blood products.“ I can’ t do it,” he says, still calm. I run out and shamefully do what no resident ever dares to do in the middle of the night: I call the attending. He comes in. We discuss Factor VII, the exorbitant cost and whether it will be covered for a terminally ill man with a DNR order.
I go back to his bedside.“ Please, please, at least let me call your daughter.”
“ For what?” he replies,“ So she can watch me die? After all these years? No. I drank too much. I wasn’ t a good dad. It would just be morbid.” I deflate the blood pressure cuff and tell him it’ s too low.
“ There’ s not much time. Please let me call her.” I would like to say that my intentions were benevolent. But the truth is that I needed him to say yes. I needed to know he wasn’ t going to die alone today because of me.
I don’ t remember how long I begged, but eventually he recited her phone number that I crammed into the tiny margin of my signout list. I hid in a call room so that nobody knew I was past duty hours, drifting in and out of consciousness while typing my notes into CPRS, and refreshing the vitals in his chart. At 36 hours post-call, I finally had to leave.
He passed away at 3 a. m. the following morning. His daughter came after I called, my co-resident said, and she spent several hours with her father before he died. The wash of relief when I heard this felt like his cool, thin hand patting the back of mine, comforting me.
I learned the value of the social history that day, and that everybody deserves a narrative. A seemingly irrelevant detail may hold the balm to years of shame, the reason for decades of self-sabotage and maybe even an unexpected key to healing beyond the body itself. Like all of us, I have an internal room of pedestals for the physicians who mentored and inspired me throughout my 13 years of medical training. But the greatest influencer in my personal practice of medicine was a dying former alcoholic who was a bad father, who comforted and forgave me even when I didn’ t feel I deserved it. Through him I met my two greatest teachers: mistakes and details.
Dr. Perrotta is Medical Director of Adult Congenital Heart Disease and Assistant Professor of Pediatrics at the University of Louisville School of Medicine in the Division of Pediatric Cardiology at Norton Children’ s Hospital.
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