Working against the Grain

I paused under the carved lintel that crowned the doorway of his battered clapboard farmhouse. Despite the sanction of the Hippocratic oath (Into whatever houses I enter, I will go into them for the benefit of the sick …), I remain uncomfortable when entering my patients' homes, especially when there is little to offer beyond the dubious benefit of my presence. The probing intimacies of routine medical practice don't bother me much anymore, but home visits still seem a deeper invasion of privacy—like sitting abruptly on the corner of an occupied hospital bed, or eavesdropping on an unguarded telephone conversation while reading a chart outside a room.

But that night's visit felt different. Neither my patient nor I knew yet that he was dying, and neither of us knew that the same disease that would take his life would soon touch me, too. For more than a year, the farm's owner had been urging me to visit his expansive wood shop, his passion and pride; it was the only thing I had ever known him to boast about. After months of delays and indefinite plans—and a long drive through gathering dusk on increasingly rough and lonely two-lane roads—I had finally arrived. I reassured myself that I was there by his special invitation and found the courage to ring his doorbell.

Though he was not quite 60 years old, he was my “oldest” patient, and over time, he had become a friend. In the first few weeks of my medical internship, I inherited his care from a departed resident. Back then, we had little to do together beyond keeping a watchful eye on his blood pressure. Yet, his clinic visits were always a pleasure, because there were so many more interesting matters that we found to talk about: the sturdy cradle …