Strength and Frailty

Strength and Frailty February 16 2010


With love, I learn a person’s different looks.


At work, the set of face and shoulder muscles –

Resolute, reliable, ready for all challenges --

Inspires, tells us we can follow. 

I admire that, and trust arises.


When I know and love that steady person,

I also see, inside, the frailties, the fears, the hopes, the dreams –

All covered up with posturing and costume.

As the person turns away, intent on what comes next,

My heart trembles, feeling tenderness,

Wanting to protect and love, to nurture and caress.


We all have that inner self, that place that feels hurt.

We’re blessed when someone knows and loves our inner face,

And fortunate to know the inner self of our beloved,

To feel a deep and caring fondness.



Reflection

I met Ellen after she had retired from her life work as a hospital attending physician. We grew very close personally, of course. I found it fascinating when, at times, she went into “doctor mode.”

She looked and acted like a different person from the one with whom I shared round the clock moments. She would get an analytical look in her eye, her jaw would set and jut out a bit, her eyes would scan more quickly, her shoulders would move forward. Every part of her body language bespoke intent focus; her pose could have come straight from a Norman Rockwell painting of a sympathetic, knowledgable old-fashioned country doctor. Ellen, of course, had trained as a doctor in Switzerland, learning from old-time clinicians, and thus knew how to look just like her role models, Swiss country doctors.

Another time, I got to see Ellen in “Emergency Room” mode. We were on a plane, returning to California from New York. It was a six hour, trans- continental flight, and somewhere over Utah, the head stewardess came on the PA system, asking any physician on board the flight to ring his or her call button. Ellen rang hers -- the only doctor. She was immediately put in charge of the situation. On that airplane, I saw a total transformation of the fun-loving wide-open person I knew and loved every day.

 Ellen’s focus sharpened to laser intensity. Her eyes and her nervous system transformed her into a finely tuned medical machine that yet retained the gentleness and compassion of the person. Her motions became rapid and well rehearsed, as she went through the diagnostic procedure for the young man who had fallen, unconscious, while waiting in line for the rest room at the back of the plane.

A part of Ellen’s Swiss medical training had taught her the fine art of physical diagnosis – discerning through the doctor’s senses what was going on inside, without needing scans, images, or machines – not even a stethoscope.

She knelt beside the young man, who slowly regained consciousness as he lay in the aisle. She examined him quickly, then reassured him that he was all right – he had not suffered any major illness or injury. She performed a differential diagnosis (is it this or that?), by asking him a couple of quick questions about his day so far, and determined that, although it was mid-afternoon, the young man had been travelling since early morning with no opportunity to eat anything. She diagnosed hypoglycemia, telling the stewards to give her patient a couple of glasses of juice to drink, then some peanuts – using what was available on board to rectify the hunger that had caused the young man’s fainting spell.

As Ellen walked back up the aisle to her seat next to me, I could see in her walk and her eyes her feeling of satisfaction for challenging work well done, and also the extent to which her whole body had leaped into action to meet the situation – adrenaline, epinephrine, norepinephrine. Fifty years after medical school, the grueling 36 hour shifts on duty as a young intern and resident still produced their ineluctable response – wake up and be totally alert immediately – on duty; work with every fiber, sinew, and synapse to correct the emergency situation and preserve life. Behind the disabled older person, in her 70s, slowed down by chronic pain, still lay a superbly trained mind and body capable of responding fully to the requirements of an emergency. And underneath the brilliant physician lay a woman vulnerable to shame, doubt, and fatigue -- a person who was also gentle, funny, and affectionate. I experienced a surge of love for her -- feeling privileged at that moment to know both sides of my beloved partner and spouse.

I find that most of the time, we trust the competent persona that consummate professionals present to their clients and colleagues. Yet, I also know, from having loved several intensely competent people, that everyone also has his or her vulnerable, tender core, known only to those who are truly close. It’s a great privilege to know both sides of a fellow human.


Couples February 21 2009

At the airport, I watch

Two women traveling together,

One in a wheelchair.

They chatter freely, share tickets, bags.

I feel a pang of memory of our trips together.



At the gate, new love,

A young couple traveling to a great event,

Special clothes in garment bags with hangers.

His camera captures her from different angles.

She glows with joy within his loving gaze,

And smiles coyly up at him.

Their bond is clear.



I sit here, bonded too -- with you—

Though it’s my first trip in ages without you sitting near.

I look within and smile,

Knowing you are with me, in my heart.