My heart is a little heavy tonight.  I just opened a new case today.  The man is 54 years old.  He has been in the hospital because he had a pulmonary embolism, which could have killed him and often does kill people without even a moment’s notice.  I had a co-worker once who had a patient who said: “Susan – ” and who then died right in front of her.   This man’s was caught early enough and he is home now but in a very weakened state.  Pretty straightforward physical therapy – strengthen him up, correct his balance deficits, send him back to his life.

Except…his life is not like most 54 year old men.  He had a brain injury.  When I read this I figured he was in a car accident or bike accident or the like.  I have worked with many TBIs especially in my early years at San Francisco General.  It was a trauma center and I helped pull more people out of comas than I care to remember.  They are rarely ever the same.  This guy is among the lucky.  He has been living independently, is able to take public transportation and shop for himself but is not really much more capable than a very smart 14 year old.   He has social support and a loving family who keep an eye on him.

This one is different for me, though,  maybe because I’m older and have raised three little boys to manhood.  He is a handsome man, 6’4″ tall and 195 lbs, with beautiful blue eyes and a kind demeanor.  His sister told me they think of him as their “gentle giant.”  It is what happened to him that breaks my heart, that hits me in the gut when I think of the chances my little boys took, and that I let them take because I did not want to break their spirit.   He was 4 years old.  He was playing near some construction at their home.  He fell, head first, into a hole lined with cement. 

When I spoke with his aged mother, asking general questions about his ability prior to this recent hospitalization, her voice became soft and wistful when she told me about his balance that has always been a problem.  “He’s awkward, clumsy,” she said, “I don’t know why – he’s so big and I guess he just grew too fast.”  I could hear a sort of dreamy denial in her voice, that it wasn’t the head injury, that maybe it didn’t really happen, that maybe her beautiful son was whole, with a normal life.   When the sister told me he was their gentle giant I held back my tears. 

Devastating things like this happen to families all the time.  We are blessed when we are spared. Experiences like this are what have made my career beautiful and horrible.  It serves to remind me of all the platitudes we hear but don’t practice enough.  Tomorrow is not promised to us.  Be kind to all you meet.  Hug your loved ones tonight.  Be grateful for your blessings.  There but for the grace of God go I.