Place: Los Angeles area emergency room.
Time: Various times over the past 18 years.
Scene: White male, around 50, brought in by ambulance, pale, short of breath, in distress.
Intern: You're going to be all right, sir. I'm replacing your fluids, and your blood studies and electrolytes should be back from the lab in just a few minutes.
Patient: Son, you wait for my electrolytes to come back and I'll be dead in 10 minutes. I ran the ICU here for 10 years. I'm pan-hypopit and in [circulatory] shock. I need 300 milligrams of hydrocortisone right now. In a bolus. RIGHT NOW. After that, I'll tell you what to run into my IV and what lab tests to run. Got it?
Intern: Yes, sir.
This scene played itself out at least a half-dozen times. The patient was my brother, Marcel. He'd call later to regale me with the whole play-by-play, punctuated with innumerable, incredulous can-you-believe-its. We laughed. I loved hearing that mixture of pride and defiance in his voice as he told me how he had yet again thought and talked his way past death.
Amazingly, he always got it right. True, he was a brilliant doctor, a professor of medicine at UCLA and a pulmonologist of unusual skill. But these diagnostic feats were performed lying flat on his back, near delirious and on the edge of circulatory collapse. Marcel instantly knew why. It was his cancer returning -- the rare tumor he'd been carrying since 1988 -- suddenly popping up in some new and life-threatening anatomical location. By the time he got to the ER and was looking up at the raw young intern, he'd figured out where it was and what to do.
Friends and colleagues knew this part of Marcel -- the headstrong cowboy -- far better than I did. We hadn't lived in the same city since he went off to medical school when I was 17. What I knew that they didn't, however, was the Marcel of before, the golden youth of our childhood together.
He was four years older and a magnificent athlete: good ballplayer, great sailor and the most elegant skier I'd ever seen. But he was generous with his gifts. He taught me most everything I ever learned about every sport I ever played. He taught me how to throw a football, hit a backhand, grip a 9-iron, field a grounder, dock a sailboat in a tailing wind.
He was even more generous still. Whenever I think back to my childhood friends -- Morgie, Fiedler, Klipper, the Beller boys -- I realize they were not my contemporaries but his. And when you're young, four years is a chasm. But everyone knew Marcel's rule: "Charlie plays." The corollary was understood: If Charlie doesn't play, Marcel doesn't play. I played. From the youngest age he taught me to go one-on-one with the big boys, a rare and priceless gift.
And how we played. Spring came late where we grew up in Canada, but every year our father would take us out of school early to have a full three months of summer at our little cottage in the seaside town of Long Beach, N.Y. For those three months of endless summer, Marcel and I were inseparable, vagabond brothers shuttling endlessly on our Schwinns from beach to beach, ballgame to ballgame. Day and night we played every sport ever invented, and some games, such as three-step stoopball and sidewalk spaldeen, we just made up ourselves. For a couple of summers we even wangled ourselves jobs teaching sailing at the splendidly named Treasure Island day camp nearby. It was paradise.
There is a black-and-white photograph of us, two boys alone. He's maybe 11, I'm 7. We're sitting on a jetty, those jutting piles of rock that little beach towns throw down at half-mile intervals to hold back the sea. In the photo, nothing but sand, sea and sky, the pure elements of our summers together. We are both thin as rails, tanned to blackness and dressed in our summer finest: bathing suits and buzz cuts. Marcel's left arm is draped around my neck with that effortless natural ease -- and touch of protectiveness -- that only older brothers know.
Whenever I look at that picture, I know what we were thinking at the moment it was taken: It will forever be thus. Ever brothers. Ever young. Ever summer.
My brother Marcel died on Tuesday, Jan. 17. It was winter. He was 59.
Scene: White male, around 50, brought in by ambulance, pale, short of breath, in distress.
Intern: You're going to be all right, sir. I'm replacing your fluids, and your blood studies and electrolytes should be back from the lab in just a few minutes.
Patient: Son, you wait for my electrolytes to come back and I'll be dead in 10 minutes. I ran the ICU here for 10 years. I'm pan-hypopit and in [circulatory] shock. I need 300 milligrams of hydrocortisone right now. In a bolus. RIGHT NOW. After that, I'll tell you what to run into my IV and what lab tests to run. Got it?
Intern: Yes, sir.
This scene played itself out at least a half-dozen times. The patient was my brother, Marcel. He'd call later to regale me with the whole play-by-play, punctuated with innumerable, incredulous can-you-believe-its. We laughed. I loved hearing that mixture of pride and defiance in his voice as he told me how he had yet again thought and talked his way past death.
Amazingly, he always got it right. True, he was a brilliant doctor, a professor of medicine at UCLA and a pulmonologist of unusual skill. But these diagnostic feats were performed lying flat on his back, near delirious and on the edge of circulatory collapse. Marcel instantly knew why. It was his cancer returning -- the rare tumor he'd been carrying since 1988 -- suddenly popping up in some new and life-threatening anatomical location. By the time he got to the ER and was looking up at the raw young intern, he'd figured out where it was and what to do.
Friends and colleagues knew this part of Marcel -- the headstrong cowboy -- far better than I did. We hadn't lived in the same city since he went off to medical school when I was 17. What I knew that they didn't, however, was the Marcel of before, the golden youth of our childhood together.
He was four years older and a magnificent athlete: good ballplayer, great sailor and the most elegant skier I'd ever seen. But he was generous with his gifts. He taught me most everything I ever learned about every sport I ever played. He taught me how to throw a football, hit a backhand, grip a 9-iron, field a grounder, dock a sailboat in a tailing wind.
He was even more generous still. Whenever I think back to my childhood friends -- Morgie, Fiedler, Klipper, the Beller boys -- I realize they were not my contemporaries but his. And when you're young, four years is a chasm. But everyone knew Marcel's rule: "Charlie plays." The corollary was understood: If Charlie doesn't play, Marcel doesn't play. I played. From the youngest age he taught me to go one-on-one with the big boys, a rare and priceless gift.
And how we played. Spring came late where we grew up in Canada, but every year our father would take us out of school early to have a full three months of summer at our little cottage in the seaside town of Long Beach, N.Y. For those three months of endless summer, Marcel and I were inseparable, vagabond brothers shuttling endlessly on our Schwinns from beach to beach, ballgame to ballgame. Day and night we played every sport ever invented, and some games, such as three-step stoopball and sidewalk spaldeen, we just made up ourselves. For a couple of summers we even wangled ourselves jobs teaching sailing at the splendidly named Treasure Island day camp nearby. It was paradise.
There is a black-and-white photograph of us, two boys alone. He's maybe 11, I'm 7. We're sitting on a jetty, those jutting piles of rock that little beach towns throw down at half-mile intervals to hold back the sea. In the photo, nothing but sand, sea and sky, the pure elements of our summers together. We are both thin as rails, tanned to blackness and dressed in our summer finest: bathing suits and buzz cuts. Marcel's left arm is draped around my neck with that effortless natural ease -- and touch of protectiveness -- that only older brothers know.
Whenever I look at that picture, I know what we were thinking at the moment it was taken: It will forever be thus. Ever brothers. Ever young. Ever summer.
My brother Marcel died on Tuesday, Jan. 17. It was winter. He was 59.
