Hektoen International

A Journal of Medical Humanities

Elephant hide

Ethan Sellers
Philadelphia, Pennsylvania, United States


Illustration by Emily Schumann

“Let me tell you about the summer the circus came to town.” Mr. Stanton’s weathered face manages to wrinkle further as it breaks into an easy smile. I’m reminded of an old map folding along well-worn creases. I know I’m grinning back, a habit when talking with patients, but never more sincere than during my afternoon visits with Mr. Stanton. It’s my third day following the former navy-man and I’m undeniably enamored by his tales.

“I’m all ears.” I settle more comfortably onto the edge of his hospital bed.

“The circus had tightrope walkers, sword-swallowers, even those people who swing on the rings and ropes way up in the air. But the real show was the elephant.” He pauses to let this sink in. “We were a few hours’ drive from the city zoo and the only wild animals we saw were the ‘possum and ‘coon we used to ping with BBs at the old crick. But our teacher taught us about safari animals, gave us books to read about ‘em. We loved those books and the only animal we wanted to see more than a lion was an elephant. Its tusks and trunk, its sheer bigness…”

Mr. S clears his throat, but I know it’ll still sound like shells tumbling in a low-tide. “My old man was gonna take me and a few pals to the circus that Saturday and we practically bounced through school all week. Turns out, we never made it. That Friday night, I’m lying in bed, thinking about people in frilly costumes flying through the sky and pretty women shootin’ fire, and right in the center of it all the elephant, swinging his trunk this way and that. I’m about to fall asleep when I hear this commotion outside that wakes me right up. It’s a full moon so it’s bright as day when I look out my window. And do you know what I see?”

I do, but I know I’ll still be thrilled to hear him say it.

“It was that damned elephant, just strolling through our backyard!” We chuckle together and he runs his hand through stormy hair, disheveled after a few showerless days, but still cut high and tight in military fashion. “I shit you not doc.”

I’ve stopped correcting him about my title; a third year medical student is as much a doctor as anyone in Mr. Stanton’s opinion.

“That bastard may as well have picked up and walked right out of our savanna books. I was thrilled. The elephant was walking through my backyard, right past mom’s wash-line where our shirts and skinnies still hung from that afternoon.” He threads his tongue through nicotine-stained teeth. “The thing I don’t get is how they didn’t realize he was missing. Of course they knew in the mornin’ when they couldn’t find him for the show, but an animal that huge, even if it wandered off at night when nobody was specifically looking for it, you think they’d notice.”

I laugh again, “you would, you certainly would, I mean, it’s an elephant after all.”

“Exactly,” he exclaims, as if glad someone finally sees his point, “an elephant.” He shakes his head and for a moment his ever-intent eyes grow distant. “But anyway…”

His eyes refocus as the fog he’s woven burns off in bright hospital light. “What are they telling you about my belly Doc?” He rests his hand against the mass that runs most of the way down his right abdomen. When I first saw it, I figured this is what our lecturers must have meant when they described a scaphoid abdomen as boat-like, because beneath my fingers Mr. Stanton’s belly feels like the bottom of a U-boat.

“Not much Mr. Stanton. We’re still waiting on the pathologist’s report. This growth in your liver”—I motion to his bulging belly—“it could be something malignant or benign; we need to see the cells to know.” No one on the team believes this is benign, including Mr. S. We haven’t seen any mets on his scans yet, but a liver mass as large and fast-growing as this—it’s tough to believe any news will be good. Mr. S. had an ultrasound last month when he first came in complaining of stomach pain, but the read was negative. This mass either grew fast, very fast, or they somehow missed it. How anyone could possibly miss something this big is beyond me.

Mr. S. nods, “Just let me know, I’m ready for whatever, Doc.” There’s already an undertone of acceptance in his voice, “In the meantime, I’ll start thinking of more stories for you.” He smiles again, but it looks forced. No one has explicitly told him, but Mr. S. knows we’re afraid.

“We’ll let you know as soon as we hear anything.” I rest my hand briefly on his shoulder as I rise from his bed, “I’ll check back in before I leave and see if you’ve got another story.”

“Don’t worry, Doc.” Mr. Stanton’s face regains its earlier spark, an innocent, almost childlike amusement. “I’ve got plenty of time on my hands.” he spreads sinewy arms in a gesture I think is meant to indicate vastness and I hope against hope he’s right.

After I leave I try to imagine the moonlight washing across the gray of the elephant’s hide to pool and vanish in the depths of its wrinkles. I’ve become so accustomed to patients it’s difficult to picture skin that hasn’t aged to translucency. I think the crevices of elephant hide are so different from the fragile cracks of human wrinkles; as if they hold not only shadow, but an ageless resilience. I wonder if a human could find this secret strength. I wonder if an elephant could gift it.


I could tell you the pathology report came back negative for malignant cells. I could tell you our team never made the dreadful walk to Mr. Stanton’s room; that we never had to tell Mr. S his estimated prognosis was a number of months I could count on one hand.

But that’s not what happened for Mr. Stanton. The pathology report was stage four hepatocellular carcinoma. Our team made that dreadful walk, one that was unending and infinitely too brief. We explained to Mr. Stanton he had only a few months; that treatment might add a month and likely at the cost of his health, his comfort, his dignity.

Mr. Stanton and I exchanged no more stories like those of his wandering elephant; rather, we sat on lonely afternoons and talked of life, his satisfaction with the path he’d taken, and his lack of regrets. He was lonely. I think it was an emotion he’d long ago gotten used to, but that took new and frightening form in the nearness of death. He never said anything, but I could see it in the livening of his face when I entered his room and in the ever-so-slight flattening of his expression with each mention of his pending discharge.

Regardless, I knew he would bear his discharge, just like his imminent passing, with resolute stoicism and a humorous realism I had come to deeply admire. “I’ve had a good life,” he told me our last afternoon, sunlight cutting through his window slats to illuminate his gaunt face. “I don’t want to die, but I can accept it’s my time; after all, we all gotta go sooner or later, don’t we?” He chuckled and I smiled, though I wondered how I’d ever say goodbye.

Eventually, the time came to do just that; our conversation had worn thin and the hour long. I wanted to express to Mr. Stanton just how deeply he’d touched me, how irrevocably he had changed the way I’d look at patients from then on, how much he’d come to mean to me. Instead, I stumbled around my words and was left wondering if I’d made any sense at all. I let the good bye end with a meek, “thank you,” and waited, hoping he’d gained at least a hint of the intended message. At first, Mr. Stanton just took my hand. We’d shaken before, but this was different. He held me and I could feel the rough wear of years in his palm. Then he spoke, the gravel in his voice faltering slightly then returning with strength, “No Doc, thank you. For everything. When I came here, I knew I’d find a doctor,” he looks me dead in the eyes and his gaze is moist, but full of life burning brightly against approaching dark, “what I didn’t know is that I’d find a friend.”

That night, I woke in a dream to a sound outside my window. I swung to the floor, shuffled across the carpet, and peered through the night to the city below. The moon was full and illuminated the elephant as it plodded silently down Spruce Street, trunk swaying from side-to-side to brush against car doors. Beside the elephant, hospital gown flapping in the fall breeze, walked Mr. Stanton, one hand raised to rest against the elephant’s hide. As they passed my window, Mr. Stanton turned towards me, smiled, winked in an eruption of wrinkles, then turned back to gaze onwards into the night, and continued his slow march beside the quiet elephant.



ETHAN SELLERS is a senior medical student at Jefferson University in Philadelphia. He grew up in rural Lancaster County, Pennsylvania with his brother Jordan, parents Bill and Lauri, and faithful canine companion Spotopotamus. When not preparing for a career in Family Medicine he can be found writing poetry, playing board games, and hiking through the Californian countryside with his partner Van.


Spring 2016  |  Sections  |  Personal Narratives

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