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.
Today I transferred a patient to a higher level of care hospital where the physicians are super trained in dealing with rare diseases.
Alfred came to our part of a country around Christmas time to visit his family. He is 65 years old and lived in the mountains. Wild fox comes to his backyard and it snows till late April. He is an avid skier. On arrival to our city, Alfred developed a weird rash and was admitted to the hospital as his muscles were also sore. He was discharged only to come back later in one week.
That admission he couldn’t breathe as the rare disease has attacked his lungs. He was treated with high dose of steroids and discharged. Another two admissions followed one with abdominal pain along with nerve damage in his legs, and now with heart failure. He went from floor to floor. Myriads of physicians saw him from different specialities. Initially an enigma of a medical diagnosis, later he became a challenge. Seeing Alfred every day reminded us all of our incapability to cure him of his disease.
Once the decision was made to transfer to a higher level of care, the interest in Alfred’s medical condition dwindled. He stayed in the bed most of the day. The physicians, nurses went in and did the cursory rounds. There he was, an avid skier lying wasted in the bed. The only person who was still interested was Alfred’s wife who was feeding him a spoonful of soup at a time, waiting for a miracle to happen. She still had the belief.
Today while I work, I saw a very well dressed couple next to the elevator. They are in their 60s. Neatly dresses, the man was wearing black pants with a blue sweater over a white shirt. The woman had well-cut jeans with a nicely cut blouse and an overcoat. The makeup on the woman was perfect – not too much or way little. Just enough to make her look pretty and in command. The couple certainly didn’t go unnoticed.
As the day passed, I forgot about the couple.
I met with my residents and they started to tell me about David. David is 35 years old who had cardiac arrest two months back. He was resuscitated and now has a tracheostomy tube to help him breathe and a feeding tube to provide him with nutrition. He is admitted to my floor as has developed pneumonia while at a rehab facility trying to get stronger. My heart sinks. Seeing a 35-year-old previously healthy person on a ventilator is not what we want to see on any given day.
I go to David’s room. The well-dressed couple is there. David is their baby son. He used to be a film producer. He had woken up two months back with chest pain. He went to the nearest hospital and crashed. It took the doctors over 20 minutes to revive him. And now he is here, my patient, on a breathing machine with a feeding tube. David can answer simple questions but has no short term memory.
After I talk to the parents about David’s medical condition, the mom looks at me teary eyed and said – “we both had just retired from our jobs and were looking forward to a slow pace of life and travel. There goes our retirement!!”
I walk out of the room thinking – how many days I have spent being miserable and saying – Is it time to retire yet!!!
While at work, Jasmine’s phone is continuously buzzing. I’m trying to talk to her, but the emails click on her cell phone are distracting. I tell Jasmine ” you are famous, so many people like you” She picks up her phone to shows it to me. The emails are from all the stores she has subscribed to. Micheals, Lord and Taylor, Barnes and Nobles, Chicos… the list continues. She gets over 200 emails in her mailbox in a day. I ask Jasmine if this doesn’t fatigue her and if her useful emails don’t get lost in these mass emails.
Jasmine tells me about her life. She had moved from India 25 years back. She raised her kids who have all moved to different cities. Her husband works in a tech company, her family is all back in India and these emails are her way to stay connected to the world outside. We talk for a while more and move on to the next patient. The emails that Jasmine gets continue.
And, I wonder, has technology brought us together or has created wide chiasm between people and has created this loneliness in this world.
Soon, I get a text from the psych floor. I have to see Max. Max is a 45-year-old investment banker who tried to kill himself by hanging using a dog leash as he is lonely and his wife recently filed for a divorce. And I wonder, does Max also have a cell phone which continues to chime the whole night with over 200 emails a day?
Today, while at work, at 7:30am, I’m paged by a nurse to hurry up an oncological consult on a new patient who was admitted overnight.
I have barely printed my census for the day, and have just started reviewing the Electronic Medical Care.
I click on Adam’s chart. He is 41 years old who had developed some shortness of breath a week back. He came to the emergency room as his breathing was getting worse and he had excruciating pain on taking a deep breath. Emergent CT scan of his chest was done. And there was the culprit – a golf ball size tumor sitting in his lung and encasing the nearby blood vessels. The tumor is already widespread. I place an emergent call to the oncologist to see when he will be able to see Adam to facilitate the care.
I go to his room. Adam is 6 feet tall, well-built man. He is well groomed, he has life exuberating from him. But, the look in his eyes is something I can’t forget. He is afraid, tears rolling up in his eyes, he is unable to hold a conversation without his wife filling in the gaps.
And I wonder, there comes Adam’s life crashing. Nothing really matters anymore.
Whereas we, everyday people, continue with our life. We are hamsters in a wheel, worrying about small issues. The small fights, the small egos, the clothes, the money – how much does it all really matter in the bigger scheme of life.