Tuesday, August 18, 2009

All Alone

When he came to us, he had been living in a nursing home for 27 years. He was 55 years old with schizoaffective disorder and a dementia he had likely developed from his longstanding illness.

He arrived at the hospital with cancer that had spread to his bone and lungs. He had altered mental status and his speech was so garbled, it was mostly incoherent. The first time I met him, he was confused and irritable, refused to answer any questions and yelled at me to get out of his room. The first few days with him were not very pleasant, but we soon learned that he really liked orange juice. Thus, we began to trade orange juice for information. In exchange for some orange juice, he would reluctantly answer our questions about how he was feeling, if he had pain anywhere, etc. He was still confused, unable to state the date or where he was.

As some of his metabolic abnormalities from the cancer were corrected, he became more lucid, and a very gentle man appeared. He was soft spoken and polite. His speech became more coherent. He revealed that he did not have any siblings and that his parents were dead. He also did not have any friends. But, as I was getting to know him, he shared that, years ago, he would go joyriding in his car with his friends. In fact, he had enjoyed it so much that it had been his favorite pastime before he ended up in the nursing home. A big smile came to his face when he thought of the time when he and his friends had gone joyriding. Now, he was living in a nursing home with no family and no friends. At the hospital, he had no visitors, no one who called or came to see him.

One morning as I was making my rounds, I asked him how he was feeling and he began crying. He cried silently, tears streaming down his face, and he clumsily licked the tears off as they reached his lips. With his toothless mouth, he responded quietly "I'm alright", all the while the tears kept streaming down his gaunt cheeks. That was too much to bear. I grasped his hand, held it, and struggled to hold it together. It took everything I had not to start crying along with him.

Soon, his mental status deteriorated again, and he became incoherent and irritable once more. Randomly, he would have a day here and there when he would be more alert and communicative. One one such day when I sat with him, he again reminisced about how much he had enjoyed driving around with his friends in his car, and how he could no longer do that. A crazy idea struck me and I thought about sneaking him out of the hospital to take him for one last ride in my car, windows open, the warm summer air hitting his face. But, I realized that I would probably lose my job if I did that. Then, I noticed that he was crying again, silently, large tears were streaming down his face. I held his hand and cried with him.

1 comment:

kinpatsu said...

this one's true. he was my patient.