There is a scene in the late 90s classic Tom Hanks’ movie Castaway that particularly resonates with me at this time. In the movie, Hanks’ character works for the time-obsessed Fed Ex and in a freak accident is stranded alone on an island for several years before being able to escape the island.
On his return everything has changed, he has lost his wife (now since remarried), but most importantly he has lost his relative perspective of modern society. His years had been trying to fight for physical and mental survival all alone. He has been transformed but into what? The movie ends at a lonely crossroads, he is alone, he can choose any path, any road, but he will have to make a choice to return to society.
That’s the perspective I feel too. I’m off the island, my wife has passed after a long struggle with cancer. I have been transformed but into what? My path, a suburban practice raising children together as a family, is gone. Do I continue down this path? Suburban family life with a busy anesthesia practice in Silicon Valley is not designed for one person. But I have three boys still in school, they now solely rely on me in every way imaginable. Many prior concerns, money, status and political advocacy work seem mostly unimportant right now if not completely trivial. I’m seeing life, like a castaway, with a whole new lens.
I am haunted by many memories. The labored breathing of a dying wife, as an anesthesiologist and husband, is particularly tortuous, at times I could sense every breath. I felt my wife’s death in a physiological agony that only an attuned physician could experience. Her final moments were in the hospice unit at Stanford Hospital. The shallow breaths, the thready pulse, the cardiac arrhythmia I could sense this all as a clinician. No need for monitors, ventilators or arterial blood gases. I never so wished to be unaware as a husband-anesthesiologist as in the final moments when my wife died.
But there is an afterlife, I’m convinced of that. Prior to her body’s passing I was visited by what could be best described as her spirit. “Don’t cry. Don’t be sad. It will be okay”, were her final words to me, this was felt in a moment of frozen current as her soul passed through mine. There is an afterlife after all. What I do in this life will matter in that life. That’s a lot to chew on mentally and spiritually as an anesthesiologist. My late wife has gone to that dimension. What to do with this life on Earth, my life?
The standard grief therapy rule is to not make major changes for two years after a major life shock such as a spouse death. Stay in your job, stay in your house, don’t re-marry, it’s understandable rule amongst therapists. Life shock needs the stability of sameness as much as possible. So my life is frozen in observation mode. But what do I see?
I see a single father of three that has to make the best decisions possible. Clean priorities. I cannot be fuzzy or sentimental regarding their care. I am a survivor, but my health has suffered through the grueling marathon of my wife’s declining health and death. I have to take care of myself now, I am off that island. Gone are the scamming fake relatives and the temptation of home anesthetics. They are being replaced with friends and family that care, regular exercise and a wholesome diet. These are the easy choices.
More profoundly, I see people and our society differently. I have a fundamentally deeper respect for medicine and health care providers than I did before, if you can believe that is possible. There really is no flakiness in the culture of medicine. We repeatedly solve difficult problems with an ease that most other professionals cannot come close to matching. We do all of this often without even so much as a thank you. It’s hard for me to respect the haters and the fakers in our society, it’s hard for me to respect the weak-minded – particularly because I can see them so clearly now.
We, physicians, nurses, pharmacists, therapists and others of the health care delivery system, in a general class of people, have no equals in my eyes. Heart, soul, and a finely educated brain – we are a consistent core foundation of this society. Don’t let any disgruntled patient, bloviating politician or ragged activist tell you differently – you are better than them in most things that fundamentally count, especially in health care. Society needs us.
This past month the final headrest pieces of my late wife’s marbled crypt were assembled and installed at the Los Gatos Memorial Cemetery, nearby Good Samaritan Hospital, the hospital where I work. It’s all very beautiful. I had been called by the cemetery director. As I was replacing the dead flowers in the urns, with long-lasting silk flowers, the groundskeeper crew chief, a Latino man, dressed in grey work jumpsuits came over.
“Dr. Chow hi!” said the groundskeeper, “I am Jose, you may not remember you took care of my daughter when she had a baby.” I confessed to not remembering the event, but Jose told me of this past summer on Good Samaritan Labor and Delivery where I placed an epidural in his daughter at night. How I anesthetized the pain, eased the suffering, how I had been so kind to him, his daughter and his son-in-law. He now had a happy bouncing grandson. He had remembered me. He innocently asked, “Are you visiting a relative?”
I confessed to Jose that my wife had also died this summer, about the same time his grandson was born. One soul lost; one soul born. This seemed to move Jose, he hugged me, with both of us wordlessly recognizing the symmetry of life. He then called over to the rest of the groundskeeper crew who had been watching off to the side, a happy grandfather and a grieving husband bound by medicine. The groundskeeper crew, all of five of them, then lined up and with bowed heads facing Amy’s crypt, said a quick prayer in Spanish. Jose said to me, after a minute to collect himself, “I will watch over her when you are not here”. I bowed my head, tears in my eyes in appreciation reflecting in the moment that would undoubtedly become the most beautiful and graceful memory of my life.
What we do as people, especially as physicians, matter in life – this one and the next one. I am at personal crossroads, time will tell which road to take, but there is a road. I am convinced of that no matter the direction, it will be a good and just road. It’s in my training, experience and the culture I come from. Urgent competency when needed, but the crisis mode is now nearly over. I survived, I’m convinced in large part because I am an anesthesiologist. Now I have a renewed spiritual faith and to my surprise, a new loving girlfriend. Soon, very soon, I can rest my weary surgical cap when I leave the OR every day and love life again.
Harrison Chow, MD, is a practicing anesthesiologist at Vituity Anesthesia Medical Group and is formerly was the Specialty delegate to the CMA and Chair of the CMA Hospital-Based Practice Forum and Chair of CSA’s Legislative Affairs. Amy, his wife of 27 years, passed away from complications related to lung cancer this past summer. This part three of a 3-part series of articles special to the CSA.