Know When to Fold Them

“A man of good will with a little effort and

belief in his own powers can enjoy a deep,

tranquil, rich life- provided he go his own way.

To live one’s own life is still the best way of

life, always was, and always will be.”

– Henry Miller

I met Rob through his father. The old man had a number of medical issues not unexpected in someone his age. One of Rob’s neighbors gave him my name. I was impressed by his smarts and his attention to detail. From appointment times to medication side effects to the odds that certain treatment would work, he wanted to know it all. He understood everything that I tried to explain, and he made his mind up quickly. I loved the fact that I could always tell where he was coming from and what he wanted done.  Very soon we developed a deep rapport that turned into friendship.

He had suffered a devastating illness as a teenager. He was forced to use a wheelchair to move about. His wife was similarly afflicted. Despite this “handicap” they had forged successful careers and had raised two very active children. Soon after I met him, when he was in his fifties and his father in his late eighties, he retired and spent most of his time trying to help his family and his church members.

After he made sure that I made the grade as a doctor he brought his aunt in. Then he came, followed by his wife and later their children. Our appointments were a mixture of taking care of medical issues followed by discussion of national financial matters and closed by giving each other updates on how our families were doing.

Soon his life became complicated. His aunt was elderly and proved incapable of caring for herself. His dad developed a blood disease and frequently came down with pneumonias and other infections. He began to show the effects of years of nurturing a Type A personality. Through all of this he remained steadfast in his love and dedication for his older relatives, and he continued to search the medical literature for more statistics and better treatments.

He found a safe place for his aunt, and he doubled the time he spent with his father. When the fourth episode of pneumonia closely followed a serious urinary infection, he showed up in the office and asked to talk to me.

“I don’t want you to take this the wrong way. You’re young, and you have done well for my dad. But I know him better than you do.”

He paused for a few seconds. For the first time since I met him he seemed uncomfortable, as if he were not sure that I would understand him well. He continued.

“He’s not going to get any better. He no longer enjoys his life. Don’t get me wrong if I use a song to express my wishes, but you’ve got to know when to fold them. It’s his turn. I don’t want you to treat him for the pneumonia.  Let him go.”

I knew he was telling the truth, and that his father was not capable of making an informed decision on his care. We opted to keep him comfortable. Soon he died.

Losing this responsibility helped Rob. He looked happier. He was more involved in church. He had a passion for sports and gambling, activities that he vigorously pursued. Every once in a while we would meet at the race track or a football game. Then the conversations were never medical. He took these opportunities to mentor me on how to treat employees, and where to invest, and gave me child-rearing advice.

I was fascinated by how mobile he was. I decided to learn more about what it was like to live without being able to walk without an assistive device.  His existence was so “normal” that I could not help but admire his determination not to let anything get in the way of what he wanted to do.  He did extensive research on which facilities provided the best arrangements for people with handicaps. He bought a van that made it possible for him to easily drive anywhere. He got to know every usher and every manager in most restaurants and sports venues, not only in St. Louis but also in adjoining cities. He had no qualms about asking for special access, and he knew the letter of the laws pertaining to the handicapped by heart.

I also learned how incredibly hard this had to be on him, yet I seldom heard him complain, unless it was about incompetence. There was the time when we were chatting at halftime in the football stadium. During a lull in the conversation he smiled, looked at me, and said:

“I’m going to teach you something today. Follow me to the beer stand. They have a special line for handicapped patrons. Stand behind me when I approach the counter. I’ll bet you a dollar that the attendant won’t ask me what I want. He’ll look at you and ask you. As if I were incapable to think just because I’m in a wheelchair.”

I lost the dollar. Later he told me that he could have bet me his house, so commonly was he treated in this fashion.

Many years passed. His children became independent. My children (all of them had met him at one point or another; they were all taken and impressed by him) finished high school. During his appointments he expressed increasing concern for what would happen as he got older and weaker. His health began to fail: first his coronaries, then his blood pressure; later his joints and his skin. His wife and soul mate, the person who most admired him (and least allowed him to take himself too seriously), died from a devastating cancer. He tried very hard to retain a minimum of normality in his routine, but I could tell that he was losing some of his spirit. He decided to change cardiologists, and hospitals. I could see that he was no longer sure that he was making the right decisions every time, despite his research (now made so much easier by the Internet).

One day I got a call from his daughter. Rob had been hospitalized for a serious fracture; he had problems with healing; his heart and circulation no longer supported him. He had called his children in to tell them that it was time to fold them. He died within a few days.

I had lost a dear friend. I tried to figure out what made him so unique. I knew many smart executives, and I treated a lot of professionals. His determination not to let his handicap affect him made him special. His constant crusade to lead the way and raise awareness made him a hero.

Someday I will come face to face with the same realities that he had to confront when his father became ill, and later when he succumbed. I hope that I can be as strong and crystal-clear as he was. I hope that life will give me the courage to know when to fold them.