I accept his hand in mine, discreetly assess the warmth of the skin, the blanching fingernail bed, the shape of the nails - clues to the health of the man whose hand I hold. I talk while lightly stroking his hand, feeling the atrophying muscles, hot joints, thin crackly skin like the outermost layer of an onion. My ears are drawn to the wet breathing, like wind whistling through pampas grass. I look into the diluted blue eyes, watery turquoise with darker flecks of blue and green like the stone itself, the whites yellowed ivory.
His eyes open and brim with animation. The ragged voice lilts with three-quarter rhythm that compensates for his heart's ragtime beat. He tells me they call him "Sam." He can't seem to remember my name so he calls me "boy." My 43 years are no match for his additional 50. The implicit laws of dominance prevail although he is the "patient" and I am the one nominally in charge.
Sam craves life despite frailty, yet releases life's hand as nimbly as casting a dragonfly lure over glassy lake waters. Holding his hand, my hand seems to hold a greater power I don't understand.
I smile at the memories of patients who dreamily called me by their mothers' or sons' names. Some called me "doctor" and a few "God." I shudder at the responsibility.
But Sam pushes his way into his 90s, eyes bright and wit sharp as the Hd of a tin can. He recalls the strip mines of Pinckneyville, his prowess in commanding machinery that grew like his hand's extension - pick ax to gasoline engine to the diesel like a brontosaurus, its long neck craning to scour vegetation from the slopes of man-hewn craters. I'd fill those mines with water, stock them with fish, and hand Sam a line and a pole rather than my cold plastic stethoscope.
I feel hushed - me who searched for God in cathedral, university, and sweatlodge - privileged to be in his presence. I am slipping through a wrinkle in history - the 43 years I missed knowing him. I cradle his hands, comforted that he accepts touch, prefers it to the hard x-ray table, sting of the needle, or tangles of adhesive tugging his fragile skin.
Privileged to treat human responses to disease, I dread the day when I can no longer see the person but only the hands.
Names have been changed for purposes of anonymity.