A pair of Navy socks on pale, scrawny legs — that’s what I remember about him. 0300 hours in the ED and the umpteenth “What brings you in tonight, sir?” and suddenly all the patients start to meld together. I’d begun to have the distinct sense that the whole hospital was populated by clones of a wobbly mass of obese human flesh with hypertension, 12/10 pain and a blood glucose in the 300s. Somewhere around 2300 hours, I had forgotten who I was, much less who these people were. I was a med-student automaton going through the motions: get the story, present the patient, assess, plan and then listen to the resident tell you why you’re wrong.
I filled out the details of the current HPI: 86-year-old male presents to the ED via ambulance after ground level fall on the way to the bathroom. I absently made my way through the history, review of systems and physical exam, making encouraging “uh huh” noises while scribbling. If I hurried, I might be able to catch a nap before pre-rounds. Halfway through my standard “Alright, sir, well I’m going to go talk to the team and we’ll see you upstairs in a little while” speech, I noticed his socks.
He was wearing a pair of socks with the logo of the United States Naval Academy on them. On a whim, I asked him how he thought the Army versus Navy football game was going to go this year. “They would win as always,” he scoffed. Then, he told me about his time in the Navy. He had been a pilot on an aircraft carrier in the Pacific during World War II. He laughed as he told me how he and his buddies would horseplay while flying those planes, buzzing the flight deck, doing tricks and showing off between battles. “We didn’t even know why they paid us; we had so much fun we thought they were doing us a favor!” he said.
As he talked, his bony legs wiggled those sock-clad feet back and forth, and I could see the spark of that hot-blooded pilot gleaming out of the old man’s eyes. Those eyes belied the physical apparition that appeared before me, and I was struck with the realization that this body that we treat is but a vessel. The gaunt skeleton draped in a paper thin layer of skin was no different than the plane this man used to fly — a body rusted through by the passage of time, but still piloted by the same spirit.
Physicians go from room to room analyzing pages of lab values, ejection fractions, glomerular filtration rates and numbers upon numbers in such haste that we forget that we are not just mechanics trying to optimize the performance of fleshy machines. A plane without a pilot will never fly no matter how good a state of repair it is in. Similarly, the spirit is the most important part of our patients and deserves more of the physician’s attention than the body it dwells in. I challenge you all to remind yourselves of this daily by looking for what makes your patient a person, be it a card from a loved one by their bed, the rock band T-shirt they are wearing or, as in this case, their socks.