“Sickness is a hinderance to the body, but not your ability to choose, unless that is your choice.” – The Handbook of Epictetus
When I walked into his home, I acted as if I did not know.
“Good afternoon, Mr Jones. It is nice to see you today.” [I placed my bags down gently where I have before, placing a large barrier between my things and his].
“It is good to see you too. How are you today?”
“I am fine, thank you. More importantly, however: When I left 2 days ago, you had plans to go the oncologist’s office yesterday. How did you do getting in/out of the car and walking to the office?”
“I have to admit, I really had no problem moving at all. I was able to get into the car and walk all over the doctor’s office without any difficulty. A little slower than I might like, with the walker…but, boy, was I tired when I got home.”
“Jeez, I would think so. You have to remember that only 2 weeks ago you were only walking 20-30 feet before being completely winded. You couldn’t even make it up 2 steps in the house. Now, you are walking around all over the place – yes, with a walker, but you are going up and down the steps now too. Regardless…that was a lot of activity yesterday for someone who could barely walk 2 weeks ago and I would have been shocked if you weren’t tired. Again, looking back to our last visit, we talked about trying to do some exercises first and then finishing with the stairs so that you can shower. Is that a plan that is still agreeable to you.”
[after a brief pause] “Yes. Yes it is. Let’s do it.”
“Okay, lets get to it. But I would like to check your blood pressure and heart rate first…”
. . . .
Mr. Jones has made tremendous progress after returning home from the hospital after an episode of pneumonia. The biggest obstacles for him have been environmental. He has a lovely home, but his bedroom is on the second floor. His only full bathrooms are in the basement and on the second floor. When I first met him, he was in a deconditioned state and unable to negotiate stairs, he was stuck on one level, sleeping in a hospital bed (apart from his wife) and could only receive sponge baths.
At his last visit, 2 days earlier, he had been able to move up the stairs for the first time. He was proud, elated. His wife was crying, joyful for the progress he was making.
Since I had begun working with him, Mr. Jones’ primary goal had been to take a shower and – although he needed to get back down the stairs – I was not going to stand in his way that day. Instead, I left him and Mrs Jones upstairs to take a shower.
I had things to do at home after work, but they could wait. I went to the library for an hour to read stoic philosophy. He enjoyed his first shower in 3 weeks.
When I returned to help him down the stairs, I asked him how it had felt to finally get that shower he had been working so hard for.
“It was euphoric.”
. . . .
…On this day, we reviewed his home exercise program and walked throughout the home with cane (albeit unsteadily) before walking back up the stairs once again. He still required contact guard and reminders where to put his hands for support; I did not yet feel comfortable letting Mrs. Jones walk with him on the stairs. Once he was at the top, I again left him to shower. He courteously told me that is was not necessary, but I had wisely arranged to see another patient nearby and would need to drive past Mr Jones house again on my way home, anyway.
When I returned 45 minutes later, I knocked and entered the home to walk upstairs. I found Mr and Mrs Jones in tears in their bedroom. She was sitting upright at the edge of the bed. He was lying on his side with his head on her lap, her hand stroking his cheek. “We did not shower.” Mrs. Jones informed me. “I don’t know if you heard or not, but we got bad news yesterday.”
“They told me I have less than a year,” Mr. Jones said, wiping away his tears with a handkerchief as he sat up.
“Yes, I knew. The nurse had told me earlier today. That must have been a shock. I know that you were optimistic that you would be a candidate for the gamma knife procedure.”
“Yes, we were and then…I…well…[looking down at his hand, now clasped with his wife’s.”
“It is a lot to try to process in such a short period time.”
“It is…and…I…I’m sorry. Maybe we are just wasting your time…”
“With all due respect, sir, I wholeheartedly disagree. [He looked up at me, lifting his gaze from his lap] Two weeks ago, I walked into this home and you were in a hospital bed downstairs telling me that you were going to get stronger. You told me you were going to climb these stairs. You told me that you were going to take a shower. I told you that we would work together to achieve those goals. We talked about you getting enough strength to watch your grandchildren trick-or-treat this fall, visit your daughter for Thanksgiving and enjoy the Christmas holidays. While I am empathetic and am saddened by the news you received yesterday, there is nothing that you just shared with me that would lead me to believe that those same goals from 2 weeks ago are any less achievable today than they were then. The way that I see it, we already have an appointment scheduled for Friday at 2:30. I have already arranged to see the same patient after you on Friday that I saw today. Unless you want to cancel, I say that we stick with the plan: I will come in, we will exercise together and I will help get you back up these stairs to take the shower then that you couldn’t take today.”
Mr Jones, now sitting up, look over his shoulder at his wife sitting behind him. She nodded. He took a deep breath. “All right then, the date is set. We will see you then.” he said.
. . . .
Now, one week later, Mr. Jones is walking up the stairs with supervision from Mrs. Jones only. He is showering every day and sleeping beside his wife every night.
Looking back, I wonder: What might have happened if I had simply walked in last week and said, “How are you today?”