Monday, October 24, 2011

clinical experience reflection week 4

The incident that’s on my mind the most right now, perhaps because it has been simmering for the second half of the week and came to fruition on Saturday, is what I should tell the roommate of one resident who is very close to that person—think brotherly—but who, because of HIPA regulations and privacy concerns, can’t be told that his friend is not doing as well as everyone expected.

It’s not as if the resident is dying (although all of us are dying), but when he went in for routine surgery it was expected he would be discharged after a few days and all would be well. His roommate could be told he was doing fine, he sent his affections, he’d see him soon, all that. The roommate has a tendency to take into himself the concerns he has for his friend and internalize them, apparently fixating on his worries, until it absorbs him. When I saw him last, early Saturday afternoon, he was in a pretty cheery mood, smiling and saying, “Tell him I’m glad he’s okay and I’ll see him soon.”

The truth, on the other hand, is that the resident is not doing as well as everyone hoped. His blood pressure is lower than it ought to be. He’s being fed oxygen by a tube which is strapped to his head. He reports he’s in a lot of pain. Mentally, he’s more alert than he was the first day I visited him, but he’s reduced to answering “yes/no” questions by shaking or nodding his head. He remains in intensive care and his nurse tells me it will be at least several weeks before he’s allowed to come home.
Given all that, what’s my response when his roommate asks, “How is he?”

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