gratitude

THE PATIENTS I TREAT rarely thank me. It’s not that they’re ungrateful. Many can’t speak or don’t know where they are, much less what’s happened to them. And those who can speak and aren’t confused think that nothing is wrong with them and that I’m some kind of jailer. Last week I got punched in the mouth when a life care patient of mine asked me when he would get to go home and didn’t get the answer he wanted to hear. A few weeks ago I got peed on helping a guy having a seizure. Yesterday I got called a f*cker at the end of my first appointment. All in a day’s work.

     Actually, yesterday was quite a day. I admitted a new patient, a 23-year-old woman, someone’s once-vibrant daughter, ravaged by the complications of intravenous heroin — an infection of the heart, swelling of the brain, a devastating seizure, oxygen starvation. Very sad case. She floated into the conference room as gray as a ghost, her eyes wide and lifeless, the shell of a human being, and when she settled into the chair at the head of the table she might as well have been weightless. I held my hand out toward her. She didn’t respond. “Hello, I’m your doctor,” I said. She just sat there in a daze, nobody home. Her program director told me how she likes to put things in her mouth, how she bit an attendant’s finger when he tried to retrieve a puzzle piece she was attempting to eat. Left unattended she’d swallow soap or toilet paper. When the physical therapist bounced a basketball toward her in an effort to assess her reflexes, she caught the basketball and — believe it or not — tried to put it in her mouth.

     Next appointment, a motorcycle crash survivor who kept trying to remove the helmet from his head, unaware of the large soft spot over half of his head where his skull used to be.

     Then I saw a long-term patient of mine whose vocabulary consists exclusively of his first, middle and last names, but who can sing along to “Happy Birthday” and other familiar songs. I unwrapped his bandaged foot to assess an infected toe, careful all the while to avoid provoking his anger. He’s pleasant most of the time, saying be-bop, be-bop and shaking like a bowl full of jelly with laughter, but will turn on a dime, lash out and scream, “You done f*cked up now,” and kick and spit in your face. So as I’m unwrapping his foot, I’m singing Row Row Row Your Boat in an effort to distract him, ready to spring to my feet in case he decides to take a swing at me. Life is but a dream.

     We’re used to working with people who resent us or want to hit us, who can’t tell that we’re even there or that we’re trying to help them, so it took me and my team by surprise yesterday when the elderly Vietnamese gentleman — speaker of broken English before his stroke and very broken English after his stroke — stood up to address us at the end of our meeting with him. Bowing toward us, he burst into tears. “Thank you so much for help me,” he said. I think each of us in the room started to tear up as well. It wasn’t so much that he thanked us. Like I said, we’ve come to not expect it. We were just so delighted that he could stand on his own two feet without falling and utter a coherent sentence.