By Howard M. Glicksman, MD

“Bob” was a 40-something hard working, hard drinking man who had never stayed attached to anyone. He had gone out to California to visit an estranged daughter and while there had fallen down in a drunken stupor, severely injuring the soft tissue of his arm and leg. Subsequently, he became septic and was hospitalized. After a few weeks of intensive treatment he had stabilized and improved enough to fly home. But, due to his poor condition, his doctors didn’t think he had much time to live and so he was admitted to our hospice program with end stage liver disease due to alcoholic cirrhosis.

When I first met “Bob” he was staying with a friend and on slowly entering the room he sat down, with much effort, on a couch next to the large coffee table. Soon into taking the history he tearfully pointed to a large Bible in front of him and told me that he had never been a religious man but now that he knew his time was short he was “coming back to the Lord.” Like most people who come onto hospice with chronic liver disease, his belly and legs were swollen and he was very weak. In addition, he still had some large wounds on his arm and leg. I told him that if he continued to drink alcohol I could guarantee him that he wouldn’t live more than a few weeks. But, since some of his liver malfunction was probably due to his recent infection and usage of alcohol, it was possible that with a proper diet and medication he just might improve enough to last a bit longer.

Over the next several weeks, “Bob” refrained from all alcohol and his nurse did an excellent job of getting his arm and leg wounds to heal. And, with medication, we were able to greatly reduce the amount of fluid in his abdomen and legs. During this time he was able to walk better and even began to go outside. I initially had been seeing “Bob” regularly due to his frail condition and the need to adjust his medications based on his examination and lab work. But, as he improved and my caseload increased, I hadn’t been able see him for a few weeks. One day I dropped in unannounced and was told by his landlady that he was out and was given an address where I could find him. As I pulled up to the address, “Bob” waved at me with a big smile as he carried some large planks across the back lawn of a house that was getting a new dock put in. I suddenly realized that “Bob” had gone back to work! Seeing him employed again gave me a feeling of accomplishment and needless to say he was immediately discharged from our services.

Dr. Glicksman is an HPH Hospice’s physician who, like our other doctors, makes house calls wherever the patient calls “home.” He has been an internist for more than 32 years and practices in hospice and palliative medicine.