Friday, December 10, 2010

chip shot, charlie!

News item found on

"Shortly after Kent Schaible died of bacterial pneumonia at his family's Northeast Philadelphia home in January 2009, a city social worker and a nurse visited to check on the well-being of his five siblings.

During that visit, Kenneth Dixon, of the Department of Human Services, asked Herbert Schaible if he had sought medical treatment for his 2-year-old son, Dixon said.

'He said that him and his wife were faithful to their religion and they believed in God to make their son healthy,' Dixon testified for the prosecution yesterday, the second day of the manslaughter trial of Schaible, 42, and his wife, Catherine, 41.

...The Schaibles are members of the First Century Gospel Church, in Juniata Park, which shuns medicine and doctors in favor of prayer to heal the sick."

I'm sorry for the loss of this child. Also, I've made it a point to not mock religious beliefs that differ from mine, no matter how ridiculous they seem. Lastly, it's not my business to tell anyone how to raise their family or choose their actions. I feel, however, that it's time to point something out.

1. You believe God is the Creator, and responsible for everything.
2. Following this line of thought, he also created bacteria and viruses.
3. But the good news is, Man is what He created in his image, and, if I've got this right, Man is also supposed to be a steward for God's other creations.
4. Maybe hospitals and health care are part of that stewardship.
5. Parenting is definitely part of that stewardship.
6. Unless God was specifically paying attention to your situation and actively rooting for the flora causing your kid's pneumonia, you blew it. God asked you to do one thing, and you actively fucked it up.

Thursday, December 9, 2010

you don't have to go home, but you can't stay here.

The night had been a long one for the outgoing shift, especially Shane. His Patient---soon to be my Patient---had been yelling all night.


It was incessant. Patient hadn't slept a wink. And he was deaf. One had to shout at him to be heard.

Shane gave me report, head in hands. He refused to look up, to avoid accidental eye contact. Patient had come from an assisted living facility for an altered mental status workup. His family insisted that he only became disoriented whenever he was hospitalized. He was otherwise stable. I was quiet for a moment, and then asked the question that you, Dear Reader, have already thought of: "If hospitalization creates delirium in Patient, how are we supposed to observe him for a return to baseline?" Shane just moaned, kept holding his head, and half-whispered, "I don't know. See if you can get him sent back. This is the wrong place for him. Obviously."

"HELP! HELP! DADDY!" added Patient.

I went to Patient's room to introduce myself. "Hi, there," I shouted, "I'm your nurse today, and I'm going to take care of you until this evening. How are you?"
"Can you tell me your name?"

That was my neurologic assessment. I did the rest of my physical assessment while the patient alternately stripped out of his gown, yelled for help (or to be killed), and swung his scrawny, totally non-functional legs over the railing of the bed. In an effort to be a half-decent nurse, I opened the blinds to let the sun in, and turned on the daily news. If he could be alert and oriented outside the hospital, it was my responsibility to attempt reorienting him---to stop him from being coo-coo for Cocoa Puffs.

I tried to feed him.
"HELP!" Well, okay. It was meatloaf. I could understand that.
I tried to wash him a little bit.
I tried to not be extremely angry when he ripped his only IV out of his arm, leaving spatters of blood on his new gown (which he stripped out of) and his fresh sheets (which he also promptly pissed on).

I gave up, and opted to just turn the bed alarm on, so I would know when he decided to jump ship; hopefully, I thought to myself, I'd hear the bed before I'd hear Patient landing on the floor. It went off every few minutes, like klaxons in a nuclear holocaust.

Sometime in the afternoon, the resident following Patient told me that an ambulance from the home was coming to retrieve him. I went into Patient's room to let him know.

"Hey, Patient...good news! You're going home, just like you've been asking for all day. I've already let your daughter know. She'll be waiting for you there when you arrive, so you won't be alone. Isn't that great?"
Patient shook his head no, and unbuttoned the left shoulder of his gown.
"What do you mean, 'no'? You've been asking all day to go home."
Patient shook his head no, and unbuttoned the right shoulder of his gown.
I had reached a point of dark desperation. "Patient, you have to go home! Your family is there! You know everybody there! And nobody likes it here. I don't like it here."

Patient looked at me thoughtfully, and was blissfully quiet for just a moment. Finally:
His gown hit the floor.

I left the room, closed the door behind me, and put my head down on my desk.