“You were a Secret Service agent, Mr. Smith?”
“I was indeed. For Presidents Ford and Carter.”
“That’s incredible. What were they like?”
“Well, President Carter would get up at 2:00 am and ask us if we’d like to go on a walk. Since most of the staff worked nights, I walked with him. We would walk for hours and talk shop. Carter is the most interesting man I’ve ever met and had the pleasure of talking with. I think this was in the early 80s.”
“Happy to see President Carter doing well. Even seen him on T.V. recently.”
“Me too. Carter is a national treasure.”
“What was President Ford like?”
“He was … well, just Ford. We didn’t talk much about … anything at all.”
We both laughed so hard, Mr. Smith’s nurse ran into the room because of tachycardia. His heart rate climbed down as we both eased back into our chairs.
I first met Mr. Smith three weeks into my internal medicine rotation. A well-traveled man, he was a police officer for several years before becoming a Secret Service agent under Presidents Carter and Ford. I visited him every morning, and throughout his stay met his five grandkids and two sons.
“Hopefully I can get on out of here soon. It’s just beyond miserable. The food sucks and the nurses don’t know what they are doing.”
“I am sorry to hear that Mr. Smith. Is there anything we can do for you today?”
“Well, you were late to see me this morning. Your attending came to see me at 7:00 a.m. sharp, and he is decades older than you.”
“I’ll make a concerted effort to beat Dr. Thomas tomorrow morning.”
“I’ll see you to it.”
Mr. Smith was in the hospital for CKD stage 4, and we were trying to figure out his pain med regimen. He also had osteoarthritis, uncontrolled diabetes, a new bilateral hip replacement, and PTSD. Tramadol? Opiates? Morphine?
“What about you give me a bag of normal saline for my pain? I think it’ll be quite effective.”
“You’re quite the character, Mr. Smith. We’ll adjust your current meds and see if we can find a balance for you,” said Dr. Thomas.
“What about a PCA pump?”
“What do you know about the pump?”
“I can press the button when I need morphine for the pain, but I know you can cap how much I get at any one time.”
“We’ll see. Let’s start with what you are on now and adjust as needed.”
“You’re the boss man, doc.”
A week into Mr. Smith’s admission, he suffered from severe sepsis due to complicated MRSA bacteremia. MRSA is one of the worst bugs you can catch during a hospital stay because of its sheer resistance to several mainstay antibiotics. The bacteremia could have been from his orthopedic hardware or the indwelling catheter, but regardless, he improved dramatically with IV antibiotics.
“You dodged quite the bullet there, Mr. Smith,” I said as we shook hands.
“A bullet indeed, could just be death knocking at my door.”
“Why do you say that?”
“I’ve had my fair share of brushes with death. Been shot at, been in fights … I feel that my time is near. I don’t know why I feel that way, just do.”
“How are you feeling with the antibiotics so far?”
“Doing well, my pain control needs some work though as usual. I sometimes feel pain from my scar, which sounds silly I know.”
“It doesn’t at all Mr. Smith. May I ask what happened?”
“Sure. So, ten years ago, I was in a gentleman’s club and there was a fight between a dancer and her boyfriend. I was what you call being at the wrong place at the wrong time. Tabletops being thrown, faces being punched out. It was a Western brawl. And somehow, I took a knife to the neck.”
“I grabbed a tablecloth and placed pressure on it. I ran out to the parking lot, collapsed to the ground. The next morning, I woke up and I had like a million staples inside of my neck, and they were talking about how lucky I was. That the knife missed the carotid artery by two centimeters.”
“Then, my dearest, younger brother came to my bedside and goes, “Hey, man. So if you would have died, where do you think you would have went, to heaven or hell?” And I’m like, “Hey, man. No time for this.”
“But I wanted to say, ‘Oh, probably hell,’ from where I was.”
“Months after, I would sit at the edge of my chair just waiting for the panic attacks. I would wake up with night sweats too and finally saw a psychiatrist at the persistence of my wife. I’m so glad I did.”
“Does the paroxetine help?”
“Oh, yes. It does wonders. Never thought a medication could be that helpful. Take one pill every morning and I am good to go.”
We continued to talk for the next hour or so before his grandchildren came back to the room. They were all smiles, and kissed their grandpa as they were holding their ice cream sandwiches.
Mr. Smith got better with each passing day, and then the time came for him to return back home.
“Well, I am finally out of here.”
“Are you going to miss this place?” I said.
“Not for one second, except for say the people.”
“I saw that you really warmed up to the team towards the end.”
“What a strange occurrence, so unlike me! Maybe I should stay for a bit longer and be re-evaluated.”
We both shared one last laugh before his sons arrived and took him home.
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