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Medical Humanities

Obituary Blues

Clayton J. Baker, MD
Clinical Associate Professor, Medical Humanities and Bioethics
University of Rochester School of Medicine and Dentistry

October 17, 2014



‘Yes, Margarita?’

‘Take a look at this.’

My office clerk handed me a section of the morning newspaper, which was open to the obituaries. Margarita combs the obituaries every day, one of several habits that, over time, have earned her a certain amount of ribbing from the other office staff. (She faithfully follows the police blotter, too.) As I took the newspaper, she pointed to a small, grainy photo of a young man with a large Afro, wearing aviator sunglasses and a suit with anachronistically wide lapels. Beneath the photo was a tiny graphic of a waving American flag, and the following text:

US Army veteran.  Beloved son and brother.
Passed away February 3 after a brief illness. 
‘Return unto me, and I will return unto you, 
saith the Lord of hosts.’  We miss you and 
love you dearly.

‘Is that our Willie Brown?’ Margarita asked.

‘I can’t tell,’ I said, squinting at the picture, then skimming through the words again.  

‘That photo must be 40 years old.  And whoever wrote that blurb didn’t give us a whole lot to go on, did they?’

The given name ‘Willard’ didn’t sound quite right. Then again, in the clinic, we’d never known our Mr. Brown by anything other than ‘Willie.’  There had never been any indication that it was short for something else. No middle name or initial, either. No suffix. Just plain old Willie Brown.

The name kept repeating in my head, as if it were a riddle.  Willie Brown. Willie Brown. 
Then I was back in my dorm room, sitting on my bed, stacks of records strewn before me on the worn oriental rug.  I was picking on my beat-up old Yamaha dreadnought, trying to copy the riffs coming out of the phonograph speakers.  Of course.  That’s why the name seemed so familiar.  Willie Brown – just like the old-time Delta Bluesman, the one Robert Johnson referred to as his ‘friend-boy.’  Suddenly, the scratchy recording of dead guitar strings snapping out the gloomy, descending bass line to ‘Future Blues’ ran through my head, followed by the lyrics:

Can’t tell my future, And I can’t tell my past.
Lord, it seems like every minute, sure gonna be my last.

‘Doctor?’ Margarita asked, snapping me out of my daydream. I cleared my throat as I reoriented myself to the present.

‘It says here he died on the third,’ I said, scanning the obituary once again. ‘That was almost a week ago.’

‘I tried calling his phone number, but there was no answer,’ Margarita said.  ‘And the number we have as his emergency contact was out of service.’

‘I’ve already got two patients waiting,’ I said, handing the newspaper back to Margarita. ‘Please give University Hospital a call. And the General, too.  See if either of them has any info on our Mr. Brown.’

Later that morning, as I stepped out of exam room 1 between appointments, there stood Margarita, waiting for me in the hall, holding a stack of papers, stapled together.

‘Which do you want first, Doctor: the good news or the bad news?’ she asked.

I am an optimist.  Ask anyone.

‘The good news.’

‘He’s alive,’ Margarita announced.  ‘Our Willie Brown, that is.’

‘Thank God,’ I replied, suppressing in my mind the unfortunate corollary to her statement – namely, that someone else’s Willie Brown must therefore be dead.  Margarita continued to stand there, staring sternly at me. I smiled weakly, deliberately failing to inquire about the stack of papers she was holding.

‘Don’t you want the bad news now?’ Margarita asked.

‘Not really.’

‘Here,’ she said, handing the papers to me.

Margarita stood and watched as I flipped through the stapled sheets. They had originated at the General, and consisted of faxed hospital notes, labs, radiology reports, and so on, all generated over the past several days. They confirmed that our Willie Brown was indeed alive, although not by as comfortable a margin as I would have hoped.  In fact, the notes revealed that on the fifth – just a couple of days after his crosstown namesake’s demise – our Willie Brown was ‘found down’ himself. Exactly where was not specified, but wherever it had been, he’d been unconscious and incontinent of urine, with a blood glucose level of 802. When the EMTs managed to arouse him, he reportedly became combatant. Later, his tox screen returned positive for alcohol and cocaine, and his CPK peaked around 25,000. Pretty impressive. Apparently, he’d been down for a while. According to the notes, he was still in the ICU, intubated, being treated for diabetic ketoacidosis, aspiration pneumonia, rhabdomyolysis, and alcohol withdrawal.  

Lord, it seems like every minute, sure gonna be my last. Yeah, that sounds about right.

‘When do you think they might’ve been planning to let you know about this?’ Margarita asked.

I shrugged my shoulders. Practically speaking, her question was unanswerable, and therefore irrelevant.  Any number of reasons, good, bad or indifferent, might explain why I hadn’t been notified of our Mr. Brown’s status. Maybe he’d been a John Doe on arrival; that tends to mess up an admission in strange and wondrous ways. Perhaps since he was still in the ICU, would be there for a while, and would be assigned to the hospitalists once he was transferred to the wards, those currently in charge of his case hadn’t yet thought about anything as remotely discharge-related as notifying the patient’s primary care doctor. Or, maybe my name had somehow become un-linked from his in the hospital computer system.  (It was known to happen). Who knows?  And regardless of the cause, Mr. Brown was currently in no condition to provide them with any information they might lack.

‘Margarita, please send them Mr. Brown’s…’

‘Already taken care of, Doctor,’ Margarita interrupted.  ‘I called them, and I faxed over his problem list, med sheet, and last three clinic notes. They know who his doctor is now.’

‘Thank you.’

‘Now you see, Doctor,’ Margarita added, wagging her finger at me and speaking with a strong hint of self-approbation in her voice, ‘this is why I follow the obituaries.’ She turned on her heel and strode, head held high, back to her desk.

I stood in the hallway for a few seconds, scratching my head. Then I shrugged my shoulders again, this time in resignation. I have come to accept that in my practice, something well beyond my understanding happens at least once a day. I made a mental note to call the ICU at the General before leaving for home that evening. Then I opened the door to exam room 2, greeting my next patient as I entered.

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