Saturday, June 12, 2010

I'll miss you, Lady

Patients die. It's part of life and medical practice.

But last week one of my favorite patients died, and I'll miss her.

Due to shit luck she's been in a wheelchair for the last 15 years with a serious neurological disease. It made her suffer constantly from pain. When a freak accident cost her an eye 10 years ago, she accepted it as the crap it was, and went on with her life. She never once filed for disability. And in spite of this she was always cheerful.

I saw her every few months. Not that I really had much to offer her, but she came in to see if anything new was out. And when I said no, she accepted it with grace. I told her she didn't need to come back for a year, but she'd always be back sooner. Over the years our appointments became as much social visits as they were medical. So we'd chat about shoes and ships and ceiling wax.

She knew about this blog, one of a handful of patients who does. She'd been through so many doctors and tests and treatments that she loved to laugh at the insanity of modern medicine. She'd always joke with me that she was looking for herself on it, but I told her she'd never given me anything to write about.

And so it seems fitting, that, in dying, she finally ended up here.

She went to Local Hospital ER for pain 2 nights ago, and they sent her for a CT scan. While in the machine, she died. The code team worked on her for an hour in radiology, and couldn't get her back.

I learned of her death yesterday, and went over to read the chart, to see what happened. I was reading through the Code Blue note. Which ended with this line:

"After being pronounced dead, the patient was returned to ER for further evaluation and treatment."

Good night, Lady, wherever you are.

38 comments:

Anonymous said...

She sounds lovely, I'm very sorry for your loss and feel for her friends and family. I'm sure she will have been pleased to finally make it into your blog.

Vivian said...

If she could read this, she would get a really good laugh at how she ended up here, huh?

"After being pronounced dead, the patient was returned to ER for further evaluation and treatment."

Can't help but laugh at the stupidity, I'm sure she wouldn't mind.

In psychiatry you end up having many patients that are okay but you still need to check up on frequently or that just feel insecure to be seen more sparingly, so I know how you feel about her appointments. They turn into nice conversations with interesting people.

Thanks for posting even in a sad time of loss.

terri c said...

I'm so sorry, Dr.G. You were lucky to have known each other. I hope she is in a place with no pain. And I hope she somehow gets to read this entry.

Gert said...

It is patients like this who touch our hearts and hopefully make us try to be better doctors, nurses, people.....my heart goes out to you. I couldn't do my job as a hospice nurse unless I believed that there is redemption from suffering beyond this life, so it is bittersweet to say goodbye.

Anonymous said...

What amazes me is that I am 59, and even after being hardened by all life dumps on you in those years, that I still find myself shedding a tear when I read or see heartfelt emotion expressed. Thanks Dr. G for sharing this story, Godspeed Lady. I am sure that Lady understood that being returned to ER for futher treatment meant signing insurance forms.

Jacqueline said...

So sorry for your loss...here's to hoping she's somewhere reading this and laughing.

RehabNurse said...

Grumpy:

If she had a sense of humor (which seems like she did), she's probably enjoying this in the hereafter.

The irony, of course, that someone, a MD without a neuro disorder, wrote that note...priceless.

Hope one of your new patients is a good one. Sounds like you have your share already of idiots.

Suburban Princess said...

What a nice tribute :O)

I am sorry for your loss.

What is ceiling wax?

Jackie said...

I think it's only fitting that she made it here. I'm sure somewhere she is laughing her behind off!

xx
Jaxs

Steph said...

I've never commented on your blog before even though I've been an avid reader since a friend introduced me to it several months ago.

I can relate to Lady's situation, though mine is not nearly so limiting. Doctors haven't been able to offer a lot in the way of physical help - not because they don't want to of course, but there have been a few Doctors along the way that have lowered the threshold of professional distance to allow me a glimpse of their lives as well as really listening to what was going on in mine (and not just the portion that made it into my chart). I can tell you that it helps. I go in weekly for painful treatments that offer marginal benefit, but while I don't look forward to the treatment itself, I do look forward to the social aspect of the visit, and that gets me through the painful part.

Kudos to you for knowing that sometimes all you can offer is a little bit of yourself. I was both tearful and smiling at the end of your post. I'm sure Lady is smiling where ever she is.

Anonymous said...

Rest in Peace, wonderful lady. And, to Dr. Grumpy, you always make me smile.

Anonymous said...

Thanks, Dr. G. for sharing this bit of yourself.

Anonymous said...

there are statistics of how disease affects people, yet there are some who are magnets who get far more than their fair share. of misery. they deserve our gratitude and compassion. as you say, those who still live meaningfully make our days real and fulfilling. i hope the er triaged her before the bitch waiting for her mri results. wv-ainge. celtic omen?

GunDiva said...

One of the things I miss most about working with patients is getting to know them as people. I certainly didn't have a social relationship with all of them, but a select few and always looked forward to their visits. Just knowing they were coming in that day could turn around a totally and completely shitty day.

Thanks for sharing Lady with us, and I'm sure she's getting a good laugh at her final entry.

Anonymous said...

sealing wax?

Anonymous said...

Dr. Grumpy--do you tell patients about the blog or do they discover it on their own?

Anonymous said...

As a patient, I have that kind of relationship with many of my doctors. Though we do talk medical since that is why I am there; we always carve out a few minutes to "kibitz!" It confirms my doctor is human (as a teacher it is always funny when the little ones realize you don't live in the school). And I seem to get along with the sub specialists that are the best in their field but need to practice their bedside manner. Those doctors, are my favorite (and I tend to be their favorite)! Go figure!

Anonymous said...

"The time has come," the Walrus said,
"To talk of many things:
Of shoes—and ships—and sealing-wax—
Of cabbages—and kings—
And why the sea is boiling hot—
And whether pigs have wings."

A wonderful poem by Lewis Carroll. It's worth reading the whole thing.

Then shed a bitter tear.

Amanda said...

I'm so sorry for your loss, Grumpy. And as others have stated, I'm sure she caught this blog in some way and is giggling her celestial hinderparts off at her mortal remains being returned to the ER for further evaluation and treatment.

It's one of the few times I shrieked with laughter while tears ran down my face... well presented, sir :)

Phathead said...

It's funny how you can feel nothing for 999 patients, but there's always one that gets to ya.

Anonymous said...

ee cummings trumps lewis carrol

me said...

godspeed to her...

Cheryl said...

A beautiful post for a life well lived.

Bravo, I.G.

thegooddrlaura said...

My condolences on your loss, Dr. G. These are the patients that make it all meaningful and fulfilling.

bb said...

Your post gives a glimpse into what kind of person she was. Bravo to Lady for a life well lived.

Milo said...

i am sooo sorry.

Grumpy, M.D. said...

Okay, it should have said "sealing wax", not "ceiling wax". Oh well.

Julie said...

thanks for sharing Dr Grumpy and i think she would have enjoyed the irony of ending up on this blog

KateA said...

Sorry for the loss of your patient. I do remember a saying from vet school that nothing dies in radiology...when patients looked like they were tanking, the radiology folks would rush them back to ICU to run the code.

Your patient sounds like a gem. We have had a recent spate of patients either being euthanized or dying from their end stage diseases. And many of these are animals that we have been working with for years, many on a nearly daily basis for the last few weeks.

One owner lost both of her dogs within the space of a week. Now she is totally without pets. When she was in on Friday to just visit with our staff, there was not a dry eye in the building, including other clients that were there for visits. These are the people and pets that we love to serve.

Frantic Pharmacist said...

These are the kind of patients you really, really admire --- especially when I have to go back to waiting on some snotty little tattoo-ed diva who's mad because her kid's Adderall isn't approved.....

The Bus Driver said...

I bet she's reading this from up above and saying "That one's for YOU Dr. Grumpy!"

pharmacy chick said...

Great post. there are always some people who touch us in some way and leave a mark. Thankfully not all of them are bruises. My condolances.

RP said...

sorry for your loss. Unfortunately whether docs or nurses or ? We all get connected to certain people whether we want to or not. I've been there done this several times already in my nursing career.

FYI, keep up the blog. Love it because your straight forward and honest, even if it hurts or it ends up being funny, which I enjoy the most.

Mr. Police Man said...

What a cool sounding lady.

Let me ask you Dr. for Dr. advice - Not medical advice.
I have a 4mm bulding disk C5-6. It's workers comp and next week, 3 months after the date of injury, I finally get to see the spine Dr.

I don't pull shenanigans but want the Dr. to know I did my homework for him. Should I be generic or detailed for him?

Grumpy, M.D. said...

Detailed about your symptoms.

ERP said...

Cause of death?

One of the downsides of ER is that I don't often build these relationships.

vicki said...

dr grumpy
i know your lady is laughing and enjoying being in your blog and know she touched all of us.
i hope i can be a patient like her
i love all of your stories and i know your lady did too. you probably made her laugh and cry at the same time (i have) reading your blogs
as a patient who has chronic illnesses i understand her need for friendship and building relationships with medical personnel

Anonymous said...

Is filing for disability when one is disabled a bad thing?

 
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