He called ahead like so many of our patients do. Some call from the city closest to us, La Ceiba, wondering if they can bring their ailing family member from the public hospital. They tell stories of how the doctors have told them there is no hope for their loved one—there’s nothing they can do. Some come from hours away to our hospital that they’ve heard about from a cousin of a friend of a neighbor of a grandmother’s friend’s sister. “Can you help us? Can we come?”
They call ahead because we’re so far away from anywhere convenient for long-distance travelers. What an even greater discouragement to travel so far, only to be turned away. Unless it’s for something specific that we simply cannot offer (like an MRI, CT scan, neurologist, etc.), I rarely hear anyone be turned away.
I was working at the nurse’s station on a Sunday. The phone rang. Surprisingly, an English-speaker called this time. The rock-star nursing assistant who was working with me that day, Elsa, answered the phone and tried to speak with the mystery caller. I overheard the usual: “I’m sick and I need help,” “people in La Ceiba say they can’t help me,” And “Can you help me? Can I come?” Dr. Peter, our Emergency Medicine doc, was standing there with us, writing new orders for a patient, and he and Elsa switched places at the phone.
My exhaustion—emotional from a very full census the previous week and losing two patients, despite our best efforts; physical from a non-stop morning, from not having eaten in a while, from not having slept well the night before, and on and on my excuses go—screamed, “No! No more patients—we’re full! We can’t take care of more. I can’t take care of more.”
However, I am so thankful that so many things are much bigger than I am--the Bad Attitude-Hypocritical-Self Righteous-Self Absorbed Lizzie. We discharged 4 patients in the next 3 hours, providing more than enough time and space for another person.
That patient was really sick. After a conversation with Dr. Peter, he ended up at our doors, accompanied by his wife. The patient looked distraught, hopeless, defeated, and weary. He embodied how I felt that Sunday morning. After eating some food, drinking some water, praying for an attitude check and a better perspective, I stepped back into the chaos and finished my shift--the Second Chance-Forgiven-Redeemed Lizzie.
That patient was really sick. After a conversation with Dr. Peter, he ended up at our doors, accompanied by his wife. The patient looked distraught, hopeless, defeated, and weary. He embodied how I felt that Sunday morning. After eating some food, drinking some water, praying for an attitude check and a better perspective, I stepped back into the chaos and finished my shift--the Second Chance-Forgiven-Redeemed Lizzie.
We admitted the patient that day and I returned the next day to work my shift. It was also a shift of locura—craziness, but not quite the mass chaos it was on Sunday. At one point, my Honduran coworker and fellow nurse (also named Elizabeth) told me she had tried to give a medication through one of our patient’s IVs and was unable. She asked me to look at it and see if his IV was still working.
If we can stop right there and slightly happy dance together at the fact that my coworker deemed me competent enough in parenteral medication administration to evaluate a peripheral IV—a specific skill that was not a part of Lizzie Nelson’s competency toolbox 4 months, barely even 2 months ago. I’M LEARNING, GUYS! There sure are great teachers here and it seriously has taken a whole international village to teach this child.
Enough rejoicing (for now).
Normally, we refer to our patients by their first or middle names—or by “Newborn *Last Name* *Second Last Name*” (because almost everyone here has two last names or might go by their middle name). However, it occurred to me as I walked into the patient’s room, none of us nurses had really referred to this patient by his name. It was always, “El paciente norteamericano” or “El paciente en 4A”—our nothamerican patient or the patient in Room 4, Bed A. There were 3 names on his chart and we had no idea which to call him.
We're a predominantly Spanish-speaking hospital. So this particular patient, as sick as he was, would light up every time someone would speak to him in English. Our encounter was no different. I explained to him what I was there to do, asked how he was doing, and got my supplies ready to check out his IV. He was sitting on a chair at the foot of his bed, liver cancer and hepatitis C and all, patiently waiting for me. I brought a chair next to him and started talking to him.
I’ve had a bad habit for the majority of my life of hearing people in conversations without the intention of listening. It’s as if I had been merely waiting on my turn to talk. This needs to end. So I asked questions, looked him in the eye (when I didn’t need to be looking at his veins), and closed my mouth. He told me about how he was feeling: the discomfort, the lack of energy, the diarrhea, the side effects of all the medications we were giving him—everything. He told me about where he was from—Kentucky and how he’s lived in Illinois. His eyes grew sad with regret when he spoke of his children, but lit up when I asked about his grandkids. We talked about central Illinois and how he ended up in Honduras. He talked about his interest in herbs and botany. We talked about his Hebrew faith and how he had been ordained to be a rabbi several years before. He told me about he had been mistreated because of his faith and how he had walked away from God. He told me how he had been hurt by some who had claimed the Christian faith. He expressed intrigue with the hospital, because he knew we were a Christian hospital and we seem to be living what we say we believe. We talked about that. We also talked about hope and God and how through this experience he had a desire to walk with God again and to seek out his purpose.
By this time, I had removed his old IV, successfully started a new one, given him his medicine, and hooked up his bag of IV fluids. We had covered a lot of ground in a short time, but I'm sure we could have kept talking for much, much longer.
Before I walked out of the room, it dawned on me this was the same patient I had dreaded admitting on Sunday. If he never would have come, I would have missed out on the most sacred, life-giving conversation I had had all week. I listened to his heart, hurts, regrets, philosophy of life and religion, and his questions about God and redemption (and even tried to answer a few). What a privilege! This humble, sweet man, who kept apologizing for all the work he was causing us (which he had no clue how easy of a patient he ended up being), was so thankful for everything we did, as if he was somehow unworthy of such care. I’m more of the impression that I was unworthy of caring for him.
Before I walked out of the room, it dawned on me this was the same patient I had dreaded admitting on Sunday. If he never would have come, I would have missed out on the most sacred, life-giving conversation I had had all week. I listened to his heart, hurts, regrets, philosophy of life and religion, and his questions about God and redemption (and even tried to answer a few). What a privilege! This humble, sweet man, who kept apologizing for all the work he was causing us (which he had no clue how easy of a patient he ended up being), was so thankful for everything we did, as if he was somehow unworthy of such care. I’m more of the impression that I was unworthy of caring for him.
“Oh, by the way, what do you prefer to be called?” I asked, before opening the door.
“Well, my wife calls me Dawid—it’s Hebrew for David.”
“Do you like that? 'Dawid'?”
The Second Chance-Restored-Hopeful Dawid smiled as he said, “Yeah, I do.”
I smiled back and said, “Okay. Thanks, Dawid.” And I meant it.
