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Martha's Vineyard Times is a weekly publication.
March 31 - April 6, 2005 Edition
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North Road March 31, 2005 There is no new Off North Road column this week. The Miller family March 24, 2005 By Russell Hoxsie, M.D. This piece is constructed from a real happening in my early practice but some facts and names have been changed to preserve the confidentiality and privacy of the persons involved. I was deeply moved at the time and remember the family, now deceased, with great affection. Reuben Miller was a stranger to me. He was in his twenties, thin and angular of build and his complexion was sallow and pocked with old acne. Sometimes he was clean-shaven; his teeth needed attention. He worked as a self-employed carpenter and had built several small cottages on the outskirts of town. His own place, yet unshingled, was covered with building paper. Reuben seemed to live in a world of his own and seldom came to see me as a patient. I remember only rare occasions when we had spoken. I would catch a glimpse of him at the far end of the waiting room when I ushered his mother out past the receptionist's desk. If I went into the waiting room, he would acknowledge me with a brief upward nod of his mouth and chin. Then he'd leave. I could see him from my office window slouched in his aging Oldsmobile waiting for his mother. She navigated the stairs and trekked through the parking lot as best she could alone. Mrs. Miller carried too much weight and she seldom smiled. Her blood pressure ran high and her heart was weak. She wrapped her chronic leg ulcers with gray sheeting torn in lengths and wound round and round, so repeatedly washed that frays of thread streamed along torn edges. In winter she covered her legs with black cotton hose. The younger daughter appeared under-nourished and nervous with quick erratic movements. She never looked me in the eye. Her name was Martha and she was raising two small children. The Millers' older daughter, Celeste, despite bearing a family resemblance, retained an inner dignity, a softness that blunted the glacial familial crags of her face. Her humor crinkled the corners of her dark eyes and raised her thick eyebrows in exasperation, an unspoken understanding that the others in her family were burdens for her to bear, however lightly or intermittently. I talked with Celeste on occasion about the health of her mother and father. Celeste came to my office one late afternoon with the youngest of her three small children to hear my latest prognosis for Mr. Miller. The father walked slowly with the assistance of a cane and usually wore a stubble of two or three days' growth. As he grew older he acquired a sunken look and stooped stance. Both Mr. and Mrs. Miller were people of few words. Mr. Miller had severe kidney disease. “Celeste, Father's weaker. No fever, no pain, but definitely worse than last fall. Kidneys failing, life's running out. It's difficult to predict, but all of you must be prepared for the worst.” “I see him slipping,” she said. A look of sadness crossed her face. A mental picture of the rest of the family flashed by me. “Do Martha and Reuben know how serious this is? Mother seems to understand.” “Reuben never stops in. I doubt he even notices. Comes by the house when he needs something. Martha's in and out all the time. Sees only what she wants to. I'll send them in to talk.” “If you think they'll come,” I said. “They should be prepared for the worst.” I didn't relish the thought of the two young people sitting side by side on my office couch looking nervously about while I tried to explain the seriousness of their father's condition. Celeste left and I resumed other things. Weeks passed and Mr. Miller slipped gradually downhill. Remarkably, there were few outward signs: a little loss of weight and added pallor to his face. At the end of my visit with Reuben and Martha, I felt uneasy. “Looks all right to me,” Reuben muttered rising from the couch. Martha sat for a moment. “Would I be all right if I had another baby?” she asked. On a steamy Sunday afternoon I was tending my bees on the hillside facing the pond. My head-net and coveralls were hot and the bees were unusually aggressive that day. I could tell by the knock I felt when they struck my face screen and the increasing amounts of tiny yellow fecal stains they deposited on my white coveralls. “The phone's for you, dear,” my wife shouted from the porch. “And they say it can't wait. Someone's very distressed.” I grumbled out of my dirty clothes and paraphernalia, dodging the last of two persistent bees which tried to follow me into the house and I called back to the hospital. “The Millers are here,” said the nurse. “Dr. Smith's having trouble calming them down. Father was brought in by ambulance. Died on the way. There's no consoling the family. Dr. Smith wants you to come right down.” The nurse sounded agitated. The emergency area was empty when I arrived. Dr. Smith slumped in a chair by the desk. He motioned silently to the closed door across the hall and put his fingers to his lips in warning. We walked around the corner where we could talk. “That Miller kid, Reuben I think his name is, is in there with his sister. Took a poke at me.” I could see the beginning of a little mouse under Smith's left eye. “What happened?” “The old man arrived in cardiac arrest. We tried the usual things. Ambulance attendants said he was alive and breathing when they picked him up. Coming over the bridge he arrested and convulsed. They kept him going pretty well until he got here. The kid followed us down to the treatment room. After we applied the counter shock he started to howl and raced out to the waiting room. When I went to tell him we hadn't been able to save his father, he came at me like a banshee. 'You killed him, I saw you, you killed him,' he yelled. Before anyone could grab him off me he poked me in the eye. I was so mad I almost hit him back. Started to call the cops but his sister asked me to call you. He's in the night room over there with his sister. He's some savage.” Poor Smith couldn't know this family at all. I don't suppose I knew them very well. At least I'd spent several years doctoring them one way or another. Reuben was bent over on the edge of the night cot, head cradled in his hands, his long uncombed hair falling forward covering his face. The crown of his head was beginning to bald. I hadn't noticed it before. Celeste gave me a thankful glance and darted out of the room leaving us alone. “Reuben, are you O.K.? Do you recognize me?” “What?… What's happened?” He looked up through his streaming hair; jaw tightened. I could see his fists clenched under his chin now as he lifted his head. He lurched to his feet facing me with an ugly scowl. “That bugger killed my father. I saw him. He hit him with those big electric paddles. I saw his whole body move and get stiff. Then the doc comes out and tells me the old man's dead. He killed him.” Reuben pushed at me in a drunken-like lurch to get past me to the door but his effort was half-hearted. My hands fell on his shoulders and he stood there in front of me, his clenched fists hard and his mouth straightened in a stiff grimace. His eyes opened looking about the room, at the door, to the ceiling, fleetingly at my face, then to the floor. When he spoke I noticed again his poor teeth and pocked complexion. “Your father's dead, Reubie. It's the worst thing can happen to a man - your father's dying.” “He killed him.” “No, Reubie. Your father's been a sick man for a long time. His kidneys and heart killed him.” “I didn't know.” “I know. It's the worst thing ever happened to you - what's happened today. I know that.” Reuben's fists unclenched, but he stood there. My hands remained on his shoulders. “You went crazy in there, Reubie, seeing your old man so sick. You wanted him to live.” “Yeah, I couldn't do nothin'.” “You went crazy for a few minutes and you got mad. It's the worst thing ever happened to you in your life. You wanted to hurt somebody bad. You took a swing at Dr. Smith.” “I didn't mean to, doc, honest.” “I know, Reubie, I know. You were feeling so bad you didn't know what you were doing.” “My old man's dead.” “He's gone. You're right.” “Didn't know it would be so soon.” “I'm sorry, Reuben.” We were stretched as taut as a rubber band. I was afraid he might try to hit me. Then, an amazing thing happened. I thought of a scarecrow in a corn field in the fall when the corn stubble is all around and the winds have scattered the dry weeds and stalks and the scarecrow is left alone, black old pants flapping in the wind and straw hat fallen to the ground. The crows have long deserted this benighted plot. The sticks that spined the solitary figure suddenly melted and the rigid scarecrow went soft. Reuben crumpled still on his feet. His baggy pants all but waving in the wind and his hands and arms falling loosely to his sides, his legs unlimbered and flexed as if to collapse at any moment. Reuben tottered a half step toward me. It was all the space remaining between us at that moment. As his head came to rest on my chest and I reached out to steady him against me, at that instant this young man whom I knew as without feeling or grace, this begrieved human being, wept. His shoulders heaved against my chest and his head shook and shook as the tears streamed down his cheeks. His sobs ebbed slowly until he was exhausted with the effort. We stood this way for an eternity, it seemed, before he regained his own balance. “This is the worst day of your life, Reuben, the worst day, but you're going to be all right now.” |
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