May 28th, 2015
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My Hidden VA ListI knew the call was coming, and I knew when I saw the number what the voice at the other end would tell me. My oldest patient had died quietly at home that day, a week after his birthday and exactly that long after deciding that he was done, forever, with hemodialysis. It had provided him with many good years, but as he entered his mid-90s, life had become increasingly difficult. He knew, and I knew, it was time to say good-bye.A few days later, I attended the funeral of this man undoubtedly among the last few veterans of World War II that I will see as a physician. I have been working at Veterans Affairs (VA) hospitals since my student days. At that time, the wards were crowded with survivors of the Pacific theater, the battles of Normandy and North Africa, the places and times I had previously known only from history lessons.The first patient I was assigned as a third-year clerk on the medical ward at the West Haven, Connecticut, VA Hospital was one of those men. Bluish and breathing with difficulty owing to chronic lung disease, he was silent as my third attempt at an arterial blood draw failed. I withdrew my needle, apologizing profusely, and backed

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