Motke

Most of us have at least one candidate for my most unforgettable patient; the more fortunate may even have several. Mine is Motke and I am not sure if it would have been any easier to forget him had I not been his doctor. He was one of those people who embody a whole way of being; he stood over and against the materialistic, communal idealism of those among whom he lived. There was an air of saintliness about him but he would have laughed at the description, for he was an agnostic. He walked with a limp from childhood polio. The defect made him unfit for the occupations involving sword or ploughshare through which men established themselves as useful members of kibbutz society.

When a doctor feels affection for his patient, the outcome of any interaction between them may be improved. There was no way not to show warmth to Motke, but I do not flatter myself that what must have been obvious to him in all our dealings had anything to do with the surprisingly long time this story covers. By way of more explicit and clinical introduction, let it be said that he was destined to outlive some of his coronary arteries and most of his myocardium by a score of years.

My first encounter with Motke took place in 1965 when I was an intern in the department of medicine at a 300-bed peripheral hospital in the Jezreel Valley. He lay there with a great shock of white hair spread around his delicate features, a veritable halo of dishevelment, looking unwell but resigned to his circumstances. One of the senior physicianswe were making roundsshowed me his cardiogram with its towering QRS complexes, its giant T-waves, and its S-T segments depressed 5 mm or more below baseline. …