The Champagne Toast

The Champagne Toast

An excerpt from "Adventures in Medicine" - Coming Fall 2010:

     Mary and I landed in hospice about the same time. Unfortunately, she had developed aplastic anemia, and I had transitioned from emergency to hospice medicine. She was a memorable character for many reasons beginning with our first encounter in the emergency room twenty years ago. As I examined this tiny Asian woman with abdominal pain, she remained animated and talkative despite having what turned out to be a partial bowel obstruction. Her dynamic personality and prior multiple episodes had just allowed her to tolerate it. The first time I examined her, I was impressed by a huge abdominal scar, noting that it sure didn’t look like a surgical incision. I asked her about it, expecting to hear about some botched surgery to resolve her problem. “Oh,” she said, “that’s when Japanese soldier bayonet me when ten year old at Christian girl’s school in Burma during World War II. It tough time. Have problem with belly ever since.” Wow, I thought, how did she survive? As she continued her story, I realized that it had to be her tremendous perseverance and will to survive that transported her from the savagery of Burma to the competitiveness of America after World War II. After the War she had married one of Chenault’s real Flying Tigers, but the marriage…”it got me to America”…hadn’t last, not that it had fazed her as she worked at various businesses to become financially comfortable. Each time I saw her in the emergency room, she tried to get me to invest in one of her schemes, “you doctor, you got money, I take care.” I listened, amazed that she could promote a deal in her condition, and politely declined before admitting her to the hospital to resolve her bowel obstructions.

     Her personality didn’t exactly match the philosophy of the Medicare Hospice Benefit as Mary worked at manipulating the system as best she could. She had to be discharged once for seeking aggressive management, which wasn’t surprising. But then, given her history, I understood her perspective. Even in her last days she often vacillated about whether she wanted to let go. Like the rest of her life, when she made the decision that it was her time, it was a done deal, and she requested a last visit with me. As I entered her apartment, I was greeted by her current rotation…she had arranged the schedule…of friends from her church. At her bedside an Odyssey nurse was tending her with an agency CNA…also, arranged by her and not paid out of her pocket. As expected, Mary lay regally in her bed giving out orders. I reached down to give her a hug as she was too weak to sit up, suggesting to me that maybe this really was the end. On the other hand, her conversation was as animated as ever, making me wonder whether this was really it. She instructed one of her church ladies to bring out the bottle of Champagne from the refrigerator that she had been saving for out last visit. The church lady offered an apology for bringing the Champagne to the bedside as she did not approve. Our nurse declined as she was duty. I took the bottle and uncorked it slowly with the correct seven twists, not spilling a drop. Two fancy glasses appeared, and I poured a couple of short ones, keeping one for myself and handing the other to Mary. I raised my glass extolling her remarkable journey through life and our long friendship. We clicked glasses and sipped our Champagne with devious smiles. I choked a farewell and gave her another hug. Mary thanked me for taking good care of her over the years. I thanked her for being her. No further words were necessary. As if on cue, a church lady showed me to the door. She died the next day as she had planned.

coming soon

"Adventures in Medicine"