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Dancing on Air


Maybe I should have moved faster. Mentally, I reviewed the research literature on tPA. I knew that people who received the drug less than two hours after their first stroke symptoms had an excellent chance of recovery. Full recovery, however, is measured not in hours or days but in months—three months, in fact. Still, many patients never recover, even with tPA.

Then I heard myself say something that was utterly at odds with the pessimistic rumblings in my mind. I don't know where the words came from; it was almost as if some other person, or force, was speaking through my lips. "Mark my words, Irene," I said, my voice strong and confident. "You will get much, much better in time. I predict that within three months, you will do the polka with me in my office."

She looked at me silently. What was she thinking? That maybe I was right? That I was full of it? That I'd misled her and she'd never trust me again? From her inscrutable expression, there was no way to tell.

That afternoon, Irene was taken by ambulance to a nearby rehabilitation hospital to convalesce. Weeks went by and I busied myself with other patients. I hadn't heard from her for almost a month when I noticed that she was on my schedule for an office visit. I had no idea how she was doing, though I'd thought of her often with a mixture of affection and concern.

When Irene showed up for her appointment, it was all I could do not to drop my jaw. Since it normally takes about three months to recover fully from a stroke, I had fully expected her to arrive in a wheelchair, or at least supported by a walker. Instead, she sauntered in on her own two feet, a cane dangling from her right arm. She walked right up and gave me a kiss on the cheek, then reached her arms around me for a long, warm hug.

"Now see here, Doctor," she said. "I

Since it normally takes three months to recover fully from a stroke, I had fully expected Irene to arrive for her followup appointment in a wheelchair, or at least with a walker. But she sauntered in on her own two feet, a cane dangling from her right arm.

brought you some freshly baked oatmeal raisin cookies, and I want you to promise me you'll eat them." Beaming, she fished a brown bag out of her purse and handed it to me.

How did she know they were my favorite? Thanking her, I put the bag on my desk and took a good look at her. Irene's face was radiant and no longer drooping at all. "So tell me, Mrs. Polosky, how are you?" I asked with a broad smile.

"I'm just wonderful, Dr. Castaldo," she chirped, "thanks to you."

Then, before I could stop her, Irene put down her cane and purse, stretched her hands toward the ceiling, fingers dancing, and executed a full pirouette on her tiptoes. "Just look how fine I am!" she exclaimed, clearly proud of herself.

Her exam was completely normal. Search though I did, I could find no hint of weakness or visual loss. Irene was in excellent shape for her age—her limbs

strong, her speech distinct, her mind sharp.

"Come with me," I said, taking her hand. "I want everyone in the office to see you!" With that, I grabbed her two hands in mine and took her out into the reception area, where I led her in a spirited polka, loudly humming "Roll out the Barrel." Laughing in delight, Irene danced slowly but gracefully, never missing a step. As we sashayed cheek to cheek up and down the hall, I saw my colleagues peer out from exam-room doors, looking both amused and confused. But I didn't care what they thought. My heart was bursting. My patient was well and whole, and she and I were dancing on air.

It is common these days to talk about the importance of the "doctor-patient relationship." Usually, this relationship centers on the effort of both physician and patient to communicate clearly and honestly. But once in a while, in the course of working together, something more transpires between a doctor and a patient—something deeper, approaching communion.

We didn't know it at the time, but Irene and I offered each other the gift of faith when both of us needed it most. Her calm confidence in me during her life-threatening crisis gave me the courage I needed to proceed with an extremely high-risk treatment. I, in turn, offered Irene my own deep faith that she would recover fully, at a time when she was sunk in doubt and discouragement.

In medicine and healing, where does the role of technology end and the role of the spirit begin? What I know comes only from my own experience and convictions. As I treated Irene and came to know her, we offered each other the kind of faith that creates an upward spiral of strength and health. Recovery often depends on medicine or surgery, no question. But healing, I believe, also comes from deep wellsprings of hope, trust, and optimism. When the spirit dances, the body yearns to follow.


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The author of this story is a 1979 graduate of Dartmouth Medical School and also did his internship and residency at Dartmouth. He is now chief of the Division of Neurology and head of the Stroke Center at Lehigh Valley Hospital in Allentown, Pa. In addition, he does neuroscience research; is a professor of clinical medicine (neurology) at Penn State College of Medicine; and is a recipient of the American Heart Association's Cardiovascular/Neurovascular Care Award. The story here is excerpted with permission from The Man with the Iron Tattoo and Other True Tales of Uncommon Wisdom, by Drs. John E. Castaldo and Lawrence P. Levitt; it was published by BenBella Books in 2006.

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