Monthly Archives: February 2016

Missed Message

Two weeks ago, I did not say goodbye to my teacher.

He taught at a hospital where I had rotated as a medical student 20 years ago. He was there when I returned to that hospital for residency training years later. He was there when I returned to give guest lectures and work with residents. He was there, aged and ageless, whenever I returned.

Older than my parents, he had graduated from medical school in Calcutta almost ten years before I was born. Although he lived in the U.S. for many decades, he maintained his thick accent and foreign speech patterns, the paucity of words in his sentence structure leading to more power and meaning ascribed to each word he did utter.

Like the guru on the mountaintop, he hearkened to a sense of ancient wisdom, a sense of ultimate truth in tradition. He appreciated the clarity of an MRI and the insight of an ECG but never forgot the power of knowledge gained in the palpation of a pulse.

Two weeks ago, I did not say goodbye to my teacher.

He was a kind and gentle man, the archetype of the kindly, elderly doctor. I don’t think he generally made house calls, but one could certainly picture his doing so. In a world of technology and detail and research and speed, he reminded his students, the young doctors and doctors-in-training, of the importance of taking time – time to talk, time to touch, time to think.

Though patient, he was not without limit to his patience. I saw him get frustrated at times, although rarely. He felt the change in medicine, and the loss of humanity accompanying the gains in technology. He resented the computer in the room, taking the focus of the doctor away from the patient and onto the screen, taking the touch of the doctor away from the patient and onto the keyboard.

Two weeks ago, I did not say goodbye to my teacher.

We shared a love of writing, an appreciation for the power of words. When I shared my writing, he shared his poetry with me. Though sparse with words in his speech, not so was he with words in his poems. And although he was not verbose in conversation, he was ever present – understanding the connection possible in silence, in simple proximity, and with a simple touch.

“Feel the pulse,” he would always say to the residents and students. He drew diagrams of the upstroke and downstroke, labeling the points on the waves that corresponded to the opening and closing of valves, the contractions of chambers. He described the normal, the healthy, and the physical pathology that deviations from the expected wave palpation indicated. “What did you feel in the pulse?” he would ask as an intern ran through a litany of lab values and imaging reports, bringing that intern back to the patient.

Medical residency is difficult. One day, during a particularly difficult day of a particularly relentless week of a particularly rough rotational month of my residency, after a long night on call, I was exhausted, on the verge of tears, on the verge of passing out, and feeling every heartbeat in my chest. Not realizing what it was that I was feeling, not making the appropriate and reasonable connections in my head, I thought I was sick. He was rounding with my team. I asked him to please check my pulse. He took my arm in his hands and put his fingers on my wrist. “Pulse is fine,” he said. Then, “you are tired.” I nodded. “Sleep,” he said.

Two weeks ago, I did not say goodbye to my teacher.

Several years ago, during my last year of residency, he was in the hospital for about a week. I visited him every day, between patients and rounding and clinic and lectures. We talked a little about his wife and daughter, my husband and sons. We talked a little about reading and writing and poetry. Mostly we sat together quietly.

Two weeks ago, I did not say goodbye to my teacher.

An email came to my inbox from his email address two weeks ago. I was out and so opened it on my phone, on a tiny screen while in line at the grocery checkout late in the evening after a long day at work. The subject line was not clear and it had typos. Like so many spam emails from hijacked friends’ addresses, it said “please read.” I know better than to open emails that appear to be spam or phishing, but I opened it anyway. There was no text. No attachment. I made a mental note to email back at some point to say hi and to see if he had meant to email me something.

Two weeks ago, I did not say goodbye to my teacher.

Four nights ago, I was at my two younger sons’ high school jazz concert. It was lovely. I felt my phone do the text message buzz in my purse. Then I felt it again. And again. And again. I left it in my purse and listened to the music.

When I arrived home, I pulled out my phone and looked at it. My phone had buzzed so many times because I had been part of a group text that announced that my teacher had died that evening.

Two weeks ago, I did not say goodbye to my teacher.

I went to my computer. I scrolled back in my emails. I found the one from him. Unlike the tiny screen on my phone which truncated the subject line, the computer screen allowed me to read the whole line. With multiple misspellings, it said “please read poem.” It said “farewell.” It said “going home.” There was still no text in the message. There was still no attachment. All it said in the body was the auto generated “sent from my iPhone.”

The typos were from his typing on a screen as tiny as the one from which I originally had tried to read his message. The attachment technology had failed his fingers. And I had failed to get past the technology blips to the person who had reached out to me. I had not known he was ill. I had not felt the pulse.

Two weeks ago, I did not say goodbye to my teacher.

It is most likely that I will never see the poem he meant to send me. But I saw the “farewell” in the subject line. I know that the email was not address-hijacked spam. I know that this man of few words said goodbye to me. And I know that if I had heard his goodbye in time that we would have laughed and shaken our heads together over technology’s getting in the way of communication yet again.

Goodbye, Dr. Sil.

In memory of and appreciation for Dr. Anil Sil