Internal Medicine: A Doctor's Stories Read Online Free PDF

wanted it. This was how we were supposed to learn. He was my patient, and I felt responsible for him. But, also, I wanted to be the one to tell him. It’s something I can’t explain—didn’t understand then and perhaps would rather not understand about myself now. I hadn’t had the experience, and I wanted to get it. So I squared my shoulders and marched down the hallway to Mr. Jenkins’s room.
    He was the only occupant of a double on the west side of the tower. Here on the sixth floor the view out the window was a sweep down the hill to the town, garish under sodium-vapor streetlights. The yellow glow from the street was the only light in the room. Mr. Jenkins was in bed, asleep. He was snoring unevenly, a little puddle gleaming darkly on the pillow beside his open mouth.
    I stood at his bedside, listening to him breathe. Regular, unlabored, a little rattly, but basically the automatic tidal motion of a man in the middle of his life, the rhythm he had been maintaining from the moment of his birth. I stood there and listened to it, unconsciously holding my own breath for a long time until I realized what I was doing and drew a ragged breath out of the dark.
    “Mr. Jenkins?” I said softly.
    No answer.
    “Mr. Jenkins?” I said again. This time I reached down and pressed his shoulder slightly. He stirred, and abruptly he was wide awake, astounded, raised on his elbow staring around the room.
    “Wha’?” he said, or something to that effect. He was starting to pull back from me. In the darkened room, his eyes were enormous.
    “Easy, Mr. Jenkins,” I said in what I doubted was a reassuring tone. “You’re in the hospital. Remember? I’m Dr. Harper. We met this morning.”
    Mr. Jenkins continued to stare at me as if I were a ghost, but he gradually subsided, muttering something I didn’t catch beyond the tone of ebbing shock.
    “Are you awake, Mr. Jenkins?”
    He nodded, perhaps a more polite answer than the question deserved. And he lay there, still propped up on one elbow, waiting.
    I realized that I had no idea how to proceed. I tried to think of something, but all I could come up with was the tune to “The Yellow Rose of Texas.” It kept repeating itself unhelpfully, scattering my thoughts: beyond that, all of the advice from that long-ago dreary afternoon with Emily Dickinson had evaporated. And Jenkins was waiting. As if aware of my uneasiness, he was starting a shy, reassuring smile.
    “Mr. Jenkins,” I began.
    He nodded at me encouragingly.
    “I’m afraid I’ve got some bad news.”
    For a horrible ten or twelve seconds, the smile lingered on his face while the rest of his features abandoned it until it hung there in empty air.
    “That test we did this afternoon?”
    He nodded.
    “It found a—a mass.”
    This wasn’t right, I realized. I should just name it.
    “They found cancer, Mr. Jenkins. That’s why you’ve been having trouble swallowing. That’s why you’ve been losing weight.”
    I stopped for a moment, unable to go on. In the silence that lay between us I recalled dimly that I was supposed to do this, supposed to give the patient time to grasp the news. Reassured by this, I let the silence grow.
    Finally, his voice coming with effort, Mr. Jenkins said, “What’s it gonna do?”
    Patients have this terrifying ability to ask the question, the one of all others you don’t want laid at your feet. I could feel myself start to choke. The easy answer, the immediate one, was I don’t know , but I couldn’t bring myself to say it—it would be too palpably a lie. Because I did know. We both knew. But I couldn’t say that either.
    I was wrestling with all of this, starting to hyperventilate, when I heard Mr. Jenkins sigh. “That’s a bad question,” he said. The ghost of a smile shimmered in the dim light. He settled back against his pillow, ran the back of a thin hand across his forehead. “Ain’t nobody knows, do they.”
    “That’s right,” I said fervently. “But, Mr.