“. . . for the secret of the care of the patient is in caring for the patient.”


Her saphenous varices were—by her own description—the size of mice. Absent her complaints, they might have been asymptomatic. Every workday morning, my mother held the bicycle for my father—who had permanent disability from a military airplane crash after the Great War—so he could mount it and be given a push to pedal to work at the air base.

She also held the bike for me at many times in my life. When, briefly, I had no shoes, she borrowed the shoemaker's pair so I would not miss school. She patched clothes, unraveled seams from outdated military uniforms to make school clothes, darned socks, and got me ready for school, encouraging my education—but I never had heard her sing. When she thought I might be dying of typhus, upon my request, she sang to me. That was the only time, and for good reason. She could not carry a tune. But she could hold and push the bicycle! Education, above all else.

At age 19, I escaped from the Communist retaliation that had followed a briefly successful uprising. Ultimately I became a citizen, a cardiac surgeon, and a clinical professor in the United States. This put me in position to make my bike-holder's life comfortable at her home. She did not wish to part with her homestead, family, and friends by coming to America.

The comfort that I envisioned for her was not her idea of comfort. Money and personal items, especially her favorite (compression hose), she habitually distributed to family and friends. It pleased her.

As my father declined into senility—“Son, what do you do for a living?”—she made sure that his tasks remained on course. “Did you feed the rabbits? The chickens?” In the mid-1990s, after the fall of Soviet Communism, I accepted an offer to establish heart surgery at one of the medical schools in my native country. That was when I realized how much more valuable that professorship was, in my mother's eyes, than anything I had achieved before. Visible, touchable—as opposed to remote, even abstract. She attended my inaugural open lecture. In good American custom, I recognized her presence publicly. Mother beamed in her 90-plus-year-old body. Her son had arrived!

Driving home from a European Association for Cardio-Thoracic Surgery annual meeting, a colleague and I stopped at her house for a brief visit and the mandatory cookies and espresso. The next day, she had a stroke. The local hospital was a teaching institution of my medical school. As the mother of the “Lord Professor” (Herr Professor), she was hovered over by the staff. Visiting her was painful for me, because she was aphasic and hemiplegic. The outlook on the quality of her life was bleak. A “do not resuscitate” order appeared reasonable to me, but not to the nursing staff. Culturally, it was barely acceptable. Her venous disease resolved the issue in a couple of days. She died suddenly and with her dignity preserved, from a pulmonary embolus.

She had helped me onto the bicycle and had given me momentum. The rest of the pedaling was for me to do.