While pondering the metaphysical issues of life & death in health care these days I recall one particular but striking case.  I was told that it involved the issue of inserting a feeding tube [known as PEG, percutaneous endoscopic gastrostomy tube] into a fifty ‘something’ year old chronic resident of the Woodbridge State School.

I knew that the unfortunate inhabitants of this ‘school’ were severely handicapped individuals whose family could no longer care for them.  Many had congenital abnormalities which necessitated long term, often life long institutionalized care.  Many were either mentally or physically impaired.

My initial reaction was to ‘feel’ that I should not insert a feeding tube which would only prolong what I had assumed to be a horrendous lifestyle, one filled with sadness, suffering & despair.

I will never forget my first meeting with ‘Fred’.  He was over 50 years old, clearly mentally retarded, with a childlike contracted, underdeveloped body.  I do not know what he official diagnosis was but he was not able to speak, move or feed himself.  He drooled & and stared back at me.  He was accompanied by a lovely, beaming black Jamaican woman who was his caretaker at the school. She was joyous and smiling.  She asked me, ‘When will you place the feeding tube in Fred?’  He must eat & get his strength back you know!"

She smiled at Fred.  He stared and smiled at her. His smile was off kilter, drooling but radiant.  In a instant I was simultaneous ashamed of my prejudiced belief and transfixed by the presence to real love.  The feeling between these two souls was inexplicable but absolutely real.

I stepped away from the loving glow that the couple emanated.
I performed the procedure the next day.

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