Sunday, January 15, 2006

James, 46y/o M with ischemic limb

James lived in an average home, in an average neighborhood, on an average street in an average town. He ate average meals, had an average wife, and the average number of children. His job, middle management. His car, mid-size sedan. His favorite ice cream flavor, vanilla.

James was forgettable in every way, another person walking down the street. It's not that he was a boring person, or tepid. He was wild and carousing in college. He had his sights set on being a corporate pirate. He dreamed of the 80's bonds brokers like it was a decade of fiction rather than fact.

But after his first child, he lost his carelessness. Seeing his little daughter's newborn hand curl around his index finger, he couldn't see the point in all the risk and all the danger. Safe bets. Sure things. Slow and steady. He couldn't put her bright future in peril. He'd be careful. He'd look both ways. He'd measure twice and cut once.

So when he had his first heart attack at 40, he was as shocked as everyone else. He hadn't even seen it coming. Indigestion, he kept telling the doctors. Indigestion, he told the cardiologist. He left the hospital with 2 stents and some Prilosec.

His second child, a perfect little boy, only cemented his resolve to shape up. He didn't even eat spicy food. He took up jogging. He did sit ups. So he was as surprised as anyone when his leg turned blue and painful. While out for a jog, suddenly his leg was weak and pain ran up and down like it was being torn open. He fell to the ground and that was the last step he'd ever take. He smacked his head, and it was blissful unconsciousness till another jogger found him.

In the ER, they took one look and sent him upstairs. He had a procedure done to remove the clot that blocked the blood flow to his leg, but it was a touch too late, the surgeons said. His foot was still red and painful, and angry. It looked fierce. And then it turned purple, and James didn't remember anything after that. He'd gone for surgery 4 times, each time removing more and more of his leg, till even the surgeon couldn't stare at him.

And as they disarticulated his femur from his hip, they knew he'd never see morning, but to look as his wife and 2 children and tell them James, a man of 46 years, who had only been to the ER once before in his life, would die, it was too much. And so James died from gangrene due to ischemia from arterial thromboembolic disease.