Late last week I received a call from our Emergency Department, directly to my office phone.
This is not usual.
“Doctor Deaton,” a voice greeted me, the edge therein more than a little palpable. “This is the charge nurse in the ER. One of the doctors has a question for you about Suboxone. Can you speak with her?”
This too is not usual.
It turned out that a young man had appeared in our emergency room who was in great abdominal pain. He had been on Suboxone through a private doctor in town, and when he became no longer able to afford the medication, he had to stop it, precipitating withdrawal symptoms. The situation was even more unusual, though, in that the man had only been on a relatively small dose of Suboxone, yet was having quite serious abdominal symptoms. By the time the doctor got to me on the phone, matters had become so difficult that, shall we say, help was rapidly needed in the ER to keep matters under control. (I heard the call for it over the hospital loudspeaker. Never a good sign.)
The young man was hurting, and apparently he was not a happy camper.
Eventually he was admitted to a medical floor of the hospital, from which another doctor called to ask me to consult in a few days about the Suboxone. When I did call those few days later, I learned from the young doctor caring for the man that “he’s got a lot more problems than just Suboxone. His wife says that he’s really got problems from the war, and I’ll tell you: he really looks like he’s suffering over here, too, especially at night. I think he may need some time on the Psychiatry service.”
Fortunately by the time this young man had arrived at my office, much had improved. He was back on a good dose of Suboxone. He was taking medication both for his nightmares and for his mood swings. He was living in a much calmer world.
Sitting there before me, in his late twenties, he was the paragon of the “good old country boy”: on the slim side, but still with a military man’s body, along with a respectable blotch of hair on his chin and a respectful grin on his face that would have made Andy Griffith proud. Obviously, he was feeling much better.
“I’m back on the Suboxone dose I was on before,” he told me. “It’s a lot better. And the new medicines are helping, too, already. I’ve slept better these last couple of days.”
Matters had been worsening for a while, long before he stepped into our hospital for the first time that previous week. He is several years out of his last deployment. Fortunately he has been able to work effectively, but he’s been just as fortunate to have understanding superiors who have genuinely liked him and appreciated his hard work. Apparently he has not always been a pleasure to work around.
Similarly, he is fortunate beyond belief that he has had the family he does. He married his high school sweetheart quite young, and their first child quickly followed. His wife has stuck with them through thick and thin. His parents have been extremely supportive of the couple, and they remain so to this very day.
Still, he had had opiate problems long before his enlistment. He did become clean for his first few years of service, but after an injury in the field, he returned to the medications, first as prescribed, but later, especially when he returned home, as a way to deal with all the demons that were haunting him. He finally got himself to a Suboxone provider in the community, and matters changed for him.
“What was your MOS?” I asked him. (MOS is, essentially, his job in the military).
“Infantry,” he told me, sheepishly, yet still pleasantly. “But I spent most of my time on transport. We were ‘outside the wire’ all the time.”
With that final sentence, his whole tone, his whole demeanor changed. When a soldier or Marine is “outside the wire,” he or she is outside the (very, very relative) safety of the operating base and out in the world of curious kids begging for chocolate bars–oh, and IED’s (improvised explosive devices) ready to destroy everything in range, including you.
The change in him was dramatic. I paused. He suddenly looked about ten years younger, far more vulnerable, far less sanguine. He was staring down at the carpet–or through a tunnel of time, I’m not sure.
“Bad?” I finally say.
He nodded, said nothing.
“How many did you lose?” I asked, trying to keep my voice at a respectful quiet.
“Four,” he finally whispered. “One . . . one was my best friend in the world.”
“Who was he?”
He told me his name.
“Where’d you guys meet?”
He looked back at me, a slight smile returning.
“We were in AIT together (Advanced Individual Training, where one goes after Basic Training to learn one’s job). We just hit it off. He was a farm boy like me, you know, just simple, no big deal. He was so funny. We’d laugh our heads off. He . . .”
He looked back down, his smile suddenly retracted into his face with the breath he’d drawn in, held. It appeared that his body was betting that if he just didn’t move, that tear at the end of his left eye wouldn’t dare move either.
I said nothing.
As he began breathing again, he looked back at me. The tear had already headed points south.
“He was just twenty, Doc,” he barely whispered. “He was a lot younger than me. He was just twenty when he died. He . . .”
Our eyes remained padlocked on each other’s. Ever so slightly, he began to shake his head. As he did, he bit his lower lip–but the tear in the other eye paid no heed.
“He never even lived, Doc. He never even got a chance to live his life.”
This was not, of course, the first time I’d heard that sentiment. Yet somehow, coming from him at that moment, so honestly, so sincerely, so achingly, almost as if Jim Nabors had transported his Gomer Pyle across time to sit right there in front of me, but this time with no “Howdy, Sergeant!”, no “Gollllllllllly!”, just a farm boy’s face, trying, begging to understand.
“What happened?” I finally asked.
“He was in the Humvee right ahead of me, inside. Then all of a sudden, everything exploded. The gunner on top just blew right off, the gun and everything, gun landed right on top of the guy in the hole that had just opened up. I ran up, and . . . and my buddy still had a pulse in his leg, I could feel it, but they . . . they Med-Evac’ed him but . . . he never made it.”
We were staring at each other, but the padlock on our gaze had fallen off. The chain connecting our eyes just hung there, limply.
“The NCO,” he continued, “we got a tourniquet on his leg in time. He lost it later, but he made it.”
Neither of us said a word.
“Does anybody,” I finally whisper, “understand what’s going on inside you?”
Our interocular chain dropped, he briefly looked down, smiled, and then looked back. “Yes,” he nodded. “My wife. She knew him, too. He and I were stationed together. He lived over in the barracks, and we had our own apartment, and he’d come over every weekend and stay with us, and . . .”
He stopped, pursed his lips, seemingly sending another telegram to the eyes to lay off.
Obviously they didn’t receive it.
A few seconds, nothing, then,
“She really loved him, too. I was his big brother. He was my little brother. She . . . she knew he was dead before I did, heard it on the news. She was freaking out. She knew we were joined at the hip. She . . .”
A tear was nestled in the bush of hair on his chin. He was so sincere, so genuine. Gomer himself never looked that genuine.
“He was only twenty, Doc. Twenty.”
“I don’t want to live like this any more, Doc. I’m tired. I can’t do it.”
Now it was my turn to smile, ever so slightly.
“You want to make it right for your family. For his sake. Your kids would have played with his kids. Now you’ll just raise your kids right and remember him, in his honor. True?”
Slowly the smile arose on his face. It was still slight, but the eyes–they had brightened ever so slightly.
“Thank you,” he whispered. “I’d never thought of it that way. That helps. Thank you.”
After he left, I decided to do it. After all, I cannot remember the last time I had a full name. I went to Google. I found him, he who, unlike Harry Potter, was the boy who never lived.
I looked at his picture, smiling brightly, his beret just at the right angle to add a year or two to that face, that . . . young, so full-of-life face.
As I looked at that young man’s face, I saw the face of my daughter’s boyfriend, of her buddy beaming from the stage of his Rent production, of her boyfriend’s roommate who could win at least a silver medal in whatever “sardonic smiles” competition he might enter, of the young man across the street whom I’ve watched grow up since he was in kindergarten.
I couldn’t stop looking at it. I couldn’t help but imagine the three of them, this young man in the beret, my patient, his wife, all laughing their heads off.
On the way home, it hit me, a memory of my own.
Twenty-five years ago, the minister and his wife of the church I was attending, the church at which I met my wife in the choir, lost their six-year-old daughter to cancer. The congregation was devastated. The funeral was huge, unforgettable.
From that time, what I can least forget is one song, the choir accompanying a duet of two sopranos, one the wife of one of my law school classmates, the other–my wife, a voice major from Michigan. It was Andrew Lloyd Webber’s Pie Jesu, which at that time had just recently debuted.
Back in the present, when I got home, I grabbed my phone and headed straight to Spotify. There I found it, the original recording of the song with Webber’s then-wife Sarah Brightman and the boy soprano, Paul Miles-Kingston. I played it.
It was as I remembered it.
Pie Jesu means “kind Jesus,” and it forms part of the old Latin funeral, or Requiem, Mass. Webber takes those words and combines them with another phrase of the Mass, the Agnus Dei, the “Lamb of God,” to create a seamless hymn of memorial:
Pie Jesu, pie Jesu
Kind Jesus, kind Jesus,
Qui tollis peccata mundi
Who takes away the sins of the world.
Dona eis requiem
Grant them rest.
Agnus Dei, agnus Dei
Lamb of God, Lamb of God
Qui tollis peccata mundi
Who takes away the sins of the world.
Dona eis requiem sempaeternum.
Grant them eternal rest.
To this day, it remains the song I recall immediately when contemplating the death of one who has died too soon, one who never even had the chance to live. It is the song I recalled as I looked at that smiling face under that dapper beret.
We live in an odd world. Here they are, two farm boys, both laughing their heads off as they make their dads proud when they go into the military, honorably, bravely. The last thing on their minds would have ever been some high-falutin’ song sung in Latin, of all things, Latin.
Yet for centuries we have all mourned the loss of those who never had the chance to live, the Roman church through its Mass, the country Baptist church of this young man’s childhood through its hymnody, a group of Iraqi women who cry over their sons, their daughters who never wanted to harm anyone, who got caught in the crossfire, wrong place, wrong time, through the soft sounds, the wails of their songs.
All of us are united.
And today, the song weaves its way around two country boys. To say goodbye to one of them.
Creator God, dona ei requiem. Grant him rest. Amen.