A patient asked me in the sweetest voice if I would go for a stroll with him. You would have thought we were college classmates and that he had just asked me out for a date. I found out that he was hitting up every female who entered his room to go outside to the garden with him. The nurse had told him that morning that he could not go alone due to the nature of his medical needs. He had been fixated on that all day long, trying with no success to find a buddy—preferably female—to accompany him outside.
I understood how boring a stay in the hospital can be, and he had been with us a few days already. But most patients just slept a lot and watched tv. Not this guy. He was aching for fresh air.
I wondered how antsy I would be if I had to be confined to a hospital bed. I get jumpy when I get the flu and can’t get off the sofa for 24 hours. I really do feel for my patients.
He became more agitated as the shift carried on. When it came time to get his dinner order his mood had soured. He was growling and hostile, and no, he did not want to order any of our “fuckin’ food which sucks.” Though it is never comfortable to encounter a patient who has this level of antagonism, it seems at times like a good sign to me. Patients who are so sick and damaged from a trauma or a disease that all they do is sleep the heavy sleep of sedation, they are kind of lucky in that they are cocooned in Sleepyland. It’s a kind of peaceful state, even if that peaceful state has been chemically induced.
But when the sedation wears off and the patient begins to rouse and become aware of the story they find themselves in, sometimes that peacefulness evaporates like a mountain creek under the blaze of an unrelenting sun. The antagonism, the boredom, the resentment and anger of what happened to them can begin to bleed out. Not all human beings are saintly when they suffer as glossy magazine stories like to portray it.
Some patients are just assholes. They are asshole’ish when they are healthy and are asshole’ish when they come to the hospital. I have served a lot of difficult, asshole’ish patients. They are not hard to miss.
But this guy was not an asshole.
He was young and had suffered a head injury in the course of an ordinary day in his workplace which was miles away in a small Oregon town. His antagonism and hostility,these I took as good signs of his road of recovery. He now had enough strength to care as before all he could do was lie there and drool. Now he was pissed. The nurse later confirmed that “he really is a sweet guy.” Head injuries, she explained, can cause personality changes.
“It’s good that he’s a bit agitated, isn’t it?” I asked. “Is this a good sign that he is regaining his strength?”
“Definitely it is,” she said. This made me smile. By the end of the week, our antagonistic patient had become more cooperative about ordering food. He was still unhappy about his damaged body, who could blame him? At least he was eating, though, and that was definitely another sign of progress in his recovery.
I remember another patient like him, a married man with two young children. He had contracted a disease that required amputating some of his limbs. I worked on his unit for a couple of weeks. He didn’t eat much. By the end of my second week on his unit, he had started to wake up and with that waking up came the realization that his body had been chopped up to save his life.
He began to hate our food. I recognized it, though. Every time I went in his room to inquire what to get him for his meals, he would see me and turn his head away. I tried to talk less forceful with him, focusing the tone of my voice to be as normal as I could. I would not show any pity, I willed, though my gut was reeling with pity for him every time I thought about his missing limbs.
“No, I do not want to eat anything,” he said to me, his third day in a row of refusing to order. His nurse had told me not to push it since his family was bringing him a meal just about every night. I didn’t even want to go into his room as the pain of seeing his mutilated body with my maternal instincts to nurture him created a helpless tension that made me uncomfortable.
Walking into his room and other patients like him is kind of like walking a log across a churning river. I have to focus to get to the other side. I can’t think about that what happened to him could happen to me or my husband … or my children. I can’t let myself indulge my paranoia of someone I love falling off a ladder and banging their head. I cannot let the story monster in my imagination breathe fear into me that one of my kids could end up with a flesh-eating disease.
I would never come back and clock in for another shift if I let these patients get to me. It requires the practice of detachment while also holding onto compassion to do this job. Sometimes I feel like an asshole, like an asshole’ish food server who only cares about the tray and not the patient’s condition. I cannot emote to my patients how affected I am by their tragic conditions. I have to camouflage my feelings with professional detachment, for their good as well as mine. It would not do my patients any good if as their food server I entered their room and collapsed into a heap of crying flesh and bones. They need a team of people working together to guide them along their road of recovery.
Compassion is not a feeling. I found out that the root meaning for the word compassion is to suffer together. I used to think that this meant I needed to feel the pain that the suffering feel, that I needed to enter their pain with them. But after working with many suffering human beings, I now wonder if compassion can also mean to be together? Perhaps it is the presence of another with him who is suffering that is a truer face of compassion. Feelings are so flighty. But presence is concrete, the holding of a hand, the administering of a dressing change or a dose of medicine … or the provision of food for sustenance. These acts combine together into a kaleidoscope of compassionate care that serves patients on their recovery journey.
Bringing food service to my patients was in itself a compassionate act, even though I remain detached as I did my job and did not allow myself to feel too much. It felt dishonorable at times, but now as I think on it some more, I realize that it was far from it. Honoring the patient with steady, consistent food service was a demonstration of human kindness each and every time.