Monday, July 10, 2006
Tales from the Last Chance Motel
Last week at work, I took care of J., the woman who was in withdrawal and suffering from extremely altered mental status, although she was coming around a bit. I also took care of W., an engaging southern politician who said things like, "I have a five-pound appetite but a three-ounce stomach." He was a genuinely nice guy, the kind of person who, when he asks you how you are, asks you because he actually wants to know. I admitted him one night then got him ready for discharge him the next. So I came back to work this week and was guilitily pleased that J. had been transferred to another unit the day before. Then I found out that she had died that morning, a victim of her aggressive stage-four gastric cancer. And although I had discharged W., he had been re-admitted the next day but was currently on his way back home, via air ambulance, as he had relapsed and suddenly gotten sicker, so he wanted to be home to die. That night my another patient on my unit died, and I helped her nurse wrap up her body. My patient is also awaiting a celestial discharge, but remains full-code status and continues to undergo all treatments, such as mechanical ventilation, kidney dialysis, and a levophed drip (cardiac medication to keep her blood pressure up). She has gained over 80 lbs in less than three weeks, and when I move her or touch her she cries. Her tears are bloody and leave permamently stained rivers down her cheeks. Last night one side of her neck started swelling up like a baseball and we found a strange (fungal?) rash/spots across her chest. Yesterday another patient that I'd had a few weeks ago received her stem cell transplant but shortly thereafter went into respiratory distress, acute renal failure, and suffered a huge MI (heart attack). She was intubated and dialysed but her blood pH had been around 6.1 for nearly four hours. That's real BAD. So...yeah. I don't know why I'm typing all this, except that its what I mean when you ask me, "How was work?" and I say, "It was okay."