Convinced

I was wandering around at the end of my shift. I'd promised the patient in room 31 that I'd give them some Relpax before I left and the pharm had just delivered it. We don't keep these triptan drugs handy, and I didn't want them to wait any longer.

I absolutely hate migraines. The patient had it all: photophobia (the room was darker than Dick Cheney's soul,) nausea, drippy sinuses, noise intolerance, frequent urination, the whole migraine constellation as well as the slow-motion jackhammering in the right side of their head from the back of the neck all the way to their eye.

No aura though. They had common as opposed to classic migraine. Too bad. The auras are the best part.



The Lancet on headaches:

"Similarly, migraine costs American employers about $13 billion a year because of missed workdays and impaired work function, of which close to $8 billion was directly due to missed workdays.

[Snip]

Nevertheless, some individuals may pursue with work despite having migraines, as theirs may be a mild form, or indeed they may just be apprehensive about taking time off. A study (13) showed that when at work with headache, work effectiveness was reduced 41% for migraine headaches. It is apparent despite all the best intentions such individuals have, they may still not be as effective as they would like to be."

Speaking of headaches, the patient across the hall was cussing out the oncoming nursing assistant. After I heard about fifteen really loud exhortations which included the word "fuck" I decided to step in. Fun.

Not kid fun, like riding a bike to the store for a soda and to see the cutie that sits behind you in homeroom. Adult fun, like an uphill bike ride on a moist windy day in the Adirondacks.



The verbally-abused nursing assistant took off in a jiff as soon as I got to the doorway and asked what was going on.

"I told them eight times that I didn't want any fucking male nurses touching me and they should get me my pain medicine because that bitch took the Dilaudid herself and I didn't get it I can tell because I didn't fucking puke and she was gonna give me fucking Haldol and I'm not a fucking psych patient and I don't need that shit, and she was gonna give me something so I didn't get sick but that's how I can tell if I'm getting enough pain med because it makes me vomit and she should have just upped my Dilaudid like the doctor said but instead she I dunno took it herself and got sparked, the bitch. Look I'm in pain here and if I don't get a cigarette I'm gonna go off on somebody so you guys better take me to the ER right now or I'm gonna light the fucker up right now. Call that fucking doctor again. But I gotta tell you if one more male nurse comes in here I'm gonna rip this tube right out and get the fuck outta here and smoke a fucking cigarette..."

And so on.

Once at home I got talking to the delivery guy. He was a recovering methamphetamine addict. He said it used to calm him down. He'd do crystal and then hang out and watch TV. Paradoxical effects.

People just talk to me. Like waiting at the grocery checkout or just walking down the street total stangers approach me, pull out their wallets, and show me pictures of the grandkids and pets. They tell me how their mutual funds are faring. It's always been that way.

This patient was obviously and completely gone. That ethereous void in their eyes, the stunning lack of a personality. They had turned themselves into a paranoid drug-seeking sociopath. Nothing mattered to them except drugs.

And air. Not much choice about that. They had suffered, again, a burst lung bleb which scored them a chest tube and the requisite hospital stay.



"Take this fucking shit out so I can go smoke and that bitch who took my pain med better not be there and if you send another male nurse in here I'm gonna tell them to fuck right the fuck off like I did that doctor who said there was fucking tweak in my blood test, he fucking put it there is what he did..."

Etcetera.

Then they lit up a hand-rolled cigarette.

I politely told them that they couldn't smoke here.

Blank stare.

Nothing.

Then they took the cigarette out of their mouth, flipped it around in their hand, and extinguished it by butting it out on their tongue. After that they put it in their pocket for later.

That was enough to convince me.