During my year as a surgical intern, the only work hour restrictions were the limits of human endurance—the 168-h week. It was hard. Your view of reality, of yourself, of others and the world around you became fundamentally altered when the alarm was set for 3:45 am and you began seeing patients before the sun came up. What day was it? What season were we in? None of those designations mattered as much as which rotation it was—hepatobiliary month, followed by cardiac, and then the intensive care unit. In a real sense, it was an internment…a forced (yet voluntary) removal from society at large and indoctrination into the virtual medical hermitage that we all join. Amidst the bile leaking around nasogastric tubes, attempted sutures anchoring a drain in an ascitic abdomen, and the neverending diabetic dressing changes on nonhealing wounds, there was one woman who remained a steadfast beacon of humanity and compassion, even as the meaning of those words escaped my immediate grasp. The Cookie Lady.
It was innocuous enough when it began. On days when I had time for lunch in the cafeteria, I would swing by the bakery cart by the large plate glass windows overlooking the river—often my only glimpse of the outer world during a frenzied day shuttling between floor patients, the operating room, radiology, and the emergency room. The Cookie Lady would be there and hand me one chocolate chip cookie for normal days, two cookies if I was on call. She was kind and warm, always making sure I was doing okay. She never charged me a cent. Some days, there was no time for meals in the cafeteria, and I would swill an unopened Boost from a patient tray in the dirty utility closet. The first few times, I would pour it over ice because the taste was chalky and horrendous. I graduated to drinking warm Boost from the can when I had no time for the upscale niceties of ice in a glass. I missed the Cookie Lady dearly on those days, as Boost fills neither the perceptual void of a chocolate chip cookie, nor the smile and kind words from my friend.
Over the year, by virtue of being herself, the Cookie Lady reminded me that the power of humanity may be as strong or even stronger than the treatments that we offered our patients. I think because of her I took a few minutes and sat beside one of my patients and tried to spoon a few extra ounces of thickened liquids into her mouth. She was old, spoke not a word of English, and had had multiple small bowel resections for cancer. Between her nausea and ileal edema and her weariness with the world she was no longer interested in eating anything. I tried and kept trying every meal to have her take another mouthful to get the calories she needed to heal. She refused to eat herself, but when I fed her, she would relent. She did not get better, but maybe I made her feel better. I hope I did.
I thought of the Cookie Lady when I saw a plastic wine glass in the gift shop. One of our endocrine patients, a famous gourmand, was recovering slowly from her thyroidectomy and neck dissection. The nurses and I looked the other way when her family brought her the nightly Grand Cru that she was accustomed to, but it pained her to drink that wine from a paper cup. Her eyes glowed more brightly than I could imagine with the small gift of the stemware I brought her that evening. She explained to me why these grapes were useful for convalescence; acidity, humidity, so many details that I did not have time for but listened and smiled. I learned about the gourmand’s passing weeks later, and I silently thanked the Cookie Lady in my heart, for it was her kindness towards me that had prompted mine towards the gourmand.
It saddens me that as she was alive, I never knew the Cookie Lady’s name. She played a vital role in my welfare during that gauntlet of a first year. Without her, I fear that I may not have completed the year at all. She kept me grounded and remained a beacon of light and warmth. I saw the plaque on the wall when I visited that hospital recently. The Cookie Lady had passed on, after a long career in the cafeteria. Not written below the photograph was her impact on my training and my overall being. Thank you, Cookie Lady, for who you were, for the kindness you showed me, and who you reminded me to become.