It was a busy night as I struggled to keep up with the patient load. I looked at the ambulance call recording sheet to see what was coming in next.
Time: 0107.
88 year old female coming from a nursing home facility with altered level of consciousness and running a fever. Lung sounds are crackly with possible decreased sounds on the right side.
"Pneumonia," I thought casually as I walked away from the charge nurse desk slightly irritated. "Why are they coming here? It's busy as it is already." I thought nothing more of it while I prepared the room for her arrival. It was just another patient taking up another bed in an already busy ER. The paramedics arrived in no particular hurry. They wheeled her in, gave a quick report and left as quickly as they came. I didn't stop to notice the patient really. I was too busy just going through the routine. I got her hooked up to the monitor, placed an IV and helped draw blood for the lab tests. As I was securing her IV, I started to slow down a little and take notice of the patient. I looked up and saw a frail elderly woman. Just by looking at her, I could tell she wasn't in good health and probably hadn't been for quite some time. She was pale and sweaty. I noticed her right eye had lost color and muscle control. It was not the beautiful light blue her left eye possessed. Rather, it was a hazy gray that enveloped her iris and pupil. Her peppered gray and white hair was thrown about every which way in a mess. Her wrinkled pale wrinkled skin told stories of her past medical history. She was severly disoriented. Her brow was knit with confusion as the nurse and I performed our tasks. If I had held a mirror to her face, she would probably not recognize the woman staring back her. She looked at both her hands as if she had just discovered them for the first time. I took her by the hand and told her it was going to be ok, we were going to take good care of her. As I held her frail hand in mine, I noticed she was shaking. Her jaw quivered uncontrollably. It was not just a look of confusion anymore. It was fear. As if she had been accustomed all her life to people in scrubs and stethoscopes causing her pain and frustration. The fear was much like a childs fear of getting shots at the doctors office. Only recognizing the scrubs as the landmark for her pain. I felt hopeless knowing that no words or actions could calm her fears. She couldn't understand. Then it hit me hard. Looking at her frail state reminded of what I had suddenly become. I hadn't treated her like a patient. I treated her like a chore.
Time: 0107.
88 year old female coming from a nursing home facility with altered level of consciousness and running a fever. Lung sounds are crackly with possible decreased sounds on the right side.
"Pneumonia," I thought casually as I walked away from the charge nurse desk slightly irritated. "Why are they coming here? It's busy as it is already." I thought nothing more of it while I prepared the room for her arrival. It was just another patient taking up another bed in an already busy ER. The paramedics arrived in no particular hurry. They wheeled her in, gave a quick report and left as quickly as they came. I didn't stop to notice the patient really. I was too busy just going through the routine. I got her hooked up to the monitor, placed an IV and helped draw blood for the lab tests. As I was securing her IV, I started to slow down a little and take notice of the patient. I looked up and saw a frail elderly woman. Just by looking at her, I could tell she wasn't in good health and probably hadn't been for quite some time. She was pale and sweaty. I noticed her right eye had lost color and muscle control. It was not the beautiful light blue her left eye possessed. Rather, it was a hazy gray that enveloped her iris and pupil. Her peppered gray and white hair was thrown about every which way in a mess. Her wrinkled pale wrinkled skin told stories of her past medical history. She was severly disoriented. Her brow was knit with confusion as the nurse and I performed our tasks. If I had held a mirror to her face, she would probably not recognize the woman staring back her. She looked at both her hands as if she had just discovered them for the first time. I took her by the hand and told her it was going to be ok, we were going to take good care of her. As I held her frail hand in mine, I noticed she was shaking. Her jaw quivered uncontrollably. It was not just a look of confusion anymore. It was fear. As if she had been accustomed all her life to people in scrubs and stethoscopes causing her pain and frustration. The fear was much like a childs fear of getting shots at the doctors office. Only recognizing the scrubs as the landmark for her pain. I felt hopeless knowing that no words or actions could calm her fears. She couldn't understand. Then it hit me hard. Looking at her frail state reminded of what I had suddenly become. I hadn't treated her like a patient. I treated her like a chore.
"What have I done?" I thought. "What if this was my grandma."
It's not your grandma.
"But what if it was? Would I want her to be treated by someone like me?"
She is not your grandma.
"No, but she is SOMEBODY'S grandma!"
I don't think it matters what your job title is. Nurse. Tech. CNA. Doctor. I think they all tell you not to imagine a family member in place of a patient. Objectify, not subjectify. Don't put yourself through it. They aren't your family and they probably never will be. You have a job to do so do it correctly, not subjectively. Still, I struggled with this frame of mind. I've been in several different hospital jobs in the past five years. I always told myself that I would never be that person. I would never be that hardened. Yet, here I stood; dumbfounded by my own sense of shame. Have I forgotten what brought me to the medical field in the first place? To help others. Make a difference. Outside of work, I would tell everyone that I loved my job. I would tell everyone what a tremendous inspiration it was for me to work with such talented and hard-working people. I would tell myself how much it motivated me to become a doctor.
"How can I fix this?" I thought quickly. I had moved on to other tasks in the meantime since it was a busy night. "I know! I can go in and try to talk to her. Any company is better than none." I jogged to her room only to find she was fast asleep. "How much time has gone by?" I looked at my watch. "0330! Has it really been that long?" I hung my head in shame. I stood there silently watching her sleep. She didn't seem so sick anymore. Her oxygen saturations and respriations had returned to normal. She seemed so at peace laying in that uncomfortable stretcher, unaware of the fact I was watching her. Unaware of how many other patients in the department demanded medical attention in our chaotic environment. I couldn't look at her anymore. I had failed myself........ Wait. No, I hadn't. I looked at her one more time. "I'm sorry, my dear. I failed you." I walked off to tend to another patient.
I didn't go in there again for the rest of the night. She was there long after I had left my shift. When I got thinking, I realized that this happens to even the best of the medical professionals. I'm still relatively new to the medical field and have a long way to go in what I hope to be a successful medical career. It's a shame that it took a frail, sick elderly woman to remind me of why I got into medicine. Not the trauma cases or cardiac arrests. It definitely isn't about the money since my position can only pay so much. She reminded me of what is supposed to be an endless pursuit of medical perfection. Not just the treatment but the care we give as individuals. She reminded me of what I aspire to one day become. Not just a doctor. But a sincerely kind and caring medical professional. This is something we should all strive for. Not just as medical professionals, but as people as well. I think this is something we can all agree on.
