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House Calls, Rounds, and Healings: A Poetry Casebook

Folding Both Hands
By David Schiedermayer, MD

On Sunday morning
it is now clear
he is dying.
His ammonia is 800
His creatinine is 6
The dialysis is not working.
Here's the truth:
He is puffed up with fluid
and twitching.
When the liver fails
the kidneys fail too
the lungs congest
the brain swells.
And when I come back
from talking and praying with
his wife and sister and daughter
(we folded our hands
and prayed
and I asked for comfort
and healing
and also for God's Will
to cover the bases)
he is brain-dead.
His temperature
does not register despite
the heating blanket.
He is not triggering the vent.
His blood pressure is 50
on maximal pressors.
So I talk with the family again
briefly this time
- the news speaks for itself.
His wife hugs me
a familiar face in a foreign land
and I can feel her stress and grief
as she holds on.
No decisions to be made now, I tell her -
no guilt about making decisions.
Just go and see him.
Take as long as you wish.
On Monday morning I call down to the morgue.
We happen to be doing him right now,
the pathology intern says.
I find the room just as the diener is saying,
as he deftly cuts and pulls out the viscera,
the funeral director has called me three times
wanting the body. If he calls again, I'll have him here!
And I look in the body and see where the bone graft is laid
neatly into the vertebrae; the bone is clean and fresh.
No pulmonary emboli. No visible infection.
I see the enlarged spleen.
Please cut the liver
I ask the intern, and he slices through it with a long
stainless steel knife.
There is no actual liver tissue present,
no nice dark tissue, only yellow scar replacing
the organ the liver should be.
That's why they call it cirrhosis, stupid,
I say to myself:
You think you're so bright
fighting with death
and here is just one more loss
in your long series of losses.
Thanks, I say to the pathology intern
and he smiles and bows,
folding both hands around the knife.
©2001 Galen Press, Ltd., Tucson, AZ