strange things

illness can do strange things to a person.

a couple of days ago, i suffered a bout of sinusitis. i sneezed all day, mucus dripping from my nose whenever i bent down to take blood or set a line. i didn’t eat lunch and i went through the day in a hypoglycaemic state, resenting the irony that is the difficulty of getting medical leave as a houseman. but i made it to 5pm and then spent an awkward 40minutes at a bar with some people i didn’t know, sipping cider until it was time to go home and crash. it was irrational behaviour, but illness does strange things to you.

during that time, i found myself “promoted” to the acute cubicle, where i inherited a patient who is living on borrowed time. he’s a pathetic sight to behold and i have no doubt that his devoted wife and ridiculously adorable daughter feel as much pain as he does each day.

but illness does things to a person, and he became demanding and rude; hurling abuse at his daughter because she didn’t know how to use the telephone, shouting at his spouse because he could not move. he cursed me for attempting to insert a cannula (for the nth time) so he could get the inotropes he needed for his ailing heart.

after two days of watching him drive his wife and child to tears and being on the receiving end of some of it, i lost it. i had enough of apologising, of trying to empathise. i could not understand how a man who attracts large crowds of friends and family from 600km away, can be such a jerk. i stormed off after yet another failed attempt at attaining venous access for him and said, “fine, do what you like!”

i tried to think about the woman i met in the high dependency unit as a surgical house officer – an obese lady who was, at one point, labelled “death in life”. she gave me hell during the week i spent looking after her, complaining of breathlessness every 5 minutes (because she kept taking her oxygen mask off) and asking for painkillers (because she was unable to reposition herself). but she did spend a good period of time in intensive care, her heart pumping solely on the action of drugs, and yet she made it through; she was discharged by the end of my 4 months.

i tried to think of her and tried to hope the same will happen for this young man…but i couldn’t. i was infuriated by his behaviour. i didn’t regret my own unprofessional conduct (well, not immediately anyway) and i didn’t think anything would change my mind.

about half an hour later, after my medical officer managed to somehow find a vein that was still available, i went over to the man to obtain consent to perform a peritoneal centesis. he quickly grasped my hand and apologised profusely for the harsh words he said to me…and it took everything to maintain my composure, tell him that there are no hard feelings. no, none at all.

i wish there were a happy ending to this. since the incident above, we’ve added yet another drug to keep his heart going. he’s still oxygen dependent. we have no idea exactly what has caused him to deteriorate so quickly. it just doesn’t look good.

illness does strange things to a person. it turned my patient, who is probably an absolute delight whenever he’s well, into someone i’m sure even he doesn’t like, judging from the genuine tears of remorse he shed that day when he held my hand. it’s also turned him into a person i’m not sure i want to revive should he collapse…because he’s been through the kind of physical pain i would never, ever wish on anyone.

medicine is really so, so hard.