Seeing patients as their former selves

Image from Waltham Public Library
I have often found myself envisioning patients the way they used to be, when they were young or before whatever happened to them happened. The result is that I wax nostalgic by proxy over sometimes-fictionalized accounts of their lives, but I can't stop myself. It happens even more with elderly folks who just love to reminisce (and I love to let 'em). I think keeping in mind that people are far more than what we see in the moment keeps my interest and compassion alive.

I once had a patient who had advanced Alzheimer's disease, and every 30 minutes or so, she would say, as though it were a brand new idea, "I know what we should do. We should go dancing!" She would sometimes go on. "We could find two fellas: one for you, and one for me, although I'm probably a little bit older than you." Her face lit up, and it was impossible for me not to envision her as a young woman going out dancing. Another time I was dance-walking a lady back into bed (nurses, you know what I mean), and she burst out of her flat affect with a huge toothless grin and said, "May I have this dance?"

I was once in an OR observing a below-the-knee amputation for a very elderly woman, and as the OR nurses put the lower limb in the red bag they observed a moment of silence and then addressed it: "You have been a good leg and served her well for a long time." I got a little tearful and began to imagine all the things that leg had done for that lady over the decades she had had the use of it: did she jump rope as a child? Play hop scotch? Climb trees? Did she go dancing with the man who would become her husband? Walk the floors at night with a new baby? Wrap her legs around a lover (possibly the husband...) in the throes of passion? Given all those possibilities I thought the OR nurses' habit of addressing amputated limbs was highly appropriate.

In the peds ICU of one hospital where I had clinicals, the staff would put photos of the preaccident child on the wall near the head of the bed so that they would remember to interact with the still form on the bed as if he or she were still that person inside.

Patients come to us with a few major problems, and we have to focus on those because we have limited time and resources (we can't get all rogerian for every patient we meet). Still, my life has been greatly enriched in the short time I've worked in this wonderful field of nursing by the times I have been able to get to know patients beyond their chief complaint and last bowel movement. There is no doubt about it: if you are a nurse you may be busy, angry, overworked, and underpaid, but you will probably never be bored.