Every three weeks, without fail, I take a little trip to the hospital. A very close friend of mine is off to his blood treatment, and I either take him or stop by for an extended visit. He is in his early 60s; he has no friends or family besides me. I am his emergency contact and have all the legal rights of making those serious decisions at the end of one's life.

He has a rare blood disorder, Hypogammaglobulinemia, and to add insult to injury he is allergic to the medicine that is infused into his body every three weeks. As a result, he is blasted with large doses of Benadryl and other drug cocktails so the medicine can get into his body--because without it, he would die. No ifs, ands, or buts about it--he would die.

This can create some fun hospital visits. One time, for example, he woke up and stared passed me toward the door of his room.

"This hospital is really going downhill," he said shaking his head.

"Oh?"

"Yeah, I think we should go somewhere else from now on," he replied with conviction.

"Why's that?"

"I don't know who keeps letting these chickens just wander in and out of the room. Chickens are dirty," he said as if the general hygeine of chickens was new and awe-inspiring information, "One was just sitting on top of the table not too long ago just looking at me...and they can be mean bastards, too!"

Hallucinations often are the result of the blend of drugs they give him, which is why the nurses breathe a sigh of relief when I am visiting for the evening because I will be able to keep a stern eye on him.

Another time he was eating his fruit cup and had gotten to the bottom. I heard the click-click-click sound of a fork hitting clear plastic.

"What are you doing?" I asked looking up from the work I had brought with me.

"I can't get that last piece of grapefruit," he said quite irritated with his fork's inability to pierce that last bit of fruit.

I walked over, the clicking sounding continued, and I saw that he was trying to stab through the plastic bottom and  into his own finger that was holding the bottom of the clear fruit cup.

"Oh," I exclaimed. "That looks like a good piece of grapefruit. Mind if I have that last piece?"  He nodded and handed over the plastic cup and fork. I've learned not to argue with him when he is in this state of mind, so I manipulate how I need to in these types of situations.

Then there is work. My work. A few years back he was in very poor shape. I called him at lunch and then phoned his doctor--it would be wise to get him to the hospital his doctor told me on the phone. If an ambulance had been called, he would have been transported to the nearest hospital--a rural, sad excuse of a hospital that has never heard of nor dealt with his blood condition.  His hospital is 30 miles from our town; 50 miles from my work.

"Well, this doesn't classify as a family emergency," is what my boss told me when I said I needed to go. Needed to go....now.

I was incensed. Not too long before this incident I had dealt with the same line of discussion at the emergency room--this was before I was the legal contact and all that nonsense was dealt away with. The teenage looking boy kept a stern eye on me repeating some blasted policy about family.

"He has none. I am it. No one else. If you need to contact someone, guess whose phone number you are going dial? Mine. That's who!"--and then I made a scene that made Shirley McLaine's in Terms of Endearment look tame. I'm almost certain I saw some tears in that boy's eyes when I was finished with him. And I know it wasn't the kind or compassionate or adult way to act toward him, he was just doing his job..and I apologized to him when I left. It was just overwhelming to me knowing that 15 feet and through a set of wooden doors my friend sat all alone, scared and alone with only the beep of a machine to provide him any comfort.

Needless to say, I got into the emergency room. I'm fairly convinced that there is a file on me somewhere in that hospital, because ever since, whenever I show up I get the quasi-red carpet treatment. I've never been called "sir" so many times in my life....

My boss, on the other hand, who had known me for several years, was not used to such outbursts; so, when I told him I would be leaving and he would need to find coverage for me because I was walking out of the doors within the next 30 seconds--he didn't argue. He just let me go--like he could have stopped me if he wanted to.

All around us we hear these little dictums about how one's friends are their family, and John Donne comes to mind saying "No man is an island"--yet when a person truly only has a friend or two to rely on in times of crises, there are all these impediments to allow the "family" to act. Perhaps I get defensive so quickly and lose my patience almost immediately because 30 years from now, when I am in my 60s, I probably will be in the same place as he is: alone. 

Tomorrow is our April treatment date. Nurses will come in and go out. They will smile at me; we are on a first name basis now. I think I can name 15 different ones that I have seen over the past 10 years. They will call me "sir" and ask me if I need anything. I always say "no, thank you" and we will make chit-chat about the weather and television.

While I am there, I take care of the little things: help him to the bathroom, make sure he orders food and eats it, ensure his cords don't get wrapped up around him, turn the television volume down when he falls asleep, and deal with the renegade chickens or other animals that may appear unannounced.  The nurses will stop in less frequently while I am there; they know I have things under control--because I am family and it goes with the territory.