Letting Go

I have known Marie since I began working at my clinic few years ago. Marie always stood out against the backdrop of the clinic. She looked much younger than her 70 years, jauntily walking on her thin heels, dressed with Parisian chic, her hair in perfect order, her nails impeccable, holding an ever-present thin cigarette. You couldn’t miss her. Marie always had a joke or a funny anecdote to share with me. I was always happy to see her in the midst of a busy day.

One morning, my colleague came into my room, noticeably shaken. “Marie’s blood pressure is 240/120 and she is suffering from headaches. She refuses to go to the emergency room despite all of my explanations of the possible dangers of such high blood pressure. Maybe you can convince her?”

I joined her in the nurse’s office. Marie awaited us with her usual elegance. I didn’t manage to change her mind. “Don’t worry about me. I’m fine. I am not going to any emergency room,” she took her purse and promptly got up to leave for home.

“I want to see you tomorrow,” I managed to say before she left.

The following day Marie returned to my office, her blood pressure skyrocketing again, and again refused to go to the ER. “If you knew my story, you would understand,” she said. I asked her to return the next day for a follow-up but she didn’t come.

Two weeks later, Marie returned. She came into my office and before sitting down she asked me not to check her blood pressure. I agreed. It was clear to me that I should check her once again considering her previous readings, yet I also knew that if I attempted to do so or said anything at all about her blood pressure I would lose her completely.

She removed from her purse a faded picture of a young happy couple. “This is Roger, my first husband,” Marie began. Marie’s parents did not approve of this young man, particularly because he was not Jewish. Despite the lack of family support, Marie decided to pursue her heart’s wish and married her beloved. Her family immigrated to Israel and the couple’s relationship with them remained distant. They shared a comfortable and pleasant life and had two children. After Roger’s sudden death, his family severed all relations with the young widow.

Marie was left with two young children and no means of support; she joined her family in Israel. Marie’s resourcefulness and skills saved her from falling into the abyss. She learned the language quickly, found work, and after a short while met Joseph. Joseph was not a successful provider and Marie had to care for everything. Using her wisdom and her charm, she was eventually able to purchase a home for her family. A few years later, Marie asked for a divorce. Her husband, in turn, demanded the house Marie had worked so hard to provide as part of the divorce agreement. After the divorce she refused to completely leave the house, remaining in a small shack in the garden. The years passed, the children grew and she remained in the small hut outside her home.

“You see, doctor,” Marie continued, “every morning I wake up and see the beautiful house I bought, in which my ex-husband lives, while I live in this shack…I appreciate that you didn’t check my blood pressure today, but I think now you can understand why my blood pressure acts the way it does.” She abruptly stood up and left the room.

My mind spun with thoughts. I never knew that such a tragedy lay behind Marie’s smile. I was left with so many unanswered questions. Why did Marie forego the freedom she held so dear? What was in the house that she could not leave it? And how did all of this relate to her blood pressure?

I thought long and hard about Marie, for whom I had developed a true affection over the years. Her story continued to trouble me. It made me think of various decisions each one of us makes in life, and how these may have such significant consequences on the course of our lives. It was hard for me to accept Marie’s choices, which were so different from what I might choose had I been in her place. Yet I realized I could not change her mind no matter what I said. She was of completely sound mind, and knew the risks.

I thought of how Marie could not let go of her past and her home. I thought of how hard it is for me to let go of my measuring tools, my medical agenda, and how hard it was for me to let Marie set up the rules and lead the encounter in her own pace, despite all that I’d been taught about respecting patients’ rights. It clarified for me that the ability to let go is indeed a great strength.

Marie taught me to accept my patients’ choices when they were different from mine and to respect them. I realized that Marie’s clear will helped me to overcome my own fears of what might happen to her. I had no idea why Marie didn’t want me to check her blood pressure, but when I let go of this issue, I was able to be there for Marie and to meet the old powerful Marie who once could overcome any trouble.

Marie continued visiting me. During her subsequent visits to the clinic, I continued to not check her blood pressure, while she continued to share her stories with me. I didn’t get answers to all my questions, but I decided just to listen to her stories without judging. Then, she disappeared for a while. When she returned, she said “Doctor, I want you to check my blood pressure.”

It measured 140/80.