I met Mr. Archer on the 7th floor around 9 AM on a forgettable day in May. He was basking in the morning sun at the window near the end of the hall, staring out onto Mitchell Field below. He reminded me of my grandfather; an aged farmer with gruff hands and a warm smile like morning coffee. Mr. Archer turned as I approached. He smiled and shook my hand the same as he had done the past three mornings. However, I hadn't come this morning to ask more probing questions about contact with cats and cattle, travel to the Southwest, or to check on his fevers- I came to find out how much he knew.
"It's leukemia," he said, with a twinge of grief in his eye. Apparently he knew a lot. "They told me last night." He forced a meek don't-you-worry-bout-me smile. I gently returned the smile through a frown. I had been working Mr. Archer up for possible infectious endocarditis. He had fevers without a clear source and some recent heart surgery, two minor Duke criteria. But he also had a peculiar rash that didn't fit the bill. A skin biopsy of his rash returned the night before- leukemia cutis. Probably from acute myeloid leukemia. Blood cancer.
It was not my place to inform Mr. Archer of his cancer, but I don't deny that I wanted the task. I had liked him instantly. An old-timer with a solid heart, nothing more and nothing less. I had spent time with him. Asked him about his crops and kids. He deserved to hear about his leukemia from someone familiar.
This medical jungle inspires strange desires and peculiar prayers from its inhabitants. As a prime example, I have never wished so badly that a man had endocarditis.
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