Umana

I can talk to Umana about everything.

“Death? Yes, what would you like to know, doctor? Am I afraid? Am I religious? God? Doctors? Words heal, doctor. What more would you like to know?”

“I can barely see. The prednisone has worn out my eyes. I raise my arms and I get short of breath. The oxygen hose irritates my nose, but enough about me—how are you? Really, how are you? You help me so much, you really do. I like a doctor to whom I can talk. How is your practice? What do you think about health care reform?”

His paintings and sculptures clutter every room of his house. This is no house call, it's a “museum call.” Looking around the room, I think about all the silica dust he has inhaled over the years. The stuff of his creation, the stuff of his demise. Books everywhere.

“Books make us interesting people, doctor. Philosophy, history, literature—I read a lot when I was younger and my eyes were better. Books help me to see. Helen reads to me every night. What do you like to read, doctor?”

“Tolstoi,” I said. I muse about the doctor bending over Ivan Ilych, pretending his physical examination will make a difference. I won't do that to you today, Umana. Yes, let's just talk.

I sit across from him in a worn chair. Helen looks affectionately at both of us, and I return a smile. I ask, “How do you keep your mind so sharp?”

He sits up in bed, rustles the blankets, and tells me. “I write stories. I recite and Helen records. Famous friends, not so famous friends, women I've painted—these are my subjects. Maybe even you one day, doctor. What pleasure to recall old friends! Take care of your friends, doctor. The memories are so pleasing.”

Helen continues to touch him gently, lovingly. They have something special, it's clear.

I tell him I visit him for selfish reasons. Nonsense, he says. I look down on the floor and follow the oxygen tubing with my eyes. The concentrator hums in another room. Helen, oxygen, and words sustain him.

I try to imagine him reciting to Helen: “There came a time when my mother asked me what I would like to be when grown up. I said, ‘An actor, because I like the way they dress and behave.’ My mother pointed out, ‘No, that's not good for you because you will not be able to support yourself since the only way you will find work will be in groups, never alone, never independent.’ I replied, ‘Well then, I will be an artist,’ and she said, ‘That will be fine, but remember this: If you want to be an artist, you should be the best artist. Be like the eagle flying to reach the highest peaks and crashing against the rocks, and not like the crawling reptile mashed by the hooves of the jackass.’”

I look at his hair, uncombed, and as white as the sheets on which he lies. I get up to leave and he thanks me. I tell him I would like to see him again.

At the next visit he does not look as well. Helen leads me up the stairs. My eyes roam the walls of faceless women and abstract landscapes. Before we enter her husband's room, Helen shows me large portraits of hippies that Umana painted in the 1960s.

“Good morning, doctor. Thank you for coming. How are you? What are you reading these days?” The whole time, I'm thinking, How can he ask me how I'm doing when he is so sick? I tell him he differs from most of my patients. He talks about his life, not his aches. He wants to learn from me. He nourishes our friendship even as he dies.

His dog jumps on my lap. Helen rushes over to brush him away and the three of us laugh. I ask Helen about his medications. Morphine seems to be helping. I say goodbye, and Helen walks me to the door.

A week goes by before Helen calls. “Doctor, Umana is not doing well. He's in a coma.”

Helen, his nurse, and a close friend stand quietly by his bedside. I take his pulse and touch his forehead as the nurse recounts the events of the last 12 hours.

“Has he said anything? Does he moan or groan as if in pain?”

Helen shakes her head.

The thick rug and heavy curtains still the small bedroom. I look at his books, water jug, and medicines on the side table. I glance at one of his paintings on the wall. I carefully put my knee on the bed, bend over his body, and speak into his ear.

He mumbles, “Thank you, doctor. You're so kind.”

• Copyright ©2004 by the American College of Physicians