I park my bike and enter the hospital through the parking lot. The first thing I see is a sign announcing LUNG CANCER AWARENESS MONTH. Great. My mother died of lung cancer, 3 packs of cigarettes a day for 50 years.
The pager goes off. I need to order an ambulance for an elderly woman to go home. I head back to the trauma area to leave the paperwork on the chart and I see a young man sitting on the edge of an elderly woman’s gurney. I go over and introduce myself. He’s the son. The patient has advanced Alzheimer’s. She is a beautiful and wizened old woman who used to be a farmer in Nigeria. She has that vacant expression that is the hallmark of Alzheimer’s disease. She has constrictures in her arms and legs and is curled up in a fetal ball. She only speaks Ebo. I ask the son how it is going at home. It’s hard he says, he is the sole caregiver. There are other siblings, but they live in faraway states. He has been with his mother 24/7 for 3 years. He doesn’t get good sleep because she wakes up at night literally drowning in secretions and he has to suction her. I can see he is approaching “caregiver burnout.” There is a lot written about caregiver burnout and how to prevent it, but as a society we are not preventing it because that would take money. The state/federal governments don’t allocate much money to help families take care of loved ones. The Family Leave and Medical Act is a joke. It’s unpaid and most people can’t afford to take it. The United States has the stingiest social welfare policy of any country in the developed world.
There was money though, to put a feeding tube into this patients body. Feeding tubes in patients with dementia are cruel and unusual punishment. They only prolong the inevitable. When a patient with dementia no longer desires to eat they are telling us something. And once the tube goes in, it’s difficult to take it out. To take it out means the person will die. Doctors don’t want patients to die. Doctors often don’t tell the family they don’t have to put in a feeding tube to avoid a difficult discussion about the end of life. It’s about quality of life. I asked the young man about his mother’s quality of life. He wasn’t sure. Sometimes she recognized him and said a few words. Most of the time she was mute. The goal of the family was to get her healthy enough to fly to Nigeria to see extended family and to die. I asked him how they were going to pay for it. He didn’t know. I looked at his mother’s eyes again, she was gone, she was already home, back in Nigeria.
Cell phone rang. I could see from the caller ID that it was an extension from inside the hospital ER, but it was a patient. I wondered how he got the number. He was shouting into the phone that he was laying on a gurney in the hallway in his own urine and he was in pain. Could I do anything to help him? I asked him where his nurse was. He yelled loudly, she won’t help me, she doesn’t help me, can you come over here and help me! I told him I couldn’t and to talk to his nurse.
I go to use a bathroom near the social work office. I open the door and a woman is vomiting into the sink. I open the door to a stall and the smell of feces is overwhelming. I dash out the door holding my breath.
An elderly man with a foot fracture needed a wheelchair. He was in the ER with his wife who was wearing a beautiful purple sari. He introduced himself and told me the doctor said I could help him get a wheelchair. He wasn’t insured so I told him he would have to pay for it. He said he didn’t have the money. He was a proud man and said he had never applied to any public assistance program. He worked his whole life until he got sick and then broke his foot. He and his wife moved to Chicago to be with their children when he retired. The man was an engineer, originally from Pakistan, and worked for oil companies in the Middle East. He was kicking it in Dubai when no one knew the place in the desert existed. He made $8000 a month. Now he was poor. I made a wisecrack about Bush, the war, and oil. He smiled broadly and said yes, he used to work with Mr. Cheney’s partners at Haliburton. We ripped on Cheney for a few minutes. It felt surreal to be having this conversation in the hallway in the ER that was busy and full of people walking by. He said the United States leads the world but not in health care and that was a shame. He told me I was a good social worker because I listened to him. He asked what ethnicity I was and I told him Irish on my father’s side and German on my mother’s. But I don’t feel Irish or German. I told him I love Indian food and try to get to Devon Avenue as much as I can. He told me the best Indian food was at his house and invited me to come for a meal. I asked if he cooked and he said no, his wife did, and her food was outstanding. She smiled shyly when he said this. He wanted to give me his phone number but I told him I couldn’t accept it. That thing about professionals and patients. He said he understood and thanked me profusely for taking the time to listen to him.
My plea to the government: Nationalize the corporations that make wheelchairs. Free wheelchairs for every person that needs one! Wheelchairs are a human right!
Pager is going off again. The resident explains she has a 15-year-old male who was tasered by the police. They tasered him in the back as he was running away. The shock of the taser made him fall forward and crash on his face. He had facial fractures and an eye injury. Was there anything I could do for this kid? Yeah, I’ll call the Office of Professional Standards (OPS) and help him file a complaint of police brutality against the cop who tasered him, I told her. I didn’t say that. Instead I told her there was nothing I could do. The security cops at County were guarding him and as soon as he was discharged he was going to jail to await arraignment. Besides the brutality of the assault on this young man, I thought, this is how they waste the health care resources of the county. Because those fat cops spend their time at Dunkin Donuts chowing down dozens of donuts and sit on their fat asses for hours in squad cars in hidden locations doing nothing, they are incapable of chasing suspects and apprehending them. So they use tasers and guns because they can’t run. And the person gets injured. I looked in the 15-year-old’s chart and he had all kinds of scans, medications by IV, and was seen by opthamology, neurologists, neurosurgeons, etc. All of that pain and suffering could have been avoided. But that’s what the police are all about – inflicting pain and suffering on young black males.
Sometimes what the residents write in the chart sounds like a poem:
In blue hallway on a stretcher, comfortable
very thin/cachectic, poor oral hygiene
pale, long conjunctiva, unicteric sclera
no spider angiomata
I swipe out and as I’m tiredly trudging down the long hallway a group of Indian women who work in the hospital are leaving, too. They’re all carrying insulated food bags in bright colors. I marvel at their long, black, shiny hair that’s pulled back into pony tails. They are laughing and speaking either Hindu or Urdu. I walk with them and we say goodnight. I turn the corner at the end of the hall and there are a bunch of Philipino workers whose shift has ended. They are speaking Tagalog and are headed to the parking garage. We say goodnight to one another.
The last thing I see as I exit the hospital is that damn sign for lung cancer awareness month. I don’t want to think about lung cancer.
As I ride my bike home along Taylor Street in the crisp night air, I see groups of smokers shivering and huddled together on the sidewalks, outside of bars.