My Patients

One of the best things about being in the medical field is that we get to see patients and take care of them. We get to make them feel better from a variety of causes. They may have an infection, a cut, depression, asthma, anxiety, etc. We can do something to help them... most of the time. Of course there are times where the only thing we can do is make them comfortable so that they are not in pain and distress. Sometimes, aside from treating their disease, patients just need someone to talk to.

There was one patient who unfortunately was morbidly obese with an abdominal hernia, skin graft, an ostomy (poop bag), and 4 other tube drains coming out of her. There wasn't much I can do when I rounded in the mornings except talk to her and check her drain outputs and vitals. I talked each morning with her for a bout a week until we decided we had to get her into the OR to see if we can fix some possible infection with her bladder. When I finally met the family before the operation, the patient told them I had been taking great care of her because I would come in every morning to make sure she was okay. I told her and her family I would be there throughout the operation, which I was. After the operation, I was able to follow her for another week and we were able to remove all the drains, except her ostomy. However, since we had to get into her abdomen, we had to cut through her skin graft which she was so proud of how it had healed.

One of the interesting conversations we had was when we removed all the tubes from her, we joked about how she was finally "becoming human" again. For a long time, she had been bed-ridden in the hospital with doctors and nurses just coming in and out to check up on her, look at drains, monitor vitals, and draw blood. Slowly but surely, we were able to discharge her to a rehab center where I hoped she would improve. I wished her the best of luck and to keep working hard because even though she had so many medical problems, she had an amazing outlook. Each morning, she fought through pain and discomfort to say, "We are taking things one day at a time. I probably should have been dead by now, but I'm still here. Let's get this solved and move on to the next step." Unfortunately, I actually saw this week that she had returned to the hospital. I don't know why as I was not present when she arrived to the ER, but I hope she's in good hands.

The comment about becoming human struck a cord with me. We all know patients are people too, but sometimes a hospital can be a very scary place. It can be a dehumanizing place. You can be feeling your worst--at your most vulnerable--and be all alone. What if no family or friends visit? All you have is the medical students, residents, and nurses who pop in for a few minutes to make sure you are okay, but not much else? On top of that, you have an IV tethering you to a pole, a foley because you can't get up to urinate on your own, an ostomy because you had a serious GI problem, drains to clear out fluids, and a nasal cannula so you can get oxygen. I have never been hospitalized so I have never been in that situation, but I can't imagine what it does to a person's sense of self. To their soul, seeing their bodies broken down so much.

In movies and tv shows, they don't show that if you get shot or stabbed, especially in the abdomen, chances are you will end up in the hospital for a few weeks with and have an ostomy for at least 3-6 months. Why, because it isn't heroic. Maybe they'll end up in a wheelchair and crutches which may make them tragic, or they will recover in a testament of willpower and faith. No one wants to see someone with a bag of urine taped to their leg, or an ostomy leaking stool. The image of a person in a hospital bed portrays a sense of weakness (even if they may be the most couragest of people), disease, and a fear of death.

There was another patient I had, a little old lady who was a pleasure to talk to in the mornings when I was on surgery. She was doing well but I had to keep visiting her to change an open wound she had on her abdomen so it could heal properly. However, one afternoon, I was walking by to make sure she was okay when I realized she had to change her dressing. I then noticed that the patient in the next bed was arguing with the nurse because the two patients were getting annoyed with each other. My patient was positioned by the door and felt claustrophobic so she wanted the curtain to be moved so she can see outside the window. The other patient wanted her privacy. The nurse tried to play mediator but in a horrible way. The other patient began yelling at the nurse saying that my patient was disrespectful, and that her and her husband were mean and should move out of the room. All this was said with a curtain in between, as if my patient couldn't hear through a piece of cloth. And as I was changing my patients dressing, she started to cry and told me that all she wanted was to see the window. I tried to comfort her and the nurse said she would look into separating the patients.My patient then turned to me and wished me the best of luck. She said how she believed I would be a great physician because I took the time out to talk to her everyday and check up on her to make sure she was okay. She said she felt that I actually cared for her. It's important to be able to be there for your patients in a way that they feel as if they have someone they can talk to, someone they can open up. I think it improves their experience in a hospital.

Today, I had a patient who was this older gentleman with urinary retention for 2 days. He was also great to talk to, and we made a few jokes and laughed, but I decided to keep our little talk short because I knew he was in a lot of discomfort and unfortunately would need a foley catheter to empty his bladder. I checked up on him a couple times to make sure he was okay and he felt much better. At the end of his stay in the ER, he shouted out for me and wanted to thank me for helping him feel better.

It's a great feeling to meet new people everyday and help them in someway. Obviously in the ER, we are treating very acute illnesses, trauma, or life-threatening things, but it's also important to be there for the patient emotionally. There have been multiple times when I would stay a few minutes longer with a patient because she just had to divulge her story to me. It may not even be relevant to her treatment, but she just had to talk about her job, or he had to talk about his family, or they talked about a trip they did.

The rapport between a healthcare worker and the patient builds a sense of trust and comfort that can make being in a hospital tolerable. No one feels good when they are sick or are in pain, and so it's worth spending a few extra moments to hear them out. That is why I hope to to try for each of my patients to:
1. Make them smile or laugh once a day
2. Learn something about them outside of their disease
3. Make sure they have what they need such as a pillow, blanket, cup of water, etc.

I want to learn and work hard so that I can take care of my patients to the best of my ability, but I hope to always remember that my patients are more than just the disease. They are still people with feelings and fears. They are people who at the present time are vulnerable and weak. And if I can, I don't see why I can't help calm those fears and provide them support.