when i work now, i am “agency” which means i make more money per hour and it generally gives them permission to give me crappy more challenging…long term patients or two patients, which is what they did sunday. i don’t really mind, i just get on with it. …it’s a reminder to me that i shouldn’t get to smug about my trips to london and my meetings with little sandwiches.
my first patient i kind of knew from the day before…a real friendly, chatterbox with a big but cheerful family. the interesting thing about him is that i was just confirming his date of birth with him…17 july 1945….mmmm, i said… oh dear right at the end of the war?
he went on to tell me that he was the baby of the family…he had 5 older brothers and 2 older sisters. he said they lived right here in south birmingham all through the war…i was just really humbled with the thought of raising all those kids during a war and still being hopeful or foolish enough to have another baby…
i know lots of people did it and lots of people are doing today but they must have been really incredible people to have produced such optimistic kids…but then maybe the only way from there~~~was up…
the other funny thing was i asked him what he did for work when he was younger….he rattled off a list of menial labor jobs but said he liked the bins the best…..loved the bins! it took me a minute to understand he meant he was a garbage collector. he said he started at 4:45am finished a 1pm and was in the pub at 1:15pm…that kind of lifestyle is what is missing in the young men today….it’s fine to hang out in the pub with your mates….after you’ve put in a days work!!!! anyway, trev was really funny and made me laugh…a lot!
i really needed that to offset my other heartbreakingly sad and difficult patient. i still can’t get my head around how this can happen but as far as i could find out from his notes, up until this past summer, 2009, he was a dairy farmer…he started to have leg/hip pain which increased rapidly over 4-6 weeks to the point his leg was giving out, he had falls, was on strong pain killers and wheelchair bound.
in sept 2009, he was seen at the orthpedic hospital and after several attempts they were able to get scans which showed a “mass” extending from his leg up to his spleen, pressing on his IVC and other organs and nerves. they have been unable to get any definitive diagnosis and the truth is that it doesn’t matter because if it is growing so fast and intertwined and stuck to so many organs ~~~they have already labeled it “inoperable”
to say this man is miserable is the understatment of the year..and who can blame him? nothing was right for him and due to his size~~~i assume he was a fairly big guy even before we filled him with 10 liters of fluid…his left leg is twice as big as his right and takes one person just to lift it and another person to adjust the pillow.
i really tried to do what i could for him, he alternated between being fast asleep (thanks to the morphine) and being drowsily awake and telling me was sooooo uncomfortable and just wanted to shit…i did manage to hoist him into the chair for awhile.
the whole situation just makes me so angry…angry at our biology…and angry at the healthcare system because a nurse who used to work in palliative care suggested more effective ways of keeping him comfortable and angry that when he goes to the ward, the nurse will have more patients and less patience than me and will do even less for him…he certainly does not deserve that.
did i mention he was only 48 years old?