Monday, November 3, 2008

A Monday by any other name is still a monday

Today I had two separate cases of the opposite of sibling rivalry. It was love and unselfishness and forgiveness of any childhood injury inflicted. I'm a fortunate soul to be witness. Let me preface the rest of this entry by saying that today was by far the worst Monday I have had in quite some time. It lived up to its reputation of being complicated, awful, and exasperating. It was a three martini sort of day, if I drank martini's. Which I don't because they are even more bitter than Mondays.

In the midst of the complicated patients who seemed to be on the verge of death or as I like to say "One foot in the grave, the other on a banana peel" and others who were fogged over by their psych meds, and even a couple of angry folks (because they were scheduled behind the lady with acute heart failure and they weren't at the front of the line), were a pair of sisters. I'd seen the "healthy" sister (let's call her Maria) for a heavy case of ear wax a few months ago. Today she was wheeling her older sister (let's call her Bernadette), age 74, in for follow up after being released from the hospital in Albuquerque. The Bernadette started out with a heart problem and come out with half her colon removed. Both were diabetic, but Bernadette had upped the ante by developing a tricky heart, scar tissue in her belly from previous surgeries which blocked her colon, and a host of other medical issues. Neither of them really understood the reason for the emergency surgery or why the Bernadette had diarrhea and I didn't either because I couldn't get ahold of her physician in Albuquerque until they were long gone.

What was really beautiful about this whole mess was that Maria was managing Bernadette's diabetes beautifully. Maria was changing Bernadette's diaper's, bathing her, making sure she got all the right medications, all the right food, and all the other things she needed. She took Berna to all her appointments, to the pharmacy, cooked and cleaned for her. It didn't matter any more what had happened in the hot days when their parents were alive, when they were young and pretty. The unconditional love was laid out like a table, full of food carefully prepared and presented. A gift that they may not have known was in them to give.

Another pair was a brother and sister. The sister was mentally disabled, probably from the seizure disorder and the polio and who knows why really. She was in the clinic for a pre-operative physical exam. She needed a new hip because the old one had rotted in it's socket. Don't really know why that happened either. Her brother brought her in to see me. I think he also took care of their elderly mother. He looked tired, washed out. But he answered all the questions and asked all the questions. He was gentle with his sister's inability to pay attention to the exam, reminded her to to stay in the present. It was his time and effort that would get her to the cardiology appointment I had to schedule and him who would take her for her surgery and interpretted my explanations about abnormal EKG's and abnormal kidney function. He was the one who steered her down the hall carefully as she veered from one thought to another. I felt like I was cutting down the last tree in their forest. Bad heart, bad kidney's; can't wait to see what the orthopedic surgeon says when he see's her labs.

But there he was, probably a role he's played all his life. Don't leave your sister alone, she's fragile. How long had he been taking her by the elbow, making sure she didn't careen into the walls? What had he given up to the altar of unconditional love and protection? How long will he last once his mother and his sister have slipped this earthly coil?

In this middle of all this mess of monday: the frustration, the diplomacy, the irascible nursing staff is this shining light of love and sacrifice. I hope I can find something like that in all my days here.

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