It’s the Hard-Knock Life (Reprise)

Monday morning I was driving into work when my pager began beeping. I recognized the number as pre-op holding.

About thirty minutes earlier, after Birmingham left and as I was putting the finishing touches on this post, my intern paged me to say that our pancreatic cancer man was heading down to the O.R. So I’m not surprised when I called and my intern picked up the phone. There had been several traumas brought in and our man’s surgery got bumped to the afternoon. My intern wanted to know if that was alright.

‘There’s not much we can do about it,’ I told him.

When I got to the hospital, the patient told me he’d been having cramps and vomiting occasionally over the weekend. The weekend physicians, he said, had treated him well. Since the last time I had seen him, he had started hiccupping, badly.

I apologized about the surgery being postponed. He was rather stoic about the delay, but started asking questions that had clearly been weighing on him over the weekend.

‘Do you think this surgery will relieve this cramping and vomiting?’ he asked. ‘Cause if it doesn’t, I’m going to walk out of this hospital, get my pistol, and walk around back behind the garage.’

‘I hope it will,’ I said, ‘there aren’t any guarantees, but our goal is making you comfortable.’

That seemed to be what he wanted to hear. He seemed to relax some and started asking about possible treatments, chemo, or radiation if he did turn out to have cancer.

‘I can understand your wanting to think ahead,’ I told him, ‘but today let’s just get you through your surgery and hopefully get you some relief.’

He paused for a moment while a wave of hiccups made it impossible for him to speak.

‘I understand that there isn’t a cure if this is what you think it is,’ he said. ‘It’s not that I want to die; I’m just not afraid of it. I got right with the lord a long time back.’

He stopped for a moment while an other wave of hiccups overtook him. ‘My wife took off and left me with five children to raise. I had a heart attack when my youngest was eleven. I told God then that if he let me live for long enough to raise my children, when he was ready for me I wouldn’t complain.’

He stopped for a moment as the hiccups returned again. ‘My youngest is twenty-three now, with a baby of her own.’ He paused here, but he was not hiccuping. ‘I’ve seen three of ‘em graduate from college, something I never did. He kept his end of the bargain and I’ll keep mine.’


I shook his hand and told him I’d see him after the surgery. I walked into the nurses’ station, into the restroom, locking the door behind me. I lifted the lid to the toilet as I felt a wave of nausea overwhelm me.

Hanging my head over the basin with my left hand pressed against the wall and my right hand keeping my tie out of the way, the reflex hyper-salivation started and poured from my mouth. There were no heaves, the coffee in my stomach stayed there. I was not hung-over. I waited for the next wave and when it came, the saliva poured out again.

I tried to focus my thoughts away from here, away from the hospital. I focused on Stockholm’s hair, on Chicago’s skin, on Birmingham’s eyes.

The nausea abated.

Was one of them going to be the key? Was it going to be this easy? Would the simple act of falling in love complete me? Would it soften my edges and allow me to become both human and doctor?


But surely you know by now that it’s going to be more complicated than that to unlock a better version of me.