The Hospital: A First Rotation

by Jaraad Dattadeen, MSIII

 

The hospital is a strange place because it contains real people, not just numbers or diseases. Though this seems obvious, it can still shock you to the core. Over the course of a week, I found myself drawn into the emotional spiral of interacting with a living, breathing person whose sanctity of life was at stake.

It started out as a mere experiment. An elderly patient with Alzheimer's and recent MI sat outside his room, restrained in his chair because he was at risk of falling if he stood up. Leaning against the observation desk, I smiled at him. I wanted to see how he would react, whether my smiling would somehow make it a little bit easier on him, since he was just stuck sitting in his chair with no friendly faces around.


As I'd hoped, every time he saw me smiling, he smiled back. He didn't speak English so this was the best I could do. Every now and then, I pushed back his restraint to prevent him from getting up and possibly hurting himself. I could see he was getting a little agitated with me because I was ignoring his verbal cues about wanting to get up. I guessed that part of the problem was that he was bored so I gave him a book to look at. Though I saw him turn the pages, I don't think he got much out of it. Eventually, he was moved back to his room.


Two days later, I saw him again when my fellow students and I visited him with our attending. I was sure he wouldn't remember me but to my surprise, he quickly recognised me amongst the many people on the team. He looked straight at me and a smile grew on his face. Pulling down his covers so his hand protruded, he used whatever strength he had to wave at me.


I finally had a result to my simple test to see if smiling at a patient would make a difference. Despite his Alzheimer's, he remembered me and was happy to see me.


They said that he was getting discharged later that day to his family and I left his room satisfied that his stay with us wasn't all that bad.


However, such stories don't always have happy endings.


After the weekend passed, I checked his room and was glad to see that he had left as planned. To my dismay, I later learned he hadn't been sent home but rather transferred to the ICU. Over the weekend, he had developed trouble breathing and they put an oxygen mask over him.


Unfortunately, because of his age and condition, he had not understood what was being done and had pulled off the mask. He eventually aspirated and developed pneumonia. Despite everything done, he expired in the hospital.


I never expected things could turn so quickly. It was the first time I had bonded with a patient, only to find out that things didn't go the way they were supposed to. It hurt; it really did.


However, life goes on and we do not have the luxury to mourn our patients' deaths for long. We must pick ourselves up, brush ourselves off, and move on. I'm sure I'll have similar experiences in the coming years, but this first time truly opened my eyes.

 

~~~

 

Supplemental Note: The author indicates he wrote this selection during his core clerkship in Internal Medicine at Lutheran Medical Center in Brooklyn, NY. A selection of Mr. Dattadeen's writing was recently published in the narrative medicine journal, "Pulse."