How To Save A Life (or not): Episode 1

Picture Clint Eastwood. A scruffy, rotting, bitter Clint Eastwood with black gangrenous toes and fingers. That’s my patient for the next twelve hours. 

“I’m hungry!” he shouts while I stand in his room trying to get report from the night shift nurse. And by shout, I mean whispers. The man can barely swallow his own saliva, let alone shout. But when he does whisper, it’s filled with a gravelly gusto that refuses to be ignored.  

“Is he on a diet? Can I order him breakfast?” Please say yes my eyes plead with the night shift nurse when it becomes clear this guy will not give it a rest until his mouth is filled with some sort of sustenance.

“Speech therapy needs to see him first,” she tells me. “All he’s allowed until then is pills with applesauce.” 

The patient hears this and does not approve of the answer. “I demand something to eat!” He pulls off his EKG wires. Attempts to rip off his blood pressure cuff. 

“Please don’t do that,” I tell him as we begin to engage in some sort of weird arm wrestling competition over the blood pressure cuff. I look to the night shift nurse for help. She’s gone. I think I hear the screech of her tires peeling out of the parking garage. 

“Get back to work,” the patient growls at me in the same manner I imagine him saying, “Get off my lawn.”  

“I am. This is me working.” I struggle to get all his EKG leads back where they should be and offer up a prayer of thanksgiving he didn’t pull out any IVs. 

“Get back to work,” he tells me again.

Not knowing what that means—and fairly certain the patient doesn’t know what that means—I take it as an excuse to step out of his room. My hope is he’ll forget about food by the time I return. My even stronger hope is I’ll never have to return.  

Alas, neither of my hopes are fulfilled. He has medications due first thing. I return to his room with pills and a container of applesauce.  

He looks at me. Looks at the pills. Glares at the applesauce. “I’m not eating that.”

“I thought you wanted food.”

“Not the type that gets stuck in my throat.”

“What about the pills?”

“Give them to me.”

“How are you going to swallow them?”

He holds out a mottled palm. Cough, cough. “I’ll chew them.”

Now there was a moment at the start of my shift when I cared very much about whether the pills he swallowed ended up in his lungs. That moment has passed. I hand him the two pills.

“What are these?” he asks.

“One is aspirin. The other is a medication to help raise your blood pressure.”

He frowns at them. “I take a blue pill at home.”

I inhale slowly, then release my breath and explain it doesn’t matter the color of pills he takes at home. These are the pills he’s taking here. In the ICU. So he doesn’t die. 

He puts the aspirin in his mouth. “What pill did you say this was?”

“Aspirin.”

“Aspirin?” He spits it out on his blanket. “Do you know what aspirin is? A blood thinner,” he whisper-shouts before I can answer. “Are you trying to kill me?”

“Sir, in light of the fact you had a heart attack during this admission, the aspirin is probably a good idea.” 

“Throw it away,” he says. “I want moved to a different ward.”

“I would love to move you to a different ward.” I speak truth. “But seeing as you are currently on IV medications that can only be given in the ICU, if we moved you to a different floor, you would no longer be getting those medications and you would die.”

“All I take at home is pills.”

“I understand. But unfortunately you’re not at home anymore. And the reason you’re not at home is because you have pneumonia. Your lungs are sick. Do you normally wear oxygen at home?” I honestly don’t know.

“No,” he says.

“Okay. Well, now you need it. Just like you need this pill.” I hold up the slightly dissolved aspirin. “Do your body a favor and take this.”

“Throw it away.”

“Please—”

“Throw it away!”

Fine. Nobody can say I didn’t try. I throw the pill away. “Will you at least take this one?” 

He chews the other pill down without fuss. Then says, “Was it a baby aspirin?”

“The one you spit out? Yeah.”

He holds out his palm. “Give me the pill.”

Is he kidding? Is this really happening right now? “Sir, it’s gone. You told me to throw it away and I did.”

“Give me the pill.”

“It’s in the trash.”

“Give me the pill!”

By this point, the speech therapist has arrived and is standing inside the room, quietly observing this tender-hearted display between nurse and patient. 

I look at the speech therapist, then peek in the trash. “It landed on a clean glove,” I say with a shrug, as if that ever makes it okay to dig something out of the trash and shove it into a patient’s mouth. Which may or may not be what happens the next second. I’ll never tell. 

Oddly enough, though, the patient and I get along much better afterwards—just so long as I adjust his legs fifty times every hour and promise to always come back.

“You’re very kind,” he tells me later in the day.

“Thank you.” I smile, rather pleased with myself for winning him over with my charm. “I have another pill for you. Are you going to take it?”

He holds out his hand. I place the pill in his palm. He cocks his arm back and chucks the pill across the room.

My smile tightens. “So…no, then?”

“Get back to work.”