Monday, July 16, 2012

The Old Man

The old man stood about a foot shorter than the others gathered in his clinic. This made the tarnished streaks in his silvery hair easy to spot, but he still combed it so that the thin ivory strands stretched across the barren areas of his scalp.  It was like this every morning.  Perhaps what time and experience had not provided him in stature, it had offered back in depth.  Years of refinement and wear—buried in his eyes.  It was such that his age reflected most profoundly not from the specks and the creases of his skin, nor from the tarnish in his hair, but from a shadowy well within those eyes.  A flickering, rippling depth that you could catch brief glimpses of, magnified through the thick lenses framed upon his nose.  And it was with those eyes, and in spite of his height, that he peered keenly down at those around him.  He spoke bluntly, moved deliberately, and gave orders without wasting words on common courtesies.  His thick Vietnamese accent delivered his speech in rolling jabs that never quite crossed the line into rude.  But his presence—his quiet, cavernous presence—brushed uncompromisingly against my senses.  It was the entirety of this old man’s presence that irritated me from day one.
Together, we were perhaps nothing if not an ill-formed match.  An intense, eager, yet green medical student teamed with an intense, stubborn, and seasoned family physician.  It was determined from the start that I would prove myself to this old man.  And from the start, I quickly realized this man had no desire to prove anything to anyone.  The pace and fashion in which he worked was fixed, mechanical—like a piston, or maybe a turbine set long ago—still steadily driving and being driven by the charts, the exams, the prescriptions.  With a quick flurry of questions, a few inquisitive glances, and a practiced touch, he moved from patient to patient until the lights in the waiting room dimmed and it was time to clock out.  It was an inertia built up over a lifetime.  And the unwavering force with which it moved caused everything around it to bend.  I imagined how in his twenty-seven years of working at the same clinic, he had witnessed everything around him evolve.  Computers being installed, electronic records being implemented, new systems, new nurses, new policies, and new technology—all buzzing in a colorful blur around him.  And I imagined him standing calmly in middle of it.  An aging yet unmoving constant.  Like an ocean carving fissures into the side of a mountain, the old man’s steady presence swelled up against those around him, causing all of us—patients, nurses, and me—to bend and abide.
“Good morning, Doctor Pham.”  I offered the same greeting each morning as he walked into the clinic.  A brief nod and a thin smile indicated his readiness.  For six weeks, we operated just as we were—two entities set into motion sixty years apart.  We clocked in at the same time each day and clocked out one right after the other each night. Yet in all the time and space bracketed between these choreographed bookends, we managed to operate side by side, but never quite together.  It was as if the inner workings of his faded exterior hummed in constant disharmony to some of my most basic values.  And as a result, my frustration simmered beneath a thinning patience.  Only behind closed doors and beyond the old man’s ear would I allow it to escape in harsh whistles from every pore of my skin.  But for the most part, I kept my grievances a secret smolder, hidden from the old man yet fanned daily by watching him practice his stiff, spindling brand of medicine.  There was something in the jaded physician’s disposition that must have been forged fiercely long ago, and as a result presented itself more rigid and ill-fitting than might otherwise be expected.  For patient after patient left the clinic having battled in those hurried moments to steal from the man some small resolution to their private concerns, only to be blown backwards by the invisible force of his forward-churning style.  It was a style driven by the weight of his unbending disposition which he yielded with a mechanical ease.  And it stood upon that oceanic depth which pooled within those black eyes, guarded behind the thick frames which he cleaned intermittently on his coat sleeve.  The grand effect was an undertow that remained placid at the surface, but swept rippling hues of frustration through the old clinic and clean out the door.  In a way, I drew a strange comfort from noticing this.  Every clenched jaw and furrowed brow meant that the agitated secrets which bristled beneath my fa├žade were being shared among others who happened into the old man’s dusty wake.
I turned the ignition and with one last pained sigh, my truck pulled out of the parking lot, away from the faded white building and the sunburnt sign that simply read “clinic.”  I didn’t look back as I drove away that final time, and seldom have I since.  The irritation that circulated within me for six weeks gradually dwindled and eventually vacated altogether.  Perhaps to haunt some other host.  But every now and again, I can’t help but think about the old man.  In my less restful nights, I wonder if maybe it wasn’t really his disposition or demeanor that clashed so harshly against my own, but rather the injustice of time itself—strewn across his every wrinkle and draped in his every movement.  It was an injustice largely shifted in my favor during the snapshot of our interaction, and magnified by the coincidence of our proximity.  By the nature of my youth, time still presented itself as a dimension soft and moldable, like clay.  Yet being next to the old man provided proof that this would not forever be the case.  For the old man, his allotment had already been shaped.  Only the last intricate details remained to be sculpted, and as we stood beside each other in that clinic, we stared from opposite ends of time’s unforgiving canyon, eyes fixated on different sights within its depths.  And perhaps it was exactly this difference in perspective—this ever-shifting injustice—that irritated me most deeply.  When I think back to the old man, I wonder if all the discomfort I harbored poured forth from a more basic anxiety.  A fear that the time grasped before me might solidify before I can mold within it a fraction of my dreams.  It seems to me that youth has an easy way of staring into the canyon of time, giving little notice to the ledge on the other side, and the old man who will one day stand upon it.


  1. 40 years from now, when you start noticing a few ivory strands of hair on your head, come back to this essay and remember what it was like to be now.

  2. I love this line: "It was an inertia built up over a lifetime. And the unwavering force with which it moved caused everything around it to bend."

    I frequently feel that while you write specifically about the medical profession, I still am able to relate to your posts based my own experiences outside that field. I gain good insight into my own life as a result.

    How to avoid becoming like the old man? Have a few bad experiences, let your heart harden as a result, and I think you're already on your way to a jaded attitude. It feels harder though to stay positive and flexible through tough experiences over several years.


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