Medicinal Compassion

So this is what Stefanie Powers did before she became "The Girl From U.N.C.L.E"! (A TV show from the '60s, you young whippersnappers...). The intern with the cigarette breath and the full pack in his breast pocket is actor James MacArthur. God, I love trivia.

Smoking didn't used to make one a social pariah. I didn't smoke but my nursing colleagues in CCU did. They would all puff away while we would get report, sitting in the room in the middle of the unit! The odd thing was, it never bothered me. It never occurred to me that I should be bothered. Between my routine Hershey bar, coffee and their nicotine I was a very hyper, happy camper. If that happened today, I'd be choking and my eyes would burn. Somehow I developed politically correct physiological responses. The human body never ceases to amaze.

hhhhhhhhhhhhhhhhhh

It was a dark, stormy, late winter night. For weeks the Bay Area had been the recipient of a torrential deluge; a hard-driving, chill-to-the-bone downpour. I was working night shift in a quiet, "stand-by" emergency department.

We had cleared out patients left from the PM shift and finished our routine duties. About 0100 we were settling in for our usual night of nothing when a middle-aged man walked in and asked to see a doctor. He was a mess, his skin, hair and clothing thoroughly soaked. Water trickled to the floor as he sloshed to the triage chair.

He said he had chest pain. I started to run through the usual triage questions and assessments but soon realized something wasn't right. His speech was clear, his answers vague. A vague smell of alcohol and stale urine permeated the area. He wouldn't look me when he answered. I put my pen down. I had to know.

"Are you really having chest pain, or do you just need a place to sleep?", I asked. For the first time, he looked me in eye and said, quietly, "I need a place to sleep." He told me his story. He was homeless and an alcoholic. He had tried to take shelter under a bush in a park a few blocks away from the ER and intoxicated, had passed out. He estimated that he had been there in the rain for about four hours. His last drink had been just prior to walking to the park. He denied having any chest pain as he sat shivering in triage.

I put the patient in a room and gave him a gown and some pants along with a cocoon of warm blankets. I told the patient's story to the doctor on duty. There was no eye rolling, no sighing, no anger, no sarcasm, no disgust. He asked me to see if there was any food in the back for the patient, said there was no way he was sending anyone back out into the storm and then went in to perform his examination.

We hydrated the patient. We gave him medication for tremors. We fed him (I found some soup and crackers) and gave him a safe place to sleep (which he did, soundly). It took a few phone calls during the middle of the night, but we were able to find a shelter he could go to in the morning.

I'll never know what happened to the patient after that night, but I can tell you that I will never forget that doctor. Before laying eyes on the patient, he wanted to make sure a meal was available and decided the patient had a bed out of the storm. This doctor was a seasoned veteran of the ER with decades of experience behind him, yet he wasn't cynical or hardened. He couldn't cure alcoholism but he could treat this patient with dignity for the time he was under his care. He was no angel; he could be a bugger to the nurses when he was in a mood, let me tell you. For almost ten years I saw the respectful care he gave the less fortunate.

Compassionate medicine. He wrote the book on it.