Clinical Geriatrics

I just returned from rounds and cannot forget the 96-year-old severely cachectic woman I saw who had left the ICU to continue to recover from a bout of pneumonia. Her family surrounded her, and they all seemed to enjoy the moment. They told me when I entered the room that they were reminiscing about the past. “Mom was a practicing physician and always healed herself,” they said. I could see how strong their relationship was with her. I knew that they would be a key factor if she was to regain her strength. The food at the bedside remained from earlier that day, and we spoke of ways to improve her dietary intake. The family did not want “tubes or heroic measures,” but somehow I felt that there would still be time to share memories and to continue to look back on the past.

I could not help but reflect a little myself. I was reminded of my late father-in-law, Henrik, who was a silent and adventurous Norwegian who lived to age 96! Fortunately for him, he was in excellent health until the last year of his life when he broke his hip after a fall, and also required prostate surgery. He lived his last months in an assisted living facility, no longer able to enjoy his walks in the Norwegian mountains or ski the trails he had groomed only a few years before. I remembered his taking me on my first ski trip into the mountains when he was 70, with strength and agility that would embarrass most 30-year-old men. I enjoyed his stories of the past every time I was able to visit; he had many tales to tell and we always eagerly listened, hoping to gain some new insight. After he died, my son found buried in papers on his night table the following poem that he had written but never shared with his family:

The world is silent and still
With glistening snow covered trees
Just as the holiday feast
Everything that is gone, is here.

Sprinkles of snow fall down
and cover each flower on earth
Opening memory’s halls
Where flowers in winter grow.

In the snow lies all that I remember
and dream and sing of too
Dreams and songs that find themselves
Hidden in a lonely mind.

Every snowflake that becomes wet on a cheek
In the sprinkle of fallen snow
Is like a tear that I should have cried
With a prayer for all that will die.

There are pieces of life’s many puzzles
Lying within the fallen snow
In it, and in tears that are moist
Lives something that never can die.

In the snow that sprinkles down
In the sudden snows of each spring
A song that is tugging calls out
Where in this world am I to go.
A song that always will sing
About something that is mine all alone
A note that will always ring
Back to all that is yours!

Of something that is still to come;
It is the universe’s great puzzle:
Time!

Then I am standing in the path
Unchanging through all the years
But autumn’s first whistling in the hillside
Conceals memories
Of the spring.

When the world is silent and still
With glistening, snow covered trees,
Remember
Nothing goes and nothing comes
Everything just is.

—Henrik Nissen Biong (1 March 1904-8 February 2000)

We can learn a great deal from the elderly, sometimes even after their death.

Send comments to Dr. Gambert at medwards@hmpcommunications.com.