Sunday, May 25, 2008

The job

There are lots of times I sit down to write about work and end up never publishing the post. I struggle with how much to tell these stories because they are, at least in part, stories about patients. These are other people’s intimate moments. They may not be mine to tell. As a result, most of my really great days at work are not recorded here.

But, this time, I'm going to go ahead with a work story, mostly because I don't ever want to forget why I do this. This is a story about a patient named Jane and her partner, Anne. In telling it, with every word I write, I am asking myself, If these women ran across this post some day and saw themselves in it, would they be honored by what I wrote here? I hope so.

A little over a week ago, Jane came in with what looked like a hell of a sinus infection. When she came to the hospital, she thought she’d only be in a few days. But then, she got sicker. A lot sicker. Around this time, the medical student who was assigned to Jane’s case quit coming to work. He’s on a two to three day a week schedule now. More power to the turd for getting away with that shit.

On the first of many of Turd’s vacation days, I stole his patient. I was fascinated by the whole sicker for no reason thing she had going on. And, although this may sound a little strange, I also felt like someone was missing from Jane's case.

A few days earlier, during our morning rounds, Jane had a visitor—a woman who gave off odd vibes. She introduced herself as Jane’s good friend, but something about her smelled like an opportunistic jaded wannabe girlfriend. No one else smelled that, but I often have the most powerful nose in the room. I trust it because it’s big and usually right. As we walked out of her room that day, I thought, Jane is gay. She has a partner somewhere. We need to find her.

And so…when Turd quit coming to work, I stole Jane as my patient. On that first day, I had a long conversation with the infectious disease doctor. In discussing Jane with her, she suggested that I call someone who knew her well to try to get a very detailed history.

I hunted down Jane’s emergency contact form where I found the names of a couple of cousins and one local friend. I tried everyone on the list. Twice. I finally got a hold of cousin’s wife who gave me her husband’s work number. I explained to him who I was and that everyone’s vitals were stable. This is important when you call from the hospital. Until the person on the other end hears that no one is dying, he or she hears nothing else. I went on to explain that I needed some important information from whoever may know Jane best. He gave me the name of a boy she dated when she was 14—forty years ago. I was thinking, Dude, you’ve got to be fucking kidding me. But, I took a breath and said, "Okay…anyone else?"

He paused and said, "Well…there is a woman who she’s friends with. Her name is Anne."

I got the number, hung up with the cousin, and called Anne. I explained that no one was dying and then started asking questions. Does she swim in fresh water? Does she drink unpasteurized milk? Does she live with cats? Does she eat raw seafood? Does she breed mosquitoes? Or raise earthworms? Does she vacation in Sub-Saharan Africa? Does she spend her spare time tipping cows? Or licking bats?

As Anne answered my questions, I got the distinct impression that she was more than just a friend. I had avoided saying much about Jane’s condition. Anne wasn’t on the emergency contact form, and giving her information would have violated privacy laws. I knew what I was hearing, though. Finally, I said, "Anne, I have a 54 year old woman here with three cousins and a two friends. I feel like we’re missing someone."

Anne answered, "We’ve been together for 20 years. I’m just out of state right now because of a job."

"You’re the person I’ve been looking for for two days."

"Well, you found me," she said, "and I'm on my way." She was on the next flight.

I’m not going to go into the specifics of how all this happened—how Anne’s name ended up being left off of that emergency contact form. I will say this…when we institutionalize bigotry by writing it into law, it is not difficult for individuals (in this case, hospital employees) to exercise discrimination. If Anne and Jane had been married, even if separated by thousands of miles, Anne would have been on that form.

Because she wasn’t on the form and wasn’t getting information from anyone else, I told her I would meet her when she got here. At 8:30 that evening, long after the rest of the team had gone home, I drove back to the hospital to find Anne and introduce myself.

Anne and I met and spent awhile talking. Understandably, she had a lot of questions. Jane had been out of it since Anne arrived. She didn’t even know Anne was there. I explained to Anne that she needed to find the Durable Power of Attorney paperwork that she and Jane had completed. And, praying that such paperwork actually existed and that I wasn’t violating 746 privacy laws and flushing my career down the shitter by doing so, I went ahead and updated her on Jane’s condition. I answered all of her questions as best I could.

At 9:00, as Anne and I talked in the hall outside the ICU, Jane’s nurse ran out to say, "She’s awake." We all high-tailed to Jane’s room. Anne wanted to see her. I wanted to see Jane’s reaction, to reassure myself that I had found the right person.

When Anne walked into that room, Jane took a huge breath and smiled. Anne slid between the IV pole and the bed, leaned over the side rail, wrapped Jane in her arms, and began whispering in her ear.

I don’t know what she said. I can imagine. But, I will never forget the look on Jane’s face as Anne held her. I leaned against the wall of that ICU room and thought, This is it. And this…this is worth it.

The next day, as I walked down the hall towards the ICU, Anne stepped off the elevators, appropriate legal documents in hand. She smiled and said, "Thought I better bring these in. You know, so they don’t kick you out of med school." I thanked her for saving my skin and gave her the names of all the physicians she should ask to speak to.

"Now that you're all official," I said, "you should get your updates from someone besides the med student. You deserve better."

In truth, though, Anne still gets most of her updates from me. I wish I could say that all of her love has healed Jane. Unfortunately, she’s not quite there yet. What I can say is that I am absolutely privileged to have met these two women, to have been a small part of this amazing week.

I am incredibly lucky to have this job.
All the work…it’s worth it.


MmeBenaut said...

Yes, Terroni, you are privileged but so are your patients, to have such a caring doctor with such a sensitive nose. If you ever give up medicine you could easily slip into the role of private investigator. Well done!

Christine said...

You .... you are really, REALLY great at your job! You have what so many in your profession don't always have - a heart for the actual person.

Don't ever change.


joshua said...

this is quite nice.

nina said...

Your patients are the priviledged ones terroni.

Lately, every time I come here you make me well up with emotion. You are truly a gem.

I feel privileged too.



Now, after saying that...I could kiss your big nose.

Terroni said...

Maria, until I saw that paperwork, I was scared shitless.

Thanks for the kiss.

Shan said...

Thank you for sharing this story T. It sounds like you are definitely in the right place! In fact you might have found your specialty-whatever that guy on 'House' does. Investigative medicine? I don't know what its called. ;-p
I would love to see unmarried or same sex couples get equal treatment when it comes to medical rights and insurance. Someone needs to make that easier! It must be frustrating to have to deal with that mess in a crisis health situation.

deboo said...

Ah, T, You are the Best. What Maria said, BTW. ::sigh:: It is professionals like you that help my partner and I cope with institutional horrors. I teared up when you wrote how Anne whispered in Jane's ear. Been there. Done that. Both of us have.

Thank you so much for posting this story.

MLC said...

A beautiful post and gutsy move on your part. Andrea Gibson, a slam poet, has an amazing poem she wrote called "I Do". You can find it on You Tube. In any case it was inspired by a story like yours except in that case the woman died and her partner was not allowed in to see her.

what a compassionate gesture you made-

Terroni said...

Thank you all for your kind words.

As Shan said, someone needs to make this easier.

I actually believe that Christians should be on the front lines of this battle.

You're madly in love with the Jesus who said, 'I did not come to judge the world'? Prove it. Show the world what your love can do.

.j.william. said...

"I actually believe that Christians should be on the front lines of this battle."

keep preachin', sister! It's so true it hurts.

You rock, by the way.

Alice Kildaire said...

Bless you for your courage and your heart....damn sure a gutsy move! Yes, your patients are indeed the fortunate ones.

Rich said...

I enjoy reading your medical stories more than anything. I think as long as you do not disclose names etc. there's nothing wrong with it as long as it's comfortable for you to do so.