Thursday, November 18, 2010

The Goodest Samaritan? Part I

In driving back from Long Beach, California, on Tuesday, November 9th, in Fresno, I picked up a passenger.  And what a passenger!

I had stopped at Denny's for a burger and, short of dog food, a hamburger patty for Scout.  There were two ramps to enter the restaurant.  Near the base of the left ramp sat a scruffy-looking old man hunched over a red anodized aluminum walker, exuding a very negatory vibe, shock of hair in every direction, no upper teeth, beard of neglect, bloodshot eyes and a hunched habitus.  So I avoided him by going up the right-hand ramp.  This I did twice.  But when it came to dispose of the box in which Scout's patty came, I had to walk by the man to the trash.  And it was then I made my mistake.   I asked him how he was doing and he said, "Not very good."  And instead of "'Too bad!", I, whether by psychiatric habit or Christian politeness, chose to listen to his tale of woe and intervene.

Call him Humphrey, a 58-year-old electrical engineer whom the doctors have given "three months to live" (I love these stories, I have rarely had a patient who didn't have a story about how he or a family member had been pronounced terminal and miraculously survived to eventually bury his doctor!). 

He had been traveling by bus back to Oregon when he was robbed in Fresno and relieved of his wallet, keys, and other valuables.  All he had were a few dirty clothes in as beat-up athletic bag, a thin sleepng bag, and his walker.  His only ID consisted of hospital discharge papers, which did him no good when I took him to the DMV in Fort Bragg, which required a birth certificate.  And with no ID he couldn't access his funds, though he purported to be a relatively wealthy man, at least compared to me.  We rested at my place in Mendocino for three nights while I wrestled with what to do with him.  There are no social services adequate to provide a man with 24/7 personalized care while traveling, which is exactly what Humphrey needed, being near entirely helpless because of his crippling neurodegenerative disease.  I asked my stepson if he wanted to drive Humphrey home for the promised $1/mile up and back, but his car wasn't running and he was pissed at me for whatever reason, so when I presented the offer to him he immediately called the police, thinkng a restraining order was in force when it wasn't, as it was Veteran's Day and I had not yet been served.  Afterwards a nice policeman, a sargent, escorted me to the station where I received the necessary papers forbidding me to come near my wife and stepson until a hearing on December 8.  Why they feel they need protection from me I'll never know; I've spent the last eleven years protecting and providing for them, and I've saved Derek from suicide once and Kathleen, twice.  I've delivered Derek from prison, jail, and a dead-end life in a metal shack in Oaxaca, Mexico.  But people get strange ideas in their heads--I can be very intense, and it was sometimes hard to distinguish whether I was manic or filled with the Spirit over these last months, so I may have appeared threatening to the undiscerning eye, but know that I have never touched Kathleen physically.  As for my condition I am happy to report that I am indeed filled with the Spirit and not mentally ill.   I have never violated a restraining order, nor would I.  I respect my mate's need for privacy for as long as she needs it and I would never jeopardize our love by insinuating my presence into her life when it was unwelcome, though I weep frequently over her absence.

It finally came to me that I was the only logical person to get Humphrey home, though I hate to drive, especially since I suffer chronic back pain and driving aggravates it.  But Humphrey needed a doctor 24/7, especially one also trained in the humility of a hospice worker, as I have been.

As for Humphrey's condition, he suffers from severe emphysema, mononeuropathy multiplex, "spots" on his kidneys, "multiple melanomas," is addicted to cigarettes and alcohol-- and is the grumpiest man and most demanding person I ever met!

It's the multiplex that's really messed him up.  It is a poorly understood syndrome of multiple foci of damage to peripheral nerves, and I included a link above.   In Humphrey's case it is crippling.  His hands are so bad, for instance, so that he needed me to put a cigarette in his mouth, light it, and remove it from his fingers near the end of the smoke before he burned himself, as he could only clutch it between immovable fingers like some weird exotic bird and had no way to extricate it from his knuckles.  Yet he was constantly demanding cigarettes, which I bought him, and  afterwards I would sometimes have to hold his albuterol inhaler to his mouth and hit the button in time with his inhalation to counteract the effect of the cigarette smoke.  In addition I had to keep him constanty supplied with vodka and coke, or failing a liquor store, "Steel Reserve," 24 oz., which he could drink through a straw with the can positioned in my van's cup holder as he leaned forward. 

And if he ever uttered a "Thank you," it was in a gruff, semi-apologetic voice, as if it pained his pride to say it.  For here was a man who had bossed twelve electrician crews in construction, a man used to authority, a man of business.  His helplessness was killing him though he was loathe to admit it.  He wouldn't even admit to "bad luck."  But is this bad luck?

He has no family in this world, having buried his older brother.  His wife and son were killed in a car accident 26 years ago.  He was stricken with this neurodegenerative disease 4 1/2 years ago and has been steadily worsening.  Truly he needs 24/7 hospice care.  But I, being a doctor and a hospice volunteer, was prepared for his case.  I just didn't think it would cost me over 1300 miles of driving and a night in jail to boot.

(To be continued.)



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