It was nine years ago, the significance of which will shortly be revealed. I was attending on the medicine ward service. Our team—myself, a resident and two interns—was on-call every fourth night. If we were lucky, we would manage to squeeze in a few hours of sleep between admissions and pages from the various wards.

At morning report, the interns would present the cases and I would offer comments and a critique. After that, we’d go down to radiology to review any x-rays that accompanied our cases and then we’d go up to the wards to visit the patients. From an academic medical point of view, there were no particularly rare or challenging cases that day, but there was one patient who I could never forgot: Mr. Johnson.

Mr. Johnson was 103 years old, blind and stiff from arthritis, but entirely alert. Mr. Johnson did not have Alzheimer’s. Instead, he was admitted for treatment of a community acquired pneumonia.

When I went to the bedside I felt obliged to draw on my experiences to say something educational both for the housestaff and for the patient, but as we entered Mr. Johnson’s room I was drawing a blank. In the course of this clinical rotation, we’d pretty much discussed pneumonia to the limits of my knowledge. The interns and resident had taken excellent care of Mr. Johnson. He was getting the correct antibiotics and a whiff of oxygen through some nasal prongs. The TV was on, but I could tell he couldn’t see it through his clouded eyes.

“Good morning Mr. Johnson,” I said and I shook his hand. “I’m Doctor Eshleman—one of the doctors who’s taking care of you in the hospital.”

“Hello,” said Mr. Johnson.

“Mr. Johnson, we don’t get many patients as old as you. In fact, I think you’re the oldest patient I’ve ever had. Can I ask you a few questions?” (more…)