Today my petulant 60 year old GI bleeder allowed me, for the first time, to listen to his heart. Whereas my presence was previously greeted with a grunt, a demand for food, or a tirade on how this hospital system resembles a fascist regime, today it was none of these.

Just now, going back to take out the Foley catheter which he surprisingly let us put in today, I felt a pang of sadness -- seeing him, I think for the first time, not as someone determined to make my call-days miserable, but as a patient, an once-able person stricken with illness and who finally, finally resigned to his fate. Seeing him, head propped up on his pillow, his gaunt, bony features, scarcely more endowed than a skeleton, asleep, I almost wished for that angry man that swatted my stethoscope away just four nights ago, that refused to drink his contrast, that told me what a horrible doctor I am. As unpleasant as his temper was, his resignation was worse; it was so devoid of hope, so lifeless, that I felt as if I have failed him somehow.

It reminds me of how, sometimes I prefer the bitter, angry patients to the calm, complacent ones stricken with terminal illness. I think their placidity a manifestation of their acceptance that fighting for their life is futile-- a stolid declaration that our ability to cure has failed them, and, despite all the fancy medication and machinery, so many of which I cannot begin to comprehend now, we are still weak, ignorant of the monsters that infest and pervade our well-beings so readily, clinging on while we hopelessly watch on.

Perhaps he will again be frustrated at all our tests and attempts to keep him without food for further tests. Perhaps he will not be convinced, still, that all our mean attempts are really meant for his own betterment. But until then, I am stricken with guilt -- that I had felt frustrated at him previously, that I have though ill of his disposition, but moreover that I have nothing more to offer him.