By: Leif Hass, MD, Hospitalist, Sutter Health, Oakland, CA
I rush into the room at 4:30 p.m., hoping for a quick visit and maybe an early exit from the hospital; I had been asked to see Mr. Bryant in room 6765 with sigmoid volvulus.
“Hey, Dr. Hass, my brother!” he says with a huge smile. Somehow, he must have gotten a glimpse of me before I could see him. I peek over the nurse’s shoulder, and then I see that unforgettable smile with only a few teeth and big bright eyes. Immediately I recognize him and think, “How could I have forgotten his name? Ray – like a beam of light.” He certainly had not forgotten me.
“It’s been more than a year since I was last here,” he says proudly.
When we met during his last hospitalization, I was struck by a thought that implanted itself deep in my brain: this guy is the happiest person I have ever met. And after what must have been 18 hard months for him, he is still smiling – and more than that, he is radiating love.
The fact that he is the “happiest person” is made more remarkable by all the hardship he has endured. Ray was born with cerebral palsy and didn’t walk until he was 10. The continuous spasms in his muscles led to severe cervical disc disease. His worsening pain and weakness were missed by his health care providers until he had lost significant strength in his hands and legs. When he finally got an MRI and then emergency surgery, it was too late. He never regained the dexterity of his hands or the ability to walk. He can climb onto his scooter chair only with the help of a lift.
“Wow! How you been, Ray?”
He replies with a phrase that jumped back out from my memory as he was saying it: “I just wake up every day and think about what I can do to make people happy.”
The goosebumps rise on my arms; I remember feeling this same sense of awe the last time we met – a feeling of real spiritual love for this guy.
“Today I feel so much better, too. I want to thank y’all who helped my stomach go down. Man, it got so huge, I thought I might blow up.” One of the consequences of the nerve damage he sustained is a very slow gut that has led to a stretched-out colon. The other day, his big, floppy colon got twisted, and neither our gastroenterologist nor radiologist was able to untwist it. He still has a tube in his rectum to help decompress his bowel.
Ray fills me in on the details in the slightly strained and slurred speech that sometimes comes with cerebral palsy. As he relays his story, my mind goes to work trying to diagnosis this mysterious case of happiness. How can I not try to get to the origins of this wellspring of love? I I can’t help but thinking:was it Ray’s joy and his speech impediment that made him seem childlike or was it some brain injury that blessedly knocked out his self-pity? I would be wallowing in self pity if I were as gravely disabled as him.
After a moment’s reflection, I recall the research on the amazing stability of our happiness setpoint: good things and bad only move our happiness for a while before we return to our innate level of happiness. I see I had likely fallen prey to a stereotype of the disabled as heroic for just being themselves. Ray’s happiness is largely due to his lack of self-absorption, his focus on service and love.
Finishing our conversation and leaving the room feeling enlivened, I realize that Ray‘s generous spirit is a gift.
That night, my heart aches. I think about the inadequate care that led to Ray’s profound loss of function, leading to a surge of anger towards our flawed health care system – one that routinely lets down the most vulnerable among us.
The next day, two sisters and an auntie join Ray in his room. They ask for hugs, and I happily supply them. “Ray told us about you,” says Sheila, his sister.
“Well, we have been talking about him here at the hospital, because he brightens everyone’s day. He is truly amazing. Has Ray always been so full of love?” I say hoping to get some insight into his remarkable spirit.
Tonya, his auntie, responds first. “We were raised that way – to look for the good and keep love in our hearts. But Ray has always been the best. He never, ever complains. He brings joy to so many people. You should see him every day out on his scooter. That’s how he got that big sore on his butt.”
Ray indeed had developed a pressure sore, one that was going to need some thoughtful, ongoing care.
“But I finally got the right kind of cushion, before it was real hard,” he says.
I move from hospitalist mode to primary care mode and ask about his equipment at home and his dental care. But they all want to keep talking about love.
“If doctors showed more love and their human side, they could bring more healing,” his sister says.
After 20 minutes of chatting, I pause. It is my last day on service, I had run out of medical reason to stay and I have others to see. So, I reluctantly give my goodbye hugs and leave. At the door, I turn back around. “Hey, Ray, can I get a picture with you?”
“Yeah, I want one with you, too!”
So, not surprisingly, Ray never complains. Maybe his spinal cord injury wasn’t from negligent care. Maybe he was so accustomed to looking past discomfort and too busy with his ministry of love, it didn’t occur to him to seek care.
Still such a tragedy that he lost so much of the function little mobility he did have… But maybe not so bad. His injury brought him back in contact with me and our staff. He is still waking up trying to make people happy and I can see his efforts are working. “He made my day!” I hear from a nurse. There is a healthy buzz at the nurses’ station after visits to his room.
Before walking out the door, he gives me an awkward fist bump from the bed and says, “I want to thank y’all again for everything. And I want you to know I love you.”
I find myself tearing up. “I love you too, my brother. And I am the one who should be grateful, Ray.” Saying it, I feel myself playing a part the cycle of gratitude Even small gifts put us under an obligation to give back. With great gifts, the desire to give is inescapable.
There is only one Ray, but he has given me something to aspire towards and what feels like urgency to do it. I want to “wake up each day thinking about ways to make other people happy.”
And understanding the potency of the gift from him has alerted me to the value of looking for other gifts and other inspirations from those I care for – something as those of us who tend to be in the “doing” part of the provider patient relationship can easy miss.
I will never be the beacon of light and love that Ray is, but being compelled to be my most authentic caring self with him, I see that for years I have held back – in the name of professionalism – the positive emotions that naturally arise from the work I do. I will try to shine and try to connect with that “Ray of Light” residing in all my patients. I hope, too, that the cycle of giving Ray started will continue spreading to all those I care for.