The Files of the Living

I worked at my father's medical office this summer, discarding inactive patient files. They've never been sorted, and my father has had a practice of 5,000 patients for thirty years. My job is to consider twenty thousand files.

Each file has a tab for the last year the patient was seen, so the task should be simple. It's complicated by three factors: first, that the files are kept in the office's un-airconditioned attic, which heats to deadly by noon. Second, that the files are alphabetized in a line of "shelves" that actually consist of stacked boards, the files propping the shelves, so that removing a stack makes it all collapse. The third issue is the rub: according to Oregon law, you must hold the files of minors. That means that before I can discard a file, I must locate the patient's birthday, which is often on the last sheet of four hundred. Usually, an intake form in the patient's own hand tells me their age; at times, I rely on my father's notes—after all, children rarely suffer from arthritis or hemorroids or have contracted stds.

The work is terrible. I sweat through my clothes, remove my shirt and hope none of the secretaries come for a file. I have dust allergies and the attic is a dustrap, so my eyes water and my nose runs. Sometimes I am distracted by noises from the clinic—a child's shout, laughter, the insistent rhythm of my father's voice—and I lose myself in medical history, my father's chickenscratch hand recording all the suffering of the world. Personal notes from these patients fill the files: notes on flowered stationary and cards, thankyous to the good doctor, updates on their health. My father is close to his patients. There are stories in these files—a Korean named Sung Hee whose bruises to the arms and chest were inflicted by her husband when she refused him sexual favors. A fellow named Jim hospitalized with chest pain, and my father's note to call and arrange a six-pack of beer—the man is an alcoholic and a boozeless night would be destabilizing. An eight-year-old girl, and the referral to CSD for signs of abuse. And then there are the files of the deceased.

The files of the deceased are thick—dying people accumulate paperwork in visits, hospitalizations, lab-work. I still must examine these files, because the law for retaining records applies to the dead. Often, these files contain death certificates, then living wills signed in the patient's unsteady hand. Clipped obituaries are often attached, sent by the family. The pictures are enough to tell me the patients aren't minors—a beaming adult face, images from the best years of the patient's life. The dates are on the clipping, and so I should stop. But there, bleary with heat, sweating, I cannot look away from the faces of the dead, cannot keep myself from reading of their life, flipping through their letters, noting how and where they died, where they lived, how they lived. It is intimate and morbid, and time and fate and death are all about me in the still, hot air.

It has changed how I look at my father, when I see him now at home, tired from a long day, or when I catch a glimpse of him at the office on my way up or down. He's always intent on reaching a destination, walking stiffly upright, shoulders thrown back and head tilted as if trying to see through whatever's before him. My whole life, I have been subject to that gaze, but never understood its purpose. My father's claims as to the urgency of medicine were mysterious: another hospital admission or errand, a phone call in the night, excuses for absence and distraction. In these files, in the hundreds of pages of notes, the record of all these lives and his struggle to heal and help, to ward off death for another day or week or year, only here, in the sheer volume of it, do I understand how staggering a task, how great the stakes. How terrible the responsibility.

It has been a strange summer, sorting the history of my father's work, tracing the anatomy of his burden. And though it is awful work, sweating in the attic while he labors in the rooms below, I'm as close to my father as I ever will be.