Living Life: I’m Back

A couple of weeks ago I was rounding and needed to go see another old, frail patient with an LVAD (left ventricular assist device). He was admitted to the hospital again. This time it was for pneumonia. He is 79 years old and is getting older and older.

I hear the complaints of the staff. “What are they thinking? Why do they put LVADs in these old patients who just get sick and end up in and out of the hospital?” I find myself asking the same question sometimes. I rounded on the rest of the patients in the hospital and left seeing him for later in the day. The nurse called me. The family was questioning some of the medication orders. 

Sigh. Ok. I will go and talk with them.

And then … I was given an important lesson.

We can always learn something. No matter where we are in life or in our career, we can always learn. And sometimes the lesson comes in an unexpected way and in an unexpected time.

His wife was in the room. The patient looked better than what I thought he would. His wife had a series of questions. It turned out they were all rational and logical questions. We worked through them together. 

Then she stopped me. She looked me in the face and told me that she wanted to thank me. 

“It has been over 7 years since he had his LVAD implanted. Those have been 7 more years that I have had my husband. They have been 7 years where he has really lived his life.”

Wow. Has it really been 7 years? It has gone by so quickly.

She wasn’t finished. 

“I have got to thank you for those 7 years and for something else. You probably don’t remember. It may not have meant much to you, but it has been very important for us. You told us that the team was not going to put his LVAD in for him to just sit at home. It was being put in so that he would really live his life. I have never forgotten that.” 

“When we first got home, he was too weak to do much. But then he got better, and he started getting up and doing more and more. One day some friends asked if he wanted to go play golf. He asked me if he would be able to. I told him what you said. I reminded him that he had to try. He didn’t have the LVAD just to sit at home. He needed to try to live his life. He played golf. He enjoyed it. In fact, he has played golf again and again and again ever since.” 

“Next came bowling. One of the men on the bowling league had to have a knee replacement. The others on the league asked my husband if he could fill in. He told me he didn’t think he could do it. I reminded him again. You told us he didn’t get the LVAD to not do things. I told him he had to try. He went bowling. He did fine. He enjoyed it. And he continued to go bowling again and again and again.” 

“I have you to thank for all of that. You helped us get to the LVAD. You have given us seven more years together that we would not have had. More than that what you told us helped us so that they were seven really good years. Thank you.”

I struggled to maintain my composure. I think I pulled it off. But there were tears in my eyes after I left his room and as I walked down the hall. I slipped onto a side stairway where I could be alone and out of view. I didn’t know what to say. Wow. 

We forget. We get used to it. When we first had LVADs it seemed like such a miracle. Each and every time we saw patients that were going to die and then – they didn’t. More than that we saw them start to do things again that they hadn’t been able to do in years. It was such a heady and amazing time. One patient went back to work. Another got married and had a baby. Another did the River Bank Run.

Over time however we have gotten used to it. We know that all of our patients (all of us too) are going to die someday. Is it really worth going through the surgery and recovery and hassle of an LVAD? Or should we just let our patients have a more simple and uncomplicated death? 

We see the 79-year-old man admitted for an aspiration pneumonia and we wonder if we are doing the right thing. 

But we have forgotten. I had forgotten. I needed a nice older couple to take me back to school and teach me.

It is seven years later. It is seven good years later. He is getting older and with it is accumulating more illness. I shouldn’t be so surprised by that. But he is alive. He has really enjoyed and lived these past seven years.

His wife told me that she hoped I still give that instruction to my patients. I told her that I do. I explained the phrase that I use: “We do LVADs and transplants not to just keep people alive. We do them so that they can really live.”

What an honor to be in a position to make that sort of difference in someone else’s life. It really is a privilege to do my job. It makes me so excited to think that they heard that lesson and really lived. He learned how to “live” and not just remain to remain alive.

I suppose there is a lesson in this for all of us.  Life is not just about marking time. It is about finding purpose and meaning and going after that purpose and meaning.

That was my first weekend on call since my diagnosis with cancer, the treatment and the long recovery time that it took to get my energy back. 

When I was first diagnosed my brain was flooded with questions about how I should use my time. What should I do? What would you do if you were told you had cancer? What was important? Should I just run away from all my responsibilities and hide out on a sailboat or beach somewhere? What should I be doing with my time? Now that I was coming back on call, I wondered if this was the right thing for me.

Life is not just about marking time. It is about finding purpose and meaning and going after that purpose and meaning. Why do I do what I do? Is it worth it?

That day – in that moment – I was told with some forcefulness – yes – yes – it is. 

I am back.