Slyvester

Sylvester

Sylvester had a delicate build and was barely 5 feet tall.  He spoke rapidly with a high pitched, whisper-like voice.  His words were frequently interrupted or accented by sighs and the pursing and smacking of his lips. His mannerisms matched the fictional stereotype of an elderly lady. 

Now 60 years old, single and always celibate, he had spent his entire life with his parents.  His father had died 20 years previously. He had never been close to him and following his death his bond with his mother had grown even stronger.  They read the bible together and attended services at the Lutheran Church nearby.  He added to the income she received from her husband’s pension by giving piano lessons in their home.   He cared for her in her last years when she had become so feeble that she needed assistance with things like dressing and bathing

When mother died Sylvester had found himself without relatives or friends who could in any way substitute for the intimacy he had shared with her.  Convinced that they both had led virtuous lives he looked forward to and wished for the time when he could die and blissfully join her in Heaven.  Rather than a transient stage in the grieving process commonly experienced by many, his wish became stronger and more encompassing with each passing day.  In fact it had progressed to the point that the contemplation and preparation for how and how soon he would die had become his only purpose for and satisfaction in living.

He spent endless hours arranging for his funeral, indicating the scriptures to be read, hymns to be sung and had even written the sermon for his pastor to read.  The latter was rejected with the comment that the way he lived would determine what would be said about him at the time of his passing.   He had briefly contemplated taking a short cut to his desired end. His pastor had then made it clear that anything he might do to hasten his death would certainly result not only in a sermon he might not have wanted but, more importantly, in a permanent separation rather than reunion with his loved one.

This left Sylvester with the hope that he would soon contract a terminal illness. Each new ache or pain he would experience would be encouraging in that respect. However, while wishing to die soon he did not want to experience any of the pain and suffering that might precede it and would immediately call his family physician to request medication to alleviate his symptoms.  He had another problem that interfered with his planning. He had a germ phobia.  Because of this he was afraid of hospitals where he might come in contact with more of them that could make him sick.  To protect himself from germs when he came to my office or the offices of his other doctors he would carry a bright yellow child sized Sunday School chair and would sit on it in the waiting room as well as when he came into the office.  To avoid the risk of exposure to germs in a hospital he arranged for social services to provide him with a hospital bed in his home where he could be cared for in his last days.

Sylvester continued to visit me periodically over the course of many years in order to satisfy the requirement that he see a psychiatrist in order for his SSI payments to be continued. I think he also enjoyed the opportunity to fill me in on his progress in terms of his attempts to meet his goal in the best way possible. I learned very soon that the worst thing I could do was to say he was looking relatively healthy. He’d smile, however, when I’d tell him that it looked like he might be going downhill just a little bit.  He once explained to me how delighted he had been after he had sought an opinion from a neurologist who had informed him that he was of an age where he might certainly sustain a fatal “stroke” that would be quick and painless.

Was Sylvester eccentric?  Yes.  Was he mentally ill?  Maybe.   But I remain comfortable with the decision I had made after our first meetings to avoid attempts at treatments that he was not seeking, treatments that were doomed to fail, treatments that might detract from the special meaning he had found in his life, a meaning I was allowed to share.