Right before Christmas was my fifth time attending palliative care rounds at County Hospital. It is becoming clear that how my day will go depends greatly on who the attending is. This attending was, on the one hand, very mindful of my presence and that I needed to be given something to do. She did not forget about me in the slightest. On the other hand, what she thought I should do did not include visiting patients with the rest of the group. She gave me a list of four patients she thought I should see on my own.
When I asked, in a low-key manner, if I should come along on a certain group visit, she said she feels it’s better for patients on comfort care, as some of these were, to get little “doses” of care throughout the day so that they feel connected to their care team, so I went around on my own and saw three of the four patients. The fourth had several care team members in his room, but he smiled merrily at me through the little window in his door. The next time I checked back, the situation was the same; this time the patient waved as if I were his best friend. I’m sorry I didn’t get to talk to him.
I didn’t learn anything new about palliative care on this day. However, I was done by 2:45 p.m. and could go to the bathroom any time I wanted, so I guess it’s fine that the experience varies. The prior week, I did not have the opportunity to go to the bathroom the entire day, let alone drink any water. On that day, I scribbled page after page of notes. On this day, I hardly took any.
Besides the three palliative care patients, I was asked to see another patient whose nurse felt he could use a visit. I found him to be extremely labile. He got really, really angry several times during our visit, but only briefly; he was able to calm himself quickly. He also proved to have the unfortunate habit of blaming others for nearly all his problems, though he did talk honestly about his own drug use.
He said he would like a Bible, so I went down to the chaplain office to get one. We have newly relocated to the bowels of the building, far from the light of day. I took the Bible to the patient and said I hoped his eyes were good; the print was microscopic. The patient replied, “My eyes are terrible,” so off I went in search of reading glasses, which I could not find, but I did find a pleasing little mesh bag with fragrant sage in it, so I decided to take him that instead, to make him feel better about not being able to read his new Bible. Then I got a text from Clementine, the boss of the volunteer chaplains, saying she had reading glasses in the office. I thought this meant the chaplain office, so I schlepped down there again, but she meant her office, in a completely different area of the hospital, so I went there and told her my plan in regard to the sage.
She did have some reading glasses and she also said not to give patients sage unless it actually is meaningful to them. She said it is meaningful in her tradition, which suggested that she might not look favorably on the casual handing out of sage. Anyway, she had something better. She has collected some rocks from the tops of mountains and some rocks from rivers. As it happens, this patient had talked about wanting to go live next to a river, so Clementine gave me a river rock to give him. Perfect! Then it was back to the basement to put the sage back where I found it, and up to the patient’s room to give him the reading glasses and the rock. He was taking a shower, so I asked his nurse to pass on the glasses and the rock, and to tell him it was a river rock.