Well, it has been since January 2020 that we have been talking about COVID-19. It was December 2019 when first cases of infection were described in China, or maybe when the first case appeared in these United States on the West Coast.

The disease or the pandemic as it is called now has affected several million folks in the U.S., India, Brazil and other countries. It has killed almost four million people. Some say the count is lower than in reality because we are not testing everyone, and others say we are overcounting as the hospitals are labeling many cardiac and pulmonary deaths as COVID-19 deaths to get higher reimbursement. 

The disease is affecting mostly elderly men, blacks and Hispanics, and those with heart disease, lung disease, kidney disease, immunosuppression, and others with diabetes and hypertension and smoking history. This is what our study in the American Journal of Cardiology showed.

There was much scare initially in Europe, and now all these countries are facing a second or third or even fourth spike. These countries have had lockdowns to contain the disease, and then intermittent opening of the economy – how long can they keep large number of people, young and old and in-between, in their homes? The schools and businesses are opening and closing and opening again. And then the teachers do not show up. What good is the opening of schools and businesses?

The incidence of lonesomeness and unhappiness is rising because people must stay home. The dynamics of interpersonal relationships between spouse and children have become strained as people are on each other’s faces all the time. No wonder the divorces are at all-time high, as is crime. The number of suicides is up, even among children, particularly among Blacks. Has anyone figured out why the suicides are much higher among Blacks?

We are animals that like to wander around, and go to the countryside, jungles, oceans, and skies, and visit our friends near and afar. We like to go to art galleries, symphonies, movies and take part in or just watch sports – which are all or mostly closed, or “on-line.” On-line stuff whether be educational or entertainment is not the real enchilada.

Despite an initial setback, the stock markets around the world keep setting new highs. I guess people have lots of cash that must be put to use somewhere. And playing in the stock market gives a sports-like high.

In February and March 2020 when the disease attracted everyone’s attention, I thought it would disappear by summer, and I was nonchalant about it even though I personally had almost all the risk factors. I used to help others think that it was a short-lived, mild problem that would just “go away.” Some believed me, most did not.

We had planned trips to places near and afar, including Florida, Montreal, Boston and Europe. We did not go to any restaurants, but I kept going to Kroger and Walmart and Sam’s, and occasionally to the mall, more for getting my walking steps than for shopping. Everywhere we went, we had a mask on. It was no fun.

We had visits from our children and even one from my then 9-year-old grandson Jasper who took his first solo trip ever. The visit was brief and pleasant, but I had some mixed feelings because we had to be ever so careful.

Now the summer or 2020 is gone, and so has fall, and it began to get wintery cold, and then came the spring and summer of 2021. Some days in Little Rock in winter were colder than in Boston. The year 2021 is more than half gone. We are still talking about COVID and new variants – Delta that originated in India and rapidly spread around the world. In Arkansas, the Delta variant is the primary cause of a new wave of COVID hospitalizations and deaths.

I guess a new reality has set in. I am not seeing new patients – just follow-ups, mostly by phone.

Even the patients I see in my clinic appear bored. Many come for a visit to get out of their house. Some like talking on the phone, but there is no personal connection, and whatever is there appears artificial.

The hospitals lost money for lack of patient visits and the “procedures” that were in any case meant to generate revenue and on the side “help” patients. Hospital revenue began to pick up around the winter of 2020. Patients in the hospitals were allowed minimal visitors to keep the bug away. But then as COVID-19 was controlled in the U.S., clinics and operating rooms and cath labs were opened, and all was back to “normal” around February and March 2021, and the healthcare industry started all its money-making operations.

Restaurants that closed for months began to open on a limited basis around the beginning of 2021. Even those that were open had to enforce social distancing and use of masks. So, you eat with your mouths closed!! Gyms were by and large closed and are now open, but people still manage to eat out, go out to establishments and use gyms. No wonder we have second and even third spikes of COVID-19.  Perhaps it is time we call it COVID-20 or COVID-21?

People felt lonesome stuck at home. Children were staying at home as schools were closed or open intermittently, studying at home on Zoom, and going berserk, as were parents, many of whom never had the experience of having children at home for spring, summer and fall and winter as they forgot about the on-line education. Even my daughter Asha moved with her family to Florida where schools were open and the weather was warm.

I had an interesting interaction with a patient. I mentioned it to Paulette and she wrote it up for me. In essence, one of my patients who was taking care of an elderly man was very upset not because she was let go from taking care of the elderly subject by his family, but more so because the man died of loneliness, not because of COVID-19, but from lack of his only contact. 

We expected one or more vaccines to be available to protect us from Corona virus, but the virus keeps changing initially into type A and B, or D614 and G614, and now it has mutated in Denmark in sheep. It will now affect mink prices since the government there has ordered culling of millions of sheep. So, the vaccine may not be effective, or only partially protective. And of course, the Delta variant which started in India and spread worldwide. More variations will come.

The vaccines came, initially from Pfizer-Biotech, then Moderna, and AstraZeneca and Jensen, and of course from China, India and Russia. 

The U.S. elections came and went (not really!); the Trump team did not believe the results. I will remember these elections forever. Very few people voted in person, yet more votes were cast than ever before – by mail because of the Corona fear. The former President is still contesting the election with fights in courts. Can anyone deny that (mis)management of COVID-19 cost him the election as POTUS? He claimed we will have the vaccine before the election; it never did happen. He himself had COVID-19. He got better enough to campaign mightily, but that was not enough. 

Well, Joe Biden is now the President. He has mobilized COVID vaccinations and almost 55 percent of the population is vaccinated, but COVID infections continue to soar in the U.S., India and many other countries, a result of people becoming more used to COVID and not following precautions. India until recently the world’s supplier of vaccines had a shortage of vaccines and oxygen for their patients; it is asking Germany and other countries for the gas generating plants.

There are now Indian variants, UK variants and South African variants. Vaccines may or may not be effective against the variants. And before I forget, the AstraZeneca vaccine has been associated with unusual thrombosis in the cerebrovenous sinuses and the hepatic veins, a picture mimicking TTP. I wrote a paper with Peppino in Italy and Pier Paolo in Ireland.

I am afraid I will get COVID and die of it, although they say that vaccinated individuals are unlikely to get serious infection and less likely to die, but with poor lung and CV situations, who knows? 

Oh, COVID, don’t be so proud. We will get used to you, or you will just disappear – after killing millions, a price to pay to pacify you.


Jay Mehta, M.D., Ph.D., served as the Director of the Division of Cardiovascular Medicine at UAMS. Currently, he serves as Distinguished Professor of Medicine, Physiology and Cell Biology, and Pharmacology and Toxicology.

By Conrad Murphy

Everybody has one. Everybody has their person. The one who was “the reason for going into it.” Who knows how many different names show up in each medical school application? Clarke Wesley Johnson. Not born to but adopted by Hans and Judy Johnson; the first boy of the family. He had darker skin than the rest of the household and a large scar from the top of his chest to his belly button. 

When I came along much later and asked why, he told me that his parents were Native American, and his scar was a battle wound from fighting off a buffalo when he was a baby. Only half of that was true, but I was too naive to tell which part. That was all I knew about his biological parents, besides the other thing. Their unintended but nonetheless terrible thing they left him with. The thing that made his lungs fill up with what my seven-year-old self described as gunk. The thing that made him take a duffle bag worth of medicines every morning. The reason he couldn’t work at a job, the reason he floated from our house to my cousins’, to my grandma’s, and back. I could pronounce cystic fibrosis at the time even though I couldn’t spell it. CF was a household name for us. For all that Clarke was, it would be best to say that he was my person. My reason.

“Uncle Clarke, why do you look so much bigger in this photo?” We were glancing through albums that my mother put together and we came to his section — one picture of him as a child next to my mom and aunts, the other of his high school graduation. 

He pointed to the corner of the room where that duffle bag of medicines lay, always in sight. I never knew him without it. During one stretch of his life, he stayed with us in our house. When he was home, he’d take my bed, making me sleep on the top bunk every night. I used to hate that. The land my family owned was his playground — field after field of a cattle farm, ponds to fish in, deer to hunt, hills to ride over. We’d take his metal detector out to the old burned house; we’d walk the boneyards hunting coyotes so we’d stop losing cows to them. Those were the years that I hardly remember him having a cough. Times like that never last though. 

Years passed and I found him at our home less and less. I got my bottom bunk back. He would often go to the hospital for tests, back out to Oklahoma with other family. I would see him for one weekend at home, but he was gone the next day because he only needed to pick up a few things. 

“Can I come this time? I’ll be quiet and won’t get tired.”

“Not this time, but the next one, maybe,” Uncle Clarke said. The coughing started to increase, not enough for me to notice it at the time, but in hindsight it was more than in the years prior. I found myself taking back the top bunk in case he came home and needed his bed back. Waking up to the bottom bunk still made was always a disappointment. 

The first scary day was on the brink of summertime, during my last days of school for the year. I got home and mom was on the phone, getting her things gathered and ushering me back out the door toward her car. 

“Yeah, just meet us there, and it will be fine.” She dropped her keys several times on the way out the door.

“Mom, where are we going? I just got home; can I stay?” 

“Your uncle is stuck in Alma; he needs us to come pick him up. Michael is meeting us to help drive him back.” Her voice gave a little bit, but she steeled herself when she heard it.

“What’s wrong with him?”

“He can’t drive all the way back to the house, we’re going to get him. Just get in the car, now.” It was a quiet drive, a long drive. 

Two and a half hours later we arrived at a gas station outside Alma, seeing to find my uncle leaned back in the front seat of his car. My stepdad and mom helped him walk over to the passenger side door before we all drove back home together. 

“Uncle Clarke is going to be staying with us for a while now, so you’ll have to help him if he needs something,” Mom told us. Although I would have much preferred him back without the illness, I wasn’t going to complain. 

Life resumed; however, my uncle was approaching two duffle bags rather than one and we stuck to video games indoors rather than running around in the fields all day. He seemed to get better and later invited me to go with him to his hospital visits. 

Not many children would enjoy spending the day watching their uncle go through multiple offices, scans, or blood draws, but I enjoyed going. One reason was because I got to spend time with him, and the other was that he always bought me a video game afterward. We got up early in the morning, had breakfast, and I watched him open his duffle bags. I spent the day watching him interact with several doctors, nurses, respiratory therapists, and radiology technicians. All of these people were working really hard to make sure my Uncle Clarke could breathe properly. 

I walked the halls of the tall buildings at UAMS, and it wasn’t long until I knew my way around easily. My uncle could trust me to go find the vending machines without getting lost and the nurses came to recognize me since we were there so often. I watched him groan as one of the nurses said that he had to complete another breath test. We walked to a different floor of the hospital where he greeted a technician while unenthusiastically handing me his backpack and medications. 

“Another one already, Clarke?” she said while untangling some wires and logging into the software for this big machine she had next to her. 

“I’m going to be breaking records on this thing if they make me come down here any longer. I’m going to have to really try on this one or they won’t like me upstairs,” he told me as he slipped on a large plastic mask. 

The technician gestured to him like they had their own secret language. My uncle nodded and took a deep breath before he exhaled as quickly and completely as he could. His dark face turned a purplish hue for a few moments until he couldn’t breathe out any longer. He swiped a few very fast breaths and took a few moments to recover until he was going again. The technician understood him without any words. 

We then left to go to a radiology waiting room and I had to watch him drink something that looked like the glue my mom would use to paste his pictures in the scrapbook we looked through years before. 

“This one is grape flavored, apparently,” he said as I laughed, and he giggled and gagged his way through the large bottle. He told me that he had to drink it because they were going to put him through a scan that lights up his lungs to see if they’ve gotten any worse. He told me that the scanner was like a big white doughnut, and it took pictures of him while he was passing through the hole of it. These visits continued and increased over time. I found myself going almost every two weeks toward the end. 

It wasn’t long before he started doing worse on the breath tests, and the impressions on the CT scans became longer. I went a full month without going to the hospital with him because he had been stuck there for that long.

“Mom, why can’t they just give him a new pair of lungs? If he had new lungs, he’d be fine!”

“Honey, they already did that.” Suddenly all of the medications and the large scar down his chest made more sense to me. 

When my mother came home with doughnuts for breakfast one morning, I knew he had passed away. We only got those when a family member had passed. She walked into my sisters’ room while we all were playing just as the sun was coming up. She explained to us that he loved us very much and wished that he had more time but was happy because he didn’t have to cough anymore and could finally sleep for more than two hours at a time. I just looked down at my doughnut, imagining a tiny Uncle Clarke passing through the hole.

Clarke chose to donate his body to cystic fibrosis research in the hope that gains would be made in the fight against it. We had a memorial service at the Methodist church in my small town. Every part of the service was miserable for me. It was the first time I really understood the cost of death. There was nothing but sobs around our table as we listened to the kind words that were said about him. I remember thinking these words would have meant much more to him if he were alive to hear it. Months later we had a second small graveside ceremony when we buried his ashes. My mom stood consoling my grandmother because she knew that children were not supposed to pass away before their parents, no matter how much longer he lived past the life expectancy for CF. I stared at the small canister on the stand at the head of the grave, trying to envision that it held all the memories, lessons, and laughs of a life. 

I considered my Uncle Clarke a second father figure. He instilled life lessons into me. He taught me how to shoot a gun, hook a fishing line, and how to ask a girl for a dance. He didn’t have any advice on dancing, though. The reason his memorial service was so unbearable was because his presence was the complete opposite. He meant so much to people. It wasn’t until much later as a high school senior that I came across a paper weight in a stack of his old stuff. It looked like a glass coaster that you would set a cola can on, but it was engraved with a pair of lungs surrounded by the St. Louis Gateway Arch, the monument of the city where my uncle had his operation. Below the paper weight was a picture of him shaking hands with the doctors who performed his surgery. 

As I walk onto the UAMS campus again as a freshman medical student, that image continues to stick in my mind. Some friends ask me, “Why would you want to work in a place like that? It’s where people go to die.” They aren’t necessarily wrong. It is the place where my Uncle Clarke died. To me, it is more of a place that he returned from, over and over. Although they did not cure him, they gave him time. They gave him time to teach his nephew, to make his sisters laugh as he always had, to play video games with his family, to attend Thanksgiving and Christmas gatherings. That handshake in the picture was an understated social transaction between a hardworking uncle who wanted to have as much time as possible and a doctor who wasn’t going to give up trying everything for him. He was my person, the one who got me here. He was the one on my medical school application. 

Telling people that I want to work in a place like this is easy because I want to shake the hands of the mothers, fathers, uncles, aunts, sisters, or brothers that only want to teach their kids how to shoot a gun, hook a fishing line, or teach them how to ask a partner for a dance. That’s what I would say now, if we held another memorial for him today, if he were around today. I would tell him that I’m a medical student because of him. Not because he died, but because he struggled. You don’t struggle if you give up — you surrender. He didn’t surrender to CF. He struggled against it and struggled well. 

How could I expect to fight for future patients if someone didn’t show me how to fight first?

Conrad Murphy is a first-year medical student in the College of Medicine at UAMS. He lives in Conway with his wife Sarah and daughter Reuelle. 

By John Graham-Pole

‘Your voice is his. Your gestures, too.’
So his fleshless ash lives on in me. 
After Dad’s Cremation, 1991

A month after I retired from the University of Florida in 2007, two letters came in the mail from England: my birth certificate (February 23, 1942), replacing the one I’d lost somewhere on my travels, and my final pension award from Newcastle-on-Tyne. Newcastle is not only home to the British Pension Office but also the city of my father’s recent death. This full life cycle, tucked into two envelopes resting one on the other in my mailbox, sent me off on a journey of reminiscence.

In October 1941, my mother turned up for her weekly Women’s Institute fitness class in the village church hall. Mummy looked all set to deliver me into the world, but she reassured her friend Christine who expressed concern about her doing Jumping Jacks so far along in her pregnancy: “The doctor says it’s fine. Might even move things along a bit—after all, this will be my fourth.” No further argument from Christine; after all, Mummy was the Women’s Institute’s president. Her doctor was my dad, aka Dick, whose word on any health issue was law in High Bickington and the surrounding Devonshire hamlets. 

I have this conversation on good authority, because I met up with Chris seventy years later on the eve of her hundredth birthday. Once she had figured out who I was, she recounted a favorite memory — that of me bouncing up and down inside Mummy at thirty-six weeks while Mummy herself bounced up and down to the rhythm of Run, Rabbit, Run, which was topping the 1941 hit parade. She came by her nickname in college, “Tigger,” honestly, a lively leader in everything.

I was born at term, so I calculate those two gametes that created my very first zygote came together on May 29, 1941, my sister Jane’s second birthday: Dick’s sprightly young sperm flying solo through Mummy’s fimbria folds to pierce a single blushing ovum. They say the conception is much more fun than the delivery, but I never got to ask either Mummy or Dick their opinion on that. 

They were living in my paternal grandmother’s house in Golders Green in North London at the time, while Dick finished his surgical internship under William Girling Ball, Dean of St. Bartholomew’s (Bart’s) medical school. I like to picture the two of them cozied up like canned sardines right underneath squadrons of dog-fighting Spitfires and Messerschmitts. So began my replication towards the thirty-seven-trillion-cell being I would become forty weeks on. Meanwhile I spent my first blissful months of life tuning into the soothing rhythms of Mummy’s placental blood-lullaby. 

By delivery time (a mercifully swift one for both Mummy and me), the thunderclap of bombs would have been replaced by the evening chorus of blackbirds and wood pigeons in the hawthorn hedges of rural Devon. Dick had bought a 300-square-mile practice in the village of High Bickington, a Saxon settlement dating from 700 AD sandwiched between Exmoor to the north and Dartmoor to the south, where Conan Doyle’s hellish Hound of the Baskervilles had been wont to roam and ravage. Our home sat astride two country lanes that converged to form a long hill up to the village. In time-honored English custom, the house had at some time been given a name—Dobbs—though the origin and significance of this are lost. The ancient pear tree in our back garden still bore fruit and the seventeenth-century well yielded its spring water year-round. 

I was born in my parents’ bed, with Dick and Nurse Lumney— an old flame from medical student days whom Dick brought down from Bart’s for all of Mummy’s confinements — in attendance. He may have looked approvingly upon his firstborn son after fathering three girls, but my first day was hardly without its trauma. Having no truck with paragraph five of the Hippocratic oath — I will not use the knife … but will withdraw in favor of such men as are engaged in this work — he circumcised me at one hour of my extrauterine life on our dining room table: a heavy slab of 1920s oak upon which I am right now leaning my elbows as I write, flinching at the very thought. 

He brought to this work a special mix of sangfroid and ritual, while probably paying more attention to Nurse Lumney than to the suffering willy on the end of his scalpel. Circumcisions were bread-and-butter stuff to him, and he tackled the task without benefit of local anesthetic. True to most doctors of the day, he thought of neonatal nerve endings — boy ones anyway — as too immature to feel the knife. We now know that all of a newborn’s senses are finely honed from well before birth: mothers are quick to sing lullabies to their beloveds as soon as they start stretching their limbs within their cozy bedchambers, to the palpable pleasure of both parties. 

Mummy slept through my bris blissfully unaware of my agony as I pined for the blessed balm of her nipple. A surgeon manqué, Dick used that sturdy oak table for many other less minor procedures, from setting eldest sister Elizabeth’s fractured radius, sustained when after crashing off her bike on Ebberley Hill as she was cycling up to the village, to injecting the newly available penicillin into the cerebrospinal fluid of a toddler Dick suspected of meningitis. He was the only person for miles about with a car — a racing green MG Midget that dated from the earliest 1936 prototype. The villagers spoke of him as a fine doctor but a devil of a driver. I think he kept the hood down through winter as well as summer. After completing his early-morning house calls in the surrounding villages, he would roar into the driveway fronting our house with a screech of brakes and a scattering of gravel, barely avoiding his lovingly tended boxwood hedge. He would stride into his morning clinic hauling off his massive leather driving gloves, where his patients would have been gathering for some hours through our back door, each time triggering a bell to peel throughout the rest of the house. Two rows of farmers and laborers would likely be perched with their wives and children on the benches under the windows awaiting his ministrations with either eagerness or dread. 

For carrying out his physical examinations, Dick had two curtains on casters that Mummy had no doubt sewn and assembled. But there can have been few secrets in the village’s butcher or baker shop because he never lowered his voice below a bark. One morning when I was around four years old, I succeeded in easing open the door to his clinic enough to get a clear view of the scene unfolding before me. Lo and behold, a sight worthy of undiminished memory: a comely fourteen-year-old girl seated naked to the waist on Dick’s examining table, while he recounted his store of home remedies for period and growing pains. Her mother was clearly struggling to keep up, while her daughter looked utterly at home with the attention, if a little chilled. Perhaps she’d grown accustomed to such early-morning exposure to her fatherly-seeming doctor.

Dick had constructed pine shelves on three of the clinic walls to hold his multitude of medicinals, giving loving attention to each perfectly tooled edge and elegantly engineered dowel. He stored his placebos in amber-colored jars, mounted with ground-glass stoppers and labeled in his calligraphic scroll with names like Nux vomica, Chlorina liquida, Gentiana spp., Camphora officianis, reminiscent of an eighteenth-century apothecary’s shop.  He dispensed these identical-looking white powders and poisonous-looking potions with a customary flourish, to the obvious awe of his clientele. He always insisted that they be consumed in wine glasses, though was this last injunction ever followed? I do wonder: it’s hard to imagine such unworldly country folk laying their hands on a single crystal goblet between them. 

But his awesome authority surely served as an even more potent placebo, whatever the presenting complaint — asthma or angina, chickenpox or collywobbles. In the memoir he wrote shortly before his death, there is a verbatim account of one grateful patient, the broad Devonshire brogue readily detectable: 

“You been very good to I, Doctor Pole. I brought a big fat duck for ’ee, Doctor Pole; look ’ee ’ere. Us ’ud like another bottle of that there red medicine, Doctor Pole, thank ’ee kindly. ’Ere be your ’alf-a-crown.” 

When I first read this line it took me irresistibly to a Monty Python sketch of John Cleese playing the BBC interviewer and Terry Jones as the “local yokel.” 

The clinic’s remaining wall space was adorned with watercolors and pen-and-ink sketches, for Dick was as skilled an artist as much as he was medical scientist. Not only was he adept with the paintbrush and fine-line marker, but also he could construct a three-story doll house, glue together the intricate parts of a fully working model engine, and perform magic tricks with impenetrable sleight-of-hand. His espaliers of roses and apple trees ranged along the garden walls in glorious symmetry, while his beehives won prizes every August at the Exmoor agricultural and livestock show. 

Somehow he also found time and opportunity to indulge his fleshly appetites, indulging in frequent brief trysts with our two maids. But his younger women patients were also far from immune from his advances. He eventually came a cropper after an apparently passionate affair with a mother of two whom I’ll call Erica. When Mummy demanded he break it off or she’d head home to Grandma with us four children, he made some effort to put an end to his philandering. Erica promptly threatened to report him to the General Medical Council unless he left Mummy and married her. This brought him within a hair’s breadth of losing his medical license, and after several trial separations Mummy divorced him and moved us children sixty miles up the west coast of England to Weston-super-Mare in the county of Somerset, where her parents lived on the edge of the Bristol Channel.

I was three years old, and I have no memory of his leaving our home nor any warning of his imminent departure, though I learned later Dick wasted no time after the divorce from Mummy in marrying Erica. For the next sixteen years there was not a shred of a connection between me and my father. His name was barely if ever mentioned at home during this time, and the only trace of him was a photo—“Dick and Doreen, October, 1933”—taken in a moment of honeymoon bliss. They are sitting close together in the heather of a Scottish Highlands hillside, he sporting a meerschaum pipe and Mummy nursing a picnic hamper. Did this bliss make it through to my conception? Or was I the offspring of a momentary reconciliation after more shenanigans—a brief blip in the downward spiral of a marriage already dead? 

And was the sixteen-year silence between him and me of Mummy’s choosing or of his? I never found out, but I have a strong hunch my grandmother’s acrimony towards Dick played a decisive part, given his minimal, if any, financial support of us four children and Mummy’s almost total financial dependence on Grandma throughout my childhood. One wonderful irony of this whole debacle was that I was awarded a full scholarship to Epsom College boys-only private school from aged twelve to eighteen. The college had been endowed in 1855 and began life as The Royal Medical Benevolent College, with the express goal of “providing the orphans of medical families with free housing, clothing and schooling.” The college’s medical foundation saw me as an abandoned child and essentially an orphan, so not only did I become a fully paid-up Foundationer’s, but when in my last year at Epsom I won a Classics scholarship to Bart’s medical school (Dick’s alma mater), the foundation went on to pay every penny of my six years of tuition there too. 

I had one other small but significant connection to Dick during my schooldays. Just before my first term at Epsom College, Mummy brought down a fairly battered trunk from the attic to ferry my possessions on the train from home to school and back. On it were two address labels, one with Dick’s address at University College in London, where he had obtained a B.Sc in Physiology, and the other bearing his subsequent address at Bart’s medical college. They became a talisman of sorts for me during those years.

The sixteen-year silence between us was finally broken during my third year at medical school by a three-minute phone call inviting me to celebrate my twenty-first birthday with him and his new family. So at 7:30 p.m. sharp on February 23, 1963, I shook hands with my father on the steps of the Odeon Cinema in Leicester Square. He was a man I had no reason to recognize, having no visual memory of him beyond that thirty-year-old honeymoon photo. There followed handshakes with Erica and my two step-siblings, after which we sat in the Grand Circle of this palace of a cinema and watched four hours of Lawrence of Arabia. The total silence between us seemed somehow longer than the decade and a half that had preceded it.

But now we were connected once more and I spent many weekends with him, with medicine being a natural bond between us. He would tell me tales of several other doctors in our family tree, none of whom I had ever heard of. Among my medical forebears was my great-grandfather, John Nicholson, who graduated from Edinburgh Medical College in the 1870s, then traveled as a ship’s surgeon from Penrith in Cumbria to Benalla in Victoria. He attended the notorious bush ranger and bank robber, Ned Kelly, and was alleged on one occasion to have removed nineteen bullets from various gang members while never revealing the gang’s whereabouts to the police.

I had always thought my decision to become a physician was inspired by Mummy’s early death from cancer, but perhaps there is a doctoring gene that gets passed down through the generations. On the face of it, I was ill-suited to my chosen profession, given my early passion for the humanities —an aptitude matched by an equally intense aversion towards the sciences. After Mummy’s death, I moved to my Uncle Ken’s home in Yorkshire. He was Mummy’s brother and another doctor, and he did his level best to talk me out of following him and Dick into the medical profession. 

As the sole doctor for 3,000 miners and their families in the coal mining district of Yorkshire, he was soured by a never-ending attendance at the deathbeds of these men, almost all victims in their thirties and forties to the “black lung” (as pneumoconiosis was popularly known). He would rouse me from my bed in the early hours to hold vigil with him, probably thinking of it as a deterrent to my misguided career ambitions. But looking back, I think it was these experiences that drew me late in my career to fulltime hospice work. 

Dick’s marriage to Erica ended in acrimony. She evicted him from the marital home one Christmas Eve and dumped his possessions on the doorstep of his clinic. She then took him to the High Court of Justice where it was decreed that “the marriage be dissolved by reason that the Respondent had treated the Petitioner with cruelty. The Commissioner orders the Respondent to pay the costs of his wife’s suit.” (Dick claimed to not have the means to do so). 

He worked on for several years in his single-handed practice in Guildford, the county town of Surrey in the heart of the stockbroker belt. To the bewilderment of his sassenach patients he would make his house calls wearing the kilt of his family clan—Graham of Menteith—complete with belt and buckle, horsehair sporran, dark kilt hose and garters and a prominently displayed dirk. He no longer conducted formal clinics and I rarely saw him field a phone call that called for his attendance. When I visited him we would mostly spend our weekends at Farnham Sailing Club or at Kempton Park racecourse placing lavish bets on losers.

In time he retired with his third wife, Frances, who had been Erica’s children’s nanny, to the village of Milburn in Cumbria in the heart of Wordsworth’s Lake District. He spent most of his time in thigh-high waders casting his elegant bamboo rods into the local tarn to hook many a delicious rainbow trout. For several years he joined me for New Year festivities while I was working at the Yorkhill Children’s Hospital in Glasgow. Hogmanay was celebrated in grand style, with long lines outside the liquor stores throughout New Year’s Eve. It was at one of these celebrations that I tried to get him to talk about his severing all connection with me throughout my childhood. We were both fairly liquored up by then, so our conversation quickly turned into what he saw as bitter recrimination on my part. He took off home next morning, and this proved to be a final severing of all links between us: the second time in my life he had left me without so much as a wave goodbye.

Having outlived Mummy by fifty years, he died quickly at eighty-seven from acute monoblastic leukemia—a rare illness in the old. He had himself admitted to the Freeman’s Hospital in Newcastle-on-Tyne, where he challenged the interns with tests of his own concoction. My sister Jane phoned me the next morning while I was working at Shands Hospital at the University of Florida, where I was the attending pediatric oncologist. The call came through to our bone marrow transplant unit while I was sitting at the bedside of a seventeen-year-old girl who was also dying after a failed transplant for her refractory leukemia. 

“They don’t give him long,” Jane told me, “maybe a few weeks. But he’s determined to get chemotherapy.” 

It was a measure of the distance that had opened between us that Dick had made no attempt to contact me after his diagnosis, though he knew all about my quarter-century of close acquaintance with the very illness that had beset him. I shuddered at the thought of my aging father suffering through the rigors of intensive chemotherapy, whose horrid toxicities —devastating even to the young — I witnessed every day. I put in my own call to his hospital ward, only to find that he had died six hours earlier, lulled in the arms of merciful narcosis. I found out later that he had changed his will the night before his death, removing the names of five of his offspring, including me, while naming as beneficiary only my sister Mary, who had kept in close touch with him during his declining years. 

I stood in the nurses’ station of our bone marrow transplant unit and wept for the unresolved issues between us, grieving the bitter way our patchwork fifty-year relationship had ended in one final burst of disconnection. Ayman, my Syrian fellow, wrapped his comforting arms around me, then took over my attending duties without a pause while I flew home to Cumbria for the funeral. The next day I visited the ward in the Freeman’s Hospital where my father had died, and Judith, his nurse for his last night on earth, talked to me with tears in her eyes: “He was hiding all his terror behind outbursts of belligerence, until I was finally able to lull him into slumber with a blessed infusion of morphine.” At his cremation I was reunited with three generations of my family, including my two eighty-plus-year-old paternal aunts, Peggy and David. Auntie Peggy, whom I had not seen for thirty years, told me: “Your voice is his. Your gestures too.” 

So his fleshless ash lives on in me, leaving me with a lasting sense of sadness and failure — that we two human beings, both of whom had chosen working lives committed to the healing of others, had so failed to heal the sad disconnection between our common tissue. But what is left of my feelings for my father himself, some eighteen years on from his death? I have much more compassion than anger towards him for his lifelong narcissism, his petty cruelties, his arrogance, and his depravity.  But can this amount to love? 

Mister Rogers was said to carry a note in his pocket that read: “You can love anyone if you know their story.” I could claim that I never really knew my father’s story. But I have pieced together as much as I need to have a strong sense of him as a deeply troubled man—one who could never face up to the hurts he had inflicted on his wives and children—and who knows how many others. 

Despite his abandoning me twice without a word, I know that deep down he wanted to have me in his life – to share times of fun and whoopee, of good food and drink, and of deep and often metaphysical dialogue. For my part, I can feel not only affection but also awe towards him for all his skills and accomplishments as a multifaceted artist as well as a medical scientist. Would C.S. Lewis have recognized such feelings as love? The Greek word, storge, fits for me, meaning the two-way affection between parents and offspring.  . 

But how did I avoid most of the pitfalls that ensnared Dick, devastating his own life and threatening to do the same to all those he professed to love? I know almost nothing about his early life and upbringing, so I can’t begin to judge how far they molded his personality and his moral values. I do know that it took me until I was thirty-six — a university professor, twelve years out from medical school, and the father of two adopted children who had just ended his first marriage — to recognize my own deep-seated emotional trauma. Trauma, I came to recognize, that was born primarily out of Dick’s abandonment and Mummy’s early death. It took two years of skilled and intensive psychotherapy for me to begin to feel the kind of lasting joy and purpose that has sustained me in my life ever since. 

To the best of my knowledge Dick never acknowledged the need for any kind of psychological help, but trans-generational trauma is now a widely accepted entity. Is there perhaps a parallel between my family history and the recent revelations of clinical psychologist Mary Trump, the niece of the former President? Dr. Trump has diagnosed her Uncle Donald as suffering from malignant narcissism and a profound lack of empathy, which she attributes to the ruthless code of his “high-functioning psychopath” of a father. 

The hardest question to reflect on is this: what of Dick’s fleshless ash lives on in me? I too have had a lifelong desire for knowledge and a strong creative streak (I pushed myself against the odds to rise high in my profession as a medical researcher, then late in my career came to champion the arts over the medical sciences). I too am an extrovert, sometimes to the point of eccentricity (I used to run regular “play shops” for medical students and peers where we all dressed in silly costumes and played children’s party games). I too can admit to a potent sexuality expressing itself in a lifelong hunger for intimacy and gratification (more than fulfilled in my marriage to Dorothy after a lifetime of searching). 

Dick said to me on his eightieth birthday: “The biggest mistake I made in my life was to fail profoundly in my marriage to your mother.” He followed this up soon after by writing in his memoir that “she was kindly and compassionate toward all with whom she came in contact … greatly loved, I would say revered … a wonderful wife and mother.”  So whenever I feel anger toward my father for the largely self-inflicted screw-up he made of his life, these two affirmations — too little too late though they may be — free in me feelings for him that are as closely akin to love as I know how.

John Graham-Pole, M.D., is a retired professor of pediatrics and the co-founder of the Center for Arts in Medicine at the University of Florida. An author of numerous books, he lives in Nova Scotia, Canada with his wife Dorothy Lander.