November blog

"Under my umbrella"

Their money would run out before the next check arrived

 

By Dr. Lynn L. Swan MD

 

On the outside, he was a cantankerous, blustery man whose way of managing something he didn’t understand was to defend his ground with vigor often aced with loud cursing.  Trust did not come easily.  He and his wife had lived in their small car with their small dog for many years.  Housing never seemed to last very long, and he didn’t trust giving information to those who could have helped.  He was secretly illiterate.  Reams of healthcare paperwork overwhelmed him and he burnt a lot of bridges when he responded in his usual manner. 

 

I stopped in often over the next year as his cancer progressed, bringing Boost, medications, long underwear, sock, gas cards.  I often glanced to see if they were in their parking spot as I went by several times per day.  This became a habit long after he died and I came to realize what a part of life this had become – more people “under my umbrella.”  

 

On particularly frigid days and nights, I’d think about them in their car, huddled under blankets with the car running. Their money would run out about ten days before the next check.  Family relationships were troubled and complicated- there was no haven in that direction.

 

He had worked his whole life at various jobs, many ending in “getting screwed by the system.” He told me difficult stories of a troubled childhood.  He would tear up when talking about his death and only wanted his wife to be taken care of because he had promised her father that he would do so.  He trusted only one oncologist, whose staff patiently explained the baffling treatments, needed testing, and prognosis.  

 

I went to see him once as he was being infused with chemotherapy.  I had just lost the dog of a lifetime – also with an abdominal cancer and ascites.  He showed me a tag on his car keys from the dog that he would never forget.  Suddenly, he became animated, sitting upright from the chair and stated, “I’m going to get you a puppy!”  I talked him out of getting me a puppy, but I put my dog’s tag on my car keys.  

 

It got very uncomfortable for him to sleep in the car with the driver’s seat tilted back and the abdomen meeting the steering wheel.  Despite many attempts for end of life planning, it was delayed until only days before his death.  Goodwill Street Outreach, hospice, and other donations helped to get him a hotel room while the owner who donated some nights allowed his dog to stay.  We brought food and made many visits.  He consented to a priest coming and give him the last rites.  A day before his death, with the help of a trusted banker who came to the motel, he signed over his accounts to his wife’s name so that she would be cared for. 

 

He died comfortably in a warm bed with his wife and dog by his side, cared for lovingly in his last days and free of earthly concerns. He died with dignity and peace with the help of many kind hearts. 

 

Dr. Lynn Swan is Outreach Medical Director for Traverse Health Clinic and TC Street Medicine. She is also a member of the Safe Harbor board.