Ithink I may have been the first to chuckle when my pathology professor, Dr. Edward McCarthy, allowed his thoughts to wander to the nature of health and illness. He was talking about being "in sympathy with the ebb and flow of life," and his reflections seemed somehow misplaced, almost comic, in a room filled with slides of assorted diseased tissues. Contentment with one's life, he was saying, was a key ingredient in the formula of how patients would respond to illness -- and whether they felt ill at all.
But with all the grinning, I've come to believe him. I've taken to the obscure notion of a human factor tempering disease -- something deeply personal, mystical and immeasurable. And my contact with patients at Johns Hopkins Hospital, now beginning in earnest, has helped to convince me.
If you had come with me into the room of one particular patient, let's call him Pete Brown, you would probably agree. Pete Brown is a retired laborer. He left the job he held for over 20 years when his diabetes first put him in the hospital. His liver started to fail about the same time, probably because of the half-pint of whiskey he drank each day for so many years. It's hard for him to walk now -- he's lost toes to infection, and his back never did seem quite straight to him.
Yet Pete Brown doesn't complain much. He says he doesn't feel terribly ill, and he's anxious to get home to his wife of 40 years. I think it has something to do with what Pete Brown has done with his life. He's made it. You can see it in the smile he'll flash you when he shakes your hand. And you can hear it in his voice when he tells you about several children he sent to college and the one he still wishes took that scholarship instead of a job.
Pete Brown started with nothing. He still remembers his father's axiom that black men didn't go to school, they went to work. He has just the slightest bit of trouble covering up his pride when he tells you that he graduated from high school anyway.
"It wasn't easy, you know that?" he asked once. And, of course, I said that I knew when I really knew nothing of the kind and had never attempted anything as difficult. I said that I knew because I wanted to understand how hard it must be to come home from cleaning buildings and encourage his children to go to college. I wanted to know how it must feel to sit back at 70 and realize that you've burnt yourself out, but that it was worth it, every bit of it. I wanted to understand, and I was beginning to, why such a serious illness hadn't taken its toll in spirit.
I wanted to feel like Pete Brown. Because I couldn't help but admire him.
I don't know how I would react to similar health problems. I've never been forced to take a final tally on what I've accomplished, and I don't know if I'll ever achieve the kind of contentment with life that allows Pete Brown to put his illness in a different perspective than most. There are no certain steps anyone can take to capture the satisfaction he feels. It is highly individual, incorporating dreams and setbacks and, perhaps, great victories.
It might be that certain harmony with life that my professor tried to address, the kind of inner peace that a man whom I'll call Allan Potter seems to enjoy. He is not married, has no children, and has accumulated no great wealth. At over 80 years of age, he has few of the things that traditionally serve as safety nets when cancer confines a patient to the hospital.
But Allan Potter doesn't look sick. He's lost some weight, but it's difficult to see the change through the pin-stripe pajamas he brought with him to avoid hospital gowns. His hair is neatly styled, and a copy of The Wall Street Journal lies next to his breakfast tray. Even though the walls in his room are a dull shade of tan, the many cards he has arranged among the flowers on his windowsill somehow brighten them.
There is no defeatism about the place or the man. He still makes people laugh, sharing his gallbladder scar from 20 years ago, "when they still gave you something to show people," and complaining about his brother who "turned 70 and started to think he knew it all."
Allan Potter has lived his life well, as a teacher and businessman, and he has no regrets. He never married ("Nobody ever asked me"), but there is a card signed in a female hand that still makes him blush when someone notices it. Something about his contentment with life has kept him from becoming his disease. The cancer is external to him, frightening nonetheless, but no match for his strength of character or composure. II 've seen the flip side, as well. I've listened to patients like the one who told me that he I "feels sick all the time" and hasn't felt well since he can remember. I've sat with him as he graphically, even dramatically, described every facet of each illness.
The symptoms have taken over his life, made him preoccupied with when the next episode of shortness of breath might occur and when his gout will return. He does not describe himself as a happy person, and he does not have the tone of an individual eager to get back to the business of living again. Even though he will get well, one leaves the room feeling as if something very frightening is happening within its walls, when, by any physical measure, the more threatening things are happening to Pete Brown and Allan Potter.
My intent is not to judge any of these patients. A particularly graceful response to illness inspires our admiration, but only because every concern and fear can be sympathized with completely. Disease processes are not fully understood by most patients, and they may feel a loss of control, being forced by circumstances to trust professionals they often have never met before.
But whatever the reason, there seems to be a dimension to certain people's lives that makes them suffer less from the same symptoms that cause others great preoccupation or terrible pain. It is not something I could have learned in a classroom. But I owe Dr. McCarthy a debt of thanks for planting the seed of the concept in my mind and for taking the time to ask that we put away our microscopes long enough to think about things not to be found on the slides.