relieved and half disappointed. “To be honest, initially, I thought he was playing the game of One Thousand and One Nights with us.”
“One story per day to stay here?”
“It certainly felt that way. Don’t you think so? A little bit everyday?”
“Hmm, what do you think now?”
“It’s strange. I feel...how do I say it, I feel sad that he’s leaving us. I’m glad I’ve never rushed him. I actually like...him...I’m kind of addicted to his stories.”
Dr. Wu nods appreciatively. “Do you know the word origin of ‘doctor’?”
“No.”
“It means to teach. Sometimes, I think who are the doctors? Us or our patients?”
“Hmm...”
“So, you feel you’ve learned something from Mr. B?”
“Yes. It’s a humbling experience meeting him.”
Dr. Wu says, “That’s’ the word, ‘humbling.’ We, humans, like to judge, at people’s looks and at what and the way people say and do things, despite we know little about them.”
“That’s true. I even feel I’ve grown wiser, like older people.” Andrea doesn’t say like you.
“You mean like me? Yes, I’m twenty years older than you, but I still don’t feel old. Isn’t that strange?”
Andrea thinks, But, you’re so much wiser.
Andrea looks at the clock on the wall. It is late. She says, “Before I forget, I double-checked his wound one last time today. It looked completely healed. Strangely, while I was doing it, I asked myself, ‘What am I checking? Which wound? Can it be healed?’”
Dr. Wu nods. Good questions. Andrea has changed. I wasn’t like her at her age. She is a good listener. Isn’t this why people tell and listen to stories?
Yes. Andrea has spent years packing her brain with endless “medical knowledge”; now, she has to spend more years to unpack and sort things out.
June 15th Friday
Friday morning, Andrea and Dr. Wu come to say goodbye to Mr. B. He sits in the wheelchair, looking relaxed, waiting for medical transportation. He wears a gray-blue hat with Marine Corps embroidered in the front and the same jacket that’s covered with military emblems on the left upper chest.
“Mr. B, make sure you have a seatbelt on in the ambulance. You have a long ride,” Dr. Wu says. She knows her patient lives sixty miles away, and it usually takes one and half hours for him to come to her clinic.
“I will.”
“Do you have any questions for us?”
“No, but I want to tell you one more thing.”
“Please do,” Dr. Wu says.
“Remember I told you about my hot sauce company?”
“Yes,” they both nod.
“We are doing very well. Only after two years, we began to make a profit. And last year, we won the third prize at an international hot sauce competition in California.”
No kidding!
“That’s awesome. Congratulations!” Both doctors speak in unison admiringly.
A couple of nurses standing nearby hear this too. One of them says, “Wow, congratulations, Mr. B. You’re famous.”
“Famous or not famous isn’t important for us. My wife said money isn’t our goal. She just wants to keep us busy to stay healthy and leave the rest in the hands of God.”
“She’s right,” everyone nods.
“Let me show you this.” With a dignified composure, Mr. B takes out a large cellphone from his pocket. He holds it with one hand and glides his calloused index finger of the other hand across the screen several times. Then he raises it up and shows it to the crowd. It’s a picture of three bottles of hot sauce with a golden trophy on the side. On the base of the trophy, they can see the words “Third Place” and “2015.”
“It’s unbelievable. You must be so proud of yourself!” people say.
“What’s your recipe?” Andrea asks jokingly, knowing that she won’t make such things.
Mr. B turns his head toward her and says slowly, “Our recipe? It’s my whole life, bitter, sweet, salty, sour, salty, and spicy.”
Hmm...those stories. He has made his life worth living. Andrea blinks back her tears.
Mr. B raises the cellphone higher, so that everyone can have a closer look at the picture on the screen. They see three bottles of hot sauce, and each label has a different shade of red flame: yellow (mild), orange (moderate), and red (very hot). The flames are burning—vivid and bright.