good medicine

Yesterday I worked on the cardiac unit. Our census was unusually low and I had only 7 patients. I'd had an extremely pleasant evening the night before and sailed into work smiling and energized. I made my way round and saw each of my patients: my new admission with a history of vertigo that suddenly had 2 days of syncope and oddly good BM's with vomiting associated; my lady with the lovely family who had a abdominal bleed as a complication from her cardiac cath when she got too much a/c over the weekend - gratefully being managed medically; my 91 y/o lady who still walks to the store with her 92 y/o sister, who now needs a pacemaker due to dysrhytmias; my 85 y/o spring chicken who had a total knee arthroplasty and was visiting us because she has a little bradycardia with some aberrant pvc's for good measure; my italian lady who's advancing dementia now comes with hallucinations that caused her to leave her house late the other night and her husband found her after a fall which she can't recall (but is ok from) and the room at the top of the hall with my two CHF'ers, one who needs an MVR and I wish they'd do it or let her go home and the other anxious lady who DID go home -novina candles all around for their safe recovery and return home.

I tend to spend a little longer than need be with each of my patients because I hate that we live in a time when clinicians spend so little time with their patients, sacrificing rapport and trust in the name of efficiency. But this morning I went beyond my usual when I came to the room of my 85 y/o spring chicken. I finished my exam quickly and had only two other patients yet to see that were both familiar to me - the day was early and I was inspired to sit. Literally, I did - perched on the foot edge of her bed, I asked a most benign but inviting question: "where are you from originally?" This set my lady off on a story of her life, the love of her husband and some of her favorite memories. I chimed in on occasion, but mostly I listened and watched as she had a willing audience for dusting off some of her favorite places and recalling anew happiness.

Ten minutes time in a hospital is an eternity. When I gently lay my hand atop hers and mentioned I needed to get back to work, she grasped mine and thanked me quite genuinely for the conversation. 'It made my day. Really. It's so nice to have a real conversation and not about medical stuff, ya know?' she said smiling as I departed.

It was a selfish impulse really. She completely reminded me of my grandmother, whom I adore. It made me feel good to open that avenue for other-than-hospital-routine for a women stuck in bed with her knee in a brace. It was selfishly good stuff I walked away with, but it went both ways. I am not saint nor angel as I have been called on occasion by my patients. I just know, with all I've yet to learn, that attention and attentiveness is good medicine.