Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler






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    Sunday, July 06, 2003
     
    I'm Not Demented, I'm a Surrealist

    This morning I did my usual weekend nursing home rounds. "Skilled" patients have to be seen once a week, "custodial" patients once a month. (The qualifiers do not refer to the patients' talents, but to the level of nursing help they require.) Currently, I have more skilled patients than usual and therefore am having to round more frequently than is my wont.

    I was sitting at the nursing station reviewing my patient's blood sugar levels when I became aware of a little old man in a wheelchair nearby. Actually, it would have been difficult not to be aware of this fellow since he was yelling at the top of his lungs. This isn't exactly an unusual situation in nursing homes, but this particular scenario was priceless. Picture the following:

    Yelling old guy in Wheelchair Number One. Perpendicular to him, and slumped over, grumpy guy in Wheelchair Number Two. Guy Number Two clearly cannot stand Guy Number One.

    Guy Number One: Telefono!
    #2: (slurred speech) Shurrup.
    #1: Telefono!
    #2: Shurrup.

    (Repeat about half a dozen times, then a pause, then the telephone rings, setting Guy #1 off again):

    #1: Telefono! Hello!
    #2: Shurrup!

    I start to mimic Guy # 1, though more quietly: "Telefono!" The nurses are cracking up. Things start to calm down a bit and I finish my charting, but then the first guy decides to start yelling something else:

    #1: Help!
    #2: No!

    #1: Heeelp!
    #2: NO!

    -- etc. (He didn't appear to be in any sort of distress, if you were wondering.) The head nurse is rolling her eyes; apparently this has been going on for awhile. I wish her a good day as I hand her the orders for review.

    "Yours will probably be better," she replies dryly. As I head out the door, I can still hear "Help!" faintly in the distance.

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