I didn't have anything planned to write about today so I'm going with what's on my mind as I sit here post-rounds*.
We were walking into a patient's room this morning when the nurse stopped us and informed us that he had passed away this morning and there was a lot of family at the bedside. We hadn't met the family yet this week, it was a patient whose care our team was peripherally involved in, and we were just checking in today so we could write a formal follow-up note indicating a minor medication adjustment we were making, to tie things up before the weekend. So really, we had no personal relationship to this patient and we knew that the prognosis was poor so it wasn't a complete shock. Yet it still affected us. We were sad, subdued. We took a moment and then went to the next patient on our list, but we walked slowly and didn't talk. I felt like the loss of a life too soon needed to be acknowledged in some way. I never get used to it, and I don't want to.
There is a patient on our service with one family member that is very aggressive. Verbally abusive. Whenever I see this kind of thing, my first thought it "don't you think your loved one would get better care if you weren't scaring and angering the providers caring for her?" But yet, when I dig deeper, I realize that there is likely profound and utter fear underlying this behavior. He can't control the disease that is taking away the life he knew, he can't control the emotions that are overwhelming him, so he tries to control the day to day care, and the minute details, in some hope that this will all make senses somehow. Does he realize he needs to change his behavior, but can't figure out how? I still am glad he wasn't at the bedside today but maybe I am developing some modicum of empathy for him.
Friday afternoon is a always a wild-card. People love to squeak in non-urgent (often B.S.) new consults at 4:30 PM, as if that is more humane than calling on Saturday when you actually have the whole day ahead of you. I am looking forward to my pizza & wine tonight (with the kids watching a movie so we can chill) so so so much.
*details have been altered, etc...