Today I discharged Dr. Matthews from the hospital. He was admitted with a viral infection which had settled in his lungs.
Dr. Matthews worked as an ER physician for a long period of time and had retired when the joints in his legs gave up and he couldn’t stand long hours. In the last ten years of his life, he was diagnosed with Heart failure, Diabetes, Spinal Stenosis, and Osteoarthritis – the diseases of old age.
Dr. Matthews came to the hospital with a viral infection causing his heart to fail and fluid to build up in his lungs. His heart rhythm decided to get erratic – again a sign of aging heart which made the heart failure worse.
He became progressively weak. His mobility decreased and his arthritis worsened. His muscles failed to remember how to swallow food and he started aspirating on thin liquids. Knowing all that was in front of him, Dr. Matthews made a decision to get a feeding tube. He became confined to his bed and wheelchair. Today at the time of his discharge, he was a bundle of flesh, weak legs, protuberant belly, a tube coming out of his stomach and another tube supplying him with oxygen to keep him alive.
In spite of it all, Dr. Matthews stayed sharp as a whip. He managed his care, his diuretic dose, his feeding schedule, and his laxative dosing. He had fights with the providers, he expressed frustration, anger and fear. But finally, the body gave up, the fierce will to survive has vanished. The body seems to be taking over the mind. Its the triumph of a dying body over a sharp mind.
Rachael appeared sad and dejected. She is 49 years old. She has a broken hip, a torn muscle in her leg, a broken wrist, no medical insurance, no money, and no family to call her own. She had had various surgeries done but has no place to go. She has no home to go to, she can’t go to a shelter as needs ongoing medical care and rehab facilities wouldn’t take her as she has no insurance.
I start taking to Rachael to understand how she reached where she is. Her answer – all this happened in the name of love.
Apparently, Rachael was living with a man for 15 years. She decided not to have kids or pursue a job. As per her, her man left her for a younger woman when he turned 50. She moved back to California to be close to her elderly mother as there was no place to go. She started living with her elderly mom and was working as a waitress. While at work she fell and sustained all these fractures.
We called Rachael’s mom to understand the whole picture. Rachael had moved back home 6 months back. She had not been able to hold a job as she was not used to working for her upkeep. The money she made occasionally was all spent on buying alcohol. The fall happened as Rachael was dead drunk and was having an argument with her mother.
As I walked out of Rachael’s room, I couldn’t help but wonder – is it all in the name of love? Shouldn’t Rachael have known enough to understand that circumstances change and life changes? Is her boyfriend to be blamed for it all? Or rather the blame lies on Rachael for not having self-sufficiency even at his age?
I don’t know how long Rachael will stay in the hospital and where she will be discharged. And all this while, she sits in her room all angry at her boyfriend and the world around her.
Sam was admitted two days back to the hospital. He is on the orthopedist floor. I saw Sam sitting in the chair with a smile on his face. A new face for him, another doctor to see, once again he would have to tell the whole story about his fall.
Sam is hard of hearing, he has two days old beard on his face and he is almost 80 years old. He had the surgery done to have his hip fixed. His left side of the chest still hurts. Sam took a nasty fall and broke his hip and a few ribs.
Thankfully the surgery went well. His broken hip is fixed. He has a long recovery ahead of him. He will be discharged to a rehab facility soon where his mobility will be gradually increased based on his pain tolerance. He still is at risk of developing pneumonia, infection at the site of surgery, or blood clots. Hip fractures are a leading cause of death in the elderly population.
When I see Sam, I ask him the reason for his smile. He mentions – “to be or not to be”. Sam fell as he saw a big nasty yellow bee in his living room. He vividly described the bee. It was yellow with black stripes and big antennas. . Afraid that the bee will bite him, Sam stomped on it. While trying to kill the bee, Sam took the nasty fall leading to the hip and rib fractures!!
This story explained the smile. What would be worse, a sting by the innocent bee or the fall leading to six months of misery with the hope the life will come back to normal.
Amy is a 25-year-old woman. She is 5 feet, 8 inches tall, she has pearly white teeth and thick blonde hair one can only dream of. Seeing her, no one can avoid staring at her. She is beautiful and in a wholesome way. A young beautiful woman.
I met Amy on the psychiatry floor. She is admitted there as she has lost all hopes and wants to kill herself. She has committed herself voluntarily as she is afraid of doing something erratic. I was asked to see her as she was complaining of headache and dizziness. Physical exam was completely normal, her vitals are stable. She is talking in full sentences, but not eye contact and is teary eyed.
Amy has devoted parents, siblings who visit her regularly. Her room is full of get well soon cards. She has fresh flowers in her room, she is wearing fresh clean clothes carefully picked from home instead of hospital-provided medical scrubs.
Amy still feels lonely. She has something deeper missing in her life. She finished her Bachelor’s in Journalism and has a meaningful job.
Why does Amy feel lonely? As she says, she needs a purpose, a definition, a role more meaningful than her current life. She has everything anyone can ask for, but is that all there is to her life. We are born, we study, we work, we have kids, we get old and we die. To what end eventually? She doesn’t see any purpose behind doing what generations have been doing for ages. She says, this is a lonely planet, where there is not much more to achieve than live the same old mundane life.
While at work today, Winston was walking the hallways at 7 in the morning. The nurses called me that he wants to talk to me ASAP. I arrived at work, sans my morning coffee, to diffuse the situation.
Winston told me he had a heart transplant around 7 years back and he had come to the hospital yesterday with chest pain. He was getting the necessary workup done as ordered. But while reviewing the medications he got yesterday night, he realized he didn’t get brand name anti-rejection medication but rather was given the generic version. In his mind, his heart will fail if generic medications were given.
He was pacing the floors for us to find the solution. Two pharmacists worked with local pharmacy the whole morning but we to no avail and Winston finally signed out AMA later in the afternoon.
I talked to Winston. He was visiting from South Carolina where he had his heart transplant. He had his “non-generic” medication at his summer home but didn’t have anyone to fetch the medicine. In his words, he is a loner. His parents had died a while back, his two kids are all grown up and moved on with their lives, his wife left him when he was battling a failed heart.
Talking to him, I remember reading somewhere about Buddhism. Are all the material possessions, the relationships, the grudges worth it. Do they add anything to our lives? What are we chasing eventually – peace, ultimate happiness?? Are the word complexities the way to all this or rather denouncing it all like Buddha did? Are We Meant To Be Social Animals?
While at the hospital today, I met with Kishwar. Kishwar is 90 years old and of Indian descent having moved to the USA when he was in his 20s. While in India he lived in a small village at the foothills of Himalayas. He taught himself basic English and overtime worked as a librarian in the USA for 40 years.
He was admitted to the hospital as his heart has weakened and is pumping at 20 percent of a healthy person. He couldn’t breathe at home due to the gradual build of fluids in his lungs. He is on a continuous intravenous drip of a medication at home which keeps his heart beating strong enough to keep his kidneys and brain perfused. When I went to see him, he sounded weak and tired. His voice was muffled and he barely had enough energy to raise his head.
After I examined him, I started talking to him about his birth country. A familiar smile appeared on his face. He became more and more animated. He told me about his life 60 years back and his memories of the fresh air and open fields.
Currently, at the age of 90, he is involved in raising awareness in his home state to start public libraries. He and his friends have raised enough money to start a model library in his village. In his fluent English and Punjabi (his native language) he is busy dealing with the bureaucracy of India. He told me, his voice very strong, his purpose of life is to get funding from his state to open public libraries to encourage grass root education.
As I left his room, I thought, likely this purpose in life is what is making him go on with the weakened heart that needs continuous medication infusion to keep it pumping.
While at work, I was talking to Mary. She is from Trinidad originally and now lives 50 miles from my hospital. She was in her husband’s room who was airlifted to our hospital from a smaller hospital for complex surgery.
Mary asked me when her husband will be discharged as he has been in the hospital for over a week. Her husband had just had a complex surgery and if baffled me that she would want to even start talking about the discharge.
On further questioning, she stated -” he is a part of me, and I’m a part of him. The home, the life, the world seems incomplete without him”. Mary met her husband when she was 16 and they have been together for over 60 years. She is the first man she fell in love with and still is in love with.
As I walked out of the room, I wondered if this deep a feeling even possible on our new new world?
So much more comes in the way – career, money, choices, glitter, options. There is so much more in our world. Relationships are important, but so much at par with the rest.
Somewhere I would want to feel I’m a part of someone, to believe so strongly in someone. But, I think we are way far to go back to this way of living.