I, like most people live day to day, passing along a chain of petty and momentous events throughout the day but not out of the ordinary daily life experienced by the people around me. But through having had an unusual trajectory into life, parental and family background, childhood experience, quirky personality, and exposure to momentous events in society and personally as a physician, scientist, and notorious eccentric. Although I will tell of a number of extraordinary “once in a lifetime” experiences, my focus will be to keep to those that I believe have universal human meaning, perhaps even a life’s lesson. I will keep each installment to between 600-1000 words so they can be read in less than 3-4 minutes. Longer stories will be told in a linked series of parts, each of the same ‘bite size’ portions.

I will initially try to group the stories by themes and sub-themes, within the categories such as “personal history”, “scientific discovery”, “greatest medical cases ever” “life lessons learned”. But I suspect in the breadth of time the readers will see the stories all coalesce by time-line, by theme and story line, into a single life story.

A heart wrenching lesson in life: learned early, learned well. Part 2 of 3.

A heart wrenching lesson in life: learned early, learned well. Part 2 of 3.

Joseph Fisher
Transformative, Interesting medical cases, Family History

The next day I got all the rest of the tests back. I presented the patient to my staff at ward rounds. “Cancer.” he said. But as lab results trickled back, no sign of cancer. No. It couldn’t be cancer. I had seen cancer patients die emaciated but nothing like this. Starvation? I have never seen anything like this in pictures from famines in the horn of Africa. The nearest to this are the obscene photographs from Nazi starvation lagers like Bergen Belsen, where Anne Frank and her sister died. Here the Nazis perfected an art form where food and forced work were titrated to prevent death until every gram of flesh was melted away. The prize winning specimen was a pure skeleton. These photographs showed emaciated young girls, or possibly women—it was impossible to tell the age or even the sex of most—as total skeletons, standing naked, some so protein depleted that their uterine ligaments failed and their uterus prolapsed through their vaginas (no doubt a source of amusement or eroticism for the photographer). How did my patient get like this in Toronto?

Well, when all the interrogations and fancy tests fail, fall back on the ancient art of “talk to the patient”. After rounds, I bought a tea and muffin in the hospital tuck shop, went up to the patient’s room. Instead of standing, and interrogating as is the custom, I pulled up a chair and began to converse.

The story: When he was a young man and newly married his dream was that on retirement he would buy a recreational vehicle (RV) and travel around the country with his wife. But he was a low-level civil servant and couldn’t look after his family and save the money he needed for his dream retirement. So he got an additional part time job. Then a second part time job. Basically he was working nights and then week-ends, and missed his family growing up. He didn’t really have a relationship with his children or extended family. Probably not much of one with his wife either. Didn’t do much in the way of recreation and enjoyment. Truth be told, didn’t miss it much. Focused on the job, part time jobs, earning the bucks, looking at RV’s places they would travel to.

At age 62, he suddenly became acutely ill. Hard to say what it was, but probably a bad flu. He was sick in bed for a few days. He felt like he was going to die. Then the thought: “If I die, I won’t get to my retirement and my pension. I won’t get to travel with my RV.” Then he thought about his present condition: “My kids have grown and moved away and I don’t even know where they all are.” “ And even if I recover and go back to work, and get my pension, I don’t feel like traveling around on the highways in an RV with some old woman.” He realized that year after year, he obsessively perseverated in the foolish squandering of a life. After recovering from his illness he loathed himself, his foolish obsession, and his life. He couldn’t bear to go back to work. He stayed home, ruminating, with regret and self loathing; literally eating himself up alive. Now he was nearing 63 and he was glad to be finally dying.

I told him: “Look here. You are 63. People live into their 80’s. There is lots to salvage from your life. You can get your RV. You can track down your children. You have insight and you can have many years to make up for what you lost.”

“No,” he said, “I wasted my life and I want to die.”

Not if I can help it. I called for consults from psychiatry and social work. Their consults, were not very insightful. It was up to me to help. He claimed he was eating fine, but the nurses said his food trays were barely touched. Later that day I came in and place a subclavian line to supplement his nutrition with intravenous feeding. While I was putting in the line, I heard a snicker under the drape over his face. I asked, “Are you OK?”

“Doctor, I appreciate your enthusiasm but you are wasting your time. I am going to die and there is nothing you can do about it.”

“No way.” I persisted in thinking.

When I came in the next morning, the nurses told me they found him dead in his bed. Instead of doing rounds with my staff, I went to the autopsy. His body was pristine: no cancer. No nothin’.

Read more in Part 3

A heart wrenching lesson. Conclusion. Part 3 of 3.

A heart wrenching lesson. Conclusion. Part 3 of 3.
A heart wrenching lesson in life: learned early, learned well. Part 1 of 3.

A heart wrenching lesson in life: learned early, learned well. Part 1 of 3.