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Gold Foundation Essay

A Story that Illustrates Humanism in Medicine: Garlic Every Day, and Other Wisdom

Wilson, F Perry

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Two weeks into my first-year stint taking blood pressures at the senior center, and I was already an expert in hyper-efficiency. I figured I had 30 seconds with each senior before somebody behind them in line started complaining. It was me, 45 senior citizens, a stethoscope, and a sphygmomanometer. Every stereotype about rushed doctors was personified and magnified in my person. Each patient was two numbers—systolic over diastolic. Both numbers were invariably too high, and therefore, the numbers needed to be reminded to keep taking whatever drug they were taking. Of course, being a first-year, the drugs they told me they were taking sounded like alien battle formations: “Hyzaar, Lexxel, Mykrox.” Still, I was great at telling them to keep taking whatever it was.

There was no time for names, obviously, but the faces were the same from week to week, so I had private nicknames for everybody. “Free-Medical-Advice Guy,” who asked about Viagra; “Debonair-Greek-Guy,” with the slicked-back hair; “Old-Frail-Lady” whose arm was so thin the cuff would barely stick; and then there was “Garlic-Man.”

Claiming to be 86, Sid's body showed none of the ravages of age that were so common in the center. He walked steadily and confidently, spoke clearly with no lapses, looked hardy and unshakeable. Here was a guy that was made for those commercials that make retirement look sexy. His secret? 1,500 milligrams of garlic a day—plus cooking with as much garlic as possible for every meal. He had a distinct garlicky aroma, hence the nickname.

The first time we had a sit-down, he lectured me on the importance of garlic in every diet. He never took any medicine, and hadn't been sick for as long as he could remember. I promised that I would educate my friends in the medical profession about this wonder drug, and left the center that day with a joy in my heart felt only by those who confront their own mortality, and decide that the confrontation is pointless because they will never die anyway. I would be Sid. Old-Frail-Lady was for quitters.

One week, Sid was gone. I didn't worry; people could come and go as they pleased, but I wondered why my regular client had passed up a teaching opportunity. He returned the next week, but looked haggard, shaken. He wore dark black glasses and his head hung low on heavy shoulders. He took his place in the end of the line, and I watched him with trepidation as he inched forward with each successive blood pressure reading. Old-Frail-Lady smiled as the cuff fell down her arm. Free-Medical-Advice-Guy said he was quite happy with how things were working out. But I wasn't paying attention. I was looking at Sid. He wore no smile—no expression at all really. Just as he sat down, I noticed a faint urine stain on the front of his pants. I quickly looked away, but it bothered me how much it bothered me.

“How's it goin'?” I asked, not expecting his usual answer. His hands shook as he told me that he had just been to visit his wife, diagnosed with Alzheimer's six months ago. She no longer recognized him. His glaucoma was acting up, he had no one to talk to, and he was sad. I pumped the cuff tighter. Under his thick glasses I may have seen tears.

I was stunned silent. It was all I could do to read his numbers to him—numbers that, to both of us now, seemed awfully unimportant. I wish I could write that I said the right thing; that we had a long heart to heart and reached some sort of closure together. But I was the student in the relationship, though the class I was taking was odd. I didn't know how to be a friend to him, how to help him through this. I ended our conversation with “I'm really sorry about your wife, Sid.”

“Yeah, me too.”

As he walked away, his head was still bowed, and it pained me deeply that he was no better for our encounter. I walked home that day disillusioned. I thought about the tough front he had been putting up all this time—how he was probably talking to me so much not because he wanted me to eat garlic, but because he had no one else to talk to. I thought about how he was not invincible; how he was tired, old, and powerless in so many ways.

The walk home was also the first time I really thought about why I liked Sid—because he was easy. He had never been fragile or out of it, he made eye contact and smiled, he looked alive instead of like the walking dead. But that image had been a fantasy—constructed by Sid and myself. The truth was that Sid was old, just like everybody else. The deeper truth, I found, was that Sid was a person, just like everybody else.

The next week at the center, I looked upon my nameless 45 with new eyes. Old-Frail-Lady had a beautiful smile. Her name was Doris. Free-Medical-Advice-Guy, Sergio, had a new girlfriend. Debonair-Greek-Guy, who spoke no English, may have told me his name or the name of his prescription, but it didn't matter. Though I still only had 30 seconds with each of them, they were no longer their numbers. Their numbers were nothing—a trifle in a picture so much larger that they seemed pitifully small by comparison.

I can't say that I learned the intimate details of all the lives of the 45, but I can say that I wanted to. When Sid's guise broke down, he had inadvertently revealed a truth easy to understand abstractly, and difficult to own personally—that we are all both strong and frail, both brave and frightened, both loving and lonely. The trick is never forgetting that the part you don't see in 30 seconds is still there.

F. Perry Wilson

Mr. Wilson is a third-year student at Columbia University College of Physicians and Surgeons, New York, New York.

© 2004 Association of American Medical Colleges