The names have been changed to protect the innocent. (That would be me… HIPAA, you know!)
My third year of medical school at Emory I rotated through the pulmonary unit at “The Gradies”. That, of course, would be Grady Memorial Hospital in Atlanta, dubbed “The Gradies” by those who depended upon it for medical care. It was not one, but hundreds of clinics, departments, mini-medical centers, and schools, all of which were and still are a labyrinthine medical behemoth.
The main mulit-story tower is a giant “H”-shape edifice that looms over a curve of the “Downtown Connector” that runs through the center of the city. Each arm of the “H” was labeled A, B, C, or D wing. I found myself assigned (imprisoned and thoroughly lost, actually) on 6-“C”, the medical pulmonary unit. Fact is, as I learned my way around Grady at first, I seriously contemplated leaving a trail of bread crumbs, Hansel-and-Gretel-style, the better to get out at the end of the day.
And my patient’s name was Otis.
Otis was a truly frightening creature. Long before “Lord of the Rings” became popular in cinema, I, as a Tolkien fan since the early Sixties, recognized Gollum when I saw him. Restrained by soft but secure straps to the bed because of fever and delerium and a snarling combative disposition, he writhed and hissed, a skeletal and sinewy goblin of a man. His scarred and pocked brown skin was stretched tight over a cachectic frame like dried cowhide on a tanner’s rack.
More frightening still was the nearly demonic visage that spewed gurgling growls from a nearly toothless mouth. Threats of death and mayhem – those that were comprehensible -were punctuated by vile obscenities. Those teeth remaining were jagged, black, and decayed, the source, I was to learn in my tutelage, of the anaerobic bacteria that he had inhaled into his lungs in a drunken stupor, causing a massive “empyema”, a veritable septic tank of fluid filling up most of one side of his chest. A scarred socket marked the spot where one eye had once been, the product, I was to learn later, of a knife fight in some nameless subterranean back alley.
I skulked into the room sheepishly behind a seasoned surgical resident, ostensibly to assist him and a nurse in the insertion of drainage tube between his ribs and into the space between lung and chest wall. Had to get rid of the pus.What happened next will forever be imprinted in my olfactory memory.
The cloudy grey soup that poured out of that poor man’s chest was the foulest thing that ever smote me in the face. The surgical resident, accustomed to such things, and I myself, having stayed up all night and not eating since the previous evening’s duties, did not suffer from the involuntary, upward dry-heaving of our diaphragms. The nurse, well… we all found out what she’d had for breakfast.
The stench was so bad for weeks that the entire wing, except for the ICU at the farthest end, and separated by double doors, had to be cleared. Otis became a legend among my classmates, who, having heard about the case would come to the end of the wing just to see how bad it smelled. I, on the other hand, as the assigned student on the case, was obliged to wade through that feculent fog daily to go to the bedside of the unfortunate Otis, to check on his status and document his progress.
Early on, to approach for the purpose of examining his lungs was risky. But for the restraints he would have clawed or even bitten me. But, despite the malevolent atmosphere, I made my daily rounds, spoke to Otis calmly, and told him how well he was doing. He grew calmer and more lucid as the infection abated.
With still a couple of weeks to go before Otis was ready to be discharged back to who-knows-where, my rotation ended. I was headed for the main Emory University Hospital where my next clinical experience would commence. I went by to say goodbye to Otis.
After some encouraging words and a soft “See ya” I turned to walk out of his life for the last time. It was then that he spoke clearly to me for the first time. “Doc!” he said. “C’mere.”
As I turned back around he was extending toward me, as far as the wrist restrains allowed (for he was still having his “moments”), a gnarly clawed hand.
“Jist wanted to shake yer hand, Doc…. Say g’bye. ‘N thankyeh.”
“OK,” I took his hand cautiously and shook it. “For what?”
” ‘Cause you wuz da only person whut treat me like I wuz a human bein’ .”
Had no trouble negotiating my way out of the hospital that day, now that I was a seasoned Grady veteran. Even with tears in my eyes. Experienced a curious mixture of gratitude, sadness, relief, guilt, conviction….
My best medical Teacher’s words kept going through my head: “Inasmuch as ye have done it for the least of these….”