Shoulders
His facial
features had lost all character due to the swelling. As the nurse lifted the gauze from his face,
I noted only the severe bruising and edema of his eyes. His nose still had congealed blood filling
the sinuses…his mouth and lips were marked by the ventilation tube that had
delivered his last breaths before passing on.
It was an unrecognizable friend, now deceased.
As my eyes
wandered along his cold neck line and down to his torso, I was attracted by the
only remaining feature that had once helped to define his individuality. His shoulders were intact. I remembered having admired those shoulders
once months before.
Mike had just
finished working out, and as I had been consulting him on the status of one of
his men, my gaze had been captured by his well sculpted musculature. To most, it would seem both unusual and
awkward for another heterosexual male to admire one’s physical attributes, but
from a medical standpoint, Mike’s shoulders were a specimen of perfection. I remembered his deltoids, each portion well
defined, as they tapered into both heads of his equally well shaped biceps
muscle. I remember noting the
demarcation of his pectorals as they rose upward along his anterior shoulder
girdle and meshed into the symphony of his upper extremity.
Now months later,
it stuck me as odd, that the last vestige of character I would remember him by,
would be those same well crafted shoulders lying motionlessly on the steel
table before me.
The medical staff
had worked for hours trying to resuscitate the poor guy. The impact to his face and head trauma had
proved to much, and darkness overtook. Sometimes there are things worse than
death. Perhaps Michael had been spared
after all.
The colonel asked
the chaplain to say a prayer. We knelt
alongside the table upon which our friend lay.
It seemed reasonable to place my palm upon his left shoulder and lay my forehead
on top. This left me looking down
towards the floor, and as the chaplain began his words, I watched the
rhythmical drip of blood that was flowing off the table onto the floor. My thoughts wandered to the electric foot
pedals that operated the bed. They were
now immersed in blood and I felt sorry for the nurse that would have to clean
them. I was momentarily ashamed that my
thoughts had deviated to such and made a conscious effort to focus on the
chaplain’s prayer.
His prayer was
uninspiring however. There were pauses
in between his sentences. I was
uncertain if they were for dramatic effect or simply due to a lack of
words. It would seem that a clergyman
might already have a library of speeches prepared, and would merely need to
fill in the particular blanks…sort of the equalivent
to a spiritual Mad-LibTM, but obviously
not in this case.
We arose, said our
good-byes, and exited.
Closure is an
important portion of any loss. With the
previous losses from our battalion, as well as funerals of other friends in my
life, that closure comes with the burial.
Michael left me
however, with unfinished business. I
owed him something, that I fear I will never be able
to repay. It’s a duty, sort-of, that I will probably spend the rest of my life trying to
live up to. It was a standard that he
set for me. I had been hoping that by
the end of our deployment he would have acknowledged my attainment of this
standard, but with his death I’m left with the realization that that standard
continues indefinitely.
What I owed
Michael, was unconditional positive regard for all my patients, just as he did
so for all his soldiers. This is a
concept repeatedly taught throughout medical school. Lip service is generally paid to it by all
health professionals, but few rarely attain it.
It’s easy to dismiss.
For Michael’s and
my own case, it had come with a malingering and histrionic soldier. It played out with an Oscar-Award winning
display of pain and discomfort in the middle of the Bravo Company headquarters. The particular soldier was dead-set on
receiving more narcotics for his less than impressive complaints and symptoms
of lower back pain.
Most physicians
would have easily fallen into the same trap.
I had treated the soldier less than twenty-four hours earlier with pain
medication and muscle relaxants for what was clearly suspect pathology. I had also given the soldier a profile to be
excused from work for the next week, but this was apparently not enough to his
liking.
The soldier’s
theatrics had gained the attention of the whole company, most of all,
Michael’s.
What I had lacked,
was not judgment in the diagnosis and treatment of his fictitious disorder, but
rather the tact and empathy in handling it.
I met the patient’s escapades with equally vibrant and emotionally
pronounced callousness and indifference.
It was to this response that Michael took offense.
Michael was well
known for his concern for his soldiers.
He cried over the loss of a previous soldier’s eye. He was also noted to be emotionally shaken
with each ill event his other men encountered.
He was empathic to all, and his reputation preceded him.
Michael charged me
with the responsibility to learn from this.
He charged me to inherit the unconditional positive regard that he
already professed time and time again.
And during our dialogue that evening, outside his company barracks, I
had promised to him to endorse his same empathy for all my patients.
I’m proud of my
endorsement. It’s extremely difficult at
times. There are always those deadbeats, that one knows are using you for personal
gain. There are always those patients
whose symptoms serve a higher purpose, but for Michael’s teachings, if one
looks hard enough, they can discern the subtle difference between
inappropriately playing into a patient’s plan and the more divine act of
playing alongside it.
Perhaps it was
this definition of character that made Michael stand out…just like his
shoulders.