It Doesn't Matter How Far You're Gone

It seems to be the week of repeat visits by patients over 90 years old. I had seen Mr. Far Gone many times before. He could not walk nor move nor talk- he was not mentally cognizant, hence incapable of putting the thought processes together to do so in a deliberate way.

The EMT's plunked him down on the bed and he quietly let us do our work-up with the monitors, ekg's, labwork, etc. He had an innocent look about him, with a mouth-agape, toothless expression as his eyes followed what we were doing, but did not process any further.

Hi Mr. Far Gone! I had greeted him when I walked in, and his head swiveled toward me, recognizing the sound of his own name.

For several hours, he was very quiet. Suddenly, I heard from his room a terrified "Help me! Please!" Rushing in, I found him terrified and shaking "please!" he looked in my eyes, "please help me!" Tears flowed down his cheeks and I did not know what to do but take his hand. I realized that he suddenly became aware and scared that he was in an unfamiliar place. Stroking his hand, I cooed to him, "You are in the hospital, Mr. Far Gone, the hospital. They will take good care of you here." He looked at me, not processing my words. He only knew that I was stroking his hand. He grasped mine in a childish way and I just stood there with him, holding his hand, letting him watch my face smiling back at his.

It was the most basic and primitive of human needs- to know you are safe. It was the most basic and primitive of human actions- to hold hands. Maintaining eye contact with a mind far gone but not entirely, I did my best to reach that basic human understanding that things were going to be ok, despite a large list of other things I had to do. In that short moment, time stood still as I waited for him to comprehend. His eyes were locked on mine, desperate and full of tears. After a few minutes, I was called into another room, and patting his hand, I tucked it carefully under the covers. He watched me leave the room. Maybe he was much farther gone than before or maybe I had calmed him this time, or maybe something had happened to him during his time in the nursing facility that had silenced him for the most part- I don't know, but he did not make another peep during his visit. On previous visits, he would plead and plead with us to help him every few minutes with no hope of appeasing him.

It is so hard to know the right thing to do with the old and demented patients; for some, the attention would spur more attention-seeking behavior. For others, it would help, but then they would forget the calmness in a minute and cry out again. For yet others, it would not make a difference.

Every day here is a learning experience- I am thankful for that.

S