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72  march 28, 1998 I wondered if she really believed what she seemed to believe, whether she wasn’t really quite frightened “underneath.” D uring my internship year I spent a month with patients, most of whom were dying of blood diseases, various kinds of leukemia, the lymphomas. At that time, the middle years of this century, we didn’t have the powerful chemotherapeutic drugs that now go a long way toward a cure in many instances of such diseases—though, alas, there is much more we need to know, and many still succumb to the kinds of illnesses young doctors like me, back then, could only resist with one blood transfusion after another. To this day, memories of that hospital experience keep coming to me, especially when I lose perspective about life, get all caught up in some situationthatseemstobethemostimportantmatterthissideofKingdom Come—onlytorecallwhathappenedwaybackthen,whenInotonlywas trying to get blood into exceedingly vulnerable and weak patients, but was having conversations with them and, not rarely, learning a lot from themaboutwhattrulycountsinthislifeandwhatisoflittleconsequence. I remember in particular a young woman of about thirty, the mother of two small girls, who was dying of what we had diagnosed as acute  73 myeloid leukemia. Her husband was an English teacher in a Chicago high school, and I winced when he and the two children would arrive to be with someone all three of them knew was in great jeopardy. Yet the husband seemed strongly composed, even cheerful, and his daughters, just old enough to be in the early years of elementary school, were constantly attentive to their mother, with no evident anxiety or fearfulness. I knew that both my patient and her husband were well aware of her poor prospects, and I also knew that both had taken pains to tell their children what most likely was ahead. The older of the girls announced to me one afternoon while I was at her mom’s bedside: “God is deciding when he’ll be asking our mother to come visit him.” A pause, and then her ominous afterthought: “And it may be soon, you know.” I most certainly did know; and I also “knew,” at that time in my life, to be troubled by what I was seeing and hearing—an almost eerie calm and composure in a patient and her family as a mortal illness relentlessly and quite evidently was closing in on them. I was, then, by no means willing to ignore this family’s way of behaving. My head was all full of psychiatric thinking: they were resorting to “massive denial”; they were far more anxious and fearful than they could let on, even to one another, let alone me; in the long run they would need “help” in coming to terms with the sadness in their lives, the considerable anger as well—that such a tragedy should have befallen them, out of the blue. I had no time to dwell on that psychiatric line of thinking; I was overwhelmed with my medical obligations, to the point that I was lucky togetthreeorfourhourssleeponanygivennight.EarlyoneeveningIwas called to the bedside of the woman I have just described. She was having trouble breathing; her pulse was unsteady; and, not least, her transfusion was in trouble and needed to be fixed (or started again in another vein). 74  After I examined her, got the blood going and figured out that she was in noacuteorimmediateperil,Ipausedtoaskherhowherfamilywasdoing. Shetoldmethattheywereallright,thatshedid“sometimes”worryabout them, but she had great confidence in their ability to manage without her. I was surprised by what she said—the first time she had, by implication, acknowledged the gravity of things, the future that awaited her husband and two youngsters. But now she changed the subject; she asked me how I was doing. I quicklysaid“OK.”Shesmiledandbeggedtodiffer:“Iknewyou’dsaythat, but I know it’s not true.” I was surprised, then more than a little confused and, finally, irritated. In no time I had mobilized a host of psychiatric and psychoanalytic words to take care of her, so to speak—she wasn’t really able to accept her own bleak prospects, so she was ascribing to me worries really felt about herself, her kin. I kept such thoughts to myself, of course—merely insisted upon my “OK” condition—whereupon she told me this: “I see you here on the ward day and night, and I see how tired you are. I include you in my prayers.” She went on to thank me for the “help” I’d offered her in the...

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