As I walked into room 308 I glanced at my notes from yesterday’s sign out, “EtOH abuse, end stage liver disease.” The night before I had arrived late – my flight from Burbank to Sacramento had been delayed, and my exhausted colleague and I didn’t begin our sign out until about 11 pm.
One look at the patient filled in all the blanks from the hurried exchange that I had the night before: the patient’s color was a odd mixture of pale gray and yellow. His mouth hung open and he was hyperventilating. His oral mucosa was dry and he had the unique odor associated with patients with hepatic failure. His abdomen was distended and tender.

“How are you doing Mr. De Lado,” I asked, realizing as soon as I spoke that his hepatic coma would prevent any meaningful response. Images of the many similar cases of alcohol-induced physiologic chaos that I had seen previously flashed through my mind as I made a mental note to make sure that the patient’s code status was “DNR.” It appeared that he was soon to spiral into one of the many well known fatal scenarios that are associated with liver failure.

As I turned to leave the room a young man quietly appeared from behind the curtain separating the beds. He introduced himself as a friend and former co-worker and asked me how the patient was doing. I was surprised to learn that the patient had any friends – I had been told that he had no family and that a conservator had power of attorney.
I was in a hurry to get on to the next case and quickly explained to the friend that the patient was dying, that he probably had peritonitis, and that based on his combination of problems (severe infection, liver dysfunction, and worsening renal failure) he would probably not survive another 24 hours.

As I spoke, I saw that the friend was genuinely concerned and saddened by his impending loss, and suddenly, out of the blur of a busy morning which promised to be part of a very busy day, I was reminded of the fact that there was more to the “the guy in 308 with liver failure” than what I initially imagined.

Mr. De Lado’s friend had a choked voice and moist eyes as he pulled an old black and white photograph out of his pocket and showed it to me. The photo presented an incredible contrast to that of the man dying in front of me. A handsome, youthful, vigorous George De Lado stared at me from his studio where he worked in Burbank some 45 years earlier.

His friend, Steve Weir, explained that he met George at work about 10 years ago and was impressed by his non-conformist, renegade attitude and lifestyle. Despite his problems with drinking, Mr. De Lado had lived a full and interesting life. He was born in 1926 to parents who immigrated to the United States from Hungary. He was hired out of art school to work for Walt Disney and had been involved in production graphics for MGM and Disney. His art was featured in the advertising for The Hindenberg and several Clint Eastwood movies. George had raced his Jaguar against James Dean on Sunset Boulevard and talked of working on the set of The Misfits with Clark Gable and Marilyn Monroe in Reno.

He had become disillusioned with Hollywood and the pace of life in Los Angeles and had left in the mid 1970s to become the manager of a bar in a small rough mining town in Northern California. He was a gambler who enjoyed trips to Las Vegas and who frequently made those trips as the pilot of his own plane.

His last full time job was with the city planning department of a small community outside of Sacramento. Steve told me that he was known for his sense of humor and irreverence at work. Several years ago George gave Steve one of his old drawing tables that he had used while at Disney. Steve, an artist and draftsman himself, referred to the table his “magic table.” He told me that ever since using the table he felt that his art had greatly improved and that he was in the process of submitting a cartoon to Warner Brothers which had been drawn on George’s old table.

The conversation at the bedside lasted about ten minutes. I realized once again that there is always a story behind the story. I was grateful to Steve for sharing with me what he knew about George De Lado. George died quietly later that day. He, like all of our patients, was much more than “the guy in 308.”

-by Bruce GIpe, MD
 

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