The Addict by Michael Stein

Author:Michael Stein
Language: eng
Format: epub
ISBN: 9780061970870
Publisher: HarperCollins

CHAPTER 6

Thursday, August 10

When I close my door after hours of interactions with patients, it seems unnaturally quiet for a moment until the men and women I’ve seen over the last few days appear in my mind. They are a line of expectant faces, nervous and awkward, offering good and bad reports. Their news—the death of a sister, the arrest of a son—is smaller than the news from the wars of the world, where the avalanche of the dead and missing crushes hope almost completely. My patients retain aspirations, and they bring their hopes to me; I listen to their news and do not despair. Perhaps I can help. I fear disappointing them.

If someone were to watch me from outside my window when I am alone, they would see me open a newspaper, look in my drawer for a piece of chocolate, or reach into my pocket for the paper with the phone number of a handyman who might help repair the broken shutters on the bay windows outside our dining room. Or I take out a shopping list to jot down a few things I’ve forgotten earlier—bread crumbs, limes. I write too quickly and my penmanship is poor to begin with, so even as I am adding items, I know that later, at the market, I will have trouble reading my scribbles below the rounder, fuller writing of my wife who has started this list. These chores are what I use at home to distract myself, what I use here as a defense, so that my mind is not suffused by grief and dismay. Unfortunately (and fortunately), I know what kills people, and I know all about the tests and difficult days before they die. A patient with liver failure from hepatitis C virus infection that I’d diagnosed died last week. I remember testing him years ago when I’d noticed bruising on his legs, a sign that his platelet count might be low. In testing him, I was going against his plan regarding his own health—if it’s unnoticed, it will remain undiscovered (and magically go away)—but in fact he’d come into the office because of his fatigue, his inability to walk to work without stopping to catch his breath.

The nineteenth century is called the century of hygiene, and the twentieth is the century of medicine. The twenty-first century may be the century of behavioral change. Changing everyday, long-term behaviors—how we exercise, what we eat—is the key to adding years and quality to our lives. People find refuge in their habits, their likes and dislikes, just as I find refuge in my room, or in the monkish solitude of my research data or my shopping list. I understand how hard it is to change forty-plus years of smoking, thirty years of going to a bar on Friday and Saturday nights and forgetting to take medications on the following mornings, ten years of daily Vicodin use. There is no simple prescription. Every day I ask patients to interrupt the repetition of their habits.

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