VA hospital’s cycle of caring


The woman appeared to be in her early sixties. She was trim, neat, wearing clothing that was a little more formal than that worn by most of the people in the waiting room. Her skin was dark ebony, and the way she held her head and shoulders spoke of dignity, but she was ill at ease.

She wasn’t reading, chatting or napping like so many others. This was the hematology/oncology clinic day at the Atlanta VA Medical Center, and her attention was directed to the hallway across the room, for this was where the exam rooms were located. I tried not to be conspicuous, but there was something about this woman that tugged at my heart and demanded that I watch.

Suddenly, she sat up straighter and turned toward the far hallway. Her attention drew my own down the line of closed doors to one that had just opened. A man there was receiving a sheaf of papers from another man in a medical coat, who was speaking quietly.

I couldn’t hear the words, but there was earnestness in the doctor’s manner and attentiveness on the patient’s part that spoke of important information. When he was done, the doctor looked the man in the eye, seemingly asking if there were any questions. All the while, the woman watched.

A few more words were exchanged, and then the man walked toward the woman. His steps were slow, almost hesitant. She noticed. He said nothing, but handed her the papers as he stood before her. He was now totally focused on her, the lines on his face deepening as she read. This was a couple who had faced hard times before and had brought each other through. The woman’s shoulders sagged. A single tear ran down her cheek. She sought his hand.

Neither spoke, but he sat and looked at her, holding her hand with both of his. They communicated more in that silence than many couples do with a thousand words. During what seemed like a long time, but may have been only 30 seconds, strength returned to their faces. She managed a small, tight smile, which erased the worst of the man’s frown. Then their expressions softened to adoration with a bit of tension still an undercurrent. She gave a tiny nod, and they got up and walked away, his hand on her shoulder.

I was there for a routine appointment with the hematology/oncology folks, who had been monitoring the progress of my chronic lymphocytic leukemia, a disease that has been linked to Agent Orange exposure in Vietnam. The patients are mostly my age, but many are older. Some youngsters are in their 20s or 30s; many wear prosthetics where arms or legs once were. The older veterans often wear jackets or baseball caps proudly displaying their branch of service and place names, most commonly Vietnam.

Watching the hospital staff is equally fascinating. It’s actually hard to tell who are doctors, nurse-practioners, nurses, even non-medical staff without looking at the ID badges. All seem intent on what they are doing, but rarely too busy to say “Good morning,” or “Hey, how ya doing?” Every time I’ve found myself lost and looking for a directory, someone has stopped and asked if they might help.

Obviously, folks here have developed and continue to maintain a culture of service, and this was evident the first time I set foot in the place, long before accusations hit the press of bureaucratic snafus.

I write this from a chair in the VA Medical Center’s oncology department, where I am getting chemotherapy. When I first came to this place that administers those harsh, cancer-killing drugs, I expected to find sad, morose patients and stern-faced medical staff. But I found quite the opposite. The medical staff is competent, like everywhere else I have been in this hospital, but they might even be friendlier, if that is possible.

Some of the patients are very sick, and they sleep or talk with family members who sit with them when the treatment process allows. Some look inward, thinking their own thoughts. The majority, though, banter with each other and flirt a lot with the nurses, who come right back at them. If it weren’t for all of the infusion bags hanging on poles and the lines running to IVs and chest ports, you might think you were at a community picnic with beer flowing rather than things like Cytoxan and Fludarabine. The place resonates with a mix of competent care and compassionate caring.

As I was leaving, I saw Irene, my primary care provider at Atlanta VAMC. I always address her formally, as her position warrants. But in my heart, she is Irene, a woman who cares for me and cares about me and who has hugged me and my wife at one of those couples’ sessions. When I saw her, she was exiting an exam room with a man and a woman. As she hugged the woman, who had been crying, she smiled at me over the woman’s shoulder, but returned her full attention to that woman when they broke the embrace.

And so, as I left for the day, the cycle continued, each patient just as important to these caregivers as me. I wouldn’t have it any other way.

Robert C. Fuller, a Vietnam veteran, is professor of GeoScience at the University of North Georgia.


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