More Things I Forgot to Remember

During my medical training, attendings reminded us again and again to treat patients with dignity:  simple things, such as addressing them by title and last name, keeping them properly draped during physical examinations, sitting down at eye level when possible. The physical nature of the relationship between doctors and patients does not always bode well for that injunction:  there is no dignity in the rectal exam, or in dropping an NG tube, or in any of the many invasive things we do to patients during the acts of healing.  Nevertheless, there are certain things we can do that serve as reminders that our patients are adults, and that their bodies and minds deserve care with compassion and dignity.

So I had forgotten with my father.

“Dad, please eat the last few bites.”  I feed him.

“Dad, you need to take a shower.”  I undress him, I put him in the shower, I soap, I wipe, I dry, I redress him.

“Dad, time to brush your teeth.”  I put toothpaste on toothbrush, fill the cup, watch him brush.

“Dad, wash your hands.”  I give him soap, or hand sanitizer, and I watch to make sure he cleans his hands.

“Dad, please don’t use the stairs by yourself.”  I sleep on a makeshift bed, a human barricade on the staircase landing so that he cannot go downstairs in the middle of the night.

All these things that I think my father need to do, but that he refuses to do on a regular basis.  They are for his own good, right?  Why would he refuse to take care of personal hygiene, or to eat, or to get out of bed, or to do any number of other things that any reasonable human being does, as he did do for most of his life, but has stopped doing since Mom died?

My father is his own person, with his own reasons, making his own choices.  Who am I to try to force him on a course he doesn’t want to take? He wants to be with Mom, and as a thinking being, he is doing something about it.  And it’s about time I remembered the lessons of compassion and dignity.  No question it is a hard thing to watch my father dying, and to let him go on his own terms.  I choose to believe that is his gift to us:  that we are not his parents.

Conversation of the Month:

Me:  “Could you make sure after guests leave Mom and Dad’s house that you clean the                     toilets?  They were filthy after _____ stayed for 8 days back in May, and I had to                     clean them when I got here, 5 months after the fact.  Not fun.”

Brother:  “I did check the toilets, they were fine!”

Me:  “Did you flip the seats up and look underneath?”

Brother (in bewilderment):  “Why would I want to do that?”

Reuse Reduce Recycle Project, Part 2

I spent my internship year at St. Elizabeth’s Hospital, a somewhat run-down community hospital in a not entirely salubrious part of town.  The place was old enough that most of the patient care areas did not have air conditioning, and during the summer the nurses would set up industrial-sized fans (the kind they use in gyms) at ends of hallways to help ventilate and cool the wings.  The in-patient population tended to be elderly, and there was a rumor that one of the attendings had the biggest Medicare billings amongst all private practices in the state.  The typical admissions were old, institutionalized, and usually DNR, except when they weren’t — and there were also rumors about certain families who kept Dear Old Mom/Dad/Aunt/Uncle alive in order to collect their social security benefits.   The hospital was strapped for money, so various services went home after 7PM:  phlebotomists, EKG techs, respiratory techs, unit clerks, runners who delivered radiology films (yes, these were the days before everything could be pulled up on screens).  Even the cafeteria closed down by 7, which is how I ended up eating my first, and last, White Castle burger from the vending machine.  On the usual call night  the residents would drown in scut work: drawing blood and ABGs, inserting countless IVs because the nurses were required to give up after two sticks, hunting through the stacks for radiology films, doing EKGs with machines that still used rubber suction cups and required leads to be switched between readings, figuring out settings for respirators, inserting NG tubes and various other catheters into various orifices (because nurses didn’t do those “invasive” procedures, and delivering patients from one place to the next.  I got to the point where I could do ABGs on anyone, and do them in the dark!  I spent years 2 and 3 of my residency in another Saint hospital.  This one was better-run and had money, and I was shocked to discover that all I had to do was WRITE the order, and miraculously it was done!

Anyway, I had a couple of souvenirs from my internship year: scrubs (of course, because how else would anyone know you’re a doctor unless you are wearing scrubs from another hospital), and a couple of towels.  Like everything else from the hospital, these towels were depressing, scrawny and tiny even when new.  I used these towels for years as back-up bathroom mats, and kept putting off turning them into rags.  A few weeks ago,  I attacked the linen closet as part of my R³ Project, and the towels were still there, still scrawny but usable.  And this is what I did with them:

St. Elizabeth's Hospital bath mat
St. Elizabeth’s Hospital bath mat

In my short quilting career, I have still managed to accumulate a large amount of fabric scraps.  In this case, the block was from a quilt top I was never going to turn into a quilt, and it happened to fit perfectly on the towel.  I stitched the quilt block directly on the towel, added a couple of scrap fabric to the sides, turned the towel borders in and stitched them in place.  My memories of St. E are not entirely bad, and this bath mat (and its fraternal twin) makes me smile and think more kindly of that year.

The St. E mats got me on a roll, and for three or four weeks now, I have been reducing my fabric scrap pile.  We have more bath mats!  We have mud mats!  We have kitchen floor mats:

A kitchen floor mat
A kitchen floor mat

I sewed all the strips directly on top of the batting and backing, as in strip quilting.  This small rug has scraps from just about every quilt I have ever made — not that I have made that many, but still.  The backing is leftover fabric from drapes I made years ago that I no longer have:

Reverse side of kitchen mat
Reverse side of kitchen mat

We have place mats:

DH's place mat
DH’s place mat

And the reverse, flannel fabric from one of his old shirts:

Reverse of place mat
Reverse of place mat

These sewing projects reflect my personal commitment to making something useful out of materials that were probably going to end up in the landfill.  I suppose all I have done is shift the landfill day sometime in the future, but for now, it is enough that day is NOT today, or tomorrow, or next week.

Tula's Quilt
Tula’s Quilt

Even the Guinea Pig has her own quilt!

“Doctors’ Labor of Love”

Every now and then, a columnist will comment on the deficiencies of American doctors when it comes to patient care.  In an opinion piece published in the  Denver Post of 18 June, 2009, Ellen Goodman wrote about a cardiologist who walked out of a consult because the patient’s allotted time — 15 minutes — was up.  Was the consult for just 15 minutes?  Did he really walk out on the patient?  Who knows?  I can imagine a lot of things: harried physician who thought he had enough information,  a patient who needed more time and who thought she didn’t have enough information, a more pressing case to be seen, a cardiologist with a God-complex and zero bedside manners . . . .  I can imagine it all, but I will never know.  Chalk it up to “anecdotal evidence.”
A few days later, a response to the story (under the wince-inducing “Doctors’ labor of love”) from Heather Loughlin, aspiring doctor.  I don’t know where she is in her training — premed?  medical school?  — but she knows enough to proclaim:
I am here to say there is light at the end of this tunnel. My peers at the University of Colorado and I are on the journey to become physicians. Many of these bright young people have been known to take communication courses just to improve an empire that has been defiled . . . .

An empire that has been defiled?  Medicine is many things, but an empire?  I have the suspicion that had Ms. Loughlin actually been paying attention in her history classes — or if she were a better communicator — she would have realized that the conception of empire does not have the glorious connotations she has assigned to it.

After the courses that I have taken to get where I am in pre-med, I can assure you all that the next generation of physicians will be astute, active listeners, along with being healers.

And I can assure her that she doesn’t have a clue.  Yet.  However, she does already possess to a remarkable degree the one thing I would have thought she would abhor: Arrogance.