Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Saturday, July 03, 2004
    Third of July

    Today is the anniversary of one of the most memorable days of my life. It's a day I love to remember. Not that it was important in the conventional sense - no graduation, no proposal or anything like that, but it was one of those days that stands out in the memory years later. I can't remember what year it was - I was about seven - but I know it was the third of July, because it was the day before Independence Day.

    One of my father's patients was a strawberry farmer in Orange County (these were the days when Orange County still had large tracts of farmland scattered through its urban areas). It was the end of strawberry season, and he invited Dad to bring his family and pick all the berries we wanted; he was going to plow the field under in the next couple days and plant his next crop.

    So that's what we did. We went and picked berries. The nearest I'd gotten to picking fruit before was the lime tree in the backyard, not known for its productivity. I remember a sunny, breezy day, bending over to see the bright red berries on the ground and smelling the moist earthiness coming up from the plants. It was marvelous. We picked and picked, then came home with two huge flats full of dead-ripe berries. After we'd all had a bowl apiece, there were still tons left and it was obvious that we'd never be able to finish them before they rotted - they were just too ripe. My mother thought for a minute, then resignedly picked up the phone, called her mother in Tennessee, and asked:

    "How do you make strawberry jam?"

    Mom made jam! Better yet - strawberry jam! And it was summer vacation - and the next day was the Fourth of July, with the promise of fireworks. Could life get any better for a seven-year-old kid?

    This third of July is different. I'm on call, and just got back from making the rounds of the nursing homes. Earlier this morning, I admitted a patient of mine with severe pneumonia, only to watch him die in the ER. (He was horribly ill, and his friend who had power of attorney agreed to extubate him; it was the right decision.) But every year I think back to the kid who picked berries with Dad and watched Mom make jam, and now I realize that the seed for this year's third of July was planted all those years ago when I watched my father's patient thank him for his care the only way he could: by putting his crop at our disposal.

    His name was Tamaguchi. Thank you, Mr. Tamaguchi, for my third of July.



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