Missy and her in­vis­i­ble dis­ease

There’s ev­i­dence to back the ar­gu­ment that iso­la­tion is like an ill­ness

The Hamilton Spectator - - COMMENT - DAVE DAVIS, MD

I’ll call her Missy, not be­cause that was her name but be­cause it wasn’t: she val­ued her pri­vacy and wouldn’t want you to con­nect her story and her real name. And be­cause she was my pa­tient. She’s long gone now, her name on one of those mul­ti­coloured files you see in doc­tor’s of­fices. This is her story — the story of an in­vis­i­ble dis­ease.

Blonde, although in her late 70s the blond came from a bot­tle or a wig shop and not from nat­u­ral sources. Tall, el­e­gant, beau­ti­ful in her day I’m sure. Beau­ti­ful in the days I knew her too, though it was the beauty of a rus­tic farm fence, or clas­si­cal paint­ing, not the beauty of youth. The weather-worn patina came partly from her years, partly from the two pack a day habit she con­sumed for the decade I knew her. That was the rea­son for her visit on that Fri­day — the X-ray re­port had come back.

The per­sis­tent cough she com­plained of, the one that didn’t go away with an­tibi­otics and puffers, the one that had made her spu­tum be­come blood tinged, had re­vealed it­self as a bron­chogenic car­ci­noma. Its lo­ca­tion, its size, its look was as clear to the ra­di­ol­o­gist as it was to me: it was as though it had spelled its own name in the re­versed black and white of X-Rays. Its name was can­cer.

There was some good news mixed with the bad. Can­cer of course is a hard word to ab­sorb, but the tu­mour was very small, there was no sign of spread, she was oth­er­wise in good health. I was op­ti­mistic that the hospi­tal’s best-in-Canada lung surgery team could re­move it and — with our on­col­o­gists — give her years of good health. She ac­cepted the news calmly enough, even tak­ing the ex­tra time we had booked her for to hear it. At the end, I asked, “Are there any fam­ily mem­bers you can call? Any friends? How about neigh­bours?” She lived in a se­nior’s build­ing, her neigh­bours as close as across the hall.

Bob (also not his name), her ‘hus­band’ of 20 years had fam­ily but they were not hers. She was the other woman, never for­mally mar­ried to Bob: they re­sented or re­jected her, or so she be­lieved. Her sta­tus was like a phys­i­cal ob­ject for her — bind­ing her to him like a rope, walling her­self off from friends, neigh­bours and rel­a­tives, like a moat. And the phys­i­cal ob­ject, this moat, kept them at bay, I’m sure. She had loved Bob deeply, and I just bet pas­sion­ately. When he died, she set­tled into wid­ow­hood gen­tly, with good hu­mour, but in a most soli­tary way, not rec­og­niz­ing or mis­read­ing in­vi­ta­tions to friend­ship. “No, there’s no one doc­tor, I’ll be all right.” “No one? Not even a neigh­bour to spend time with you on the week­end? This is hard news, Missy. Here’s our num­ber. Please call us if you have ques­tions or wor­ries. I’ll see you Mon­day. We can talk about next steps then, an­swer more of your ques­tions.” It was the last I saw her. In seventy two hours, she was found dead by her apart­ment su­per, the cause never re­veal­ing it­self, at least to my sat­is­fac­tion. Pos­si­bly an over­dose, though the tox­i­col­ogy re­port was am­biva­lent. Pos­si­bly the un­pro­nounce­able but deadly Takot­subo Car­diomy­opa­thy, the ‘bro­ken heart’ syn­drome we read about. Pos­si­bly an ar­rhyth­mia. My own hunch? More than the can­cer, more than her chronic bron­chi­tis and aw­ful pack­year smok­ing his­tory, more than her wid­ow­hood, lone­li­ness killed her.

There’s ev­i­dence to back my ar­gu­ment that iso­la­tion is like a dis­ease, an in­vis­i­ble and deadly one at that. There was, for ex­am­ple, a re­cent ar­ti­cle in the New York Times In­ter­na­tional Weekly (that’s the one the Spec car­ries) about the sub­ject — about new re­search, about its in­creased risk for car­dio­vas­cu­lar dis­ease, about so­cial pro­grams, about rec­og­niz­ing its dead­li­ness. We are, it ap­pears, hard wired to be so­cial. The ef­fort that it takes to block that ac­tiv­ity must take a toll on the body; it cer­tainly takes a toll on the per­son.

What can we do? As a so­ci­ety, we can be­come more aware of its con­se­quences. As com­mu­ni­ties, we can of­fer pro­grams, reach out, de­velop net­works. There are dozens, hun­dreds, maybe thou­sands of Mis­sys in ev­ery vil­lage, town and city of Canada — in Hamil­ton for ex­am­ple — on your block or in your apart­ment build­ing. And as in­di­vid­u­als, we can use the word, the ran­dom act, the in­vi­ta­tion to lunch or cof­fee at Timmy’s, over­com­ing mis­per­ceived so­cial clues.

At the very least, we can, like I do, re­mem­ber Missy.

Dave Davis lives in Dun­das, On­tario and Fort My­ers Beach, Florida. He’s a re­tired physi­cian, a writer and speaker. You can fol­low him, if you have noth­ing bet­ter to do, @drauthor24, or write him at dr­dav­e­davis@gmail.com

ADRIAN HILL­MAN, THINKSTOCK

There’s ev­i­dence to back the ar­gu­ment that iso­la­tion is like a dis­ease, an in­vis­i­ble and deadly one at that, writes Dr. Dave Davis.

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