I first heard about Alvaro during my weekend shift at the John Jenkins geriatrics hospital. Fatima, my colleague walked into the Doctor’s room around noon, shortly after her ‘patient field trip’ as she called it, for fun. “He is one person I am sure has no real problem. You should see him act up as if he has breathing issues…”, she said, and enacted the sound of a wheezing horse, “…that’s how he does it, the moment any doctor gets close to him”. This was not the first time Fatima made that complaint. To top it all, “do you think I am making up my illness?”, he would scream at every duty doctor that would pay him a visit.
Shortly after his arrival into the hospital, he was shifted to ward 52 and gained quite a reputation of being “that big weird guy”. “He has a weird personal journal made from blank sides of the postal envelopes cut out and stuck to a clipper pad”, said Agnes. “I don’t like wasting so much blank whitespace”, he would tell me later. Everyone found that to be odd.
It was after a week that I had my first encounter with him, and even before I met him, I had my thoughts on what to expect from the interaction. I briefly went through his case sheet to understand the notes from previous doctors, his ailments and the ongoing medication. Until recently he was in a dual patient room, sharing it with another old person. But within a couple of days, the old patient was tested positive for Corona and Alvaro was shifted to a single person isolated room.
I gently knocked on the door and stepped in. I could get a quick glimpse of a giant person lying calmly on the bed. It took a few seconds before he realized my medical presence. He quickly got to his famous “breath difficulty” act. I gave a broad smile, and started speaking to him normally, “you have a very good name Alvaro, how are you doing?”. After a short while, he stopped his “act” and calmed down. He started explaining that he indeed had difficulty breathing and requested for cortisone. “Of course, but first let me check your lungs”, I continued to be kind to him and explained to him that his vitals were good, there was no infection, and he should not worry at all.
He was indeed a huge guy, with a heavy build, and a height of about 6 feet 9 inches. He had flowing grayish black hairput away neatly in a pony tail. Although he was 79 years old, he barely looked 60, and perhaps his physique was a reason why he didn’t get empathetic treatment easily from the doctors at John Jenkins. His demeanor was also dubious, and he looked generally suspicious about everyone that approached him. He had very few belongings, in fact just two that I could notice, his makeshift journal – several neatly cut blank envelopes tucked into a small clipped pad and a bedside mini catholic cross.
I visited Alvaro several times in the following days, and each episode started with his wheezing act. However, I tried to be kind and gave him all the attention. It was perhaps my honesty or my tiny size compared to his (I was barely 5 feet tall and quite slim), he did not find me or my words intimidating. “‘Alvaro’, what does it mean?”, I asked him casually during one of the visits. “Its Spanish, it means guardian, kid”, he replied with a heavy voice in between his wheezes. “That is very nice, you can stop wheezing now. Are you from Spain?”, I asked him. “Oh no! I come from Uruguay, it is a long story. I really believe I have something in me, that is waiting to get me”, he complained. ‘Now who is being the kid’, I thought to myself.
“You have been kind to me doc, you are very nice, not like the others, I trust your smile…”, he continued and I thought this conversation was going towards ‘can I get another dose of cartisone’, but to my surprise he said, “…I had a very painful life in Uruguay. It has been a life of struggle. People think I am a ruffian, or I work for mafia or something like that. I went to jail during a time of political unrest in Uruguay. Would you trust me if I say that I was innocent?”, he pleaded. I nodded empathetically barely hiding a sense of shock underneath my calm face. So I am not just getting to grips with a “big weird guy”, but also someone with a criminal history. I didn’t know if I should make something of it, and I thought it best not to crash land to a judgement yet.
“Thank you for believing in me. I was put in jail for a very long time. Time I could have done something with my life. I was tortured – no sleep, electric shocks, burns with cigarette butts from the guards – they didn’t let me sleep”, he said and paused and I could see a glint in the corner of his eye. “At this ripe age, I find myself slightly comfortable here far from Uruguay, but all that pain and torture has left something painful in me. I can’t be fine”, he said and started wheezing again. “I am here Alvaro, do not worry, I really like your personal journal, you care so much for the environment”, I said and lifted my tiny glove clad fist towards him egging him to do a fist bump. “What!”, he paused, smiled and gently tapped my raised fist with his huge one.
This would become our concluding routine going forward. Each time, I found something nice about him, something that he says or does, I would give him a fist bump and he would say everytime, “you are a very nice doctor, not like the others”. He would ask me sometimes, “are you a Christian?”, expecting that I would consider giving him a different answer if he asked me multiple times. “This cross is very dear to me”, he said another day. “This was given to me by my mother, and she got it from hers. I keep it close always” and lifted his fist. I beamed and said “that is so beatiful Alvaro”, as I fist bumped. He let me go through his personal journal too which had random sketches, names of doctors and their prescriptions, “I would like to keep a track of who is giving me what!”, he would say suspiciously. “Even my name?”, I asked, “nah! you are different, but I keep it for records”, he would smile.
Once I gained enough trust with him, I tried to explain the side effects of Cortisone and discouraged him from pushing the doctors and asking for it. I also made it a point to share with my colleagues about Alvaro, the innocent suffering man behind that weird looking giant. It helped ease my mind that much more for having judged him multiple times.
As we began to hit summer, the number of Corona hit cases increased dramactically, and more and more old people turned up to John Jenkins. If the work in summer was unusually high due to less staff, the Corona safety procedures added to the load. It was one of those days when we were running from ward to ward, making rounds, ensuring medical routines, and most importantly ensuring order. One of the nurses that was stationed around Alvaro’s ward walked up to me huffing and puffing. “Alvaro wants you to know that he feels something is wrong with his throat, he wants only you to come and check”. “Not this time Agnes, I am swamped, check his vitals and ensure his lungs stay clear, I will visit him later in the day, there are too many sick people here to take care of”, I rushed off without waiting for her reply. The day went long and after I have clocked in several hours beyond the shift time, I packed for home and stepped out of the hospital. That is when it hit me, ‘Oh no! I promised to see him’. Cursing myself for the slip, I rushed back to Alvaro’s room. He was relaxed and watching tv with his bed slightly brought up to lift his head and upper back. He was very pleased to see me, “I knew you would come by, I have trouble in my throat”, he complained. I did not believe that there was anything there, but just for his satisfaction, I proceeded to examine, “Okay say aaah!”, and there it was, a painful looking infection. ‘Oh dear! I would not have forgiven myself if I went home without checking this’. “It is minor, don’t worry, I will get you the meds”. We also prescribed a Covid test.
This incident acted like yet another painful reminder of the settling prejudice. ‘He looks so strong, so he should be fine, how silly of me, being a doctor’, I thought. The Covid test came negative too and it gave him a huge relief.
After few more days, Alvaro seemed to really recover, and we were getting close to sending him back home, “he is eating like a horse”, said Agnes smiling. “Do not talk about him like that in front of his favorite doc”, said Fatima winking at me. “We have done another round of Covid tests for everyone in that ward, there were few more cases recently”, she added. The test result this time turned out to be positive for Alvaro.
It was for me to take the tough news to him. “But it was negative just recently”, he expressed his shock, “am I going to die? how long do I have? how serious is it?”, he was panic stricken. “Now now! don’t worry so much Alvaro, your symptoms are mild, you will recover very well. See all those older people going home? it would be the same with you, very soon we will send you home”, I smiled. “You are not making this up to make me feel good doc?”, he asked sadly. “You have such a beautiful cross, you should have more faith, don’t worry”, I said and made him do a reluctant fist bump. “We will have to shift you to the Corona ward, you will be taken care of, I will come and visit you often”, I promised. “Can you please get me my own room?”, he pleaded. “I will try, don’t lose hope”, I said. “Can you please get me a bag for me to carry my things…”, he spoke heavily, “…please give me a paper bag, no plastic”. My respect for him went up several notches again. Despite of his state of mind and situation, he still showed that he cared. I didn’t realize then that it would be my last fist bump opportunity with him. “Of course we will get you that”, I left with a smile. That was the last I would see of Alvaro.
My health deteriorated the very next day and I was the next one to fall for the famed virus. It was a while before I could head back to John Jenkins. After the initial greetings and exchange of kind remarks from colleauges and our chief, I turned around to ask Fatima, “How is Alvaro doing? I should go check in on him, it has been a while”. She did not reply and instead nudged me to check his case file. Shortly after he was shifted to the Corona ward, Alvaro’s health deteriorated, he was shifted to acute ward where he struggled but refused to take any advanced treatment. The final comments said “It reminds me of my torture in Uruguay, I don’t want it!”. Shortly after he went into a coma and never came back.
It took me a while for this to sink in. It is not unusual for us to face death in our profession and being in the geriatics ward meant that more often than not, we would be greeted with the ultimate truth of life. However the interactions with Alvaro stirred up something completely different. I wonder what really killed him – a life of prejudice and mistreatment or the virus?
I told myself that Corona has come only to deliver him from his long suffering and felt good that I could be part of a few moments of kindness and smiles. As I recollected our fist-bump moments with tears in my eyes, I wished and hoped that all of us judged each other less and be instead the cause for few acts of kindness and smiles for someone else. May be then we would all feel much more loved and cared for. May be then we would all be not so insecure, suspicious and fearful. May be then Corona’s impact would not have been so severe. As I slowly broke out of this sad reverie, I took a few minutes to let a silent prayer for Alvaro, and told myself never to judge anyone again.
Categories: True Events Inspired