The Campfire in Room 23

Vikings, turkey sandwiches, and the joy of unexpected connection

Last winter, on a cold weekend night in a very busy ER, our charge nurse asked me the sort of question I had always hated:

“Hey Dr. J, can you just see this guy up there in triage and get him out of here?  Old homeless guy, looks like he’s ER shopping, even has a wristband on from another hospital.  Let’s get this dude discharged.” 

Discharge a patient without ever bringing him back to a room?  Well, I guess if this guys was slowing things down, and we could tell he had no true emergency, what more did we need to do?  The ER was hopping, after all…

I scurried over to our triage area, and there I found him...a rough-and tumbled old man, sitting in a busted-up wheelchair, looking like a withered, weathered, washed-up old prospector.  He wore layers and layers of castoff clothes, jeans over his sweatpants, worn-out boots—just about anything to keep out the cold. 

Before I even had time to feel sorry for this guy’s plight, though, he flashed me a particularly mischievous grin, and I now couldn’t tell which direction this encounter might go.  What was he up to? I half wondered if I should be looking over my shoulder just in case. 

“Good evening, Mr. Cassidy.  I’m Tyler Jorgensen, one of the ER doctors here tonight.”

“Jorgensen… Jorgensen…” he rasped. “Is that Swedish?” Guess Which Scandinavian Country He’s From has always been a favorite game for my ER patients. 

“You’re close…” I answered.

“Norwegian!” he exclaimed.

“Nailed it.”

His grin stretched into a smile and his eyes began to twinkle.  He sat up a little taller now and leaned in toward me, giving me a close-up view of the cigarette stains in his beard.

“Ahh yes…  Dr. Jorgensen…” He started quietly. “Norwegian! A descendant of Leif Erickson.  Or was it pronounced Life Erickson?” Where was this going?  His words sped up.

“You say Leif? I say life.  But how could he say life, sailing across the ocean in a rowboat full of death?” Now his words raced. “And do you know what they said when he got here?  ‘Are you Eric the Red?’  ‘No, I’m Life the White!’ And they were scared, because he wore horns, because he was horny, ready to rape and pillage and burn…”   

“Mr. Cassidy, Mr. Cassidy!”  I had to stop myself from laughing. I didn’t want to encourage him. The man was a quick wit, and I hated to cut him off, but we needed to get down to business.  “How can I help you tonight?” 

His voice softened, his tone turned serious. “I’m weak tonight, doc.  My back is killing me.  My legs are getting weaker.  I can’t hardly walk.”

“Well, that’s gonna be hard to sort out with you sitting in a chair.  Let’s get you in a room so I can examine you better.”

Our nurses got him in a gown and settled him in the bed in Room 23. I took a moment to gather myself and took some deep breaths as I headed in hesitantly to re-engage with this wily old wordsmith.

A soon as I entered the room, He was off to the races again, tongue twisters on full display.  The manic madness of his words bounced wildly off the walls, making it hard for me to sort out exactly what he was saying and what had brought him here. 

I did my best to keep him focused.  His smile flattened to a frown as he seemed to oversell this alleged leg weakness. "I can’t move anything, doc”—but he clearly could.  Was he looking for drugs?  Was he wanting some x-rays?  A break from the cold?  Was he tired of being dismissed offhand as just another bum looking for a turkey sandwich?   

My examination convinced me he had no life- or limb-threatening emergency, so I did a little more digging.  His answers finally slowed and made more sense when he could tell I was really just trying to help. 

It turns out he had just been seen and discharged from another hospital for three fractures in his spine. They would not require surgery, but were wildly painful.  His prescriptions had been sent to a local pharmacy electronically, but he didn’t know which pharmacy.  He had lost his physical discharge paperwork when he was discharged back out into the weather. 

We did some searching in the electronic medical record and found the pharmacy for him.  Sure it took some time, but we sorted it out.  So here he was, a disenfranchised patient, one of our city’s most vulnerable, truly in pain, with a real medical issue, and we could help him because we slowed down to hear his story.  And he slowed down to tell it!

Honestly, we could have easily discharged him from the waiting room, dismissed him as crazy, gone on about our shift, and our efficiency numbers would have looked better.  But that just didn’t seem right.  We had to slow down to sort it out, but we got to the crux of the matter.

Well…Solution in hand, Mr. Cassidy went right back to smiling and dazzling me with his word games and wild stories. 

Just before I discharged him, the old rascal dropped a real whopper on me…“Did you know I helped Bob Dylan write his Juarez song?”

Just Like Tom Thumb's Blues by Bob Dylan

“Really? From the Highway 61 album?” I asked, telegraphing my disbelief.

“Oh yeah.  Me and Bobby hitched down to Juarez together in the spring of ’65, and it was wild, and we wrote this song, hell, we wrote lots of songs.  Don’t believe me?  I can sing it for you right now.” 

“Please do!”  I wanted to tell him that this song is from one of my favorite albums, but he immediately arched his back up off the bed and started howling at the top of his lungs:

When you're lost in the rain in Juarez, when it's Easter time too…

Oh man. His voice was worse than Bob Dylan’s! But his commitment rivaled that of any great rock n’ roll front man. On he sang, louder with every line.

And your gravity fails and negativity don't pull you through…

I’d never understood this song, but I did know the words. With this much exuberance from Mr. Cassidy, I felt I couldn’t let him sing it alone! So right there in an ER room, in the middle of winter, in the middle of the night, I started singing, too.

Don't put on any airs when you're down on Rue Morgue Avenue!

And now he sang even louder because he knew I knew his song. And he looked at me right in the eyes, so I sang louder, too.

They got some hungry women there and they'll really make a mess outta you!

And then we just fell out laughing.  I don’t know who smiled wider—me or Mr. Cassidy.  His serenade had transported us like only music can.  It connected us, and I swear the walls of the ER melted away and it was as if we had found ourselves singing around some campfire on this cold winter night. 

No longer a doctor and a patient in an ER room, we were now friends, sojourners, fellow wanderers crossing paths and finding new fellowship under a starry Western sky, warming our hands and hearts as we swapped stories and songs around the fire. 

And you know what?  We weren’t alone around that fire.  I realized our song was just one chapter of a much greater story, his story, and my story too, filled with a huge cast of characters. A story of hard nights on the road and surprising encounters down through the years, and the startling connections that can happen when we humans slow down enough to listen to each other.  I felt a real honor at being invited into his world—into his present, and into his past, however real or imagined. 

I wondered if he had really crossed paths with Bob Dylan so many years ago.  I wondered how many cold lonely nights he’d spent outside—this magical, cackling, white-bearded enchanter of the ER—and how many of those lonely nights were by choice.  I often choose to camp when I’m not working in the ER, and maybe these ER visits are the only breaks he gets from his lifetime of “camping out.” 

I wished we could have talked and sang all night, but the patients were stacking up.  I thanked him for his song and his words, and off he went into the cold, starry night.

I may have helped Mr. Cassidy a little that night, but he helped me a lot. That human connection is what I needed most in that moment. Connection is what we all need in medicine (and in life!) if we are going to overcome our exhaustion, our disillusionment, our dehumanization, our burnout. And that’s what Mr. Cassidy gave me. 

Here's the challenge…connection takes time.  It takes stepping away from our urgent agendas and letting things unfold.  It takes slowing down to listen to each other’s stories. It runs counter to the speed of our society, but it seems like it’s worth it every time. It certainly was that night in Room 23.

So, to you, Mr. Cassidy, I say let your stories keep coming, you twinkly-eyed stargazer, you rib-nudging, flask-sipping, roll-your-own smoking, verbal-trickster.  Let your songs come, too, you raspy-voiced campfire-coyote, you dreamy-headed conjurer of Juarez road songs.  Keep on howlin’!  Keep on ramblin’ around the flames!  We’ll be listening.

I hope you enjoyed this campfire story. Now it’s your turn to share if you like!

• When have you found joy in an unexpected connection?

• When has slowing down to hear someone’s story led to something unexpected and maybe even profound?

• Feel free to share in the comments below! Or just let me know if Mr. Cassidy’s story resonated with you.