Wednesday, January 19, 2011

Goodbye, from Poland

“No more medicine, no more surgery,” said Mr. Orlat. “All I want to do is go back to Poland.” These were his last words.
Six months earlier, Maslo Orlat stepped off an airplane at Kennedy airport, got into a taxi, and was dropped off in the small Polish community in Manhattan’s East Village. The next day, he woke up at a friend’s house, bought a cup of coffee, smoked a cigarette, and joined a group of men, many from the same city in Poland where he was from, and worked a 12-hour day at a construction site. His plan was to earn enough money to help his struggling family in Poland and return to them.
I first met Mr. Orlat 2 months after he arrived in New York; I was 1 week into my internship. He came to our emergency department complaining of progressive shortness of breath. His only other complaint was fatigue, which Mr. Orlat contributed to the long hours spent at work; otherwise, nothing seemed unusual.
Mr. Orlat did not return to work, nor did he ever go back to Poland.
He was admitted to the hospital and diagnosed with advanced lung cancer. He spent the next 2 months in the same uncomfortable hospital bed, eating the same bland hospital food. His health did not improve. Occasionally, he spoke with his wife and son, who remained in Poland. They all agreed he should fly home to receive his medical treatment. His wife sent him a plane ticket.
On the same day as his scheduled flight departed, Mr. Orlat arrived in the medical ICU. We meet again. This time he is in respiratory distress. The cancer worsened, his lungs filled with fluid, pneumonia developed, and his mental status deteriorated. I remember standing over him, looking down while I was at the head of the bed. His eyes glassy, lids sluggishly blinking. I wondered if he remembered me from the day he first walked into the hospital. I intubated Mr. Orlat. He was the first patient I ever intubated. We contacted his wife, Anna, and told her the bad news. Her husband had only a few more days to live and she should come to New York to say good-bye.
Anna waited in line all day at the American consulate’s office in Krakow for a visa but was denied. She frantically called the hospital asking for assistance. Her message was relayed to the staff of the medical ICU. We wrote multiple letters and faxed them to the consulate’s office, explaining the dire situation of Mr. Orlat. A social worker called the consulate and demanded leniency. Mrs. Orlat returned to the office in Krakow the next day only to be denied again.
Mr. Orlat died in New York that same day.
We contacted Anna and notified her of her husband’s death. She was silent, and then in her broken English told me to “tell Maslo I say, goodbye, from Poland.”
[Ann Emerg Med. 2007;50:617.]

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