Friday, June 16, 2006

Black Equals White So Blue Is the Truest Color (except green)

The night shift nurse was still giving me a one-on-one report when Abe, the certified nursing assistant, bent over the station counter and held the glucometer up to us and said "5-B." It read 55. I've seen people reading a glucose of 30 and up walking around so I got there when I got there.

The patient wouldn't take juice. They just kept saying (for lack of a better word!) Meh, meh. A little blood oozed from their lips, and some brown-green emesis was spread a little down the hill of their upright head-of-bed. Fish in my koi pond were more verbally appropriately responsive.

We checked their temperature and they were hot, about 102F., whatever that is in centigrade. They looked post-ictal to me. They'd been incontinent too, and an embarrassed resident, who was obviously uncomfortable at the sight of a patient who'd messed all over themselves, asked if I "could clean the patient up."

Of course.

But first I wanted to give the patient a dose of D50 and an acetaminophen suppository and maybe Yankauer the crap out of their mouth, while the resident stood there like a pigeon on a wire. Then I checked my other patients, as yet unseen, just to make sure none of them were blue and lying on the floor.


They weren't.

I do not mean to run down the resident. He's a real sweetie, and one of my favorites. Usually he's all over medical issues like wet paint on a bench, but poop scares him. He's not a parent yet, I think. Diapers to him are like braille maps to NASCAR racers.

In college I particularly studied, after music, Surrealism and Zelda Fitzgerald. Whenever I find myself saying "blah-blah-blah is like so-and-so" I cannot help but recall those heady days. But mostly I studied early music techniques and free jazz. It's all of a piece, really, once you get there.

Imitative modal counterpoint. Free association poetic constructs. Adult diapers. Pharoah Sanders. Anime. There ya' go.

The other patient in the room was not of an acute situation. More chronic. Thrown from a vehicle in a motorvehicle accident, they had four broken limbs and a closed-head injury. Freakin' brain stitches, right?

More of a long-term situation here.

In an hour or so the room-mate was awake and oriented, fever and blood-sugar issues resolved, tegretol levels within normal limits, skies clear with gentle breezes out of the west.

In the meantime roomie had an episode of tube-feeding loose stool rivers of flowing crap down between the legs and over the edge of the bed, cascading out of the room out into the halls like the Slime From the Video.

Cleaned, turned and positioned, tube-feedings checked, IV sites clear, we joked a little with the patient and although they could not speak, due to the closed-head injury, they smiled and with the hand they could move a little, signalled a clear "thumbs-up."

Man, that was the best. What a grin. Cheshire cat-like. Cheesecake to my eyes.

We got there. We did something for them that they recognized and appreciated, even though they couldn't speak. They blinked it.

The other patient was basically out of the woods. Theirs was an acute situation and they'd go home soon, back to their normal life.

But this one would never be themselves again. The accident robbed them of speech, mobility, and control of their bodily functions. We wondered when the docs would finally get a PEG tube placement ordered. Some thought that maybe the patient could get through a swallow study, but I had doubts.

If you can't turn your head much voluntarily, then you probably can't swallow without dropping a bunch of crap into your lungs.

That is not a Surrealistic comparison.

It's more of a Republican comparison. You see, both of these patients are the same. They are both hospitalized. They have the same needs, politically, because neither of them are likely to vote. And they have nobody but family to advocate for them. No political lobbies shovelling millions into campaign coffers. No casinos. No churches. No Scottish golf junkets.

This is nothing.

These people are no-accounts.

And I love them with all my heart and soul and I will devote my working days to them as rainbows are devoted to the sky-waters that foster them, because I am just a normal person just like you and you'd do the same if you were me.

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