“Aaah, it’s Good to be Back!”

I have just brought back a good message from the land of 102°:
God exists.
I had severely doubted it before:
but the bedposts spoke of it with utmost confidence,
the threads in my blanket took it for granted,
the tree outside the window dismissed all complaints,
and I have not slept so justly for years.
It is hard now to convey
how emblematically appearances sat
upon the membranes of my consciousness;
but it is a truth long known
that some secrets are hidden from health.

John Updike, “Fever”, 1963

Dustin Pelletier is an extremely busy and engaging eight-year old. He wasn’t at all his usual self when I saw him a few Mondays ago. He had been hospitalized while he and Holly, his mother, were Downstate visiting his grandparents. He seemed to come down with a headache and stomach flu and proceeded to pass out three times within the span of an hour. The doctors pulled out all the stops; CAT scan of his head, spinal tap, and all kinds of lab tests – all normal.

Dustin seemed unengaged in the visit. He barely answered my questions. He still had a bad headache. He seemed to look somewhere over my left shoulder as I examined him. Dustin hadn’t had an EEG, so I ordered one, and he had a heart murmur I hadn’t noticed before. I decided to schedule an echocardiogram and repeat his labwork.

I told Holly to bring him right back in if he seemed to get any worse. That she did, at 4:45 the very next day. This time Dustin was somnolent, barely rousable.

“Could he have gotten into something?” I asked.

“I can’t imagine”, Holly answered.

“We’ve got to get him to the hospital”, I said.

I told the ER doctor about my observations, mentioned my worries about something inhaled or ingested.

The next morning Holly called. She described all the normal tests Dustin had had and how he was discharged with strict orders to call me for a follow-up appointment the very next day.

“But, you know”, Holly said, “the instant we got into the car, Dustin shook his head and looked all around. Then he said ‘Aaah, it’s good to be back’. And from that moment he’s been himself again!”

Driving home Friday night, my adjustable leather seats seemed strangely stiff and uncomfortable. Stepping out of the car, the ground seemed further down from the running boards than usual, and my knees creaked and seemed to have a slight extension deficit. The house seemed cold to me, and I asked Emma if she minded me turning off the air conditioning.

The next seventy-two hours have been a jumbled blur of chills, sweats, bodyaches and stomach rumblings. At one point I remember lying on the floor, waking up, and staring at the claw foot of a chair leg right in front of me. Once, I woke up and couldn’t figure out where I was.

I remembered a poem by John Updike, Fever, but couldn’t muster enough strength to get up and find it, so I retrieved it online with my iPhone. That, too, exhausted me. I slept most of today, too.

If I have what my young patient had, I hope the moment will come soon when I, too, will shake my head and say:

“Aaah, it’s good to be back”.

But, first, I’ve got to lie down for a while.

2 Responses to ““Aaah, it’s Good to be Back!””

  1. 1 Ross Judice August 30, 2013 at 2:21 pm

    Yikes! I hope you are feeling better and recovered. I’ve subscribed to your RSS feed and very much enjoy your musings.

    I’ve been practicing for the past 20 or so years, mostly psychiatry. Just wanted you to know there was a lurker out there hoping you are “back” soon.

  2. 2 Brian Ahlstrom, MD October 8, 2013 at 4:51 pm

    I remember the months before my diagnosis of IDDM: the constant hunger, parching thirst, tiredness, trips to the bathroom to urinate, the weight loss despite prodigious eating.

    The immediateeffect of Insulin (now 38 years ago) remains clear and sharp in my mind: the awakening, the sense of well-being, the gratitude.

    The well and the ill often live in different worlds.

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.



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