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Affiliation:A solo practice,Fort Bragg，Mendocino,California，95437 USA

I hadn′t expected to see Jim in the office that morning.He wasn′t scheduled. But many of my patients just show up with sundry needs ranging from acute problems to requests for prescription refills. Jim,however,appeared somewhat agitated:I saw bandages covering most of his fingertips. Although I had patients waiting,I asked him to come in.

When he sat down,he let out a sigh and said,"I had a really traumatic thing happen to me yesterday. I almost drowned."

As the story unfolded,Jim related how he had gone to Big River to kayak with his friend Rich and 2 teenaged neighbors. The weather was miserable,with incessant rain,but finally there was a break in the storm. While Jim and his friend were kayaking,the 12- and 14-year-old boys went boogie boarding. Then all of a sudden,Brandon,the younger one,who had gone out too far,was pulled into the water and thrown onto some rocks.

"He was in real trouble," Jim said. "Rich paddled over to Brandon,but his boat splintered against the rocks. Then they both fell into the surf. Rich couldn′t hold on to Brandon and the rocks at the same time. I paddled over but my boat overturned. I grabbed hold of Brandon,who was bobbing in the freezing water,and held him as best I could. But the waves kept breaking over us and I was getting weak. I feared I wouldn′t be able to hold him much longer. He turned blue and stopped breathing."

"I almost went under with Brandon just as the fire and rescue Zodiac boat arrived," he continued. "The volunteer firemen who had been called by a bystander had to pull me and Brandon on board. There were only 2 rescuers in the boat,one at the helm and the other trying to direct the helmsman back to the shore in l0-foot swells."

"On board,I could barely move,but I saw that Brandon still wasn′t breathing. I had to do something because time was passing. I hadn′t ever performed CPR,but I had taken a class in it years ago.I crawled over to him,held his nose shut,and started to breathe into his mouth. Then I compressed his chest as best I could and went back to giving him breaths. I was struggling against passing out. Then I saw some pink froth at Brandon′s mouth. He′d started to breathe."

Brandon is in the hospital recovering from hypothermia,but he′s OK. Jim was OK,too,except for his abraded fingertips. As Jim was telling his story,his eyes started to water and he began to tremble slightly. "You know,I really thought I was going to lose him. I thought we were all going to die." At this point tears ran down his cheeks.

"Jim," I said,"you′re a hero."

"I don′t feel like a hero," Jim said. "I just feel lucky to be alive. I could′ve lost him. How would I ever tell his parents that their son drowned after an afternoon outing?"

Jim only asked me for some pain medication for his hands. But I realized that he hadn′t really come in for that. I was his physician and friend,and he needed to vent his emotions to me. A dialogue wasn′t required; I only needed to listen to his incredible story and allow his catharsis. I prescribed Vicodin and asked if he had seen the urologist I had referred him to on an unrelated matter.He said he had just come from there.

"How much do I owe you?" he asked.

"No charge,Jim," I said. "Call me if I can do anything else for you."

At lunch,I ran into my urologist colleague. "Fred,I understand you saw my patient this morning." Fred nodded and went on to describe my patient′s urologic problem. "Did you notice the bandages on his fingers?" I asked. He admitted he had,but Jim hadn′t told him how he had acquired them nor anything about his experience. I briefly described Jim′s adventure,and Fred said,"Gosh,he′s a real hero."

"Yes,he is," I agreed,and then I thought how privileged I was to be Jim′s family physician and to be privy to his deepest feelings. And I felt honored that he had thought to share them with me.