Saturday, September 22, 2007

My Hospital Discharge

When the Internal Medicine department was short a doctor last month, they asked me/roped me into joining the rotation of inpatient care. I have gained a reputation as a utility player, working as needed in several departments and settings. Now that the new Internist has arrived on island, my stint is over. As inpatient medicine is not exactly where my talents or interests lie, I am relieved to return to more familiar territory. But there were a few moments in the hospital I found worth sharing.
Families show in huge numbers to support patients that are admitted. Often they have a few relatives already in the hospital, and many work in the hospital. It is common to admit someone that I first met as a supporter of a former patient, or to see the housekeeper sitting in the corner visiting with a familiar patient.
The hospital food, as is traditional, is pretty bad. It is rare that patients eat it. They usually have impromptu buffets and potluck dinners brought in by family and friends. These spill out into the hallway and sometimes blend in with the family next to or across from them.
I asked a patient who had had a heart attack if she was feeling better, and she smiled and mumbled yes through a mouth full of fried chicken. Patients always offered me some food, nodding toward it and saying, "Eat, Doc!"
There are no beds for visitors, so one finds bodies strewn all over, sleeping on blankets on the tile floor. They pile into the chairs and slump in the window sills. Several times, I would find the patient in a chair and several sleeping kids in the patient's bed.
One of my patients, who had been there 3 weeks for a very serious infection and liver failure, started to get stir-crazy from staying in his bed the whole time (not an easy thing for someone used to drinking all day). He couldn't move around, because the hospital didn't have any wheelchairs fitted with leg braces that could support his bandaged leg. The more restless he got, the harder he was to deal with, so the nurses and physical therapist came up with a plan. They asked the patient's son to bring in some plywood (which they did, and his wife wrapped it in bright fabric). The physical therapist made measurements and drew out a plan for the hospital maintenance (department of one) to cut the plywood into an L-shape that he could sit on and extend his leg. The frustrated patient almost cried when it was presented to him. The nurses got aggravated, though, because from that point on he could never be found.
There were some beautiful moments with families spending time during the end of patients' lives. I watched two daughters touch and hold a dying patient's feet while other relatives straightened the bed sheets. I heard a family singing (daily) around an ICU patient's bed. I saw the reunion of a man with his son, who returned from active duty in Afghanistan to be with his dad after a devastating stroke.


Diana Gallaher said...

Ryan: Thanks for sharing some of your experiences from the hospital. The sense of community sounds so strong from what you describe. We've lost that sense of community in our culture where it seems that everything is a commodity. We lose grace in the process, I think. It is always great to see a new posting. Thanks to you and Kim for doing this! Diana

Marianas Eye said...

Nice to see your blog. And congratulations to Kim for getting the sleep center off the ground.


Philip said...

Ryan and Kim,
Thank you so much for sharing your blog! I love it! How did you guys manage to swing such a sweet place to work?
Life is good with me. I'm finishing up a public health degree in Sydney and heading back to the States for med school interviews. Let's keep our fingers crossed!
Enjoy those sunsets! Wow!
Philip Storey