Dear Ms. Wren,

I am not addressing you by your real name, but I chose one that I felt captured your kind, humorous spirit and a life well lived. Our first introduction was not in person, but through a note that read, “chief complaint of vision loss.” Words fall flat and sound, expressionless on a digital screen. But your voice, softly worn and pleasant, told me a story of how you ended up in the hospital.

“Well, I was sitting on the sofa, talking to an old friend in Oklahoma. Suddenly, I couldn’t see the TV out of my left eye. All that’s left of my vision is a beetle-shaped hole.”

Asking, ‘When did this happen?’ and ‘What makes it better or worse?’ was part of a familiar routine to me. You filled in those gaps, even with details that may not have been directly relevant to your current concerns. Our bodies tell stories too, with every scar or broken bone, and yours carried many—heart failure, diabetes, spinal surgery, and a hysterectomy. Yet beyond all of that, you told me how you were a mother to nineteen children.

“You meet a guy in your twenties who is in the Navy, and suddenly you find yourself young, dumb, and married.”

We both laughed, but then a pause settled between us when you said, “We couldn’t have kids of our own,” a statement that carried the weight of ache and acceptance. “But we started fostering, and our family became bigger than I could have imagined.” You opened your phone, proudly showing me faces of all different ethnic backgrounds, none related by blood but connected by the roots of a carefully grown family tree.

Although I had been asking the questions, there comes a time when patients have their own: “What will they do to fix my vision?” And I dreaded knowing the answer was that the damage could not be reversed. I started explaining central retinal artery occlusion, avoiding jargon that could fall just as flat and meaningless. I knew it was not easy for you to accept that years of diabetes could lead to such complications. And when your voice was no longer softly worn but tired, as you expressed, “I’m done,” I felt the weight of your pain at existing in a world you could no longer perceive the same. Yet you carried on talking with me, despite there being little comfort in facing a new reality.

You lived an hour away, explaining that follow-up appointments would be difficult due to relying on insurance-covered transportation. Services often decline serving rural places due to longer commutes, and caseworker involvement was just as unreliable. The uncertainty of receiving proper care was evident, and then just as quickly as you had arrived, you were medically cleared to leave. I was left with questions, such as how often transportation is a barrier care, and whether you would be okay when you went back.

Still, you were relieved to leave the white walls of the hospital, the absence of your friendly aura leaving it a little more blank. When you got into your wheelchair, nurses on standby for discharge, you told them, “They treated me for CRS.” I looked at the nurse, silently questioning if I was missing something in the multitude of acronyms stored in my brain. So I asked with my own curiosity, “What does that mean?”

When you looked at me, your boisterous expression was the antithesis of the defeat you had displayed just prior. You smiled and said, “Can’t remember shit!” A syndrome I will never forget.

Ms. Wren, I am writing to you, even though these words may never find you. I am grateful to have known you for a fraction of a day and wish I could have done more to help. There is so much work to be done, and moments like ours remind me of the importance of being a steady presence for patients.

Here’s to eighty years of a life well lived, and to the nineteen-plus lives you have touched along the way

Celine Rochon, MS3
Saint Louis University School of Medicine