Sunday, September 25, 2016

I have all the time in the world.

It was not an easy day.

We were short-staffed, and I had a patient on palliative care, whose family needed my attention much more than the patient did. Let's face it: when their urine output drops below 20 ccs an hour (those Foleys are placed for comfort care, but it's more the nurses' comfort than the patient's--we can tell how close to dying you are by how well your kidneys are working) there's not much we can do. We turn and do a partial bath every two hours and wipe their faces and clean their mouths, but it's all for the family. The person who's dying has long since ceased to care.

So I had this palliative care patient, and a patient on a titrated drip, and a walkie-talkie woman, ninety-fucking-six years old, with a tiny lacunar stroke that didn't affect her at all. The most we were doing was tuning her up; making sure her blood pressure was okay and her electrolytes were within normal limits. We weren't going to try to change her diet or stop her from smoking. At ninety-six, you're running on genetics, and who am I to say you should give up the Parliaments for an extra, horrible year of life? Keep smoking and die at 102.

So I was in a hurry that morning, making sure her breakfast was to her liking. "My husband," she said, "always liked a poached egg every morning."

She hadn't ordered poached eggs. "I can't stand them. Slimy things" she said.

She had an omelette with mushrooms and sausage and cheddar cheese. I remember this exactly because I love that particular omelette. With hash browns and pancakes.

She had toast.

Anyway, I was in a hurry. I was hungry, I wanted my own 200-calorie breakfast, I had to take vitals on the guy who wasn't on palliative care and swab the mouth of the guy who was, and this woman said, "My husband always liked a poached egg every morning."

"I used to get up," she continued, "and make him an egg and toast, and then feed the baby. I didn't have much milk, so I had to give him goat's milk and cereal."

She reached out for the omelette and I cut it up for her. Hurriedly.

I was looking toward the door, wondering why the monitor was going off, when she took a bite of toast. "It was January when we stopped having milk at all," she said, spewing crumbs everywhere. "That wasn't so unusual. You know, cows only used to give milk when they were nursing calves."

I knew that from the Little House books and nodded, distractedly, wondering if the alarm I heard actually meant something or was just artifact.

"In April, the soldiers came and kept us from going out of the neighborhood."

That sent a prickle up the back of my neck. I looked at her, ninety-six years old, two children who came to visit and then had to leave to take care of their work, six grandkids, two great-grandkids. And I did the math and realized that this might be her and my last chance to talk about this.

We are losing them every day, those people who fought a good war, and the people who were caught up in it, or who were targets of it. I will never forget the man I took care of who had crude tattoos memorializing his jumps as a Russian paratrooper on his bicep.

"What was it like?" I asked, "not having any milk?"

She said, "You have more important things to do. People are sick."

I said, "I have all the time in the world."