Friday, February 23, 2007

"You Want Mayo"

REFLECTING ON: Feeding a quadriplegic man as a volunteer, written as assignment for Communications class on the importance of listening, pre-UCSF

In my spare time, which I don’t really have a lot of, I volunteer in the Emergency Department of a hospital in the East Bay. It’s a trip. In addition to cleaning up gurneys that have been peed, pooped and bled on, I spend a lot of time running around, acting as a communication liaison between patients and their anxious family members out in the waiting room. “Anxious” is a nice way of putting it. At any rate, the conversations I have, by and large, are very much one-sided where I am listening to or diffusing some sort of frustration that someone is experiencing. I sympathize with the patient’s and family’s situation—it sucks to have to wait for several hours in the ER while someone else is almost completely in control of your fate. I get it; I try not to take that little fact for granted. The conversations that I have with these folks, however, typically aren’t very long—two minutes tops. Last night, however, a nurse asked me if I could feed a man whom we’ll call Ishmael. Ish, which I called him, is a quadriplegic. He was in the hospital for some infected bedsores and just had some pain medication. The food, he said, helped settle his stomach from the medication. When I heard the cross-over about Ish, my mind immediately raced to the thought, “If he’s a quad, why would he need pain medication since he can’t feel anything.” Then I just let it go. Shit, if I were paralyzed from the neck down, would want some painkillers too.

The point here, however, is that while I fed this man his turkey sandwich, I realized I became the most attentive listener that I have ever been. I listened with my ears and eyes, watching and listening for the subtlest cues as to what he wanted to do next: talk or eat. I knew that he knew that I didn’t know how to feed him and I so I told him so. He just said, “That’s alright, just ask yourself how you would want to be fed a turkey sandwich, and then verbalize those questions to me.”

“You want Mayo?” I asked, and took it from there. I watched his eyes dart to what he wanted while we chitchatted about other things like the tattoos on his arms. I thought it was cool that a quad would get ink done despite having “non-working” arms and legs. He was a pretty self-aware person—able to see how newbies like myself saw him and made subtle efforts to distract me from be overwhelmed by his general situation in life. The tattoos were a good example of that—it diverted my thoughts from his gnarled fingers and emaciated arms and made me think of his life beyond the bed. Pretty clever really. Of course, maybe I’m over thinking things—maybe he just liked tattoos. At any rate, as we talked about the symbolism of the monkey-riding-the-elephant tat that he had on his right shoulder, I intuitively put down the sandwich, grabbed the can of coke, put a straw in it and gave him a sip. He burped, and I gave him another bite, noticing that he didn’t like eating the crust. When he was all done I wiped his mouth off with a napkin and then the transport person came and got him. While he was being wheeled away he said, “Good talking to you.”

“Likewise,” I said, though I really had hardly spoken but a few questions.

Ish’s obvious, physical need made me listen better than I had in a long time. I was able to listen with all my senses. The subtle yet distinct dignity with which Ish conducted himself made me wonder if I could be as perceptive as he obviously was. It seems to me that although many of us have the less obvious, less physical needs than Ish, we often still need to have those needs perceptively listened to.

Friday, February 16, 2007

Running While Laying down

REFLECTING ON: Interaction with dying patient while volunteering in East Bay Emergency Room, pre-UCSF

Tonight, my glass is filled with wine and I’m raising it to Mrs. Martinez. I will quaff deeply, and breathe easy, for Mrs. Martinez. Just an hour ago, I watched this short little abuela struggle to breathe in her own body. Her lungs were filled with fluid from pneumonia and her cancer had metastasized to her chest cavity, putting added pressure on her lungs. Normal breathing rate is 12-15. She was breathing 40 breaths per minute while sitting down. She was running a marathon without moving. It’s weird the things that I notice while events like this are going on—she was still wearing her knit hat to cover her shiny baldhead, even when the physician was intubating her trachea. They administer drugs that paralyze her swallowing/gag reflex muscles like succinylcholine. And here I am, taking mental notes on the procedure, drugs that are administered, O2 levels, hear rate, and such, but I wasn’t totally sure that I should be there. They made the family members leave the room yet I was permitted to stay. The doctor even asked me top close the curtain so that nobody else could see. I suppose I get to stay because I know how to react in this situation—which is to not react, speak succinctly when spoken to, do what your told, and stay out of the way. The family might get hysterical, I suppose, and interfere. But it’s their grandma—their mother. I watched one nurse joke with another nurse while he was administering paralytic drugs to her chest and throat muscles. I kind of wanted to slap him awake so he could see how desensitized he appeared. Like I said, this is someone’s blood—best not to take that for granted. Then again, sometimes it’s the distance that allows us to do an “objective” job. I felt like a fly on the wall—a gnat that nobody wanted around. I guess everybody has to learn in some manner or another, and shit, that’s why I took this no-pay gig…this is all for the experience. I can’t help but be pissed at the college students that come in drunk with debaucherous, self-inflicted injuries when there are folks like Mrs. Martinez one room away. Self-inflicted injury just seems so fucking selfish and wasteful—a waste of time and resources that could be better allocated to people that are legitimately in need. It’s one in the morning and I gotta wake up early. Not only that, I got to wake up early, be on my shit, and I NEED to learn Spanish. I spoke Spanish two times this evening and made things work because of it. I gotta get fluent.