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  • Between a Father and a Son
  • Sergio Salazar

I held my stethoscope, as I had hundreds of times, on the chest of my patient. My fingertips making contact with the thin rugose skin that uttered signs of unrest. His laborious raspy breaths forged a backdrop to the tachycardic and irregular rhythm I knew clamored portending demise. With his face flushed and his nares faring, he took his last breath. His heart refusing to rest, but losing its battle to the silent stillness of no more.

I looked at my patient–father's lifeless face. I had lost numerous patients in the past. Some I had cared for and known for years, their death imparting a feeling of loss and insecurity of alternate decisions not taken. Now studying his inanimate body, an ominous void of familial loss admixed with a vacancy of professional duty, brought a new meaning to what I had always known as the doctor–patient relationship.

I always held my father as an exceptional role model. A nurturing father with an infallible moral character, selfless physician, and loving husband. Little did I know that I would become not only his full time care taker but his physician.

I considered medicine as a career as a result of my father's satisfaction with his profession. I was always amazed with his ability to work long hours, go without sleep, and still find time for his family when it mattered. He was nudged into retirement by my mother when he was sixty five. In retrospect he was glad, as sadly, my mother developed esophageal carcinoma within a year of his retirement. His [End Page 30] meticulous care of my mother unknowingly would become a formative force in my enculturation of duty to family.

After my mother's passing, my father tried to stay positive by exercising daily. I remember his call when he explained his symptoms of exertional dyspnea and lower extremity edema. As he described his complaints, I knew he was aware of his diagnosis of congestive heart failure. Somehow, he needed my reassurance that his clinical acumen had not suffered since his retirement. After a cardiac evaluation, he was diagnosed with severe aortic stenosis. I flew down to Florida to be there for his surgery. His post–operative period was complicated by arrhythmias, diabetes and myalgias. During that time, I became familiar with his medical history and medications. I felt I was reading a road map without the desire to navigate it. I preferred to watch and hold his hand. After all, I was his son, not his physician.

Over the next two years his health slowly deteriorated. His calls transitioned from casual and informative conversations to advice seeking and dependency. When his health worsened and his frailty increased, my wife and I felt the need and duty to care for him. We felt our home would be a secure and health competent environment. I had been practicing internal medicine for over two decades and my wife, Leesa, was a registered nurse.

He moved to our home one summer day at eighty two. Over the first few months he was mostly independent. He was still able to drive and perform all of his activities of daily living. We would make sure to be present during his doctor's appointments. Most of his chronic health conditions remained stable but he began to complain more of weakness and pain in his lower extremities. After multiple specialist, test and biopsies, it was determined that he was suffering from "diabetic myopathy".

Over time he became weaker requiring the assistance of a walker. In addition, his mental faculties began to deteriorate and early senile dementia was added to his litany of medical conditions. Taking him to doctor's and grooming appointments became a major task. Furthermore, he did not want to leave the house spending most of his day reading or watching television on his recliner in his room. Taking a shower and dressing, a task the he was determined to do himself, would take him close to two hours every morning.

It was because of these difficulties that Leesa and I felt the need to take charge of his medical care. I...


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pp. 30-33
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