Monday, January 13

medicine: wk2, day7

i'm trying hard to think of something funny from my day, but there isn't anything.

today, i saw old pts afraid to meet my eyes because they had pooped in their beds. they know they made a mess, they feel like they like children, and they know that it smells. i tried to make it seem like it was ok, that it was normal, but my patients weren't buying it.

mr. x, who had fought like a caged animal when we put a ng tube (tube that goes up your nose, to back of throat, down esophagus, to stomach) in him yesterday, was so different today.

i was tying restraints on him, when he asked why i was doing it. i explained to him that i need to draw blood from him yet again, for yet more tests. he looked at me with watery eyes, nodded, and sat back.

i looked at him, at all the bruises and scars along his arms, hands, wrists, antecubital fossa, where he had been pricked multiple times. his arms was more purple than flesh colored.

"mr.x, if i take the restraints off, would you be still for me?" i asked. he looked at me with the same weak watery eyes. i took the restraints off. he was docile... as compliant as an asian man. i looked for a possible vein. he had nothing. what he did have had been mercilessly assaulted already. after 15 minutes, i found a 3mm strip that was a diff color on his palm.

i jabbed, and got it. prayed quickly in thanksgiving, that i wouldn't have to poke this poor dude again. he thanked me quietly, with no joy. i patted his hand as i sat there, neither of us saying anthing. i wanted to give him a hug, but he didn't look like he was in the mood. maybe we both cried a little.

he had been experiencing a lot of neurological changes. today was the first time where he was "normal." for how long would it last? who knows? he was extremely sick, and his meds were doing some a number on what was left of him. i had caught him at a moment when he was really himself. i was grateful for that.

he didn't know that he had pancreatic cancer on top of everything else he had.

for the first time, we discussed a DNR in our team. do not resuscitate. what simple words. how can such simple words be so terrible? the cheesy conferences we had during 1st and 2nd year didn't prepare me for how cold, efficient, and matter-of-fact the discussion would be. i'm not blaming my interns, residents, chiefs. they don't have the luxury of going to the side stairway that no one uses to look out the window and cry. they have other patients whose health depends on their working well and fast.

God have mercy on old people.


yakob at 11:55 PM

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