adopt a new yorker

i met a new yorker. it was a fascinating experience. it all started when i was doing a locum in private in nelspruit over christmas. i was seeing a patient in casualties and this touristy looking guy came in with his wife in clear respiratory distress. she apparently had some sort of fibrosing alveolar disease, the domain of physicians, and was duly admitted by them to icu. i just remember this guy in casualties shouting at everyone and saying if the service is not good enough, they were going to just leave. i thought he's an idiot. where is he going to go? nelspruit private hospital is about 2 hours away from any other good medical help and she looked like the ride to icu would be too much for her.

i had my own patient in icu (a gunshot abdomen who bled about 8 liters before and during operation, which means the anaesthetist was quite a wiz, but different story), so i saw her the next day huffing and puffing with a cpap mask on. (a cpap mask is a mask that delivers air under a higher residual pressure. i personally believe it may origionally have been used by the spanish inquisition to illicit a confession in days gone by). the point is she didn't look good and already i started suspecting she was not going to make it.

anyway, i left nelspruit and went back to witbank to finish the year off there. i returned to nelspruit on the second of january. initially i had no place to stay, so the hospital put me up in the local hotel (town lodge). the first evening there this same man came in and sat at the bar with me. i immediately remembered him. he soon greeted me with a twangy "how ya doin'?". i remained polite yet somewhat aloof. but soon his gregarious nature thawed even my hard surgical demeaner and quite soon we were chatting like old friends.

he didn't remember me from the night he brought his wife into the hospital and i didn't volunteer that i'd thought he was an idiot. he told me about his wife and showed me photos of her lying in her icu prison, now with a tube in her trachea, indicating that her condition had gotten worse. i feared the worst.

the poor guy and his wife had come to south africa to enjoy a dream holiday. she got sick and now he was stuck in this hotel without friends or family and also without transport. i offered to take him to the hospital whenever i could and did so a few times. i also offered to take him out just so he could get a bit of a break from what had become his dismal situation. so we spent the evenings together, joking and laughing, often until the early hours. for me it was a cultural experience. he is loud and verging on what we would call obnoxious. at every restaurant he would pepper the waiter with all sorts of demands and unusual requests, always in a loud voice. often i saw them becoming irritated, just as i had done that first day. but now that i knew him i realised that that's just how he is. he means no harm. i actually became embarrassed by the irritability of my fellow countrymen. fortunately the new yorker seemed to be oblivious to their reaction. maybe he just didn't care.

one day i arrived at the lodge in the evening and he was there waiting at the door. he approached me and said the hospital had phoned and requested that he go there as soon as possible. i immediately drove him up. as could be expected, they told him his wife had just passed away. he was devastated! this loud american that i thought so perculiar was reduced to fighting back the tears. i took him out again because he said he didn't want to be alone in his hotel room. when we went out the old man i had come to know was back, hardly giving me a chance to get a word in edgeways, joking and laughing at the slightest thing. only every now and again would he fall silent and i'd see the tears well up in his eyes.

one of the bar tenders in the lodge also befriended him and soon it would be all three of us going out making a nuissance of ourselves. what a mix of cultures and attitudes.

i learned a few things. i firstly reminded myself not to judge people so quickly, because i may not know their circumstances and i don't know them personally. i also saw the whole medical tragedy from the other side, the important side actually. the human drama of what we do we often loose. i suppose we can't always get emotionally involved, but it is still important to remember that what, to us, may be just another case, to the person involved may be the single most signifficant event in his life.

so to this new yorker who i now feel proud to call friend i say thank you for reminding me again that we only do what we do so that the patient can get back to what's really important. the task of living and enjoying life. i'm humbled.