The Other Man

The Other Man

Recently, I saw one of my long standing patients for a routine visit. I have been his physician for many years. He is quadriplegic and has been so for over 14 years. He had an accident when he was about 40 years old. He was a passenger in a car driven by a friend.

They were returning from a fishing trip. His seat belt had not latched on properly on that fateful day. He fell asleep, and unfortunately his friend who was driving also fell asleep at the wheel. The car ran off the road, and when my patient woke up in the hospital, he was paralyzed from the chest down. His friend who was driving was unhurt.

Months of rehabilitation followed. He was lucky that he still had some movement in his hands. He learnt to move around in an electric wheelchair. He even learnt to drive a specially modified van with hand controls. He had been married with two daughters before the accident. His mother subsequently also moved in with them. He had to close down a business that he had owned and gradually adjusted to his new lifestyle.

On the recent visit, I asked him how things were going with his wife. Oh I got divorced and made her leave, he said. She was having an affair, he continued. She was also using the money from his disability income to make trips and have fun with this other guy.

I am so sorry to hear this I said to him. Who was the guy? He was one of my closest friends he replied. Apparently it was a friend of his he had taken into his home many years ago. This man had been effectively homeless at that time after his father had thrown him out of his house.

When my patient found out about the affair, he was so upset that he pulled out two handguns and pointed them at his friend and wife and asked them to come clean or he would shoot. I then asked him how he did that, as his hands did not have full strength. I thought holding guns in his hands may have been difficult. Oh, I can hold the guns and I have enough strength in my middle finger to pull the trigger, he said.

They admitted their affair and he asked both to leave his house. They did leave and now live together. His younger daughter chose to continue to live with him. His older daughter had gotten married and moved out. His mother also continued to live with him.

I said that it was so very sad that his friend who he had sheltered in his home for such a long time betrayed him in this way. Oh I am better off now he said.

He was then silent for a little while then said, “he was also the friend driving the car I had the accident in”. It took a while for this information to sink in.

So, this man, who my patient had taken into his home for so many years was responsible for the accident that caused my patient to be quadriplegic. He then continued to live off my patient’s disability income, living in his home, while also having an affair with his wife.

I said to my patient that this is so wrong! He smiled at me and without the slightest hint of bitterness, said - “this is life”!

Recently my patient died at age 54 from repeated infections that quadriplegic patients often get. May his soul rest in peace.

The Paraplegic

The Paraplegic

One of my patients was seeing me in the office. He was in his early fifties, and has been my patient for many years. He is paraplegic, with no sensation below his waist. He does not have bowel or bladder function and has a colostomy for his stools. For his urine, he self-catheterizes himself several times a day.


About 25 years ago, he was running his own business and was quite successful. He was athletic and socially active. One fateful Saturday, he was doing some work on the roof of his home. He accidentally fell off and lost consciousness. When he awoke in the hospital, he found that he had fractured his back, and his legs were paralyzed.



Months of surgeries and rehabilitation followed. He was now wheel chair bound, but learnt to drive again with hand controls. He had complications, notably a tendency to develop pressure sores in his lower back. He had multiple plastic surgery procedures for this. He gradually learnt to deal with his limitations and even got a part time job.



More recently, his problematic back ulcer had recurred leading to infection in the bone. He was treated with aggressive intravenous antibiotics and more plastic surgery procedures. He always maintained a stoic and positive outlook, which I greatly admired.

At this office visit, I was accompanied in the clinic by a young medical student. She happened to be in her third trimester of pregnancy. Noticing her pregnant state, my patient asked her when she was due.  In about a month she replied. He then asked what everyone asks – “is it a boy or a girl”? She laughed and said it is one or the other as she and her husband had decided not to find out beforehand. At this point, I asked my patient if he had ever had children.

He became quiet and then said no, he had not. I moved on with his visit and was refilling his medications, when he suddenly said – “I had to go to the doctor several times”. What do you mean, I asked? Did you have trouble having a child? You don’t understand, he replied. Those visits were to take care of pregnancies. “I murdered my children” he stated rather abruptly, albeit in a quiet voice.

Taken aback, I asked what he meant. As a young man he had several girlfriends, he explained. Some of these had become pregnant. At that time, he was not ready to become a parent and convinced his girlfriends to terminate the pregnancies. By his own count he had to do this five times.

After his accident, he lost his business. Subsequently his girlfriends left him. He now lives alone. I asked him why had he never mentioned this to me before. He replies in a matter of fact manner - because you never asked.

The Other Woman

The Other Woman

It was several years ago and I was doing a fellowship in Infectious Diseases. I was on the consult service and got a call on a new consult. This was on a young woman who used intravenous drugs. She had apparently used unsterilized needles to inject herself with heroin. In the process she had developed an infection in her blood which had involved the heart. The medical term was bacterial endocarditis. We had been consulted for antibiotic management.

She was a young girl, in her early twenties. In appearance, she was very slim, and almost wasted. She had very poor dentition which is often a sign of crack cocaine use. Her heart had a loud blowing systolic murmur, a classic sign of endocarditis. Her heart Echocardiogram had also confirmed a vegetation on a heart valve and her blood cultures were positive, confirming her diagnosis.


I could not get much history from her. She was sedated as she had been withdrawing from drugs. I looked up from examining her and I suddenly noticed an older man sitting quietly in a corner of the room. I had missed seeing him earlier. He was a dark complexioned Asian man, very well dressed, probably in his fifties. He was wearing a Fedora hat. He saw that I had seen him and asked me how she was doing. I told him that she will need intravenous antibiotics for a few weeks and should recover.


I stepped out of the room and saw the patient’s nurse. I took her aside and asked her, who is that man in the room with her? Oh that is her boyfriend she said. He has been visiting her every day.


Two weeks later, I was in the Infectious Disease clinic, and a Pakistani immigrant woman was brought in for a follow up. She was a tragic case. She was brought in on a stretcher. She was in her late forties. About two years previously, she had developed neck pain and was found to have an abscess from tuberculosis in her neck. In the process of draining that abscess she became paralyzed from her neck down. The Infectious Disease clinic was treating her tuberculosis, but she remained paralyzed, essentially a quadriplegic.


I had been born in Pakistan and tried to speak to her in Urdu, her mother tongue. She was well educated and had gone to college in Pakistan. She had three teenage children and a husband that lived at home with her.


She was pleased to talk to me in Urdu and introduced me to her husband who had accompanied her. As I was being introduced to her husband, I was startled to see the same man that I had seen with the young drug addict. He recognized me too, but we kept our conversation focused on the care of his wife. She had completed her course of treatment for Tuberculosis, but her paralysis remained. There was nothing more that the Infectious Disease clinic could do.


I felt sad at the turn this lady’s life had taken. She was still relatively young, but effectively bed bound.


A few months later, this lady died. I do not know what happened to the young drug addict or the husband. I pray that my quadriplegic patient is resting in peace.

A Man in a Fedora Hat

The Teacher

The Teacher

One of my regular patients is an 84 year old retired school teacher.  She had been widowed a few years ago, and soon after that became wheel chair bound after a stroke. She lived in a nursing home. She had taught high school all her life. Her husband had run a successful motorcycle dealership.

She had two children, but her son had died of a heart attack in his 50’s a few years ago. Her daughter and grandchildren lived nearby. Despite her physical limitations, her mind and memory were quite sharp, and my conversations with her were always very illuminating. She had been a teacher after all.


On one visit, she was brought into the office by a young woman who was an aide working for the Nursing Home. My patient told me a story about when she was a young college student in the 1950’s. She and a friend decided to fly to Cuba for a weekend from Florida. The first night they spent there, fighting broke out with the communists trying to get control of the Island. She and her friend were able to evacuate on a flight out the next day. Apparently trips like these to Cuba were not so unusual in those days.


Intrigued, I asked her about more stories of those days. She told me that her life was otherwise unremarkable, but as a student she was president of the foreign languages club. One of her close friends and fellow club member was an Iraqi foreign student named ‘Fouad’, who eventually went back to Iraq.


She did not keep in touch with him and does not know what happened to him after he went back to Iraq. He had been one of two Iraqi foreign students that were active in the foreign languages club. She had become close friends with him at that time because of their mutual love of foreign languages.


At this point, the aide with her spoke up and said, “I have been to Iraq”. I was with the army for two tours there, she said.  She had been shot at, and survived an Improvised Explosive Device explosion that hit her Humvee amongst other experiences. Her direct contact with Iraqi’s had been limited.


To both of them, I remarked on the fact that their individual experiences with Iraqi people were so different. They both agreed.

A few months ago, our school teacher died peacefully in the nursing home. Around the time she died, travel restrictions to Cuba were being eased. Iraq on the other hand is a war zone and not a place most people would travel to. I thought about how circumstances change with time and history keeps marching forward. 

Cubana airlines from the 1950's.