We live in a society where many people are not who they appear to be. Most of us present some form of façade. Some people extensively alter their behavior and reactions based on what they think other people want to see and hear. From celebrities who are always playing a role to Instagram-perfect pictures to "Reality TV" (that is anything but reality), we are used to people not being who they claim to be. Acting is so common throughout our society that it is now memorable and unique for a person to be genuine. The overused buzzword "authenticity"  has become a facade in its overuse. I saw an advertisement for "Authentic Banking" a few weeks ago. What the hell does that mean?

People are genuine when they are real, sharing their true feelings, thoughts, and desires. I encounter genuineness more often in patients than in other people I know. Not surprising when one is about to exit this life that there would be no more need for artifice and less energy to maintain façades. Some patients are so genuine that it is revelatory and edifying. Fred was one of these patients.

Spending two to three hours a week with Fred for the last months of his life was my great pleasure and honor. The leaves were changing the day I met him, and the air was crisp despite the bright sun and cloudless sky. The first thing I noticed was his welcoming and enthusiastic smile. I always felt sincerely welcomed the moment I stepped into his home. That smile capped off an incredible openness. His initial enthusiasm stood out because most patients were quite reserved and standoffish at our initial meeting. It makes sense. A stranger is showing up at a challenging and personal time. But Fred didn't feel I was an imposition in the slightest. He welcomed me from day one with open arms and an open heart. He never hid his wide range of, often hilarious and informative facial expressions.

During that first meeting, Fred told me about his childhood, career, and the circumstances under which he met his wife. He always spoke with awe and gratitude about his spouse. He told me about the first time he met her and how infatuated he became. More than once, Fred  smiled and spontaneously said, "You know, my wife takes really good care of me." It was apparent that he sincerely appreciated the light she brought to his life. Again, it is unusual for a patient to be this open and utterly genuine in the first meeting. With Fred, there was no wall, not even a curb. He was happy to welcome me in from the start. That first day, I left feeling like I had a real sense of Fred. Most patients take two or three visits to get to this point. 

Fred had likes and dislikes, as we all do, but he was not shy about sharing his preferences. He was often eating lunch at the start of our visits. On the first day, Fred informed me that he only liked bland food and found no pleasure in spices besides salt and the slightest pinch of plain black pepper, preferably NOT freshly cracked. We started almost every visit talking about food, and for a while, this surprised me because he was not a foodie. I realized that Fred was sharing with me whatever was going through his mind at the time. It was all part of his open and genuine nature.

He was human and, of course, would sometimes get annoyed, but he would make a joke of it. When I encouraged him to take his medication, he would say, "Yes, Mom," with a tinge of sarcasm and then smiled mischievously. 

Fred had an insatiable curiosity. He loved to lay propped up on pillows while I read science articles to him. He nodded along and often augmented our shared learning with astute observations and questions when something was unclear to him. With each of us trained in a different science - Geology for him and Psychology for me - we could help each other learn more than we would have discovered on our own. This mutual learning was made possible by Fred's ability to point out anything he did not fully understand immediately. It was all about knowledge and nothing about ego with him. We also shared a sense of humorous outrage at some of the crazy and seemingly pointless science that gets funded. 

At the end of every visit, Fred would shake my hand. He always held my hand for more than the usual beat, looked me in the eye, and thanked me with the most sincere look on his face. It was one of the most genuine and encompassing expressions of gratitude I have ever experienced. It felt great to be that appreciated. I strive to replicate this in my own life.

In every conversation, every action, Fred was as present as his disease would allow him to be. As a result, his sincerity was profoundly moving and drew me in. I will remember Fred for the rest of my life and keep him in my heart by working to be more sincere and genuine in every interaction.