Frank

Frank

Recently we were in the process of moving from one home to another. I was going through a file of old papers, when an envelope fell out and caught my eye. It was addressed to me in such neat handwriting that it appeared printed. It was dated May 1st, 1998. I saw the return address was a Nursing Home. The name on the address instantly took me back to a very memorable patient of mine. His name was Frank. This is his story.

I first met Frank in 1996, when I was a second-year resident in Internal Medicine. I was asked to start seeing a patient who was described as being difficult and had fired two other residents from taking care of him. I did not want to have the same result, so I thought I would try to find out why he was so unhappy with his care.

Frank was a thin and short man. He had a closely cropped hair cut and looked really neat and clean. He had been admitted with an exacerbation of emphysema which caused breathing difficulties. This was mostly from a long history of smoking. He had never married or had any children. His only brother had died several years ago. I asked him why he was so unhappy with his care.

His main concern was that he liked to follow a schedule in everything. His food should be at a particular time as should his medications and breathing treatments. He even was very concerned about being able to go to the bathroom at least once a day, and he had been constipated since being admitted to the hospital. In his opinion the previous physicians had not taken these concerns seriously.

All my life I have been around family that have obsessive compulsive traits, and I realized that Frank was probably somewhat obsessive compulsive and felt the need to have more control in his life. I talked to his nurses and got him on a more rigid schedule. I even put him on laxatives and his bowels became regulated.

He did not fire me. On the contrary when he was ready to be discharged, he became my clinic patient and started to follow me as an outpatient. We became great friends. He told me stories of his career as a fireman and even shared pictures of his younger days with me. I realized then that he did not have any close family or any real friends. This may have been partly due to his obsessive compulsive personality.

Unfortunately, his emphysema continued to progress and he could no longer live on his own. We spoke at length about this and decided that a Nursing Home may be the best option. He was naturally sad about this. I would also no longer be his doctor as the nursing homes have their own doctors. We said our good byes and he was emotional, as I was. I did not know if I would ever see him again.

It was Christmas 1997, and I was pondering on my list for sending out cards. For some reason I thought of Frank and I mailed him a card to his nursing home. I was later informed that he had moved to another nursing home and was not sure if he ever got that card.

Several months later I received a letter in the mail. It was from Frank. In that letter he mentioned being pleased on receiving my card, and also described (with his meticulous handwriting), of all the problems he had in the nursing homes. He was moved from one to the other all over Eastern North Carolina. He was finally at a place he liked. In that letter he said very nice things about me, and this touched me greatly.

I later looked up the address of his nursing home, and realized that his small town was coincidentally very close to the small town I was going to be starting a new job in.

Soon after I started my new job, I did go to visit him on a Saturday afternoon. It was a typical nursing home. Quiet, dark and with a musty smell. The nurse on duty was surprised that Frank had a visitor. She led me to his room, and there he was, in a wheelchair with an Oxygen canula attached to his nose.

He was surprised, and appeared very pleased. He hugged me and we sat and talked for a while. He told me that he was quite content at this current nursing home as things were done as he liked. I promised I would visit him again.

However, soon after my visit, Frank passed away. He died peacefully in his sleep. I have kept his letter all these years and hope and pray that he remains at peace.

Excerpts from Frank's letter