Featured, Off the Shelf
Leave a comment

The Man in the Arena


"Theodore Roosevelt Island" (CC BY 2.0) by m01229

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood … who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” President Theodore Roosevelt

Dr. Goodly saw patients on Thanksgiving every year. Wasn’t that the whole point of the holiday? And truth be told, he was quite happy to skip the traditional beer-drinking and football watching that preceded dinner. He never enjoyed either of those activities and certainly was not inclined to partake in them with distant cousins and in-laws.

The office was completely quiet when he entered. He ran his appointments solo on Thanksgiving — best to let the other staff enjoy some time at home with their families. It took him a few minutes of tinkering to remember how to bring up the patient roster for the day, like every other day of the year that was someone else’s job, but he eventually remembered from last Thanksgiving. As he draped his stethoscope around his neck, he relished the fact that today he would be there for patients when almost no one else was. Besides, one of the patients he would see today would be incredibly grateful. Mr. Greatly’s scans had come in the previous night and found that he was cancer free after two rounds of aggressive chemo and a round of radiation for certainty.

Though he did enjoy seeing all of his patients, Dr. Goodly found his eyes drifting down towards his watch more often than usual during the appointment with Mrs. Arena that directly preceded Mr. Greatly’s. When he showed Mrs. Arena back to the waiting room after the appointment, Dr. Goodly’s eyes scanned the room expectantly, but the waiting room was empty except for Mrs. Arena’s three small children … and tissues they had strewn all over the floor while they waited for their mother.

“Are you all better, Mommy?” The children jumped out of the wreckage of their imaginary game and began to run toward their mother.

“Clean that up right now,” Mrs. Arena demanded quietly. Initially, she was horrified at the idea that Dr. Goodly might take in the scene and deem her an inept mother, but Dr. Goodly seemed not to notice. He stared at the door as though he expected the meaning of life to walk through it at any moment. Perhaps, it was for the best that he had seemed distracted for their whole appointment. Besides, it probably did not take much attention to detail to tell her the same thing he always said. The tumor was shrinking, but slowly.

Dr. Goodly continued to stare out the door silently while the children cleaned, and Mrs. Arena straightened the scarf covering the peach fuzz that had replaced her hair.

Mrs. Arena’s husband never looked her in the eyes anymore, and she did not blame it on cancer. She blamed it on the peach fuzz. When cancer and chemo stole her sex drive, her husband read to her at night instead. When the bills started piling up, he sold his motorcycle and took on extra shifts at work. When the kids needed school lunches and new clothes he took care of that too. When the nausea started and didn’t stop, he joked that holding her hair back while she vomited would be their daily ritual. But, then there was no hair to hold. Chemo stole even that from her, and somewhere around the same time, it took her husband too.

“Sorry to leave them in the waiting room like this,” Mrs. Arena offered, emerging from her thoughts as the children finished tidying the waiting room. “I know we aren’t supposed to, but Jorge is working, and I don’t want them in the room with me if … well, when it’s not good news.”

Mrs. Arena’s words drew Dr. Goodly’s attention away from the door. “Oh, your husband is working today, too? Nice of him.”

Mrs. Arena shrugged. “It’s not really a matter of nice or not. He gets paid double on holidays, and we need … ” She stopped short in embarrassment but realized that Dr. Goodly hadn’t heard her anyway. Whoever he had been waiting for — it seemed to be a patient — had arrived.

“Thank you for … ”

“Of course, Mrs. Arena! Have a great Thanksgiving!” he called, already ushering the next patient back into his office.

***

Dr. Goodly arrived home just in time take his seat at the head of the table. It was time for everyone to say one thing they were thankful for this year. He, of course, spoke about Mr. Greatly. “You know, when Mr. Greatly was first referred to me I had my doubts. He didn’t have one of the particularly nasty cancers, and I’ve successfully gotten other patients with the same cancer into remission, but he was a difficult patient. He had to be convinced to do what was in his best interest every step of the way. He was always late for appointments, and when he did arrive, he never seemed invested in his health care.” Dr. Goodly shook his head. “I’m thankful I was able to get through to him.” The entire table clapped and smiled. It was a good Thanksgiving.

***

Mr. Greatly arrived home an hour late. The table was already set, and the food covered in foil to keep it warm. Mr. Greatly began to apologize to his wife for his tardiness, but she cut him off short.

“Earnest, I knew you’d be late. The number six bus always runs late, and that’s only one of the three you have to take to get home from those appointments. What did the doctor say?” She followed him into the dining room anxiously.

Mr. Greatly took his seat at the head of the table and called the family to dinner, which made Mrs. Greatly smile. If he wanted to tell the whole family on Thanksgiving, then it was good news.

Mr. Greatly stood to begin the annual tradition of saying one thing they were grateful for this year. For a long moment, he was silent. He looked over at his son who had just returned home from Afghanistan. He’d come back with post-traumatic stress disorder (PTSD). Mr. Greatly had it too when he came back from Vietnam, but back then there was neither name or treatment. Taking his son to his appointments with his psychiatrist often mean Mr. Greatly was late for his own appointments and distracted when he arrived, but he never felt like a better father. When he and Mrs. Greatly were fighting with insurance companies and running all over town to appointments and pharmacies, his sister Bernadette cooked every meal they ate.

Mr. Greatly’s baby girl, Grace, was only in her first year of medical school when her brother was diagnosed. They hadn’t even taught her about cancer yet, but she studied ahead so she could explain what was happening to him. What the doctors said never made any sense. After every appointment, Grace would sit down with him and explain what his options were and what he should expect. He’d worry that she was dedicating too much time to him and not enough to her own studies. “Papa,” she’d say, using her mother’s stern tone, “I don’t want perfect grades in medical school if it means my own father doesn’t understand his own medical care. Now, teach it back to me. What is the chemotherapy for … ?”

Mr. Greatly surveyed his family with a smile: “The doctor says the cancer is gone. You all saved my life. I’m grateful for every one of you.” The entire table clapped and smiled. It was an exceptional Thanksgiving.

*All names in this article are pseudonyms to protect patient and provider confidentiality.*

Shakkaura Kemet Shakkaura Kemet (3 Posts)

Writer-in-Training

University if California San Francisco


Shakkaura Kemet, MPH, is a member of the Class of 2021 at University of California San Francisco. She completed her Bachelor’s degree at Harvard University in Human Developmental and Regenerative Biology with a minor in African American Studies in 2015. She then went on to complete a Master's of Public Health at Yale University where she focused on social determinants of health, with a particular focus on women's health. She is currently a second year medical student at UCSF School of Medicine where she is co-president of SNMA, teaches a course to first- and second-year medical students about integrating advocacy work into one's medical career, and helps to design and implement quality improvement projects with the OB/Gyn healthcare providers at San Francisco General Hospital targeted at closing health care disparities in maternal care. Her areas of interest for research and practice include women's health, maternal health, health disparities by race and socioeconomic status, and medical education.