Patients Who Have Changed Our Lives Good or Bad

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This part of the year always causes me to pause and take stock of where I am, where I've been, and what I hope for the future. I don't know what it is about the holiday season but it has this effect on me every year. It's probably because the end of the year is near and it's the time when one of the most poignant and memorable events of my life happened.

I was a very young and very inexperienced hospital corpsman working in a surgical unit at the National Naval Medical Center in Bethesda, Maryland. I was 20 and had only just arrived at this, my first official duty station. I had passed my LPN boards but like most new graduates in any field I didn't know much and had little experience so I was assigned the simpler tasks on the unit. My first assignment was transporting patients to various hospital departments for treatments and diagnostics procedures. This assignment was certainly something I couldn't screw up too badly. My mornings were often spent getting patients ready to go to the OR. This involved making sure that the patient's chart was complete, that they had their pre-op medication, putting them on a gurney and rolling them down to the pre-op holding area.

One morning I was assigned to a patient who had throat cancer. The diagnosis had been made earlier in the week and she was scheduled for a radical neck. Back then we never knew how much would be taken, whether the patient would be able to swallow normally or talk. The patients were generally given the range of what could happen but never knew exactly. As I worked to get my patient ready she mentioned to me that she hadn't seen her family yet that morning. I was very busy that day and rather than go look for them I told her that they were probably running late or already in the surgery waiting room. She didn't say anything else about it and I was busy trying to get the next patient ready that I soon forgot that she had asked about her family. As I was passing by her room a few minutes later she called out to me and asked if I had seen her family. I stopped long enough to tell her that I was sure they were already at the hospital and that they would be there when she woke up. I was just about to leave when she told me that she needed to talk to them before the surgery. As young and inexperienced as I was there was something about this woman's request that seemed important to me. I met her husband earlier in the week and had some idea who I was looking for so I left the unit to search for her missing family. Bethesda Naval Hospital is a pretty big place and I checked the usual spots that families congregate, the cafeteria, the surgical waiting area, and finally the day room on the unit. They were nowhere to be found.

As I walked past the desk on my unit one of the nurses told me the OR had called for my patient and I needed to get her downstairs right away. I grabbed a gurney, some extra sheets and headed down the hall to her room. I was thinking about what I needed to get done for my next two patients before they were called down. As I walked back into her room I could see she was disappointed that I didn't find her family. "I am sure they'll be here when you wake up," I said as I helped her move out of her bed and onto the gurney. A quick stop at the nursing station to grab her chart and we were headed to the elevators and down to the pre-op holding area.

I felt sorry for this woman. She obviously had something she wanted to tell her family but they were nowhere to be found. As we neared the door to the unit we ran into them. They had been wandering around the hospital trying to figure out where they should be and at the last minute decided to try the unit.

I stopped so that she could talk to her husband, a son about my age, and a daughter a little younger than me. Her pre-op medication was beginning to take effect so she was already a little drowsy but she took her husband's hand and said some of the most beautiful things I think I have ever heard. She looked at him with half-closed drowsy eyes. "I may come out of this surgery without a voice," she said. "If that is the case, and if it means that I can be with you in this world a little longer, then all we've been through will be worth it. But before I go I want to tell you, in my own voice, one last time, how much I love you. You may not hear it again but I want that to be the last thing I say to you." I could tell that the husband was just about to cry it and I was very close myself. She then looked at her son, took his hand and said, "I am proud of you. I have so much I still need to tell you because you aren't done growing yet, regardless of what you think. I want you to know that I love you and I want you to hear that voice in your head every time you see me even if I can't say it." By this time the husband was crying and I was so on the verge that I quickly started to look through the chart to avoid having anyone see the tears welling up in my own eyes, Finally she turned to her daughter but by this time the pre-op medication was making her pretty sleepy and she closed her eyes. I was so involved with this conversation that the noise and commotion in the unit had faded into the background and I was riveted in place. That gurney was not leaving the unit until she had the opportunity to talk to her daughter. I felt some panic at first thinking that she had fallen asleep but she opened her eyes and looking at her daughter she said: "You are a smart and beautiful young woman and you make me proud to be your mother." Her eyes closed again and it took her several moments to gather her thoughts and summon the energy to overcome the medication I had given her earlier that morning. I wanted to shake her shoulder and say "What? What do you want to say to her? You can't stop now! This is important! Wake up!" I started to feel bad about not trying harder to find this woman's family and thinking that my busy day was more important than what she needed to say to her family before she possibly lost her ability to speak. But she opened her eyes again and looked at her daughter. By this time there were people back up behind us trying to get in or out of the unit so I moved the whole group out of the way. "You are a smart and beautiful woman" she began again. I was impatient now. I wanted to say to her "you've said that already tell us the rest" but I stood quietly trying not to intrude on this conversation. As other patients and staff walked past she continued. "I hope I am still here when you are married and start your family" she started. " I hope that I will be able to hold my grandchildren but if I'm not I want you to know that I already love them very much." She closed her eyes again and I could see that she was becoming very sleepy and that I had better get her down to the OR. Just as I was about to start moving again she looked up at her daughter and said "I see a lot of myself in you. Some of that is good and some of that you are going to have to learn to control better than I ever did. But I know you are capable."

By that time we were all crying. I quietly said that we needed to head downstairs and started to push her towards the door and out to the elevators that would take us down to the pre-op area. She and I didn't speak on the way down. She rode with her eyes closed. When I arrived in the pre-op area the nurse in charge gave me a dressing down for taking so long to get my patient downstairs. "We have a schedule down here if you hadn't noticed." she snapped at me. I touched my patient on the shoulder "I'll see you when you come back upstairs" I said. She looked up at me and said: "Thank you for letting me talk to my family."

I walked back to my unit thinking about her and her family. On the crowded elevator back up to my unit I tried not to cry or look like I was about to cry. How inappropriate for a corpsman to be found bawling on the elevator. On my floor, I stopped in the elevator lobby for a minute to compose myself before going back to work.

She spent the next day in the surgical ICU and was transferred back to my unit late the following afternoon. When I looked at her chart I saw that they had in fact taken out her voice box and that she was mute. Before I went into her room for the first time I thought about what a huge mistake I almost made. Because I was in a hurry because the hospital was in a hurry because the surgeon had a schedule to keep I had almost missed the important part of my job -- the real part of taking care of patients. That was a good lesson for me and from that point on I tried my best to listen to everything I was told by patients and tried, whenever humanly possible, to make sure that they had a voice. In a way, that patient made her voice last forever and it has influenced my life in many subtle and sometimes not so subtle ways. That patient was what made me decided on my career.

I don't know where she is, or even if she is still living and holding those grandchildren she hoped for. Even now, 28 years later, she still talks to me.

Patients Who Have Changed Our Lives Good or Bad

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