Personal Narrative
Aug 2001

Through the Physician's Eyes: Two Poems

David Schiedermayer, MD
Virtual Mentor. 2001;3(8): doi: 10.1001/virtualmentor.2001.3.8.prsp2-0108.

Fighting Bare-Handed

Last night, Saturday night 
I fought death bare-handed 
in and over the body 
of a 61 year-old man 
with liver and kidney failure 
which started and worsened 
after his back surgery. 
I had a bad feeling at about 6 pm, 
looking at his 4 pm labs, 
so I went to his room and found him 
barely breathing. Breathing once 
or maybe twice a minute. 
So I sat by his bed 
and I begged him to breathe 
I pinched his toes when he stopped. 
Once, when he had stopped for a minute, 
and I am not proud of this, 
but it is just true, 
I rubbed my bare knuckles right across 
the staples on his abdomen 
(they had operated his back from both 
the back and the front to fix the bones) 
and he woke up with a start 
and a grimace 
and said, "what do you want me to do?" 
And knowing how death was possessing him, 
I said "Breathe!" to him, not to death, 
and he took a big breath before he 
fell back to sleep. 
And so I kept him alive until we could 
move him down to the ICU, waited with him 
for an hour in that quiet room at the very end 
of the orthopedics unit, just me and him and death, 
me pinching him every minute 
death quietly creeping in and through 
I pinched him and shook him 
and used Narcan to fight the morphine 
so he would have a chance to breathe 
And when I went home 
I laughed a little as I walked across the driveway 
I skipped up the steps 
because 
in the ICU they were giving him all kinds of medicine 
and putting in all kinds of lines 
but me 
I guess I really do 
like a good bare-knuckled fight on a Saturday night.

Folding Both Hands

On Sunday morning 
it is now clear 
he is dying. 
His ammonia is 800 
His creatinine is 6 
The dialysis is not working. 
Here's the truth: 
He is puffed up with fluid 
and twitching. 
When the liver fails 
the kidneys fail too 
the lungs congest 
the brain swells. 
And when I come back 
from talking and praying with 
his wife and sister and daughter 
(we folded our hands 
and prayed 
and I asked for comfort 
and healing 
and also for God's Will 
to cover the bases) 
he is brain-dead. 
His temperature 
does not register despite 
the heating blanket. 
He is not triggering the vent. 
His blood pressure is 50 
on maximal pressors. 
So I talk with the family again 
briefly this time 
- the news speaks for itself. 
His wife hugs me 
a familiar face in a foreign land 
and I can feel her stress and grief 
as she holds on. 
No decisions to be made now, I tell her - 
no guilt about making decisions. 
Just go and see him. 
Take as long as you wish.

On Monday morning I call down to the morgue. 
We happen to be doing him right now, 
the pathology intern says. 
I find the room just as the diener is saying, 
as he deftly cuts and pulls out the viscera, 
the funeral director has called me three times 
wanting the body. If he calls again, I'll have him here! 
And I look in the body and see where the bone graft is laid 
neatly into the vertebrae; the bone is clean and fresh. 
No pulmonary emboli. No visible infection. 
I see the enlarged spleen. 
Please cut the liver 
I ask the intern, and he slices through it with a long 
stainless steel knife. 
There is no actual liver tissue present, 
no nice dark tissue, only yellow scar replacing 
the organ the liver should be. 
That's why they call it cirrhosis, stupid, 
I say to myself: 
You think you're so bright 
fighting with death 
and here is just one more loss 
in your long series of losses. 
Thanks, I say to the pathology intern 
and he smiles and bows, 
folding both hands around the knife.

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Citation

Virtual Mentor. 2001;3(8):

DOI

10.1001/virtualmentor.2001.3.8.prsp2-0108.

The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.