In My Pocket

“Quentin!”

I was recently in the barbershop and heard while having my hair cut.

I was holding my eyeglasses and couldn't clearly make out the woman who called my name.

“Yeah, that's him,” my barber, James, said, aware that I was visually challenged during my biweekly haircuts so that he could access every angle of my hairline.

“I thought that was you. I knew you when you were an intern. At Northwestern Memorial Hospital.”

“Oh, wow! Yes, great to see you.”

I couldn't place her by voice alone. We see so many patients on any given day in the hospital and intern year was almost five years prior. But I thought I must have met her as an admission to the inpatient general medicine service.

“I've seen you in here before. I know a lot about you. The last time I saw you here you were preparing for your wedding anniversary and expecting a baby,” she said.

That did ring a bell. Many months prior I laughed with James, along with a hairdresser and a patron who was getting her hair done, about my trials finding a gift for my wife for our anniversary that was just a week away. The barbershop and salon where I frequent is a community staple. We often laugh about sports, politics, and our lives. It is a welcomed oasis from the medical chatter of the hospital.

It amazed me, though, that she would remember such detail about our seemingly mundane encounter.

“You got married on July 9th.”

I squinted. How did she know all of this?

Perplexed, I reached in my pocket and put on my glasses, just long enough to make out the woman who knew so much about me. She was a black woman, hair wrapped in an orange towel like a crown toward the sky. I knew her. Not her personally that I could recall, but she was the type of patient with whom I would quickly form a family-like bond as one of the only black physicians she encountered.

“I've seen you a couple of times here over the last few years. The last time you were here I couldn't remember how I knew you until you said your anniversary date, July 9th.”

My barber, looking bewildered, quipped “Oh, you're the police,” referencing her almost investigative knowledge of our history.

“No, I'm not the police, I just know him,” she said, standing up and making her way toward me.

She waltzed over, whispering over my shoulder,

“You took care of my husband in the ICU just before he died from lung cancer in 2015. He died on July 9th.”

July 9th.

That was it! The memories rushed back as if I were there, five years prior, at their bedside.

He was my first patient as an intern just days after starting in the medical intensive care unit. He had metastatic lung cancer. A white mixture of fluid and atelectasis had overtaken the once black aerated lung on his chest X-ray. He was placed on a noninvasive ventilatory strategy on admission and, even with broad-spectrum antibiotics and aggressive pulmonary hygiene, progress was at a stand-still. He had made it clear that he did not want to be intubated. But each day that passed his cancer progressed and his breathing worsened.

We spent hours at the family's bedside, his wife and I discussing as her husband drifted in and out of consciousness. They had been together since the age of 17. She could not imagine her life without him.

As the hours turned to days, we all relinquished hope that he might come off of bilevel positive airway pressure (BiPAP). That she might one day again be cheek to cheek with her soul mate without the mechanical whir helping to stent his airways open.

By day eight, we made the decision to palliatively remove the machine and focus on comfort measures alone, my first of such a transition as a doctor. Was I saying the right things, conveying the right emotions? My heart fluttered with a mix of adrenaline and sadness.

In his final hours, I remember family at the bedside. As we closed the curtain, giving them their much-needed privacy, I caught one last glimpse of our patient's wife. We made eye contact and she sent a gentle smile—one of understanding and peace. In that moment we both knew everything would be okay.

Now, back at the barbershop, in a space so alive, we met again—the whir of hair dryers in the background.

Her husband passed away exactly one year before my wedding. It was no wonder she remembered with such certainty.

I was reminded of how, in medicine, we jump from moment to moment, family to family. We give our all with each encounter but can carry only pieces with us if we are to be effective. But for the families, those moments are often etched in memory years and decades into the future.

I finished my haircut.

“I keep his death certificate in my pocket. The same place it has been for the last 5 years,” she said.

As I gathered my coat to leave, she grabbed me, and we embraced.

“Look here,” she pointed to the bottom of the certificate.

There, in black and white, was my name “Quentin R. Youmans, MD,” under “Certifier.”

In her pocket, that memory had lived for five years…and would live for years to come.