In 1986 I opened a family practice office, eager to care for patients. So I was excited when I got a call from a surgeon referring a patient to me at a local nursing home. He told me the patient was very ornery and had multi-system failure. He had a tube draining from a liver abscess, as well as a nasal-gastric feeding tube-a tube up his nose and into his stomach. He had refused further surgery and was being sent to the nursing home for comfort care only. The surgeon thought he would live only a short time. Arthur had just celebrated his 77th birthday.

I went to meet this curmudgeon. He told me in no uncertain terms that he was not going to have anyone do anything further to or for him. I sat down to talk to him. I was young and naive and thought I could talk some sense into him. Well, by the end of our talk I had agreed to every demand he made. Even though I believed he would not live very long, I still believed he had every right to live his remaining days as he wished.

The next day I got a telephone call informing me that he had removed his drainage tube. I rushed in to see him, thinking the worst. There he was, sitting quietly in his bed waiting for me. He was not as angry a man as I originally thought. He told me he just was tired of the tube sticking out his abdomen. I told him we really should have the surgeon see him and check for any damage. I reminded him that the tube was supposed to be surgically removed. He told me it had been surgically removed. "I reached down and surgically pulled the damn thing out," he said. I turned away from him so that he would not see me smile. I asked him, "What the hell were you thinking?"

He said, "I don't know what I was thinking then, but I'll tell you what I'm thinking now. You pull this tube out of my nose and let me eat, or I'll surgically remove it as well."

I removed the tube. I thought for sure that he would not be able to eat. Wrong again. He ate like there was no tomorrow. At first he refused to go to physical therapy. He said he didn't need it. I asked him if he thought he would ever get out of bed or leave the nursing home. He told me he planned to do just that. I told him if that was ever going to happen he'd need physical therapy. I was starting to believe in him.

He went to physical therapy and got stronger. I told him at the rate he was improving, the nurse would hold the front door of the nursing home open while I kicked his butt through it. He said I would have to catch him first.

The nurses informed me that on the days he did not have physical therapy he did his exercises when he thought nobody was looking. Four weeks later, he walked out on his own power. I called him "My Miracle Man."

He came to my office several times a year for his medical care. Over the years he suffered a few minor setbacks, but I tried and ultimately succeeded in stopping several of his medications. I had him consult with the surgeon who had written him off years before. Eventually, everyone referred to him as "Our Miracle Man."

The rough exterior soon revealed the gentle man within. Don't get me wrong-he was also opinionated, stubborn, self-assured and proud of it. He always walked in the office with a serious look. But once I got in the examining room, the hard features of his face would give way to a smile and a twinkle in his eye.

By 1998 it was evident that his health was starting to fail. I was not going to bet against him-others had already made that mistake. He still refused any procedure, but accepted medication. We both enjoyed his visits.

"My Miracle Man" died on March 3, 2001, just about 4 months short of his 92nd birthday. He left this world on his own terms, in his own home, in his own bed, surrounded by those who loved and admired him.

Dedicated to Arthur, "My Miracle Man," 1909-2001

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