It was deep into a winter Saturday afternoon that Mr. Monson came to the Emergency Room, drunk. Outside, the gray light was fading towards black and rain covered Solano County like a blanket of tears. In the ER, every gurney was filled. Ambulances and police cars were scattered in the parking circle, and the department teemed with busy staff, harried physicians, and worried family members.
Mr. Monson, though, was alone.
I was on hospital duty that day when the ER physician’s request for a medicine consult came in: “I’ve got an 84-year-old drunk here who’s fallen down and has cuts everywhere.”
“So,” I ask, hoping for something of more significance. After all, if I am being called upon to deploy my fined honed physician’s instincts and skills, the patient needs something wrong that I can fix.
“He’s on Coumadin for an artificial valve and his INR is 10 (meaning his blood is too thin). I think he may be a keeper,” said the ER doc.
Muttering under my breath, I reluctantly acknowledge the validity of the consult. When I get to the ER, it takes only a second to see that the “drunk” is my own clinic patient, Clarence Monson.
Far from being an alcoholic, Mr. Monson is a dedicated husband and retired printer who rarely touches a drink. His wife died of Alzheimer’s one month ago, just shy of their sixtieth wedding anniversary. They had never had children. The last three years of their life together were a living hell for him. Changing diapers and helping her bathe. Regulating her Haldol dosage, depending on her agitation level. Answering the same question a hundred times a day, his patience invincible. He tried placing her in a skilled nursing facility, but pulled her out after two weeks during which she cried nonstop.
I quickly scan his ER chart, then look up at Bed 5. Mr. Monson is loosening his restraints, clambering off the end of the gurney, and yelling to beat the band. His head is bloodied from a scrape. He looks like your typical drunk.
I get into the room in time to keep from falling off the bed, drop the side rail to let him stand up, and ask him what’s happened.
“She’s gone,” he yells. “She left me.” The tears are pouring down his face, and there is some alcohol on his breath. Swaying and rocking, he grabs my shoulders and asks, “Why did this happen?”
Fearing he might fall, I get Mr. Monson to sit down on a round stool and I pull up another one for myself. We sit there, facing each other square-on, knees touching, his hands in mine.
“Doc, it’s our sixtieth anniversary, and she’s not here.” He is sobbing uncontrollably. “I can’t go on. There’s nothing left.”
“Mr. Monson,” I say, “you’re left. I know how terrible things are for you right now, but you need to give yourself some time.”
“But why did she have to die before me? Why couldn’t I die first?” he asks. His head slumps to his chest, and the tears are falling on his hospital gown. “She wouldn’t have even known I was gone, and I wouldn’t have to suffer like this.”
“She would have known,” I counter. “You remember what happened in the nursing home. She couldn’t stand to be away from you. You were an angel for your wife. You did everything. Almost no husband I know would ever do for his wife what you did for yours. She suffered to much, and now it’s over. You suffered too, but you need to remember now that she’s found peace.”
We keep talking for a good five minutes, crossing and recrossing various events the three of us shared over the past several years. At times, Mr. Monson lets himself smile briefly.
Finally, we reach a point of silence. A minute goes by. Mr. Monson’s trembling slowly subsides. We sit there just looking at each other.
I break the silence, saying, “Mr. Monson, I think it’s beter if you stay here for a day or two. We need to clean you up, fix your blood, and get you some help. You’re a good man, and it’s not your time.”
After a few seconds, he nods his assent, but then starts sobbing again, though more quietly. I stand up slowly, dropping his hands. When I turn to leave the room, there are four or five unknown visitors, here to see other patients, standing on the other side of the glass staring at us, like we’re on display. An involuntary scowl crosses my face, but I quickly wipe it off and restore my “neutral physician’s countenance,” realizing they meant no harm. After all, it is kind of like a zoo here sometimes, I think to myself. I hope they can’t see the moisture in my eyes. It would be so unprofessional.
As I reach for the green order sheets to admit him to the hospital, I marvel at my own naivete. When Mr. Monson’s wife finally died, I had actually thought he would be relieved. His burden would be lifted. But he had only changed one load for another. And which was worse? Which burden was heavier? Only Mr. Monson knew, and only time would tell.
(March 1999)