My pager goes off. I call in and get a referral for a pre-surgery visit with a middle-aged woman. She is reported to be screaming in pain at the slightest touch. I'm told that she is severely underweight and her prognosis is serious and complex.
Entering the pre-surgical "holding area," I hear voices of moderate volume all around, which blur into a churning hum. Moving past one bed, I see a curtain, which opens just enough to glimpse a nurse standing several feet in front and to my left. Bedside with the referred patient, the nurse asks about her medical history.
Directly in front of me is an older woman. After introducing myself, she tells me, "I'm her mom" and appears relieved for my presence. Her face, which showed tension as I approached, now eases a bit. Seeing my badge, she says with enthusiasm and surprise, "a new friend of mine has the same name as you." We laugh. I ask her how she met her friend. She tells me they are in an "opera appreciation" class.
She adds, "the popular operas are easy but the other ones, you have to get into the story and the undertone to really appreciate them. It's not easy but it's worth it."
Just then, the nurse walks past me. I approach the patient's bed and introduce myself. She looks exhausted. Her eyes seem to have sunken into their sockets. She tells me that a few friends have sent her well wishes, yet her tone of voice suggests disappointment and hurt. I respond in a neutral tone, "a few..." and pause. She turns away for an instant then back to face me, and says with palpable, hushed rage, "yes."
We pause, eyes locking. Then she says, "look, I'm in pain. That's it." My eyes widen in recognition. I affirm, "yeah." She slowly nods her head up and down. She says, "I can't talk now." I say, "ok" and stand up. As I turn, her mother is looking towards me with a hollow expression that conveys helplessness, sorrow, and confusion. I meet the mother's gaze and move closer, approaching the edge of the curtain. I turn to face them both and say, "I was just thinking, the thing I love about opera is the passion, how when you listen, it feels like you get to scream."
Both women look at me with dismay, which quickly shifts to curious interest. The mother begins to smile as I continue, "Once I visited a woman in the hospital who was in intense pain. She says to me, 'I just want to scream but how can I, here?" I suggest, "how about a silent scream?" She asks with enthusiasm, 'how?' I say, 'Close your eyes.' She does. 'Now picture where you need to be when you scream.' Without hesitation, she says to me, "I know exactly where. In the middle of the street, tons of traffic. But when I go there, everything stops.' I affirm, "Ok, now slowly open your eyes." She does and looks directly at me."
I pause. Mother and daughter are looking right at me with the same fierce determination as the woman standing in the midst of traffic. I continue, "As she opens her eyes, this is what I do." Without a sound, I close my eyes and tighten every muscle in my face. Then, I open my mouth as wide as possible and my whole face shakes with intense release.
Slowly, I open my eyes. Both women's eyes are open wide and locked on to me. Their mouths are hanging open. I notice the subtle nuances in each woman's quietly fierce gaze. In the bed, I see the patient's head moving up and down with an understated while powerfully enunciated vibrancy. My whole body hears her.
"YES!"
I stand still. After a few silent breaths, the mother says softly, "thank you." I nod to acknowledge this, then turn to go.
