July 17, 2008

Dear Julie,

The same doctor who a delivered me came to our house when I was sick and saw me through the mumps and bumps of growing up. Those days seem like ancient reveries now. Medicine is Big Medicine, hospitals offer valet parking, and sometimes seeing a doctor can feel like being a widget on an assembly line.

My dad missed a step and banged his knee on some concrete. Mom treated the cut, but bacteria somehow got in and are making mischief in his leg. Over the weekend an emergency room doctor prescribed a sulfa drug that didn't seem to work. Tuesday my dad's own doctor urgently sent him straight to the hospital, saying he could lose his leg or even his life if the infection isn't stopped. His left ankle is the size of Pittsburgh. He needs powerful intravenous antibiotics.

When asked at the hospital if he'd had any surgeries, Dad recalled the hernia operation I remember worrying about in my boyhood and the operation to remove his gallbladder. He hasn't spent much of his 82 years in hospitals. He likes to stay home. He likes his big-screen TV and coffee with the boys at Hardee's.

Dad's doctor is also my doctor and the opposite of an assembly-line practitioner. He listens and prepares you for eventualities. He warned that the hospital could send my dad home with a prescription that costs $1,500. Dad wished his own doctor could treat him, but he doesn't have hospital privileges, so Dad was assigned his third doctor of the week, one who only works at the hospital and probably must sprint from patient to patient.

My dad fidgeted in his hospital room for three hours before the doctor arrived. A nice young nurse explained that the doctor had had an emergency. It was another three hours before the antibiotics arrived at his room. A different nice young nurse explained that they had to wait for the drug to be sent by the hospital pharmacy. A nurse manager came by to reassure us. All that reassurance wasn't reassuring.

Six hours is a lot of life and death at a hospital. For my father and mother waiting for the precious treatment that could cure him, six hours was a mountain of anxiety.

No hospital in the country operates any differently, I'm sure. These are wonderfully dedicated medical professionals working within a broken system. American society in general must seem disconnected and even bewildering to anyone my parents' age. Everything is done by a book written by someone nobody really knows. Nothing seems to cost what it's really worth. Nobody without a constituency counts. It's not the country they grew up in.

The poet Billy Collins compares life to a parade: "How endless it seemed until we veered/off the broad turnpike/into a pasture of high grass/heading toward the dizzying cliffs of mortality."

The hospital doctor predicts Dad will be in the hospital three days. My mother asked her granddaughter Casey to spend the night with her. My mother said she has never spent a night alone in her life.

Before she married Dad, she always had a roommate. When my dad was in the Korean War she at least had a toddler roommate -- me. Someone has always been there.

Mom is teaching Casey to sew, a craft that doesn't interest many 20-year-olds. Perhaps that is how the connections between people and generations can still be made, by showing each other how. How to operate a high-tech cell phone, and how to fix a toilet, how to download a song and how to ride a horse. How to listen and hear at the same time.

Love, Sam

Sam Blackwell is a former reporter for the Southeast Missourian.