LEGS IN MOTION | Alexis Drutchas
What I remember most – the saccharine taste of Grandma Sophie's canned peaches and how her
knees creaked like rusted hinges when she knelt in her garden. Even in my earliest memories,
rheumatoid arthritis had already annexed her knees, triggering pain and limited mobility. As far
back as I can remember, she treated this affliction with bee stings, an old country remedy from
Lithuania. Honeybees arrived in jam jars with holes punched in the metal lids. If I close my eyes,
I can see the bees wriggling between tweezers as she plunged their stingers into her inflamed
joints. As a child, I was unaware that honeybees usually die after they sting. "Hold still now,"
Grandpa Tony said tenderly once Sophie could no longer render a pincer grasp. I'm still unsure if
he was talking to her or the bees.
Sophie, my father's mother, and her husband Tony, the only grandfather I ever knew, lived down
a washboard gravel road on a homestead in Howell, Michigan, about an hour outside of Detroit.
They grew all their food and wasted nothing, a throwback to childhoods that spanned the Great
Depression. Early on, this self-reliance symbolized their vigor and independence. Massive pink
peonies and grapevine trestles lined the driveway. Their backyard overflowed with fruit trees,
vegetables, and berry bushes.
Every fall, Grandma Sophie canned their harvest and stored it in a root cellar, which hid under the
basement stairs behind a timeworn door. Even as kids, my siblings and I had to crouch to enter,
adding to its enchantment. Behind the door, dank, cobwebbed shelves stored hundreds of labeled
jars filled with everything from raspberry jam to stewed tomatoes. No visit would be complete
without rummaging through these shelves. I wiped each lid off, hunting for last year's peaches
soaking in sugary syrup. These were our family heirloom. Even now, I can taste the sweet pulp
melting the second the peaches touch my mouth.
My nostalgia for this stretch of time is fierce with movement – Grandma Sophie flipping
pancakes, blueberry picking together, and walking to nearby Thompson Pond to fish after digging
up worms in the compost pile. The expansiveness of these memories is inverse to the time they
occupied, though, because the truth is, I only knew my grandma during her distinct chapter of old
age, which was a timescape that quickly calcified. Her pain worsened, her mobility diminished,
and eventually, Sophie's mind succumbed to dementia.
When I look back on the time between Sophie's growing frailty and the end of her life, I'm
acutely aware of my obliviousness. I remember Sophie sitting next to me, thumbing through
shoeboxes of sepia photos from Lithuania. I can still sense how she craved my curiosity, wanting
nothing more than to tell me stories about her life. But instead of showing up with warmth, even
briefly, I only recall my restlessness.
It is difficult for me not to be critical of this, especially now with the eyes of a palliative care
physician. As Sophie began to repeat herself in cycles of memory and make-believe, I remember
feeling bored. My presence felt like a familial obligation; the bee forced to collect pollen rather
than experience any joy in the choice. I've tried to absolve myself by blaming youth's naivety.
I wasn't deliberately negligent or unloving, but hindsight's forgiveness only gets me so far. I hold
onto my regret like a transgression without atonement. There are things we never got to say.
Questions I never got to ask. Was she proud of me? What did she hope I would become?
In the early 2000s, when I started medical school in Detroit, Grandma Sophie entered her nineties
and became homebound. Beyond pathophysiology and pharmacology, the first-year medical
school curriculum centered on how to take a patient's history. To this day, I still remember details
about some of my patient's lives. A young college student diagnosed with HIV, a man dying of
pancreatic cancer, and a woman with life-threatening asthma. My sole job was to understand their
stories. My evaluation ultimately depended on how much I listened and paid attention.
Sitting with patients opened the door for me to grasp the fundamental need we all have to be seen
and affirmed, especially when faced with serious illness. I learned how much this attending
matters – how presence is a form of honoring. It wasn't until I understood this lesson that I longed
for a relationship with Sophie. I wondered – do I know my patients better than my grandma? But
by then, it was too late. Sophie's mind drowned in neurons with no connection.
In early 2009, I got the call that Grandma Sophie died in a hospital bed in her living room while I
was studying one night at school. The concrete walls closed in on me. My brother Jake and I
drove to Howell together. When we arrived at her house, I robotically sat on the couch, my line of
sight in a daze. My aunts and uncles were there. An old home movie flickered on the living room
TV. I stared at the screen without any real focus as relatives asked if I was okay.
As the film played, images of people swimming caught my eye. One woman in the pool seemed
familiar. She had long blonde hair and wore a baby-blue ruffled swimsuit. She laughed
generously and exuded joy. I was absorbed with her delight. Minutes passed before I realized that
this woman was Grandma Sophie. But this woman was free. She was jubilant, treading water
without care. She called out to the person recording, and although I couldn't hear what she said, I
didn't care. My eyes were fixated on her legs, moving with the ease of waves hitting the shore.
Like observing the shoreline through dawn's thick fog, my grandma's memory is hazy now. I
recall a few specifics – the vibrato of her voice, how her hands looked as she filled mason jars
while canning, and her movements as she shuffled through the garden. But beyond superficiality,
I never knew my grandma in the way I wish I had. I imagine I'm not alone in this sentiment, but
commonality doesn't lessen my regret.
Not too long after Sophie died, my grandpa Tony passed away, too. Their homestead went on the
market, and eventually, an army veteran bought it. One evening before the closing, I went with
my dad to look around. There was nothing in particular I could find to remember Sophie by. She
had no favorite jewelry or sweater. No prized piece of furniture. I could not bottle up the smell of
the root cellar. The canned peaches were all gone. I had a pair of medical shears from her days as
a nurse and some photos, but that's it. The ache of my earlier disregard struck me. I sat in silence
the whole way home.
Months later, as grief settled in, I started to panic about the fact that I did not have a keepsake of
Grandma Sophie's. I called my brother Jake, and on a whim, we drove to Howell to see if the new
owner would let us dig up one of the blueberry bushes. We knocked. A man whose arms were as
wide as my thighs opened the door a crack. "Can I help you?" he asked brusquely.
"Um…our grandparents used to live here…we know this land is yours now, but is there any way
we can take one of their blueberry bushes?" Our words burst out in one long, pleading breath.
The man looked shocked but conceded. What other option did he have with two desperate
grandkids on his stoop? We dug at the dry dirt with shovels, then dropped to the ground to
untangle the roots. Back home, we scrutinized our parents' lawn to find the perfect sunny spot and
settled on a patch of dirt next to the front door.
It's been fifteen years since my grandma Sophie died, and we relocated that blueberry bush. In
this expanse, I graduated from medical school, became a primary care physician, and eventually
trained and now work in palliative care. I wish I could tell you a beautiful story about the
abundance of that rogue blueberry bush now. But the truth is, my parents sold my childhood
home only a few years later, and the new owners re-landscaped.
Nevertheless, there is symbolism in all of this that hasn't left me, a lesson made only more
apparent by my work and my own family's health crisis – in illness, we all want to be seen as we
lived. Acknowledged for the bodies and minds that worked, created, loved, sweat, delighted,
suffered, and triumphed. The vibrant homestead, not the failing mind. The delicious blueberries,
not the turned-over soil. Sometimes, it takes a home movie to jolt us awake. Sometimes, it's in
our attending and listening that we begin to really see.
When I care for patients now on the inpatient palliative care service where I work in Boston, I'm
captivated by the pictures that often sit at their bedsides. My patients' photos, like the ones
Grandma Sophie wanted to show me, are a universal representative of personhood. Each photo
asks – do you see who I am. Each photo replies – this is what illness has taken. The gravity of
being seen, for all we are and all we have been, cannot be understated.
Not too long after I began my second medical career in palliative care, my wife, Holly, and I
decided to hike Mt. Katahdin, one of Maine's highest peaks looming at the Appalachian Trail's
northern edge. It was late September, and the fall colors were just turning. We headed north from
Boston, staying in cabins and campgrounds. The day of, we woke at four in the morning to secure
a coveted parking spot and were on the trail hours later.
I expected the hike to be challenging, but it was grueling. After a few hours, we emerged above
the tree line, and the path turned to a rock scramble that dropped on either side. Rocks careened
hundreds of feet down as I shifted my legs to find footing. Iron rungs jutted from boulders to
provide hand holds. While I usually love to hike, I'm terrified of heights, and this one made me
freeze in place. Determined not to summit alone, Holly coached me as the path steepened. "Push
up on your left leg. Good! Now, grab the bar with your right hand," she instructed calmly through
the wind.
As we drew closer to the summit, the mountain turned into a plateau called Tabletop before
precipitously sloping to the peak. When we reached this section, it was clear we would make it. I
remember that the sky was cerulean blue and cloudless. Sunlight flickered off the surrounding
lakes that dappled the landscape below.
Despite the splendor, or maybe because delight can sometimes feel too lucky to hold in its
fullness, my mind wandered to one of my patients, who at exactly my age and had died the week
before. Memories of those I had cared for flooded me, and I realized I was around the same age
my grandma Sophie was in the video of her swimming and kicking with glee. Just like her, I was
so alive, so alive I didn't even have to think about being alive.
I stopped in my tracks, breathless. Tears welled in my eyes. "Holly!" I called out. "Yes?" she said
through the drifts of wind.
"Remember me like this, always?" She paused, turned around, and looked directly into my eyes.
"Of course I will," she said.
"Promise you'll do the same for me?" she called back.
"I promise," I said.
Holly then reached out to hold my hand, and we made our way to the top.
Alexis Drutchas, MD, is a palliative care physician at Massachusetts General Hospital and an Assistant Professor of Medicine at Harvard Medical School. She trained in Family Medicine at Brown University and worked as a Primary Care Physician at Fenway Health, a nationally recognized LGBQT+ health center. Drutchas, who was a 2021 OpEd Public Voices Fellow, went on to complete the Harvard Palliative Care Fellowship and remained a core faculty member at MGH thereafter. Her work has been featured in The New England Journal of Medicine, NBC, CNN and Health Affairs, among others. Drutchas, who lives in Boston with her wife and son, co-founded The Palliative Story Exchange in 2020, building community and fostering shared meaning for clinicians through storytelling and reflection.