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Posted by Ronald M Allen on May 5, 2011

Apple Tree

During a visit with Jacobo one spring, he appeared tired and depressed. After an hour of conversation, however, he was en-livened, and I felt reassured that all was well. Several weeks passed and I didn’t hear from him; I called but got no answer. I persisted, and a weakened voice finally answered the phone: “Mi amigo, no estoy bien. I am not well,” he told me. I was alarmed and insisted, “Jacobo, I must see you soon!” The next day Jacobo came to my office, unable to walk, with an aide pushing him in a wheelchair. The color was drained from his skin, and he appeared gaunt and exhausted. We barely spoke as I beheld his image. The timelessness of our friendship had suddenly hit the reality of aging, and I knew he was dying. At that moment my friend became my patient, and I quickly made arrangements for Jacobo to go straight into the hospital. Within two weeks Jacobo was gone, drifting off to eternal sleep one morning as his liver shut down from an unknown malignancy. It was a startling departure to me, as I had previously tried to deny that, despite our close friendship, Jacobo’s eighty-five years always meant that death was not far off.

And so it was with our friendship, a refuge of time we spent together that was unknowingly and perilously a little way away from the end. Jacobo knew this better than I did. He was an incredibly spiritual man who believed with certainty that God created the world and that it was logic, not just emotion or spirit, that could bring this understanding. But when he once spoke of death to me, it was not logic but pure poetry: “When I die,” he offered with a mischievous smile, “perhaps I will be buried close to an apple tree, and I will reach out and pluck a fruit from the branch.” I looked at him and chuckled, then reassured us both that there were no trees in the near future. But the image remained in me—this gleaming apple, the symbol of all the worldly knowledge that Jacobo so eagerly sought.

As much as I agree wholeheartedly with Montgomery, I must confess what I, and many of my colleagues, have learned: Sometimes older patients become friends and older friends become patients, either way driven by the nearness of death, which eventually comes, often stealthily, and fells another soul from our practice. We are left as the final witnesses to a life long lived, once full of dreams and memories planted lovingly in this world. This is a special honor, one that grows with time if we are able to hold fast to it:

Beloved, gaze in thine own heart,
The holy tree is growing there;
From joy the holy branches start,
And all the trembling flowers they bear.

From “How We Age: A Doctor’s Journey Into The Heart of Growing Old” by Marc E. Agronin, M.D. Copyright © 2011. Reprinted by permission of Da Capo Lifelong Books.

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