An artist, Ruth, lives with quadriplegia and manages to drive (and dance) with a special wheelchair that she controls with her chin. She also enjoys terrorizing doctors in the hospital corridors, where she is seen on a regular basis because of frequent bouts of infected bedsores. She has a new computer and is “patiently waiting for” a biomedical engineer to set it up to manage, like her chair, with her chin. She wants to write, to draw, to create. But the wait list is long, technicians scarce, and every candidate deserving.

On one of her admissions, Ruth meets the physician-narrator who is appalled by a medical resident’s lack of empathy in relating her case as if she were not present. Distressed by the encounter, the doctor is all the more disturbed when he notices that Ruth’s birth date is the same as his own.

He tries to make it up to her by withdrawing from her care in order to be her “friend,” one who tries to understand and will defend her strong desire to live despite her disability. Driven by curiosity about her past, her sharp wit, and how she faces each day, the doctor never quite achieves his goal and constantly feels guilty for letting her down as an advocate and a friend, and possibly also for being able-bodied himself.  He never visited her in her group home, and when she comes to hospital in florid sepsis, he is unable to prevent his colleagues from letting nature take its course. His own bout with severe illness, possibly MS—more likely a stroke--resonates with Ruth’s plight. Long after her death, he can imagine the acid remarks that she would make about his foibles.


A work of fiction based on true events, this book fulfills a promise made to Ruth (not her true name) 15 years earlier.  It expands on the play Calcedonies also in this database.

Told in first person through two voices – Ruth’s and the doctor’s—this essay introduces a feisty, creative woman, capable of love and cruelty, caught in her plight of disability and the social shame of health care cutbacks and inequities. The doctor’s admiration for her is matched by the intimidation that he feels when subjected to her outrageous verbal pranks. He conducts a thought experiment through narrative to recreate her voice, her past and her views of “professional caregivers.” Nevertheless, he fails to fully grasp her situation. How can he? And in bringing her to grand rounds, or introducing her to his medical humanities students, he sets himself up for her relentless scorn. Ruth sees through the inadequacies and hypocrisy of these modalities even as she recognizes the sincerity of their motives.


Iguana Books

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