Reflections of a medical student
I unwound my hand from Jack’s. As I looked at the weathered skin I wondered how many other hands this vice had held over eight decades on earth. A transient interaction with a lasting impression. Not since a boy, new to a man’s body, had I reflected on this rite. While it was in the waiting room of a medical centre that I met Jack, for that flicker in time we were at footy ovals, farm gates and family meals, spanning a lifetime. I felt the response to subtle movements communicating our characters. An instinctive exchange of body language, posture straightening and head gently lowering to see before me a man whose body spoke of knowing his way. We stood within the four walls that I had come to know as my consulting room. Now, with Jack before me, that is all they were again. Plaster and pine for us to stand between and beneath. I thought of what his eyes would tell him as they explored my own. I listened to Jack. He introduced himself still standing with no intention of sitting, words unmixed with any motives other than what they contained. While he spoke, I sensed an ongoing appraisal of how I took them in. He began to tell me of the sense of unease he’d been feeling lately. The atmosphere we continued to stand in changing with the intimation of vulnerability. Jack’s voice then snagged mid-sentence. A fissure cracked through him, his equable presence shattered by some internal wound. Jack had lost his partner in life. He had fallen in love with her at the age of seventeen and known nothing else for her during the following sixty-three years until her death. Knees shaking, Jack sat down and I with him. I felt the sluice of strong emotion open and its film cover my eyes. Perhaps there is no such thing as choice in reacting to pain so raw. Jack now unsure of his way in a life which for so long he had been content. The lenses relevant to this experience are the developmental and the cultural. My thinking about the knowledge, skills and awareness relating to a person’s life stage were influenced greatly by my meeting with Jack. A man with a presence and manner that spoke of a life actualised, fulfilled by loving and being loved. Yet at the age of eighty he has lost a partner and with her a part of himself that will alter his self-concept in ways neither of us could predict. I’ve thought about culture in terms of making sense out of life, and in connecting with others. There was an overlap of Jack’s culture and my own, as well as many differences. It was interesting how the combination shaped our interaction. From the beginning the overlap was evident and it crossed our generations. Both coming from rural families, a background where speaking directly is valued, and where a man’s hands can often tell a story of their own. The way he continued to stand initially during our consult symbolised a resilience that often comes with that culture, as well as a reluctance to show vulnerability. Jack didn’t have any complaints during our conversation, his pain only revealed by a catch in his voice and a decision to sit down. His notes showed he hadn’t been to the doctor in over ten years, and the opportunity was taken to build an understanding of how a GP relationship could be meaningful for Jack, in a way suited to his culture. Today wasn’t the right time to take Jack’s blood pressure, get a flu shot or discuss his nutritional status. It was encouraging to find myself naturally recognising what would be meaningful for Jack and his health in this setting. Jack was appreciative and a partnership was established that hopefully will continue to be helpful for him. Helpful in all areas of his wellbeing, as a new chapter of his life begins to develop.