by Will Smythe
Reprinted with permission from the Annals of Internal Medicine – “On Being A Doctor” series, Ann Intern Med April 6, 2010 vol. 152 no. 7 470-471.
In my role as chair of a department of surgery, I occasionally work fairly late in the office, especially on days when Hercules shoots the administrative eagle, releasing me like Prometheus from the bondage of paperwork and meetings. This eagle may not eat at my liver, but it certainly devours a portion of my spirit each day. It is during these periods of liberation that I actually get to practice medicine and perform surgery. However, my much-anticipated time in the operating room is a double-edged sword or, perhaps more accurately, scalpel, as the other work associated with my job does not magically dematerialize during my 8 to 10 hours in the operating room—it’s just stacked up on my desk like cordwood for burning later, often with midnight oil as the only available fuel.
On one of these recent late nights, I passed the woman who cleans the floor where my office is situated. I had passed her a hundred times before and had always made a point to say hello but nothing more. She is very dark-skinned, short and plump, with cat’s-eye glasses and a close-cropped wavy hairstyle. She looked to me to be in her mid- to late 60s, and she seemed to have a friendly, cheerful countenance.
Usually when I walked by at these hours, she was in one of the open common areas adjacent to the offices. However, on this particular occasion, she was tending to her cleaning cart standing in a narrow hallway that I had to pass through to leave. When I walked by and said hello, we made more substantive eye contact than usual, and she answered my “How are you?” this time with something other than “Fine. Have a good night, doctor.”
“Hi, doctor,” she said. “You know, my husband is ill. He got the stomach cancer.”
“Really,” I replied. “Is it bad? Has he been treated?”
She looked up at the ceiling, wistfully, and smiled, “Yeah, he been treated all right. They tried hard, real hard, but it didn’t do no good—now they say he dyin’.”
“I’m so sorry,” I said, setting my briefcase down on an adjacent desk, forgetting for the moment the hour and my desire to get home. “Is there anything you want to ask me? Are you sure that he’s seen the right doctor?”
“Yeah, pretty sure,” she said. “He saw some doctors right here, and I believe they know they business. Do you think they know they business?”
“Yes, ma’am,” I replied softly, “They probably do. If that is what they tell you, they’re probably right.”
Tears began to roll down her round cheeks, silently. “Umm hmm,” she said, “I know it’s true, it’s just real hard. He hurtin’ a lot sometimes, and he know he short on time, too.”
“I’m really sorry, ma’am,” I said. “I know that I can’t do much, but you know that I’m up here a lot at night, and you can stop me and talk to me any time you want. You can ask me questions, or we can just talk.” I reached out and put my hand on her arm.
“Call me Mattie, doctor,” she said, wiping her tears with her other shoulder, her short sleeve enclosing her other ample arm. “And thank you, doctor. Thank you so much.”
I was sincere when I told her I would be willing to speak to her but doubted she would approach me again. A couple of months passed, and although I worked late on several occasions during that interval and Mattie was often on my floor cleaning, I did not see or speak to her. By random occurrence, she was sequestered when I walked by, the only evidence of her presence the cleaning cart stationed in plain view or the geographically ambiguous, rhythmic electric whirring sound of a moving vacuum cleaner emanating from some nearby office.
Finally, one night we passed again in the hallway.
“Hi, Mattie,” I said. “Are you doing okay?”
She replied, “Hi, doctor. I’m okay, I guess. ‘Cept my husband, you know, he passed on. It been a full month now, a month today.” She looked up at the ceiling again, and again I saw the tears rolling silently down her cheeks. “The end was so bad, doctor, but he in a better state, a better place now.”
“Are you doing okay?” I asked, knowing that obviously she was not.
“It was hard, you know. I sat right on the end of our bed and watch him take his last breath. He was so sick, so sick, so thin. He had one of them food tubes in his nose, and he tell me, ‘Mattie, this cancer eatin’ this food—none of it gettin’ to me.’ I told him, ‘Hon, that cancer not eatin’ your food, that just you imaginin’ somethin’.’ He say, ‘Naw, this cancer eatin’ this food, and it’s still hungry. I’m afraid it’s gonna eat me now, too.’ I don’t believe him, but I think he right. He only last a few more days.
I sat right there, doctor, right on the end of our bed, and watched it, right there.”
Her lips were quivering, and the tears were rolling down her cheeks faster now—big tears, the fluorescent lights above rendering them silver streaks on her face, like mercury. I walked over and hugged her. She let out a big sigh and hugged me back, hard, holding on for several seconds.
When we parted, she looked down. “I’m sorry, doctor, sorry to bother you. I know you not his doctor, not my doctor, neither.”
“That’s okay, Mattie, you can talk to me any time, really.” I went on, launching into a canned speech that I had given a thousand times before as a surgical oncologist, in an effort to project some future comfort that I knew to be only variably successful at best. “Can I tell you what I bet is going to happen? Your memories of your husband are painful right now, and that’s normal—they hurt. You think about the bad things, what was happening at the end of his life, his suffering.”
“Umm hmm,” she said, “I sure is, I sure is. It was so bad. He was so sick, doctor, so sick.”
I continued, “But it won’t be like that forever. As time passes, you’ll remember the bad things less and less often and focus on the good. When you think of your husband, it will be some good memory and not his suffering.”
“Really?” she asked, eyes widening.
“Yes,” I replied, mustering up as much sincerity as possible. “I hear this often from my patients’ husbands and wives after a loss. They almost all feel this way eventually, it just takes time. You will never forget the bad things completely, but they will get fuzzier in your memory, and you will remember the good things clearly.”
“Really, doctor? I sure hope so. I lay in bed now and think about him layin’ there next to me, hurtin’, sufferin’. I lay in that same bed he died in. I sure hope so. Thank you, doctor. Thank you. I might take you up sometime on that talkin’ offer.” She smiled again, put her head down, and pushed her vacuum cleaner into a nearby office.
Two more months passed without my interacting with Mattie. Then, one night, she appeared in my doorway, her backlit silhouette filling the lower two thirds of that aperture. The light was much brighter in the hallway, and my office was illuminated only by the flat-screen monitor on which I was reviewing pathology reports and trying to answer e-mails.
“Hi, doc,” Mattie said softly. In all the months I had known her, she had never initiated our contact, especially not while I was working.
“Oh, hi, Mattie. How are you?” I asked.
She stepped in, moved toward a chair near the door, and stood next to it, expectantly.
“Please, sit down,” I suggested.
“Thank you,” she said, and sat down in the chair, her movements and body language demure and formal. I could see her face now as she placed her hands in her lap. I imagined for a moment that she was wearing a Sunday dress and hat rather than the ill-fitting hospital-issued maroon polyester housekeeping uniform.
I wondered if she was uncomfortable—I was fairly certain that, except for me, few doctors here actually spoke to her, because of both the hour of her work and the context.
She sat quietly for several seconds with a reserved look on her face. Then she suddenly smiled, her round face beaming as if she were about to laugh, and her eyes danced behind her glasses.
“I just have to tell you somethin’,” she said, “’bout what you told me before.”
I mentally inventoried our previous conversations, but nothing specific came forward. “Sure. What was that?” I asked.
“What you told me ’bout what I would remember about my husband,” she laughed, as if it were silly that I didn’t remember.
“Okay,” I said, recalling now our last conversation. “Sure, go ahead.”
“Well,” she began, “’bout a month ago I was havin’ dinner with my big sister, and she ask me, ‘Mattie, your husband visit you yet?’ I say, ‘No, what you talkin’, girl? You know he dead.’ She say, ‘Yeah, mine gone too, but sometime he come to me. He visit me, I can feel it.’ I tell her, No, child—you crazy!”
With this, Mattie laughed out loud, and I did, too. However, her expression suddenly changed, and she became much more serious. “You know, then, the other night, I was watchin’ TV. I got that satellite TV, you know? I was watchin’ the Groove channel—that’s music, you know? Not TV, but like radio on the TV?”
“Yes?” I said, listening.
She continued, “A song comes on and, Lord, it made me think of my husband. I close my eyes, and I see him plain as day, wearin’ those black pants and that striped shirt he wear. He look so handsome to me. I gets up out of bed and stand up, my eyes still closed, and we start to dancin’. I dancin’ with him right there, in my bedroom!” While telling me this, she shut her eyes and started to move rhythmically in her seat, open hands lifted up in the air, moving as if dancing to some slow jazz beat—I could almost hear it.
Abruptly, she stopped, dropped her hands, opened her eyes very wide, leaned forward, and looked at me, once again serious. “Then I catch myself, and I ask myself, ‘Mattie, is you crazy?’”
There was another long pause, and then she leaned back, smiling again, eyes moist, round face shining. She chuckled way down in her throat and lowered her voice, almost whispering, “Then I realize, no. No, I ain’t crazy. You was right, doctor, and my big sister, she right, too.”
She paused again and then said, “He visit me, doctor … he visit me.”