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How an old woman—superstitious and wise—died as she lived.

By Rita Mariotti

I received a call at my seashore hideaway to come home because my oldest and longest-living patient needed me. I have been retired from medicine for several years after a 40-year career in family practice. Rosie, my brother’s mother-in-law, had been my patient for 46 years, approaching me for advice when I was still a medical student. She trusted what I said because I was a family member, and because I understood Italian. Rose emigrated from Calabria in 1935 with deeply embedded Old-World ideas of medicine: You did not visit a doctor unless you were seriously ill; you went to a hospital to die.
    Rosie continued to call me her doctor after I was licensed to practice medicine. My services to her were free, and I never pushed her into decisions with which she disagreed. She respected me, and I her. Rosie came to my office only on rare occasions, usually at the insistence of her family. In all the years I treated her, Rosie never took any medication (even if I prescribed it). She was never hospitalized; perhaps that is why she lived to be 100.
    Rosie lived alone in South Philadelphia and visited her daughter and my brother frequently at their home in New Jersey. She was an independent, hard-headed Italian woman. Banks were not to be trusted, so she carried her life savings in a small handbag, which she usually clutched against her and always kept within sight. On and off public transportation, up and down narrow streets, her mobile personal bank was a constant companion.
    She ate in moderation, and kept to a predominantly vegetarian diet. My brother owns a grocery-butcher shop, and he supplied all her food needs free of charge. Her major expense was wine. She drank at least a gallon a week. This habit caused the occasional need for my medical service—her injuries from falls due to loss of perception from excess drinking. I would patch her up, advise her to drink less, but never stopped her consumption. She appreciated this, and I feel certain the wine contributed to her longevity.
    When I arrived at my brother’s home, Rosie was seated in the chair she had staunchly refused to leave for three days, ignoring family pleas to go to bed. Her legs were markedly swollen, and she smelled of excreta. She had stopped eating and asked for only sips of wine and water. I knew she was in congestive heart-failure; she knew the end was near, but continued to fight death. I firmly offered her the choice of hospitalization or bed rest at home. She chose the latter, but whispered to me that she would never walk again.
    Clean and comfortable, Rosie lay in bed surrounded by a loving, caring family. No invading tubes entered or exited her body. We heard no screams of pain from injections and blood tests, as none were done. She chose to end her long life refusing medical assistance as she had done all her life.
    I visited her daily, offering support in lieu of the treatment she refused. She weakened each day and died quietly and in dignity five days later as she slept. Her handbag lay with-in view throughout her illness, and the day before she expired she told her daughter it belonged to her now. The only interest the contents ever paid was the probable assurance of an old-fashioned Italian-style funeral.
    Rosie had always said the Angel of Death appeared as a moth. It was a story the family enjoyed and laughed at. We were not prepared for the shock that confronted us when we went into the living room after I had pronounced her dead. On the inside of the screen door, a large black moth was desperately trying to find a way out. We shook our heads in amazement, then opened the door to allow the moth the freedom to fly toward the sky.

Dr. Rita Mariotti CW’52 last wrote for the Gazette in May 1998 about her experiences as a young doctor working in Kentucky’s coal-mining country.

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