Elegy on a Doctor's Most Challenging Patient

Dalia Frumkin, MD


August 26, 2019

Dalia Frumkin, MD

The mind, blind to the shape we create by inclination, by appetite, can raze health.
A lesson she did not learn at 55 with the first bypass surgery for her imperiled heart.
After a holiday feast overeaten by all, she admitted to a tightening in her chest, a pain.
A stroke took her father at 73, his own health he neglected.
Blamed the bad genes; a family history of high blood pressure.
Her eyes cupped tears, muscles clenched to think he died so young. She raged.

Her family of four physicians chastising, changing nothing, arguments only feeding rage.
Reluctant to see a doctor or dentist, thinking an evil eye kept her from health
She continued to ignore symptoms, deny her role, and allow her blood to rise under pressure.
A body abused by behaviors of self-spite, fated to devastate her heart.
With best intentions but worst habits, she indulged herself, allowed neglect.
She had diabetes for years, did not always take her pills, not acknowledging pain.

Her arch fell at 62 and turned her foot into a round-bottom ruin devoid of pain.
The growing frustration from physical restriction and a body changing, tense with rage
To stretching tendons, shifting bones, nerve messages undelivered due to diabetes, neglect.
The neurologist Charcot described this in the 19th century, deteriorating joint health.
The profound impact of the disease still unseen, denied, obfuscated by the heart.
This is more than artfully stacked bones reshaped by gravity from arch to chaos under pressure.

Memories fade, medications increase, hopelessness embalms, and sadness raises blood pressure.
The slow, unbalanced rhythms in the walker transform her back and legs into fire, pain.
An individual, a family, crushed under inevitable, unenviable progress, losing heart.
The caretaker once in charge is eroding, dependent, grieving, enraged.
A different personality forms, a life unmade, disjointed, disconnected from health.
A pale, anxious woman sees her foot a stranger, unshaped from neglect.

Her biggest fears were coming true, so many regrets, so much neglected.
A cycle continues, anger, self-pity, weight gain, rising pressure.
Increasing debility, a pity, a burden, short of breath at 63, no more excuses, bereft of health.
Worsening mobility, more weight, and more pain
Until there are no more excuses or blame, only acceptance, silence, no more rage.
The blowing sound in her chest: a leaking valve, fluid overload, an attack on her heart.

Despite two daughters and a husband all nephrologists, her son a specialist of the beating heart
She needed dialysis, a second bypass surgery, a muscle flap to close a chest too full of neglect.
She feared she did not have the luck, the strength, or the tense scream of rage
To survive the surgery, the tracheotomy, the balloon pump inside to maintain the pressure.
Three months of bedbound silence later, she was proved right and died leaving us her pain.
This is the price of unlearned lessons, this catastrophic complicity, this pursuit of ill health.

I was a nephrology fellow, trained under pressure in the idea of cure for health, exhausted by the raging pain in my own heart over words lost on people eager to make excuses for bad habits. Neglecting myself, gaining weight, I fear I will find myself in her footprint. She was my mother.

The author's late mother, Miriam Frumkin.

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