An elderly man startles awake after a man in a white coat touches his shoulder. He looks around and sees three other white-coated people standing around his bed.
“Sir? Good afternoon, sir. How are you?” says the man who touched the patient’s shoulder.
“Oh, I’m fine.” He’s perfectly calm.
“I know this is a silly question,” continues the man, “but do you know where you are right now?”
“Of course, of course. I’m at home.”
The slightest pause. “Sir, you’re in the hospital.” The man in the white coat names the hospital.
“Oh yes, the hospital,”the patient agrees. It’s as though being at home were just a slip of the tongue and not the mind.
“Do you know why you’re in the hospital?” the standing man presses.
“I’m here … I’m here because you’re giving me circulation to my leg.”
“Actually, you just had an amputation of your leg.”
The patient’s expression freezes, but like many people with dementia, he covers whatever internal processes he has.
“Your leg was just amputated.”
This is not the first time the patient has woken up after his surgery. According to the nurses, he had been tearful all day trying to cope with the loss of his leg.
“Can you repeat that after me? Your leg is amputated.”
The patient repeats it, in a tone that I’ve used to talk about the weather.
“Okay? Your leg is gone.”
And just for good measure he lifts up the blanket and shows the patient the nothing that is there:
“Your leg is gone.”
The doctor turns and leaves. The other people in the white coats who are not in the patient’s home not giving circulation to his leg follow his lead. The whole encounter takes no more than 120 seconds.
The third year medical student in the white coat looks back at the man’s frozen expression. With this glance, she has already fallen out of step with the team.
A social worker enters as we leave, pulling the curtain around the patient’s bed.
A curtain around a man who doesn’t wake up from nightmares but into them.
Someone please tell me.
Someone please tell me how to make a box in my mind and put patients into it and seal it and make the patients stay in there until I say they can come out and–actually, on second thought–maybe I’ll just never let them out.
Because I am having nightmares too. But at least I am waking up in my home with both my legs still there.
Someone please tell me how to steel myself against this profession I have chosen.
Shara Yurkiewicz is a medical student who blogs at This May Hurt a Bit.