Mr. Z

Mr. Z had a gangrenous toe. A dead toe. It was reddish orange and looked as though a pack of rats had nibbled it for weeks. The edges were frayed like an old sweater. Mr. Z possessed this unfortunate toe because he had insufficient blood coursing through his legs. Insufficient blood supply, known medically as ischemia, is excruciating. It is the pain that occurs when someone experiences a heart attack, which connotes lack of blood supply to the cardiac tissue. Mr. Z essentially had a never-ending heart attack of the legs.

He was old. Eighty-eight to be precise. "Old" is all relative though. I've seen eighty-eight year olds that could unquestionably cripple me in an arm wrestle. Mr. Z was not one of those. He was demented, incoherent, and frightened.

For two weeks I visited Mr. Z.  We had a well established routine.  I would shout in his ear to ask if he was in pain.  He would moan.  When I say he moaned, I don't mean he whimpered softly.  I mean he shouted his pain, with rhythm.  To be frank, Mr. Z would be moaning before I even entered the room.  He moaned day and night.  He never stopped moaning.  It was a constant vocalization that may not have even indicated pain, but was simply self-soothing noise. "OOOH, OOH, OOH!"  You could hear him from the elevator.  Sometimes he deviated from his monastic "OOH, OOH, OOH!" in favor of a more unsettling "MOM, MOM, MOM!"

We were concerned that Mr Z. was in pain, but he couldn't tell us. We tried an assortment of medications and remedies, but he kept on moaning. Personally, I think his pain was both ischemic and emotional. He knew he was dying. No one visited him. He was a frightened 88 year old child crying for his mother. He died alone in a drab Veterans hospital room with poor lighting, moaning to the very end.