The day had started out like any ordinary day. He made his morning rounds, then started at the office, one half hour late. By the time noon hour came, he had to go back over to the hospital to check on Mrs. Talliaferro, and her repeating arrhythmias. That took up all the time he had for lunch, because now the office was calling about a couple of patients with concerns that couldn’t wait, and had to be seen today, one of whom, as it turned out, needed admission, which added an extra hour to the afternoon’s load. Then, in the midst of all that, Steve Reeser called to ask him if he could look at one of his post op hip patients with chest pain. Sure, he told him, but it would have to be after getting done at the office. In the meantime, get the patient on telemetry, get an EKG, which could be faxed over to his office, and to draw some ABGs, and a set of cardiac enzymes. Finally, the last patient in the office was poor Mr. Alexandros, who had been waiting for two hours to be seen, but whose daughter, Maria, came with him, and took notes, so she could tell the other daughters what was wrong with papa.
His evening, back at the hospital, just got rolling when he was paged, STAT, to the fourth floor ICU, because Mr. Pullen’s temporary pacemaker was not capturing and, sure enough, it turned out that the lead had migrated, and he had to reposition the lead, urgently. Then, as Dr. Gilsen was checking Steve Reeser’s patient, he found that the old guy was having an MI, and needed to be moved to the “unit,” where he then proceeded to “code.” After wrestling for forty five minutes with his resuscitation, his rhythm gradually stabilized, and his blood pressure came up, but, being just one day post op, from major hip surgery, the options were limited. Next he called Steve back to fill him in, and to give him the bad news. This was before he was able to check on his office patient who had needed admitting, and, it turned out, was suffering from pneumonia.
By the time Bob was able to get his head above the turbulent waters of the evening, he realized he was famished. There was nothing left in the doctors’ lounge, so he decided to head to the ER, where he knew he could find something to eat.
Sitting down in the space usually taken up by residents, he ate his cheese and pink meat sandwich, followed with a diet Coke.
“Hey, Dr. Bob, you look like you just escaped from somewhere unpleasant.”
“Oh, hi, Judy. Yeah, you could say that. It was a bit hellish up on the floor, with Steve’s patient going south… But you don’t really want to hear about that. Just stopped by to grab this fine repast, before heading home.”
Judy Morrison just smiled at him, touching his shoulder. Funny how that touch sent a soothing balm through his body, which was aching, stiff and sore by now. He wanted to linger, but he knew he had to keep going, so he just smiled back and mumbled something that sounded like a thank you.
He then picked himself up, and trudged out to his car stopping on the way to get his coat and gloves. He did not remember his drive home. When he did get in the garage door, all was quiet. He looked at the clock – it was 9:35.
With a sigh, he sat down, and thought about his life. “What am I doing? How did I get to this position?” Yes, his life was, at times fulfilling, but a bit too busy, too out of control. Medical school, residency, fellowship had all had their times of intense chaos, but there seemed to be some order, some sense that there was someone overseeing things. Now there was no one but himself. He thought about how, in training, he had envisioned things differently, and how his life had gradually become something other, something he had no control over. “Ha,” he thought, “the more I am in control, the less control I have over my circumstances.” He thought about the last time he and his wife had actually sat down and ate a nice meal together, it was when he went out of town to a conference.
He went upstairs, and there he found her, reading in bed.
“Hi, dear. What’s that you’re reading?”
“Oh, hi. This is just something I’m reading for my book club. Actually, it’s quite entertaining – it’s about the business of medicine – you know, all the money you make, what you should be investing in and all.”
Bob just groaned. He was not, in any way a businessman, and the thought of his vocation as a business just irritated him. “You know that aspect of my practice, I would just love to turn over to someone else, someone I could trust…”
He didn’t say any more, he didn’t have to.
“I know. That’s what makes you so endearing. Come here and give me a kiss, and tell me about your day.”
Bob did that. “You know it was just another of those days, when everything takes so much longer than it’s supposed to. When every patient and every family seems to want more than I’m capable of giving, and yet I feel I’ve got to try…”
“Yeah, it’s why you’re so popular, because you do try. You can’t help it, and word gets out, and then people start expecting it of you.”
“But it’s beginning to tear me up. All these expectations…”
“And what are you thinking?”
“I was thinking of the last time we sat down and ate a real meal together, one with no expectations, no beeper, no hospital waiting to interrupt…”
“When was that?”
“In San Francisco, last year, right after my conference, in that seafood restaurant, looking out at the bay, when I ordered the cioppino, and you had never heard of it, and you ate half of mine…”
“And that fabulous wine…”
“Ah, yes, that pinot noir, that we were told doesn’t really go with seafood, but the waiter recommended, and we finished the bottle, before that incredible dessert, with bananas, ice cream and flaming brandy.”
“And you were thinking…”
“It’s just that we seem to be missing out on something very significant, something that may be irreplaceable.
“Well, if you figure it out, let me know.”
Bob then got ready for bed, climbed in next to Marilyn, kissed her good night, and was asleep before she turned off her reading light. He slept the deep sleep of one exhausted.
During the night, he dreamed a truly unusual dream. He found himself sitting in a crowded inn. He looked around and saw there were rough oak tables and equally rough oak benches, mostly filled with noisy, burly peasant-types, all dressed in clothes from a bygone era, rough and stained. Everyone had a flagon of deep, rich brown ale, and there was bread at each table. It was cold outside, but inside the inn it was warm, the atmosphere was jovial, with a sense of belonging and conviviality.
At the table next to his, there was an older man talking, telling a tale that told of magic, nostalgia, and history. All around him seemed to be held in a trance, as if under his spell. Bob was just one of the multitude, caught up in his words and gestures, rapt and attentive. His tale was one of innocence, betrayal and death, and was a tale of a book, sought after by powerful men of means.
When he had told his tale, he turned to another at the table and asked him to play something fitting on his harp. The minstrel agreed, and, after another round was poured, he took up his harp and began to play.
What began as just cords and strumming, soon developed a life of its own, with a melody appearing as a vision out of his fingers on the strings. Now Bob became really transfixed, as he had never heard anything like this before, his head swimming with the tune from the harp. He was carried in his mind to an even more distant place, to a deep forest, with running water, in springtime, with the smell of newly turned earth.