COMMENTARY
A belated note of gratitude
BY MICHAEL K. WILLIAMS, MD He showed up on time, precisely on time, for his first visit at our clinic. I walked into the exam room and shook his hand, introducing myself. A 6-foot, 2 inch, slightly rumpled, 64-year-old professor at the university shook mine. His words were carefully thought out and measured as he described his reason for seeing me. He got immediately to the point.
“I’ve been swimming three times a week for the past 24 years. Here is a graph of my times in the 100-meter freestyle.” He carefully unfolded a piece of
12-by-24-inch well-worn graph pa- per and laid it out on the exam table for my inspection. As a 40-year-old beginning swimmer, his times (he informed me) were “atrocious.” He went on to demonstrate, tracing his forefinger from left to right, the near- linear improvement in times over the ensuing six months as he achieved an increasing level of cardiovascular fitness. From then on, it was a long, nearly horizontal line with a barely positive slope over the next 23 years. “You will notice, doctor, the in- variable ravages of age. Natural, of course.”
was, surely a more comfortable posture for him. His face had assumed the visage of boyish curiosity, so often displayed by people of exceptional genius. “These recent times in the 100 meters are totally unexpected, and, I must say, somewhat disconcerting. There’s something wrong with me. What is it?”
What other profession affords its members the opportunity to have a front-
“Of course,” I nodded in agreement. “But, please, take note of this.” He tapped his capped fountain pen on the last two months of the graph. The barely positive slope had taken an abruptly upward thrust, ap- proximately 45 degrees to the horizontal. The rise was equal to the run. He replaced the pen in his shirt pocket and sighed as he
removed his bifocals. He slowly ran a hand through his long white hair, as if pondering the meaning of the cosmos, then looked directly at me for 10 seconds before speaking. The look of concern on his face began to change. In those 10 seconds, he morphed from a worried patient back into the scientist he
row seat at the human parade?
Spider had been hollering, thrash- ing around, spitting and cussing in ICU for 2 weeks. It was the worst case of DTs I had ever seen. But he slowly improved over the next five or six days and somehow survived the ordeal. At the end of that hospitaliza- tion, he told me he knew he had had a brush with death.
“I saw that ol’ hag,” he said. I didn’t understand his comment. “You know, doc. That witch. I saw her the other day.” He was describing some of his hallucinatory visions over the past week or so. Conspiratorially, he leaned over toward me and low- ered his voice. “She’s butt ugly, too.” He then resumed his normal level of conversation. “But she let me pass! I don’t know why, but she did. I didn’t deserve to live, but she let me go.” Spider and I had known each other for several years. I had tried to patch up the results of his tendency to engage in pleasurable excess on
several occasions. He had never held a legitimate occupation, but got by on cunning and a little larceny. He had taken great pleasure in detailing his life’s pursuits, with cocky bravado, in the course of his office visits with me before his ICU admission. But that was then. Now, before me stood a changed man. “Anyway, I made my mind up. I’m gonna git right. I’m givin’ this ol’ life up. Yeah! I’m gonna git right. Doc, I know I shoulda died. I know how close I came. I’m turning this thing around, you wait and see.”
February 2013 TEXAS MEDICINE 49
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