More Than This
More Than This
I used to be so much more than this. I listen to his words as I peer down at my computer screen. It is a routine follow-up for his heart failure. His well-worn clothes hang from his undersized body. I stare at the fraying edges of his sleeves as his head wavers, and concentrates wide-eyed on the floor. He is in poor condition.
His heart pumps at a fraction of the strength that it once had. His legs are chronically swollen and his breath often is lost with even the most minimal of activity. He leases a small apartment in a low-income housing rental unit down the street from the office. The elevator is out-of-order more times than not, and he is lucky to have secured a unit on the first floor.
He would have never made it up those stairs.
A Business
I used to own more than this.
Although you wouldn’t be able to tell from his most humble appearance, he used to be a successful businessman. He owned a bunch of dry cleaners around the city. He watched year after year as his revenue skyrocketed. His bank account moved into the seven figures in the early eighties when that was really saying something.
But even then, his lust for success couldn’t be quenched. He tried to parlay his success into a number of small businesses that failed. His attempts at running a fast food restaurant not only bombed miserably, but also forced the sale of his successful dry cleaning business.
He escaped with little more than the clothes on his back.
A Family
I used to love more than this.
Shortly after his business collapsed, his wife and daughter left. His mood turned
foul after losing everything. He came home late at night drunk after a day of carousing, instead of hitting the pavement in search of work. His misery played out in his personal life destroying his family, costing him his friends, and cutting the social bonds that bind.
He felt unworthy. Less than. Not deserving the love and support that he once had.
His Health
Alcohol is not good for the body. It creates havoc with the liver and changes the brain. It forms a physiologic dependence as well as an emotional one. His once strong muscles became putty under the duress of disuse and the abuse of alcohol toxicity.
But it was his heart. His heart that eventually brought him to me. After years he developed an alcoholic cardiomyopathy. The cardiac muscle weakened by years of drunkenness. As his breath became short and his legs became swollen, he had no choice but to seek help.
He was dying. A slow death. Emotionally and physically.
He had memories of being more than this. Of having wealth. Of being a father. A husband who could be depended on, and having a body that could support itself through everyday stress.
His Doctor
As I stare across the exam room at this disheveled figure, I can’t help but feel compassion.
Compassion for him and his losses. I can not restore his fortune nor his family. I can prescribe the measly medications which will keep his disease at bay. For a time. Till the water fills his lungs and his heart gives out.
Some things are unfixable.
And I also feel a little compassion for myself. Because i have a business, a family, and my health. Yet I also question everyday whether there is more than this.
Whether I am reaching my true potential. Whether my patient and I have more in common than I would like to believe.
Maybe he should have been happy with what he had when he had it.
Maybe I should be too.
I love reading you in this zone, Doc G. You have a real gift for making observations like these.
Thanks for sharing your words,
CD
Thanks man. I appreciate the positive input.
Strong reminder that once you win the game you should stop playing (and thus enjoy the winnings).
There is a point where if you have reached “enough” you can do more damage by being greedy and trying to achieve even more. It is funny you used it as an example but at one point I wanted to get into a franchise fast food place and did a little research on it. Fortunately I chose not to as I knew I had no expertise in this area and also discovered that there was a lot of work for a relatively small reward (most individual restaurants really don’t bring in as much money as I had originally thought).
I get like this all the time too. I want to jump into something that absolutely makes no sense for me.
Wow Doc, one of your best! I kind of see some parallels to the Mexican fisherman story. Be happy with what you have, when you have it. As much as possible.
Very true. I didn’t think about the fisherman story when i wrote it but similar ideas.
Great one! We would all like to believe we can avoid that reversal of fortune, but life can take an unexpected turn at any time. Sure, we do prudent things, but we don’t control the wheel like we would love to believe. Look at what happened to your father. We only have our todays and we have to make them count. As Dave has on the T-shirt I’m taking to Greece “Someday is not a day of the week”.
Life definitely can be unexpected. Best to enjoy and thankful for what we have.
Everybody dies. Some just display their dying more obviously than others. This is a story of failure of financial independence. This is a story of misappropriated risk aversion. It’s also the story of true alcoholism. Last year was discovered to be a genetic cause of alcoholism. It turns out there is a GABA pump (protein) which pumps GABA back into the cell. The expression is phenotipic, some pumps are expressed more strongly some more weakly depending on the possessed genotype. Alcoholics have weak pumps and the population genetics pretty well match the phenotypic distribution, 17% have the potential for disease, 6% are expressing the disease at any time. The trigger is how alcohol affects GABA and the cells resultant inability to reprocess the neurotransmitter properly. The solution is to quit drinking. 100% quit drinking. Not easy but doable. It is a disease entirely dependent on behavior, behavior which is caused at a much deeper level than the cortex, in the mid brain. It’s a disease that points out how little rational control we really have and how much the mid brain dominates. It’s a story of sequence of return risk played out in reality, in a very granular way. It’s also a story of humility. There but for the grace of God go I, (not the alcohol part I don’t drink), but the part about thinking his little money machine could be generalized into Mogelism. There is a story about a baby that was born just a head. Medical science worked it’s wonder and he grew a little bod y and could get around. One day he got hit by a car crossing the street. Moral: he should have quit when he was a head. I feel bad for your patient also, but his story is rich with meaning.
it certainly makes you think when you see patients like this and question your own actions. Very happy that i have no history of alcoholism in my family.
A good moral to take in, certainly. Thanks for sharing this man’s story. It definitely gives the rest of us some perspective!
The benefit of being a doctor is you get to meet all sorts of people and learn interesting perspectives.
A powerful story. I have congestive heart failure (from diabetes, not alcoholism) and my health issues cause me a lot of depression. But I am financially sound, have my loving wife and my grown children, and although I am retired, I have my blog to keep me occupied. It’s important to be grateful for what we have, and I am often guilty of focusing on what’s wrong rather than counting my blessings. Thanks for the reminder to be happy while I have what I have.
Gary, first I wish you the best of health. it sounds like you have your priorities in order.
Very keen observations on the human condition and the choices people make. Sad story.
Thanks. Sad but true.
Ah, to be happy. If we would only just let ourselves. Be. 💙
That would be too easy!
Thanks for sharing this powerful story. Somewhere along the road of life we must achieve balance. And we need to figure out our why. Without the why and without purpose, life is just a drunken walk.
Yep. A drunken walk. I like that.
“Maybe he should have been happy with what he had when he had it.
Maybe I should be too.”
Wow. That’s a great post there. It makes one stop and reflect for a little bit.
Thanks. That is always my hope.