Sunday, April 18, 2010

Strange days have found us

My dearest Nora, wherever thou mayst roam,

Another really cute nurse was added to the growing list today. She approached me and we had a great series of conversations throughout the day. Her name, however, is not one that I've ever been too terribly keen on. In fact, it draws to mind 1980s hairspray hair, gum-smacking, and loop earrings so large I could put both of my fists through with room to spare. An unattractive mental image. She was cute enough, though, that I didn't think much about it. Besides, she can't help the name her parents pinned on her.

It was a strange day. Quite slow, lots of discharges. When I went round to each room to have a bit of a chat with the patients and fill any requests that they may have, I found that everyone was asleep, with a room full of visitors, or with their door shut. I didn't feel that I should go barging without a good reason besides friendly banter.

Later, one of the patients called and when I answered, he asked if I could hear him. I answered in the affirmative and asked what he sought. No answer. Hello? Hello? Hellllooo? I hung up and went briskly to his room, thankful for the opportunity to do something productive with patient interaction.

He just wanted to know when the doctor would be in to speak with him. I told him that I didn't know, but that I'd ask his nurse and get back to him. As the words were leaving my lips, I noticed his peculiarity...not what put him on this floor, but probably occurring simultaneously with the injury that did. I felt my eyes go wide. Stop it. STOP IT. I resumed eye contact, but I wanted out of there in a hurry. I felt awful that he'd suffered so, especially since every yokel he comes across upon discharge is going to stare mercilessly. I felt awful that I was briefly one of those yokels. I've always prided myself in being highly sensitive to the feelings of others, especially in situations when other folks would just gawk, moths agape. I've seen my fair share of terrible injuries on television and online. I even have been known to eat lunch or dinner while watching surgery videos, so something so tame in comparison shouldn't have been worth a second glance. Sort of disappointing, that was, but I suppose it's only natural. As time goes by, I'm sure I'll be less affected.

During my break, two nurses were sitting across the room in the cafeteria. I smiled at them, but got nothing in return. They looked back to each other and kept talking. Ooh. Par for the course today, I'm afraid.

Not long after resuming position at my desk, the call bell went off. It was the patient who spoke very little English, only some dialect of Chinese, and surprisingly had no family or friends. He said nothing on the phone. I entered his room and spoke slowly without being patronising. He was not understanding that I was asking what he needed. I asked if he wanted a nurse. Blank, frightened look. "Maybe later.", what do you want? I asked if it was his bed or pillow which needed adjusting, or if he wanted the rolling tray pulled closer. I pointed to each item as I asked about them. "No," to each. Silence. Blank, frightened look. I began to feel frustrated, but certainly not at him. I want to help, but don't know how! He was holding the remote with the call button, tv button, etc. and kept looking at it. Finally, it came out that he wanted to watch television. I showed him how to turn it on, change channels, and adjust the volume. That was all he wanted. He looked sheepish and thanked me. It must be very hard for him to be hospitalised and not be able to meaningfully communicate with anybody. I kept thinking about that blank, frightened look. It was like some sort of primal fear that a wild animal might exhibit. No family. No friends.

Not half an hour had passed and a white coat enters the room...and plops down right next to me at the desk. Ohmyohmyohmy. Doctors don't stick around long during my shift. They probably sense that I am pre-med and want to avoid my thirty trillion questions and requests to shadow. Don't blame them...sometimes. He was around for nearly 40 minutes. My hands were shaking, as if it were someone I've long admired. When calls from other departments came in, I bumbled around like a fool...uncertainty and a lack of confidence had set in. I tried to talk myself out of it. These people don't know just how little confidence you have. You're an actor in a film; be what the scene calls for. No one will be the wiser. It worked. Soon, I was joking with the charge nurse and handling calls confidently...but I couldn't muster the courage to say anything to the doctor. Part of that was not wanting to bother him.

The doctor was looking at MRI images. Somebody had something bad going on. Tumor.

Another doctor came in and I got to listen to a bit of the conversation about risks and benefits of surgery. They ultimately decided that the best course of action would be to try to cut the beast out.

They turned to me, asking whether or not I knew if the patient's family were translate.

Oh, my. It was Mr. Blankenfrightened.

Someone actually happened to be around, a nurse on another floor, who spoke the patient's dialect. After a 5-minute discussion, everyone exited and the doctor sat down beside again and began dictating. The patient wanted to proceed with surgery.

Good for him, I thought. I began hoping that the surgery would be a success and there'd be no lasting effects from the invasion (and removal) of that awful mass.

I carried on, having a good time joking with the charge nurse. Very funny, very, very dry and morbid sense of humour. It was brilliant. Everything about him was slow and calculated and he always appeared to be on the verge of a smile. He was a reassuring presence, and I do hope that in the future, my attendings are all like him.

Not going to happen, but it's nice to dream.

As my shift winded down, I couldn't shake the feeling of strangeness that had been cast over the entire day. I was glad to clock out and be on my way home.

After dinner, I was still feeling a bit off and had a fair amount of pent-up energy I wanted to rid myself of before resuming my studies. Ah, let's take it on out to the driving range. I'm happy to report that the funk that I'd been in is getting further and further away in the review mirror. I even had an enourmous drive of nearly 270 yards...that's about 40-50 yards more than usual! That was just a one-time deal, you understand. It was a nice surprise.

Upon returning home, three hours somehow passed without an ounce of studying taking place. I can't, for whatever reason, particularly account for them. I was watching a bit of golf and had some physio slides pulled up, but I guess the distractions of the Internet got the better of me. I dozed off at one point...and woke up about 1 a.m. I stumbled into the bathroom and performed my nightly routine. By the time it was over, I was wide awake.

I crawled into bed, passively wishing that I was joining someone, and didn't feel a bit like sleeping. I've been absolutely devouring a book lately, so I picked that up to read a couple of chapters. The book, Something for the Pain: Compassion & Burnout in the ER by Paul Austin, had me hooked in the first couple of pages. It was nice to read the words of a man who made it through medical school talking about his pre-med experience and to find that there are overwhelming similarities. I found his personality to be a lot like mine, as well, which was all the more engaging. I'm nearly through with the book. I started it Monday and have been reading as much as I can when I can.

Later in the book, he treats the broken leg of a woman with Down Syndrome. As he described her howling in pain, the mental image of the woman became the image of Mr. Blakenfrightened. He wasn't screaming and didn't seem to be in any sort of pain, but the barrier to being particularly helpful seemed similar...obviously it isn't, but let's just go with it.

I started feeling a little guilty for, of all things, not speaking the man's dialect. This is irrational. There is nothing you could've done about that! I began thinking about him, all alone, in a big city hospital with a tumor about the size of a ping pong ball in his head, and it started eating at me. My mind began searching desperately for ways that I could've had a positive impact on his stay, even if it meant walking into his room and just smiling and waving. With each possibility, I asked myself why I didn't think of it then. That poor man doesn't have anyone to console him. No one in which to confide his fears about his future health. I thought about how I'd feel in that situation, and a creeping, chilling panic swept up my spine.

Maybe there are some things I could've done. Maybe not. Maybe my patient presence as we worked out that he wanted to television on was enough. I smiled a lot. He was smiling when I left. Maybe that's all anyone could've done.

I passed out last night while writing this entry. Looking back on it now, it seems a bit melodramatic and I'm almost embarrassed to have written some of it. It was such a weird day, all the way around. I'm happy that it's over, but not happy about the mountain of work before me today. Three exams this week. Three finals next week.

Cabinet full of coffee? Check.

We're cleared for take-off.

May the grace of He keep you always,

J.O. Morris


  1. I wouldn't be embarrassed about the impact the Chinese man had on your thoughts.

    I always found those patients really tugged on my heart strings and I felt particularly protective of them.

    I still very clearly remember my medical floor rotation as a student, there was a Korean woman whose feet I used to go in and rub when I had a few minutes. We never exchanged a word but the fact that she'd start clapping whenever I came in the room always made me laugh.

    I could not imagine going through pain and major life decisions alone and in a country where I cannot communicate.

    I think you'll find that it is the strangest things that get under your professional protective skin. I am getting better at recognizing things now that I know will haunt me later...but often I was really surprised at the images, interactions, situations that would keep me awake, or turn up in dreams, or crazy flashbacks.

    I think it is a sign that you'll do wonderfully once you are responsible for patients...empathy and intuition aren't gifts that everyone has.

  2. That is such a sweet tale about you and the Korean lady! I can picture such a scene in the movies... say, that's not a bad idea! Write a novel, or just a screenplay, and send it out to... uh, well, I don't know that I'd recommend Hollywood unless you could somehow avoid having some joker getting ahold of it and turning it into some slick production starring some floozy. hahaha, you know how they do.

    Thanks, yet again, for the support! It means an awful lot =) I've had 42 tons of exams, quizzes, and assorted headaches this week so I haven't had much time to think about the guy (or sleep!)... a passing thought here and there, absolutely, but no dwelling. For that, I'm relieved.

  3. Yeah I have yet to see an accurately portrayed nurse in Hollywood yet...actually no, the nurse in "Wit" was pretty bang on. If you haven't seen that movie it is required viewing before you start medicine. :)

  4. Thanks for the recommendation...I'll watch it next week!