Your Patient, The Person

  • Your Patient, The Person - An Elsevier Series by Natalie S

    Compared to the nurses and doctors running around the Hospital, as a medical student I have ample time to attend ward rounds, watch procedures, and talk to patients. I usually choose the last option because I either have a timetable clash, or haven't been fast enough to catch a procedure. Interns have been happy to point me to patients who don’t see many visitors, have been stuck in the hospital for weeks, and are keen to chat for hours. Over the past month I’ve spoken to many patients who were generous enough to donate their time to a lost medical student on her first rotation who needed a sense of purpose, a sense that she accomplished something on the ward today. And that is how I met Beth.

    I’ll call her Beth for the sake of anonymity. Her real name is Arabic because she emigrated from Lebanon in 1963. Beth had nine siblings. Had. Two of them died as soldiers in the war, and that is when her parents had enough. She told me, with a tremor in her voice, about how they gathered up all the money they could to send her to Australia. She was the eldest, at 19 years of age, and had the best chance. They sent her to live with a fellow Lebanese family. Beth informed me that she used to be beautiful – waving me away when I tried to interrupt with ‘but you still are!’ – and that she would turn heads everywhere. The wife of the family she lived with became suspicious. She’d listen to the fights between the husband and wife in the other room, reaching a higher and higher crescendo every night. Soon Beth was shoved out the door in a foreign country where she couldn’t even read the street signs. Beth’s eyes watered, but her gaze was fixed straight into mine when she said, “I didn’t know where to go. I wandered for a day, and ended up in a park. There was bread scattered on the grass that people had left for pigeons. I leapt on it and ate and ate and ate. I felt like less than an animal.”

    Beth slept in the park for 3 days, until one night she heard something familiar under the street lights. Arabic, her native language. Her pale hands gesticulated wildly, like frightened birds, as she told me. “I jumped up! I couldn’t believe there were people here who spoke Arabic! I could not help myself; I started screaming help me, help me, help me! At the top of my lungs. I grabbed onto the man’s jacket and wouldn’t let go.”

    The men were from Lebanon, like Beth, and took her to their church. Beth lived there, with warm showers and fresh food, until she secured a job as a fruit picker on a local farm. She practiced her English in the orchards. She says she doesn’t know what would have happened to her if she hadn’t found them that night.

    Beth taught me many things. I listened to her pan-systolic murmur and I learnt about glaucoma medication from reading her chart. But meeting Beth, and many other patients in similar situations, made me appreciate the challenges many people face when they arrive in Australia. I have learnt about signs and symptoms, but I have also learnt much more. Learning about the complex and unsurmountable barriers our patients have had to overcome has helped me develop compassion not only as a future medical practitioner, but also as a human being.

    4 years ago
  • Ahmed

    I wiped away the condensation on the window next to his hospital bed. Ahmed had wanted to look outside, but had trouble getting out of bed nowadays and couldn’t do it himself. There was little to see. It had poured with rain over the last few days. Commuters bustled past in long black coats, white plumes of air escaping between their lips. A thick fog had enveloped the street, and people vanished into outlines. Naked trees trembled against the bite of winter. I turned away from the window, but Ahmed continued to look outside. The television was broken, and he could not read the English in the hospital magazines.

    His chest rattled as he breathed in and out. Ahmed’s pyjamas were four sizes too big for his frail frame. Different puffers in all shapes and sizes were lined up neatly like soldiers on the bedside table. Next to them were photos of his family. A beautiful woman standing next to a younger Ahmed, children playing at the beach, a family smiling at the photographer. There were many photos. Ahmed must have been in hospital for a long time.

    “Three weeks.” He informed me. It had been one thing after another. Ahmed was diagnosed with emphysema over a decade ago. He had been a construction worker, and everybody on the site smoked. He helped build skyscrapers that were sixty levels tall. He and the boys would light up a cigarette as they dared each other to look down, while standing on makeshift balconies that shuddered with the wind. He felt as though he were close enough to touch the clouds, back then. Everybody smoked, and nobody talked about the side effects. Nowadays he ran out of breath just walking to the bathroom.

    “But really, it did not bother me until last month.” He said dryly. “My grandchildren visited, and one of them had a cold. A few days later, the Devil was knocking on my door, telling me to let him in. Barely had the energy to call an ambulance.”

    Ahmed was diagnosed with pneumonia, which had worsened his emphysema symptoms. The emergency doctor had taken chest x-rays to confirm his pneumonia, and discovered something else. Squamous cell lung cancer, a cancer that was common among smokers. It had already spread to his liver.

    But Ahmed preferred to discuss his family. His son Uncaught Error: Call to undefined method Magento\Framework\App\ResourceConnection\Interceptor::insertMultiple() in /var/www/html/apacmagento/app/code/Infopro/CheckoutManager/mp_blog_posts.php:922 Stack trace: was a mechanic, and had been taking apart and fixing cars all his life. In primary school, his son had dismantled the radio out of curiosity, and successfully put it back together when Ahmed threatened to ground him. His grandchildren were also talented, Ahmed declared proudly. His grandson was a top soccer player, and his granddaughter had all straight As.

    “What were your parents like?”

    A dark cloud passed over his face. “They always worked hard.”

    “Sounds like you take after them.” I replied tentatively.

    Ahmed shook his head. “My father worked in a textiles factory. I never saw him except on the weekends. My mother took care of the family; cleaned up after him all the time.”

    He took a gasp of air. Failing to find his words, Ahmed felt along the bedside table until he found his puffer. “It was the asbestos. She did all his laundry, and they didn’t know about the asbestos in the factory until it was too late. Did you know you can die from asbestos just by handling clothes exposed to it?” He laughed bitterly, and his laughter turned into a hacking cough. “My father couldn’t handle the guilt. He followed her six months later.”

    Ahmed fondled his puffer absent-mindedly. “Smoking isn’t that different. The first cigarette my son started smoking was mine. Cheeky bugger stole them out of my dresser. He smokes around my grandkids. I can smell it in their hair and on their clothes. And he learnt it all from me. “

    He stared through the window, which had fogged up again. His eyes misted over. “He’s visiting this afternoon, and I’m going to tell him what I told you. We’re both quitting today.”

    4 years ago
  • "Don't it always seem to go, that you don't know what you've got 'till it's gone?"

    "Don't it always seem to go, that you don't know what you've got 'till it's gone?"

    The bus driver on my commute to the hospital this morning loves loud music. He blares the radio on full volume most days, usually a dance song or happy 90’s pop music that drowns out the traffic. I vaguely recognized the song, but my mind was somewhere else. I was thinking of the clinical exams I hadn’t memorized yet, a respiratory lecture I hadn’t prepared for, the long case I needed to write up. And I needed to visit the inpatient wards to find patients to examine. My stomach rumbled. I’d eat breakfast later.

    I tried three wards without luck; the patients were asleep or had visitors. A sympathetic nurse on the last ward told me that Jack would be up for a talk. Jack might have a new respiratory infection, he might have had an allergic reaction to antibiotics, and he was a very nice bloke who would talk your ear off. Since he might also be contagious, I donned the compulsory mask, gloves, and gown before entering his room, and asked in a muffled voice how he was feeling.

    “Bloody brilliant!” He didn’t look bloody brilliant. Jack was covered in spots and very pale, with a newspaper in his lap. I took a deep breath. “Hi, I’m Natalie. I’m a medical student. If you have time, I was hoping to talk to you about what brought you to the hospital?”

    He grinned wide. “Pull up a seat!” I hastily sat down and whipped out a notepad. Jack answered my questions enthusiastically, only pausing to wink when I asked him about alcohol intake. He was 55 years old, he had been driving trucks for 30 years and the road was his home, he had a border collie called Patches. And he’d had a run of bad luck. A month ago he had developed a rare and sometimes fatal form of pneumonia. His health had gone south since then.

    Despite this, Jack seemed to be in very high spirits. He joked that his time in hospital during February was the most attention he’d ever had on Valentine’s day. I asked him the standard questions. Do you have any allergies? Do you have hypertension? Do you have diabetes? Do you take any regular medications? No. No. No. Yes. “I take Sertraline.”

    “Right, Sertraline. How much?”

    “No idea. One tablet a day.”

    “What is it for?”

    “Depression.”

    “Oh.” I was not sure what to say. “Do you mind discussing it? We don’t have to-“

    “Nah, that’s fine. I began taking it four years ago. My wife and I would argue over anything. Everything. We married too young. She’d come home smelling like someone else, I’d punch the wall. I slept in the truck some nights. A few times, I thought about ending it all. Driving it straight over a bridge.”

    I tried to express emotion through the paper mask. But he kept talking. “So I went to my doctor who yapped on about counselling. I wasn’t having none of it. Tried Sertraline instead, and it helped. At least with my mood.”

    “And you and your wife?”

    He paused. “There were good and bad days. More bad days than good. But when I had pneumonia the first time around, they put me in an induced coma. The doctors told my wife something that she won’t tell me. But she’s been looking at me differently. I don’t think we knew what we had. We’ve been kinder to each other recently.” Jack no longer sounded light-hearted. “You don’t know what you’ve got until it’s gone.”

    My mask felt heavy. “Thank you, Jack.”

    4 years ago

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