I wrote and published this several years ago.  It first appeared in Emergency Medicine News, then in the Focus on the Family newsletter.  It has been reprinted in several publications and websites.  As we struggle with so many issues in medicine, I think the key may well be simple compassion.  I offer this as a reminder to everyone.

God bless you immensely today and always.


The Golden Rule Revisited

They lie there, breathing heavy gasps, contracted into a fetal position. Ironic, that they should live 80 or 90 years, then return to the posture of their childhood. But they do. Sometimes their voices are mumbles and whispers like those of infants or toddlers. I have seen them, unaware of anything for decades, crying out for parents long since passed away. I recall one who had begun to sleep excessively, and told her daughter that a little girl slept with her each night. I don’t know what she saw. Maybe an infant she lost, or a sibling, cousin, friend from years long gone. But I do know what I see when I stand by the bedside of the infirm aged. Though their bodies are skin covered sticks and their minds an inescapable labyrinth, I see something surprising. I see something beautiful, and horrible, hopeful and hopeless. What I see is my children, long after I leave them, as they end their days.

This vision comes to me sometimes when I stand by the bedside of patients and look over the ancient form that lies before me, barely aware of anything. Usually the feeling comes in those times when I am weary and frustrated from making too many decisions too fast, in the middle of the night. Into the midst of this comes a patient from a local nursing home, sent for reasons I can seldom discern. I walk into the room, and roll my cynical eyes at the nurse. She hands me the minimal data sent with the patient, and I begin the detective work. And just when I’m most annoyed, just when I want to do nothing and send them back, I look at them. And then I touch them. And then, as I imagine my sons, tears well up and I see the error of my thoughts. For one day it may be. One day, my little boys, still young enough to kiss me and think me heroic, may lie before another cynical doctor, in the middle of the night of their dementia, and need care. More than medicine, they will need compassion. They will need for someone to have the insight to look at them and say, “Here was once a child, cherished and loved, who played games in the nursery with his mother and father. Here was a child who put teeth under pillows, and loved bedtime stories, crayons and stuffed animals. Here was a treasure of love to a man and a woman long gone. How can I honor them? By treating their child with love and gentility. By seeing that their child has come full circle to infancy once more, and will soon be born once more into forever.”

This vision is frightful because I will not be there to comfort them, or to say, “I am here” when they call out, unless God grants me the gift of speaking across forever. It is painful because I will not be there to serve them as I did in life, and see that they are treated as what they are: unique and wonderful, made in the image of the Creator, and of their mother and me. It is terrible because our society treats the aged as worse than a burden; it treats them as tragedies of time. It seems hopeless because when they contract and lie motionless, no one will touch them with the love I have for them, or know the history of their scars, visible and invisible. I am the walking library of their lives, and I will be unavailable. All I can do is ask, while I live, for God’s mercy on them as they grow older.

And yet, the image has beauty and hope as well. Because, if I see my little boys as aged and infirm, I can dream that their lives were long and rich. I can dream that they filled their lucid years with greatness and love; that they knew God and served him well, and were men of honor and gentility. I can imagine that even if they live in their shadowland alone, somewhere children and grandchildren, even great grandchildren thrive. I can hope that their heirs come to see them, and care, and harass the staff of the nursing home to treat Grandpa better. I can hope that they dare not allow my boys to suffer, but that they hold no illusions about physical immortality, and will let them come to their mother and me when the time arrives. And best, I can know that their age and illness will only bring the day of that reunion closer.

My career as a physician has taught me something very important about dealing with the sick and injured, whether young or old. It has taught me that the Golden Rule can also be stated this way: “Do unto others as you would have others do unto your children.” I think that this is a powerful way to improve our interactions with others, not just in medicine but in every action of our lives. And it is certainly a unique way to view our treatment of the elderly. For one day all our children will be old. And only if this lesson has been applied will they be treated with anything approaching the love that only we, their parents, hope for them to always have.

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