You Will Thank Me!

Sometimes my patients just amaze me.  Some amaze me because of their stories, some because of their attitude and some (what am I saying, most of my patients) because of their stupidity and ingratitude.  I always say I’ve seen it all, and then I’ll have a patient who makes me realize there is more for me to see and experience. 

This patient came in drunk.  His blood alcohol was 0.28.  This is four times the normal level and very drunk.  Not only was he drunk but he was older, in his 60-70s…old enough that he should know better and not be doing this kind of stuff anymore.  Of course in his drunken state, he had taken a little trip and ended up with a broken elbow, hip and smashed face. 

Now let me say drunken patients are not fun to care for.  I always think that with that much alcohol in their system they should pass out and sleep but that never seems to be the case.  It was a long night with a tough patient.  It was his first night in the hospital with no alcohol; actually it was only three hours since his last drink.  This was not even enough time for the alcohol to be out of his system, in fact he was still very drunk, however, he was convinced he was detoxing. 

“Hey, you nurse, I think I’m detoxing…I’m shaking and need something to help. How about some medicine right now!”  “You’re not detoxing…in fact you are still quite drunk, but I promise to let you know when you are!” 

He was ringing out on his call bell all night long, every 5-10 minutes.  It was quite frustrating and it was getting on all of our nerves.  My co-workers were even threatening me to “do something with that patient before we all go off on him.  How about you give him some Ativan, Haldol, or valium?”.  This on top of the patient “Can’t you do something for these shakes? Can’t you give me something for pain? Can’t you give me something for nausea? Isn’t there a doctor you can call?”  I got tired of saying the word NO that night.  In fact there was a doctor I could call, but I knew there was nothing they were going to do so I didn’t even bother.  I just had to wait it out and it was turning into a long night.

Finally the morning arrived and with it the surgeon.  The patient was very upset and refused the procedure with not so nice, colorful language.  (Now really!!! The refusal of this patient was going to result in a loss of movement in his arm).    The arm would end up with some big wound, infection, and then amputation due to the basic neglect this patient had for his health.

I went in plopped down into the bedside chair and stared at the patient until his swearing was finished.  Just me and the patient.  Then came the talk.  “You need to have this surgery.  If you do not you won’t be able to eat, drink, shake hands or work with that arm again?”  Of course the only word he heard out of that whole tyrant was the word drink.  We talked for what seemed hours but finally the patient consented to the procedure and signed the paperwork. 

The next time I worked (four days later) I see the patient sitting in the bed complaining and yelling.  I go in to check on the patient. “Hey you’re the one that convinced me to have surgery! I wish I hadn’t listened to you! I’m in so much pain.  I want to rip my arm off!!!!” Yep, I’m the one that convinced you to have that surgery.  You’ll thank me in a few years when you’re holding a grand baby in that arm, when you’re hugging your daughter after her diagnosis of cancer, and when you are at death’s gate holding the hand of your nurse.  Of if not in any of those moments, you will surely thank me the next time you are holding your next drink.  Yes You will thank me.